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Warsame A, Eamer G, Kai A, Dios LR, Rohan H, Keating P, Katshishi J, Checchi F. Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018-2019. BMC Med 2023; 21:484. [PMID: 38049815 PMCID: PMC10696665 DOI: 10.1186/s12916-023-03194-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND A protracted Ebola Virus Disease (EVD) epidemic in the eastern Ituri, North and South Kivu provinces of the Democratic Republic of Congo (DRC) caused 3470 confirmed and probable cases between July 2018 and April 2020. During the epidemic, the International Federation of Red Cross and Red Crescent Societies (IFRC) supported the DRC Red Cross and other local actors to offer safe and dignified burials (SDB) for suspected and confirmed EVD cases, so as to reduce transmission associated with infectious dead bodies. We conducted a retrospective cohort study of the SDB service's performance in order to inform future applications of this intervention. METHODS We analysed data on individual SDB responses to quantify performance based on key indicators and against pre-specified service standards. Specifically, we defined SDB timeliness as response within 24 h and success as all components of the service being implemented. Combining the database with other information sources, we also fit generalised linear mixed binomial models to explore factors associated with unsuccessful SDB. RESULTS Out of 14,624 requests for SDB, 99% were responded to, 89% within 24 h. Overall, 61% of SDBs were successful, somewhat below target (80%), with failures clustered during a high-insecurity period. Factors associated with increased odds of unsuccessful SDB included reported community and/or family nonacceptance, insecurity and suspensions of the EVD response, low health facility coverage and high coverage of radio and telephony. Burials supported by mobile Civil Protection (local authorities) and/or static, community-based 'harm reduction' teams were associated with lower odds of failure. CONCLUSIONS A large-scale, timely and moderately performant SDB service proved feasible during the challenging eastern DRC EVD response. Burial teams that are managed by community actors and operate locally, and supported rather than owned by the Red Cross or other humanitarian organisations, are a promising modality of delivering this pillar of EVD control.
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Affiliation(s)
- Abdihamid Warsame
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Gwendolen Eamer
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | - Alaria Kai
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Lucia Robles Dios
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | - Hana Rohan
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Keating
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacques Katshishi
- Red Cross Society of the Democratic Republic of Congo, Kinshasa, Democratic Republic of the Congo
| | - Francesco Checchi
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
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2
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After action review of the response to an outbreak of Lassa fever in Sierra Leone, 2019: Best practices and lessons learnt. PLoS Negl Trop Dis 2022; 16:e0010755. [PMID: 36197925 PMCID: PMC9534430 DOI: 10.1371/journal.pntd.0010755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two that were exported to the Netherlands. The outbreak tested multiple technical capacities in the International Health Regulations (2005) in a real-life setting. As such, an after action review (AAR) was undertaken as recommended by World Health Organization. We report on the findings of the AAR including best practices and lessons learnt. Methods A two stage review process was employed. The first stage involved national pillar level reviews for each technical pillar and one review of the district level response. The second stage brought together all pillars, including participants from the national and sub-national level as well as health sector partners. National guidelines were used as references during the deliberations. A standardized template was used to report on the key findings on what happened, what was supposed to happen, what went well and lessons learnt. Results This was a hospital associated outbreak that likely occurred due to a breach in infection prevention and control (IPC) practices resulting in three health workers being infected during a surgical operation. There was a delay in detecting the outbreak on time due to low index of suspicion among clinicians. Once detected, the outbreak response contained the outbreak within one incubation period. Areas that worked well included coordination, contact tracing, active case search and ring IPC. Notable gaps included delays in accessing local emergency funding and late distribution of IPC and laboratory supplies. Conclusions The incident management system worked optimally to contain this outbreak. The core technical gaps identified in surveillance, IPC and delay in deployment of resources should be addressed through systemic changes that can mitigate future outbreaks. The International Health Regulations (IHR) Monitoring and Evaluation Framework was developed by the World Health Organization to provide strategies to monitor and assess how countries are building their core public health capacities under IHR (2005). The framework has four components: annual reporting on IHR capacities (mandatory), Joint External Evaluation, simulation exercises and After Action Review (AAR). In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two deaths and two exported cases to the Netherlands. The outbreak tested multiple technical capacities in the IHR (2005) in a real-life setting. We therefore conducted an AAR to assess how well the country responded to the outbreak. This hospital associated outbreak likely occurred due to a breach in infection prevention and control (IPC) practices. The response launched after detection of the outbreak successfully contained the outbreak within one incubation period. Areas that worked well included coordination, contact tracing, active case search and ring IPC. Areas that needed improvement were clinicians’ knowledge on Lassa Fever, delays in accessing local emergency funding and late distribution of IPC and laboratory supplies.
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3
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Musaazi J, Namageyo-Funa A, Carter VM, Carter RJ, Lamorde M, Apondi R, Bakyaita T, Boore AL, Brown VR, Homsy J, Kigozi J, Koyuncu A, Nabaggala MS, Nakate V, Nkurunziza E, Stowell DF, Walwema R, Olowo A, Jalloh MF. Evaluation of Community Perceptions and Prevention Practices Related to Ebola Virus as Part of Outbreak Preparedness in Uganda, 2020. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00661. [PMCID: PMC9242603 DOI: 10.9745/ghsp-d-21-00661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/29/2022] [Indexed: 11/15/2022]
Abstract
Targeted risk communication and community engagement strategies to raise Ebola virus disease awareness and knowledge, particularly in setting where risk of infection is perceived to be low, may not be sufficient to motivate people to adopt protective behaviors and prevention practices. Introduction: During the 2018–2020 Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo, risk communication and community engagement (RCCE) were prioritized in geographic areas in Uganda considered at high risk of introduction of EVD. To inform EVD preparedness in Uganda, we evaluated community perceptions and prevention practices related to EVD in 6 districts in Uganda. Methods: In March 2020, we conducted a population-based survey in 6 purposively selected districts in Uganda using multistage cluster sampling. We examined differences between districts classified as high- versus low risk for EVD in terms of their message exposure from RCCE; risk perception; and EVD knowledge, attitudes, and prevention practices. Results: A total of 3,485 respondents were interviewed (91% response rate). EVD message exposure was more common in the high- versus low-risk districts. EVD risk perceptions were low overall but greater in the high- versus low-risk districts. Comprehensive knowledge was significantly greater in the high- versus low-risk districts (adjusted prevalence ratio [aPR] 1.61, 95% confidence interval [CI]=1.35, 1.93). Respondents' engagement in all 3 EVD prevention practices (frequent handwashing with soap, avoiding physical contact with suspected Ebola patients, and avoiding burials involving contact with a corpse) was very low (4%). However, respondents with comprehensive knowledge were more likely to engage in all 3 EVD prevention practices compared to respondents without comprehensive knowledge (aPR 1.87, 95% CI=1.08, 3.25). Conclusion: Our findings suggest that while RCCE efforts as part of EVD outbreak preparedness may have contributed to higher EVD knowledge in the targeted high-risk districts, uptake of prevention behaviors was similarly low across districts. In a non-outbreak setting, implementing targeted RCCE strategies may not be sufficient to motivate people to adopt protective behaviors in the absence of a high threshold of perceived threat such as in an active outbreak.
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Affiliation(s)
- Joseph Musaazi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- Correspondence to Joseph Musaazi ()
| | - Apophia Namageyo-Funa
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Victoria M. Carter
- National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rosalind J. Carter
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mohammed Lamorde
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rose Apondi
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Amy L. Boore
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vance R. Brown
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jaco Homsy
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Institute for Global Health Sciences, University of California San Francisco, California, USA
| | - Joanita Kigozi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Aybüke Koyuncu
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria Sarah Nabaggala
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Vivian Nakate
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Emmanuel Nkurunziza
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Daniel F. Stowell
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Walwema
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Apollo Olowo
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mohamed F. Jalloh
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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4
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Duffy N, Bruden D, Thomas H, Nichols E, Knust B, Hennessy T, Reichler MR. Risk factors for Ebola virus disease among household care providers, Sierra Leone, 2015. Int J Epidemiol 2022; 51:1457-1468. [PMID: 35441222 DOI: 10.1093/ije/dyac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/04/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Household contacts who provide care to an Ebola virus disease (EVD) case have a 3-fold higher risk of EVD compared with contacts who do not provide care. METHODS We enrolled persons with confirmed EVD from December 2014 to April 2015 in Freetown, Sierra Leone, and their household contacts. Index cases and contacts were interviewed, and contacts were followed for 21 days to identify secondary cases. Epidemiological data were analysed to describe household care and to identify risk factors for developing EVD. RESULTS Of 838 contacts in 147 households, 156 (17%) self-reported providing care to the index case; 56 households had no care provider, 52 a single care provider and 39 multiple care providers. The median care provider age was 29 years, 68% were female and 32% were the index case's spouse. Care providers were more likely to report physical contact, contact with body fluids or sharing clothing, bed linens or utensils with an index case, compared with non-care providers (P <0.01). EVD risk among non-care providers was greater when the number of care providers in the household increased (odds ratio: 1.61; 95% confidence interval: 1.1, 2.4). In multivariable analysis, factors associated with care provider EVD risk included no piped water access and absence of index case fever, and protective factors included age <20 years and avoiding the index case. CONCLUSIONS Limiting the number of care providers in a household could reduce the risk of EVD transmission to both care providers and non-care providers. Strategies to protect care providers from EVD exposure are needed.
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Affiliation(s)
- Nadezhda Duffy
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Bruden
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Harold Thomas
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Erin Nichols
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Barbara Knust
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas Hennessy
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Mary R Reichler
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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5
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Lucas A, Kumakamba C, Saylors K, Obel E, Kamenga R, Makuwa M, Clary C, Miningue G, McIver DJ, Lange CE, Kingebeni PM, Muyembe-Tamfum JJ. Risk perceptions and behaviors of actors in the wild animal value chain in Kinshasa, Democratic Republic of Congo. PLoS One 2022; 17:e0261601. [PMID: 35171910 PMCID: PMC8849473 DOI: 10.1371/journal.pone.0261601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/06/2021] [Indexed: 12/01/2022] Open
Abstract
In the Democratic Republic of Congo (DRC) which contains the greatest area of the second largest rainforest on Earth, people have long been connected to the forest for subsistence and livelihood from wild animals and bushmeat. This qualitative study sought to characterize the bushmeat movement-from hunting wild animals to market sale-and the roles of participants in the animal value chain, as well as their beliefs surrounding zoonotic disease and occupational risk. Actors in in eight bushmeat markets and two ports in Kinshasa, DRC completed semi-structured interviews between 2016 and 2018 in which they expressed belief in transmission of illness from domestic animals to humans, but not from wild animals to humans. Wild animals were viewed as pure and natural, in contrast to domestic animals which were considered tainted by human interference. Participants reported cutting themselves during the process of butchering yet did not consider butchering bushmeat to be a risky activity. Instead, they adopted safety practices learned over time from butchering experts and taught themselves how to butcher in a fashion that reduced the frequency of cutting. In general, butcherers rejected the idea of personal protective equipment use. Port markets were identified as important access points for meat coming from the Congo river and plane transport was identified as important for fresh and live meat coming from Équateur province. Most participants reported having heard about Ebola, but their mistrust in government messaging privileged a word-of-mouth story of witchcraft to be propagated about Ebola's origins. It is critical to better understand how public health messaging about outbreaks can successfully reach high risk communities, and to develop creative risk mitigation strategies for populations in regular contact with animal blood and body fluids. In this paper, we offer suggestions for formal and informal trusted channels through which health messages surrounding zoonotic risk could be conveyed to high-risk populations in Kinshasa.
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Affiliation(s)
- Ashley Lucas
- Labyrinth Global Health, Saint Petersburg, FL, United States of America
- Metabiota Inc., San Francisco, CA, United States of America
| | | | - Karen Saylors
- Labyrinth Global Health, Saint Petersburg, FL, United States of America
- Metabiota Inc., San Francisco, CA, United States of America
| | - Erby Obel
- Metabiota Inc., San Francisco, CA, United States of America
| | | | - Maria Makuwa
- Labyrinth Global Health, Saint Petersburg, FL, United States of America
- Metabiota Inc., San Francisco, CA, United States of America
| | | | - Guy Miningue
- Metabiota Inc., Kinshasa, Democratic Republic of the Congo
| | - David J. McIver
- Metabiota Inc., Nanaimo, BC, Canada
- UCSF, San Francisco, CA, United States of America
| | - Christian E. Lange
- Labyrinth Global Health, Saint Petersburg, FL, United States of America
- Metabiota Inc., Nanaimo, BC, Canada
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6
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Koomson I, Okumu M, Ansong D. Introducing the Disease Outbreak Resilience Index (DORI) Using the Demographic and Health Surveys Data from sub-Saharan Africa. SOCIAL INDICATORS RESEARCH 2022; 162:1149-1175. [PMID: 35068657 PMCID: PMC8764175 DOI: 10.1007/s11205-022-02881-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
Although most studies on disease emergencies underscore the need for household readiness for shocks associated with disease outbreaks, no study to date has provided a holistic measure for profiling households based on their readiness toward disease outbreaks. This paper introduces a novel Disease Outbreak Resilience Index (DORI) using a multidimensional approach that draws on the Alkire-Foster methodology. DORI measures disease outbreak resilience in four dimensions: (a) water and hygiene, (b) physical distancing, (c) energy and communication, and (d) economic security and resilience. The paper details the development of DORI and its use by presenting findings from ten countries in sub-Saharan Africa using data from the Demographic and Health Surveys (DHS) program. In addition to serving as a resilience index, we illustrate how DORI can be used to produce a disease outbreak vulnerability index (DOVI). As a versatile index, the indicators under each dimension can be tailored to meet country- and region-specific contexts based on indicators appropriate to each context.
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Affiliation(s)
- Isaac Koomson
- UNE Business School, University of New England, Armidale, NSW Australia
- Network for Socioeconomic Research and Advancement (NESRA), Accra, Ghana
| | - Moses Okumu
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL USA
| | - David Ansong
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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7
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Owhonda G, Maduka O, Nwadiuto I, Tobin-West C, Azi E, Ojimah C, Alasia D, Olofinuka AM, Agala V, Paul JN, Nria D, Okafor C, Ndekwu I, Opara C, Newsom C. Awareness, perception and the practice of COVID-19 prevention among residents of a state in the South-South region of Nigeria: implications for public health control efforts. Int Health 2021; 14:309-318. [PMID: 34383047 PMCID: PMC9070464 DOI: 10.1093/inthealth/ihab046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 05/09/2021] [Accepted: 08/05/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As with any epidemic, coronavirus disease 2019 (COVID-19) has evoked panic, fear and misconceptions. The risk communication pillar of the Public Health Emergency Operations Centre is responding to the pandemic by facilitating correct and consistent information to enable the adoption of behaviours to prevent and control COVID-19. This study explored awareness, perception and practice of COVID-19 prevention among residents in Rivers State, Nigeria, during the early stages of the COVID-19 pandemic response. METHODS This was a descriptive cross-sectional survey among 1294 adult residents across all districts of the state. It employed an interviewer-administered questionnaire. Knowledge was graded as excellent for scores of ≥80%, good for scores of 50-79% and poor for scores of <50%. Respondents who washed all critical parts of their hands were categorised as adopting correct handwashing practice. Regression modelling was employed to determine predictors of knowledge and practice of COVID-19 prevention with p=0.05. RESULTS The respondents were aged 18-80 y with an average age of 39.6 (SD=11.9) y. A total of 710 (54.9%) were male, 476 (36.8%) were unemployed with 685 (52.9%) having secondary education. The most common sources of information about COVID-19 were radio jingles (1102; 86.7%) and television adverts (940; 74.0%). Overall, 608 (47.0%) of the respondents had a poor knowledge of COVID-19. About 443 (34.9%) respondents believed they were unlikely to contract the virus. Only 505 (39.0%) of respondents washed all the critical parts of their hands correctly. Occupation (adjusted OR [AOR]=1.39, 95% CI 1.07 to 1.82, p=0.01), level of education (AOR=4.71, 95% CI 1.90 to 11.68, p<0.001) and location (AOR=1.75, 95% CI 1.29 to 2.38; p<0.001) significantly predicted respondents' knowledge about COVID-19. The significant predictors of practice of COVID-19 were age (AOR=0.60, 95% CI 0.42 to 0.84, p=0.003), occupation (AOR=1.93, 95% CI 1.41 to 2.63, p<0.001), location (AOR=2.35, 95% CI 1.65 to 3.34, p<0.001) and knowledge about COVID-19 (AOR=7.75, 95% CI 5.94 to 10.11, p<0.001). CONCLUSIONS Broadcast media has a pivotal role to play in risk communication for behavioural change for the control of current and future epidemics in this population.
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Affiliation(s)
- Golden Owhonda
- Department of Public Health and Disease Control, Rivers State Ministry of Health, 50001, Port Harcourt Nigeria.,Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria
| | - Omosivie Maduka
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Department of Preventive and Social Medicine, University of Port Harcourt, 50001, Port Harcourt, Nigeria
| | - Ifeoma Nwadiuto
- Department of Public Health and Disease Control, Rivers State Ministry of Health, 50001, Port Harcourt Nigeria.,Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria
| | - Charles Tobin-West
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Department of Preventive and Social Medicine, University of Port Harcourt, 50001, Port Harcourt, Nigeria
| | - Esther Azi
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Department of Community Medicine, Rivers State University, 50001, Port Harcourt, Nigeria
| | - Chibianotu Ojimah
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,World Health Organization, Rivers State Field Office, 50001, Port Harcourt, Nigeria
| | - Datonye Alasia
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Department of Internal Medicine, University of Port Harcourt, 50001, Port Harcourt, Nigeria
| | - Ayo-Maria Olofinuka
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,World Health Organization, Rivers State Field Office, 50001, Port Harcourt, Nigeria
| | - Vetty Agala
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Rivers State Hospital Management Board, 50001, Port Harcourt, Nigeria
| | - John Nwolim Paul
- Department of Public Health and Disease Control, Rivers State Ministry of Health, 50001, Port Harcourt Nigeria.,Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria
| | - Doris Nria
- Department of Public Health and Disease Control, Rivers State Ministry of Health, 50001, Port Harcourt Nigeria.,Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria
| | - Chinenye Okafor
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,World Health Organization, Rivers State Field Office, 50001, Port Harcourt, Nigeria
| | - Ifeoma Ndekwu
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Stakeholder Democracy Network, 50001, Port Harcourt, Nigeria
| | - Chikezie Opara
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Stakeholder Democracy Network, 50001, Port Harcourt, Nigeria
| | - Chris Newsom
- Rivers State Public Health Emergency Operations Centre, 50001, Port Harcourt, Nigeria.,Stakeholder Democracy Network, 50001, Port Harcourt, Nigeria
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8
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Jalloh MF, Sengeh P, James N, Bah S, Jalloh MB, Owen K, Pratt SA, Oniba A, Sangarie M, Sesay S, Bedson J. Integrated digital system for community engagement and community-based surveillance during the 2014-2016 Ebola outbreak in Sierra Leone: lessons for future health emergencies. BMJ Glob Health 2021; 5:bmjgh-2020-003936. [PMID: 33355270 PMCID: PMC7757454 DOI: 10.1136/bmjgh-2020-003936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 11/04/2022] Open
Abstract
Community engagement and community-based surveillance are essential components of responding to infectious disease outbreaks, but real-time data reporting remains a challenge. In the 2014-2016 Ebola outbreak in Sierra Leone, the Social Mobilisation Action Consortium was formed to scale-up structured, data-driven community engagement. The consortium became operational across all 14 districts and supported an expansive network of 2500 community mobilisers, 6000 faith leaders and 42 partner radio stations. The benefit of a more agile digital reporting system became apparent within few months of implementing paper-based reporting given the need to rapidly use the data to inform the fast-evolving epidemic. In this paper, we aim to document the design, deployment and implementation of a digital reporting system used in six high transmission districts. We highlight lessons learnt from our experience in scaling up the digital reporting system during an unprecedented public health crisis. The lessons learnt from our experience in Sierra Leone have important implications for designing and implementing similar digital reporting systems for community engagement and community-based surveillance during public health emergencies.
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Affiliation(s)
- Mohamed F Jalloh
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden .,Focus 1000, Freetown, Sierra Leone
| | | | | | - Saiku Bah
- Restless Development Sierra Leone, Freetown, Sierra Leone
| | | | | | | | | | | | - Samuel Sesay
- Health Education Division, Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
| | - Jamie Bedson
- Restless Development Sierra Leone, Freetown, Sierra Leone
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9
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Cornish NE, Anderson NL, Arambula DG, Arduino MJ, Bryan A, Burton NC, Chen B, Dickson BA, Giri JG, Griffith NK, Pentella MA, Salerno RM, Sandhu P, Snyder JW, Tormey CA, Wagar EA, Weirich EG, Campbell S. Clinical Laboratory Biosafety Gaps: Lessons Learned from Past Outbreaks Reveal a Path to a Safer Future. Clin Microbiol Rev 2021; 34:e0012618. [PMID: 34105993 PMCID: PMC8262806 DOI: 10.1128/cmr.00126-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Patient care and public health require timely, reliable laboratory testing. However, clinical laboratory professionals rarely know whether patient specimens contain infectious agents, making ensuring biosafety while performing testing procedures challenging. The importance of biosafety in clinical laboratories was highlighted during the 2014 Ebola outbreak, where concerns about biosafety resulted in delayed diagnoses and contributed to patient deaths. This review is a collaboration between subject matter experts from large and small laboratories and the federal government to evaluate the capability of clinical laboratories to manage biosafety risks and safely test patient specimens. We discuss the complexity of clinical laboratories, including anatomic pathology, and describe how applying current biosafety guidance may be difficult as these guidelines, largely based on practices in research laboratories, do not always correspond to the unique clinical laboratory environments and their specialized equipment and processes. We retrospectively describe the biosafety gaps and opportunities for improvement in the areas of risk assessment and management; automated and manual laboratory disciplines; specimen collection, processing, and storage; test utilization; equipment and instrumentation safety; disinfection practices; personal protective equipment; waste management; laboratory personnel training and competency assessment; accreditation processes; and ethical guidance. Also addressed are the unique biosafety challenges successfully handled by a Texas community hospital clinical laboratory that performed testing for patients with Ebola without a formal biocontainment unit. The gaps in knowledge and practices identified in previous and ongoing outbreaks demonstrate the need for collaborative, comprehensive solutions to improve clinical laboratory biosafety and to better combat future emerging infectious disease outbreaks.
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Affiliation(s)
- Nancy E. Cornish
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Nancy L. Anderson
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Diego G. Arambula
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Matthew J. Arduino
- Centers for Disease Control and Prevention, National Center for Emerging & Zoonotic Infectious Diseases (NCEZID), Atlanta, Georgia, USA
| | - Andrew Bryan
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Nancy C. Burton
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
| | - Bin Chen
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Beverly A. Dickson
- Department of Clinical Pathology, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Judith G. Giri
- Centers for Disease Control and Prevention, Center for Global Health (CGH), Atlanta, Georgia, USA
| | | | | | - Reynolds M. Salerno
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Paramjit Sandhu
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - James W. Snyder
- Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Christopher A. Tormey
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Elizabeth A. Wagar
- Department of Laboratory Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Elizabeth G. Weirich
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA
| | - Sheldon Campbell
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Pathology & Laboratory Medicine Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
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Vanderslott S, Van Ryneveld M, Marchant M, Lees S, Nolna SK, Marsh V. How can community engagement in health research be strengthened for infectious disease outbreaks in Sub-Saharan Africa? A scoping review of the literature. BMC Public Health 2021; 21:633. [PMID: 33794820 PMCID: PMC8012744 DOI: 10.1186/s12889-021-10348-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Community engagement (CE) is a well-established practical and scholarly field, recognised as core to the science and ethics of health research, for which researchers and practitioners have increasingly asked questions about desired standards and evaluation. In infectious disease outbreak contexts, questions may be more complex. However, it is unclear what body of knowledge has been developed for CE specifically as it applies to emerging infectious diseases. This scoping review seeks to describe (1) How CE has been conceptualised and understood; and (2) What conclusions have research teams reached on the effectiveness of CE in these settings, including challenges and facilitators. METHODS We used a scoping review framework by Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005) to structure our review. We conducted a brainstorming session and initial trial search to inform the protocol, search terms, and strategy. Three researchers discussed, developed and applied agreed screening tools and selection criteria to the final search results. Five researchers used the screening tools to screen abstracts and full text for inclusion by consensus. Additional publications were sought from references of retrieved publications and an expert call for literature. We analysed and reported emerging themes qualitatively. RESULTS We included 59 papers from a total of 722 articles derived from our trial and final literature searches, as well as a process of "citation chasing" and an expert call for grey literature. The core material related exclusively to health research trials during the 2014-2016 West Africa Ebola outbreak. We synthesized reports on components of effectiveness of CE to identify and propose three themes as essential elements of effective CE. CONCLUSIONS While there is a large volume of literature documenting CE activities in infectious disease research settings generally, there are few accounts of effectiveness dimensions of CE. Our review proposes three themes to facilitate the effectiveness of CE initiatives as essential elements of CE activities in infectious diseases studies: (1) Communication towards building collaborative relationships; (2) Producing contextual knowledge; and (3) Learning lessons over time. As there were relatively few in-depth accounts of CE from our literature review, documentation and accounts of CE used in health research should be prioritised.
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Affiliation(s)
- Samantha Vanderslott
- Oxford Vaccine Group & Oxford Martin School, University of Oxford, 34 Broad St, Oxford, OX1 2BD, UK.
| | - Manya Van Ryneveld
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535, Republic of South Africa
| | - Mark Marchant
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Shelley Lees
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Sylvie Kwedi Nolna
- Department of Public Health, University of Yaounde I, Rue Melen, Yaounde, Cameroon
| | - Vicki Marsh
- KEMRI Wellcome Trust Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, NDM, Oxford University, Oxford, UK
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
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11
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Alhassan RK, Nutor JJ, Abuosi AA, Afaya A, Mohammed SS, Dalaba MA, Immurana M, Manyeh AK, Klu D, Aberese-Ako M, Doegah PT, Acquah E, Nketiah-Amponsah E, Tampouri J, Akoriyea SK, Amuna P, Ansah EK, Gyapong M, Owusu-Agyei S, Gyapong JO. Urban health nexus with coronavirus disease 2019 (COVID-19) preparedness and response in Africa: Rapid scoping review of the early evidence. SAGE Open Med 2021; 9:2050312121994360. [PMID: 33633859 PMCID: PMC7887690 DOI: 10.1177/2050312121994360] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/20/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 also called coronavirus disease 2019 was first reported in the African continent on 14 February 2020 in Egypt. As at 18 December 2020, the continent reported 2,449,754 confirmed cases, 57,817 deaths and 2,073,214 recoveries. Urban cities in Africa have particularly suffered the brunt of coronavirus disease 2019 coupled with criticisms that the response strategies have largely been a 'one-size-fits-all' approach. This article reviewed early evidence on urban health nexus with coronavirus disease 2019 preparedness and response in Africa. METHODS A rapid scoping review of empirical and grey literature was done using data sources such as ScienceDirect, GoogleScholar, PubMed, HINARI and official websites of World Health Organization and Africa Centres for Disease Control and Prevention. A total of 26 full articles (empirical studies, reviews and commentaries) were synthesised and analysed qualitatively based on predefined inclusion criteria on publication relevance and quality. RESULTS Over 70% of the 26 articles reported on coronavirus disease 2019 response strategies across Africa; 27% of the articles reported on preparedness towards coronavirus disease 2019, while 38% reported on urbanisation nexus with coronavirus disease 2019; 40% of the publications were full-text empirical studies, while the remaining 60% were either commentaries, reviews or editorials. It was found that urban cities remain epicentres of coronavirus disease 2019 in Africa. Even though some successes have been recorded in Africa regarding coronavirus disease 2019 fight, the continent's response strategies were largely found to be a 'one-size-fits-all' approach. Consequently, adoption of 'Western elitist' mitigating measures for coronavirus disease 2019 containment resulted in excesses and spillover effects on individuals, families and economies in Africa. CONCLUSION Africa needs to increase commitment to health systems strengthening through context-specific interventions and prioritisation of pandemic preparedness over response. Likewise, improved economic resilience and proper urban planning will help African countries to respond better to future public health emergencies, as coronavirus disease 2019 cases continue to surge on the continent.
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Affiliation(s)
- Robert Kaba Alhassan
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Jerry John Nutor
- School of Nursing, University of California, San Francisco, CA, USA
| | - Aaron Asibi Abuosi
- Department of Public Administration and Health Services Management, University of Ghana, Accra, Ghana
| | - Agani Afaya
- School of Nursing, University of Health and Allied Sciences, Ho, Ghana
| | | | - Maxwel Ayindenaba Dalaba
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Mustapha Immurana
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Alfred Kwesi Manyeh
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Desmond Klu
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Matilda Aberese-Ako
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Phidelia Theresa Doegah
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Evelyn Acquah
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | | | - John Tampouri
- Ho Teaching Hospital (HTH), Ho, Ministry of Health, Ghana
| | | | - Paul Amuna
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Evelyn Kokor Ansah
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Margaret Gyapong
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Seth Owusu-Agyei
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - John Owusu Gyapong
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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12
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Matterne U, Egger N, Tempes J, Tischer C, Lander J, Dierks ML, Bitzer EM, Apfelbacher C. Health literacy in the general population in the context of epidemic or pandemic coronavirus outbreak situations: Rapid scoping review. PATIENT EDUCATION AND COUNSELING 2021; 104:223-234. [PMID: 33109429 PMCID: PMC7547635 DOI: 10.1016/j.pec.2020.10.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 10/07/2020] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The aim of this rapid scoping review, for which only studies from the general population were considered, was to describe the extent of existing research on HL in the context of previous coronavirus outbreaks (SARS-CoV-1, MERS-CoV and SARS-CoV-2). METHODS We searched major databases and included publications of quantitative and qualitative studies in English and German on any type of research on the functional, critical and communicative domains of HL conducted in the context of the three outbreaks in the general population. We extracted and tabulated relevant data and narratively reported where and when the study was conducted, the design and method used, and how HL was measured. RESULTS 72 studies were included. Three investigated HL or explicitly referred to the concept of HL, 14 were guided by health behaviour theory. We did not find any study designed to develop or psychometrically evaluate pandemic/epidemic HL instruments, or relate pandemic/epidemic or general HL to a pandemic/epidemic outcome, or any controlled intervention study. Type of assessment of the domains of HL varied widely. CONCLUSION Theory-driven observational studies and interventions, examining whether pandemic-related HL can be improved are needed. PRACTICE IMPLICATIONS The development and validation of instruments that measure pandemic-related HL is desirable.
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Affiliation(s)
- Uwe Matterne
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany.
| | - Nina Egger
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Jana Tempes
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Christina Tischer
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany
| | - Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Eva-Maria Bitzer
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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13
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Erlach E, Nichol B, Reader S, Baggio O. Using Community Feedback to Guide the COVID-19 Response in Sub-Saharan Africa: Red Cross and Red Crescent Approach and Lessons Learned from Ebola. Health Secur 2021; 19:13-20. [PMID: 33497272 PMCID: PMC9195486 DOI: 10.1089/hs.2020.0195] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Risk communication and community engagement are critical elements of epidemic response. Despite progress made in this area, few examples of regional feedback mechanisms in Africa provide information on community concerns and perceptions in real time. To enable humanitarian responders to move beyond disseminating messages, work in partnership with communities, listen to their ideas, identify community-led solutions, and support implementation of solutions systems need to be in place for documenting, analyzing, and acting on community feedback. This article describes how the International Federation of Red Cross and Red Crescent Societies and its national societies in sub-Saharan Africa have worked to establish and strengthen systems to ensure local intelligence and community insights inform operational decision making. As part of the COVID-19 response, a system was set up to collect, compile, and analyze unstructured community feedback from across the region. We describe how this system was set up based on a system piloted in the response to Ebola in the Democratic Republic of the Congo, which tools were adapted and shared across the region, and how the information gathered was used to shape and adapt the response of the Red Cross and Red Crescent Societies and the broader humanitarian response.
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Affiliation(s)
- Eva Erlach
- Eva Erlach, Mag.a iur, is Community Engagement and Accountability (CEA) Delegate and Bronwyn Nichol, MPH, is Community Epidemic and Pandemic Preparedness Delegate, Health and Care Unit; both at the International Federation of Red Cross and Red Crescent Societies (IFRC), Africa Regional Office, Nairobi, Kenya. Sharon Reader, MA, is a Norwegian Capacity (Norwegian Refugee Council) CEA Global Advisor and freelance consultant (previously IFRC Africa CEA Senior Advisor), Glasgow, Scotland. Ombretta Baggio, MA, is Senior Advisor, Community Engagement and Accountability, IFRC, Geneva, Switzerland
| | - Bronwyn Nichol
- Eva Erlach, Mag.a iur, is Community Engagement and Accountability (CEA) Delegate and Bronwyn Nichol, MPH, is Community Epidemic and Pandemic Preparedness Delegate, Health and Care Unit; both at the International Federation of Red Cross and Red Crescent Societies (IFRC), Africa Regional Office, Nairobi, Kenya. Sharon Reader, MA, is a Norwegian Capacity (Norwegian Refugee Council) CEA Global Advisor and freelance consultant (previously IFRC Africa CEA Senior Advisor), Glasgow, Scotland. Ombretta Baggio, MA, is Senior Advisor, Community Engagement and Accountability, IFRC, Geneva, Switzerland
| | - Sharon Reader
- Eva Erlach, Mag.a iur, is Community Engagement and Accountability (CEA) Delegate and Bronwyn Nichol, MPH, is Community Epidemic and Pandemic Preparedness Delegate, Health and Care Unit; both at the International Federation of Red Cross and Red Crescent Societies (IFRC), Africa Regional Office, Nairobi, Kenya. Sharon Reader, MA, is a Norwegian Capacity (Norwegian Refugee Council) CEA Global Advisor and freelance consultant (previously IFRC Africa CEA Senior Advisor), Glasgow, Scotland. Ombretta Baggio, MA, is Senior Advisor, Community Engagement and Accountability, IFRC, Geneva, Switzerland
| | - Ombretta Baggio
- Eva Erlach, Mag.a iur, is Community Engagement and Accountability (CEA) Delegate and Bronwyn Nichol, MPH, is Community Epidemic and Pandemic Preparedness Delegate, Health and Care Unit; both at the International Federation of Red Cross and Red Crescent Societies (IFRC), Africa Regional Office, Nairobi, Kenya. Sharon Reader, MA, is a Norwegian Capacity (Norwegian Refugee Council) CEA Global Advisor and freelance consultant (previously IFRC Africa CEA Senior Advisor), Glasgow, Scotland. Ombretta Baggio, MA, is Senior Advisor, Community Engagement and Accountability, IFRC, Geneva, Switzerland
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14
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Murthy BP, LeBlanc TT, Vagi SJ, Avchen RN. Going Viral: The 3 Rs of Social Media Messaging during Public Health Emergencies. Health Secur 2020; 19:75-81. [PMID: 33372847 PMCID: PMC9195488 DOI: 10.1089/hs.2020.0157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Bhavini Patel Murthy
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
| | - Tanya Telfair LeBlanc
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
| | - Sara J Vagi
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
| | - Rachel Nonkin Avchen
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
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15
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Initial COVID-19 Outbreak: An Epidemiological and Socioeconomic Case Review of Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249593. [PMID: 33371485 PMCID: PMC7767487 DOI: 10.3390/ijerph17249593] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/30/2020] [Accepted: 12/16/2020] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. It brought about the implementation of various measures and restrictions at a global level. Iran has been one of the countries with the highest rates of COVID-19 cases. This study reviews the initial outbreak of COVID-19 in Iran and examines the mitigation strategies adopted by the country. Moreover, it reports the socioeconomic challenges faced by the authorities during the efforts to contain the virus. A transdisciplinary literature review was carried out and a political measures timeline was constructed. A broad overview of the initial phase of the COVID-19 outbreak in Iran is presented, starting from the first confirmed case on 19 February 2020 until April 2020. The results of this epidemiological and socioeconomic case review of Iran suggests that the political measures undertaken by the Republic of Iran contributed to the decrease of the prevalence of COVID-19. However, due to the existing financial bottleneck, Iran has faced limited health system resources. Therefore, the response was not sufficient to restrict the spread and the efficient handling of the virus in the long-term.
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16
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Li ZH, Zhang XR, Zhong WF, Song WQ, Wang ZH, Chen Q, Liu D, Huang QM, Shen D, Chen PL, Mao A, Zhang D, Yang X, Wu XB, Mao C. Knowledge, attitudes, and practices related to Coronavirus disease 2019 during the outbreak among workers in China: A large cross-sectional study. PLoS Negl Trop Dis 2020; 14:e0008584. [PMID: 32941447 PMCID: PMC7498029 DOI: 10.1371/journal.pntd.0008584] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/10/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has recently emerged as a global threat. Understanding workers’ knowledge, attitudes, and practices (KAP) regarding this new infectious disease is crucial to preventing and controlling it. This study aimed to assess KAP regarding COVID-19 during the outbreak among workers in China. The present study was part of a cross-sectional online survey study conducted based on a large labor-intensive factory, which has 180,000 workers from various Chinese provinces, from 2 February 2020 to 7 February 2020. KAP related to COVID-19 were measured by 32 items, each item was measured with an agree/disagree/unclear format, and only correct responses were given 1 point. KAP regarding COVID-19 were measured with 20 items, 6 items and 6 items, respectively. A total of 123,768 valid responses (68.8%) were included in the analysis. Generally, the levels of knowledge (mean: 16.3 out of 20 points), attitudes (mean: 4.5 out of 6 points), and practices (mean: 5.8 out of 6 points) related to COVID-19 were high. Only 36,373 respondents (29.4%) disagreed that gargling with salt water is effective in protecting against COVID-19. Moreover, older respondents had decreased levels of knowledge and practices related to COVID-19 (both P values for the trend <0.001), while better-educated respondents had increased levels of knowledge and practices related to COVID-19 (both P values for the trend <0.001). These results suggest that Chinese workers are highly aware of COVID-19, but health authorities still need to provide correct information on COVID-19 prevention and strengthen health interventions, particularly for older and less-educated workers. The Coronavirus disease 2019 (COVID-19) has recently emerged as a global threat. It is important to understanding workers’ knowledge, attitudes, and practices (KAP) related to COVID-19. In this study, we conducted a large cross-sectional online survey base on a large labor-intensive factory to determine the status of COVID-19-related KAP during the outbreak among workers in China. We found that Chinese workers had strong awareness of COVID-19 but also had some misconceptions. Moreover, this study indicated that lower levels of knowledge and practices related to COVID-19 among older and less-educated workers. The results suggested that health authorities still need to ensure correct information on COVID-19 prevention and strengthen health interventions, particularly for older and less-educated workers.
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Affiliation(s)
- Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zheng-He Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing-Mei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ang Mao
- Department of Epidemiology and Statistics, School of Public Health, Chengdu Medical College Chengdu, Sichuan, China
| | - Duo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangdong, China
| | - Xingfen Yang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangdong, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (XBW); (CM)
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (XBW); (CM)
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17
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Jalloh MF, Kaiser R, Diop M, Jambai A, Redd JT, Bunnell RE, Castle E, Alpren C, Hersey S, Ekström AM, Nordenstedt H. National reporting of deaths after enhanced Ebola surveillance in Sierra Leone. PLoS Negl Trop Dis 2020; 14:e0008624. [PMID: 32810138 PMCID: PMC7480832 DOI: 10.1371/journal.pntd.0008624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/09/2020] [Accepted: 07/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background Sierra Leone experienced the largest documented epidemic of Ebola Virus Disease in 2014–2015. The government implemented a national tollfree telephone line (1-1-7) for public reporting of illness and deaths to improve the detection of Ebola cases. Reporting of deaths declined substantially after the epidemic ended. To inform routine mortality surveillance, we aimed to describe the trends in deaths reported to the 1-1-7 system and to quantify people’s motivations to continue reporting deaths after the epidemic. Methods First, we described the monthly trends in the number of deaths reported to the 1-1-7 system between September 2014 and September 2019. Second, we conducted a telephone survey in April 2017 with a national sample of individuals who reported a death to the 1-1-7 system between December 2016 and April 2017. We described the reported deaths and used ordered logistic regression modeling to examine the potential drivers of reporting motivations. Findings Analysis of the number of deaths reported to the 1-1-7 system showed that 12% of the expected deaths were captured in 2017 compared to approximately 34% in 2016 and over 100% in 2015. We interviewed 1,291 death reporters in the survey. Family members reported 56% of the deaths. Nearly every respondent (94%) expressed that they wanted the 1-1-7 system to continue. The most common motivation to report was to obey the government’s mandate (82%). Respondents felt more motivated to report if the decedent exhibited Ebola-like symptoms (adjusted odds ratio 2.3; 95% confidence interval 1.8–2.9). Conclusions Motivation to report deaths that resembled Ebola in the post-outbreak setting may have been influenced by knowledge and experiences from the prolonged epidemic. Transitioning the system to a routine mortality surveillance tool may require a robust social mobilization component to match the high reporting levels during the epidemic, which exceeded more than 100% of expected deaths in 2015. By November 2015 when the World Health Organization declared the Ebola epidemic in Sierra Leone to be over, approximately 95% of the population had become aware of the risk of Ebola transmission linked to physical contact with infected corpses, especially during traditional burials. Enhanced Ebola surveillance was implemented between November 2015 and June 2016, i.e. after the epidemic had officially ended to improve detection of possible new cases. Reporting to the 1-1-7 system declined nationally after enhanced Ebola surveillance ended even though the Government of Sierra Leone continued to mandate that all deaths must be reported. Based on a request from the Sierra Leone Ministry of Health and Sanitation, we conducted a telephone survey with a national sample of people who had reported a death in 2017 after the end of enhanced surveillance to understand their motivations for reporting and describe the deaths that they reported. In addition, we analyzed the five-year trends (2014–2019) in the number of deaths reported through the system. Analysis of monthly summary data of deaths reported showed that on the last month of enhanced surveillance, 3,851 deaths were reported compared to 2,456 deaths in the month immediately after (July 2016). The monthly numbers of reported deaths continued to plummet and reached as low as 1,550 in January 2017, 673 in January 2018, and 586 in January 2019. In the survey, we uncovered that people who reported deaths were mainly motivated to do so in order to comply with the Government’s mandate. After adjusting for potential confounders, motivations to report were strongly associated with the presence of Ebola-like symptoms in the decedent. Additional investigations are needed to unveil reporting barriers among people who failed to report household deaths to the 1-1-7 system to optimize reporting levels. It has been shown that during the Ebola epidemic that it is possible to reach high levels of death reporting in Sierra Leone as exemplified by the fact that in 2015 more than 100% of the expected deaths nationally were reported; albeit not counting potential duplicates. The post-Ebola-outbreak setting provides a unique opportunity to improve future overall mortality surveillance in Sierra Leone and contribute to the establishment of civil registration of vital statistics.
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Affiliation(s)
- Mohamed F. Jalloh
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Reinhard Kaiser
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Amara Jambai
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - John T. Redd
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca E. Bunnell
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Charles Alpren
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sara Hersey
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Winters M, Nordenstedt H, Mölsted Alvesson H. Reporting in a health emergency: The roles of Sierra Leonean journalists during the 2014-2015 Ebola outbreak. PLoS Negl Trop Dis 2020; 14:e0008256. [PMID: 32437345 PMCID: PMC7241701 DOI: 10.1371/journal.pntd.0008256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/27/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In public health emergencies, local media are important sources of information for the public. Not much is known about the professional and personal roles and experiences of Sierra Leonean journalists during the Ebola virus disease (EVD) outbreak between 2014-2015. METHODS/PRINCIPAL FINDINGS This qualitative study is based on semi-structured interviews with 13 Sierra Leonean journalists based in urban Freetown and rural Waterloo in February and March 2016. The majority of the journalists worked for radio stations. The mostly male journalists represented national, regional and local radio stations. Transcripts of the interviews were analysed using thematic analysis. The analysis was inspired by previously reported journalist roles and agenda-setting theory, which state that the media filter what is happening, making a few core issues more salient. Sierra Leonean journalists shifted from being sceptical monitors in the beginning of the outbreak, to collaborative instructors towards the end. While they adapted to different roles, journalists struggled with their own fears for the virus, which hampered their work. They indicated that the training they received about Ebola helped them overcome their fear. Being trained gave a sense of security that helped them carry out their jobs. By turning into instructors, journalists stepped away from their journalistic professional detachment-potentially exacerbated by their personal experiences. CONCLUSION/SIGNIFICANCE The first months of the outbreak were marked by passive agenda-setting roles of Sierra Leonean journalists. It took several months before the outbreak became a core issue in local media. In health emergencies, efforts should be made to partner with local media to use their platforms for local, trusted journalists and leaders to disseminate public health messages. Whereas this might hamper journalists' credibility and can be challenging in areas with problematic press freedom, Sierra Leonean journalists experienced the outbreak as a driver of necessary change in their profession.
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Affiliation(s)
- Maike Winters
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Aboagye AK, Dai B, Bakpa EK. The effect of risk communication on the nurses' task and contextual performance in disease outbreak control in Ghana: Application of the cause model. Int J Health Plann Manage 2020; 35:922-938. [PMID: 32323897 DOI: 10.1002/hpm.2978] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The re-emerging of infectious disease outbreaks is a menace in Ghana. As the acceptance of risk communication rises, health workers are using it to control outbreaks. Yet, research in risk communication and health workers' performance remains unexplored in Ghana. OBJECTIVE This study explores how risk communication works among nurses and its effect on their task (behaviors that are delineated based on role requirements and identified by a thorough analysis of the job) and contextual performance (behaviors that do not fall within the employee's assigned duties, but are a very important part of job performance). Thus, we adopted the CAUSE model, which proposes that effective risk communication creates five goals (Confidence, Awareness, Understanding, Satisfaction, and Enactment) amongst communicators. METHOD This study involves a quantitative approach complemented with qualitative data. It was conducted in three hospitals in Ghana, from which a sample of 398 nurses were selected. RESULT The result depicts that risk communication has a significant and positive effect on task performance (β = .65; P < .001), and contextual performance (β = .55; P < .001). CONCLUSION Our study shows that confidence is the strongest predictor of risk communication in influencing task and contextual performance. Yet, risk communication overall improves nurses' task and contextual performance.
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Affiliation(s)
- Abigail Konadu Aboagye
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, China
| | - Baozhen Dai
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, China
| | - Ernest Kay Bakpa
- School of Finance and Economics, Jiangsu University, Zhenjiang, China
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Ndaliko Augustin M, Kahindo Mbeva JB. Knowledge, attitudes, and behaviors of healthcare professionals at the start of an Ebola virus epidemic. Infect Dis Now 2020; 51:50-54. [PMID: 32320725 DOI: 10.1016/j.medmal.2020.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 11/19/2019] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION In August 2018 the Ministry of Health of the Democratic Republic of Congo (DRC) declared the 10th epidemic of Ebola virus disease (EVD) in a context of armed conflict and high population mobility. We aimed to assess the knowledge, attitudes, and practices of healthcare professionals related to this disease. METHOD Descriptive and cross-sectional study conducted by self-administered questionnaires among a random sample of 455 healthcare professionals of the city of Butembo, eastern DRC. RESULTS Healthcare professionals were mostly informed about this epidemic by the radio (72.2%). They were usually aware of the disease etiology (65.3%), contamination modes (78.2%), epidemiological surveillance objectives (89%), but they were much less familiar with its clinical outcome (37.9%) and with contact tracing (44.8%). Adequate attitudes and practices were observed in 44.3% of cases for hygiene and sanitation measures, 64.8% of cases for healthcare-associated infection prevention, and 39.7% of cases for the management of probable cases of EVD. CONCLUSION At the start of an Ebola outbreak, capacity building for epidemiological surveillance, hospital hygiene, and safety of care should be among the first urgent actions to implement.
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Affiliation(s)
- Mapendo Ndaliko Augustin
- Département de santé publique, Faculté de Médecine, Université Catholique du Graben (UCG), R.D. Congo.
| | - Jean-Bosco Kahindo Mbeva
- Département de santé publique, Faculté de santé et Développement communautaire (ULPGL), Université Officielle de Ruwenzori (UOR), Université Catholique du Graben (UCG), R.D. Congo
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21
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Kodish SR, Simen-Kapeu A, Beauliere JM, Ngnie-Teta I, Jalloh MB, Pyne-Bailey S, Schwartz H, Wirth JP. Consensus building around nutrition lessons from the 2014-16 Ebola virus disease outbreak in Guinea and Sierra Leone. Health Policy Plan 2019; 34:83-91. [PMID: 30753437 PMCID: PMC6481283 DOI: 10.1093/heapol/czy108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 11/15/2022] Open
Abstract
There are important lessons learned from the 2014-16 Ebola virus disease outbreak in West Africa. However, there has not been a systematic documentation of nutrition lessons specifically. Therefore, this study sought to generate multiple stakeholder perspectives for understanding the nutrition challenges faced during the Ebola virus disease outbreak, as well as for consensus building around improved response strategies. Participatory workshops with 17 and 19 participants in Guinea and Sierra Leone, respectively, were conducted in February 2017. Workshops followed the Nominal Group Technique, which is a methodological approach for idea generation and consensus building among diverse participants. Those findings were triangulated with qualitative interview data from participants representing government, United Nations bodies, civil society, non-governmental organizations and local communities in both Guinea (n = 27) and Sierra Leone (n = 42). (1) Reduced health system access and utilization, Poor caretaking and infant and young child feeding practices, Implementation challenges during nutrition response, Household food insecurity and Changing breastfeeding practices were five nutrition challenges identified in both Guinea and Sierra Leone. (2) Between settings, 14 distinct and 11 shared organizational factors emerged as facilitators to this response. In Sierra Leone, participants identified the Use of Standard Operating Procedures and Psychosocial counselling, whereas in Guinea, Hygiene assistance was distinctly important. Political will, Increased funding, Food assistance and to a lesser extent, Enhanced coordination, were deemed 'most important' response factors. (3) The top nutrition lessons learned were diverse, reflecting those of nutrition policy, programme implementation, community activity and household behaviours. Disease outbreaks pose widespread nutrition challenges to populations in resource-constrained settings where global health security is not a guarantee. These findings should be considered for emergency nutrition preparedness and inform evidence-based priority setting in the post-Ebola virus context of Guinea and Sierra Leone.
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Affiliation(s)
| | - Aline Simen-Kapeu
- UNICEF West and Central Africa Regional Office, Yoff, Dakar, Senegal
| | | | - Ismael Ngnie-Teta
- UNICEF West and Central Africa Regional Office, Yoff, Dakar, Senegal
| | | | - Solade Pyne-Bailey
- FOCUS 1000, 15 Main Motor Rd, Brookfields, PMB 393, Freetown, Sierra Leone
| | - Helen Schwartz
- Ministry of Health and Sanitation, Youyi Bldg, Brookfields, PMB 393, Freetown, Sierra Leone
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Schaible BJ, Snook KR, Yin J, Jackson AM, Ahweyevu JO, Chong M, Tse ZTH, Liang H, Fu KW, Fung ICH. Twitter Conversations and English News Media Reports on Poliomyelitis in Five Different Countries, January 2014 to April 2015. Perm J 2019; 23:18-181. [PMID: 31314733 DOI: 10.7812/tpp/18-181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Twitter and media coverage on poliomyelitis help maintain global support for its eradication. OBJECTIVE To test our hypothesis that themes of polio-related tweets and media articles would differ by location of interest (hashtag of country name mentioned in the tweet; country name mentioned in media articles) but would be similar to each other (tweets and media articles) for each location of interest. METHODS We retrospectively examined a 40% random sample of Twitter data containing the hashtag #polio from January 1, 2014, to April 30, 2015 (N = 79,333), from which we extracted 5 subcorpora each with a co-occurring hashtag #India (n = 5027), #Iraq (n = 1238), #Nigeria (n = 1364), #Pakistan (n = 11,427), and #Syria (n = 2952). We also retrieved and categorized 73 polio-related English-language news stories from within the same timeframe. We assessed the association between polio-related English news themes and the Twitter content. Descriptive analyses and unsupervised machine learning (latent Dirichlet allocation modeling) were conducted on the 5 Twitter subcorpora. RESULTS The results of the latent Dirichlet allocation modeling on the specific subcorpora with country co-occurring hashtags showed significant differences between the 5 countries in terms of content. English mass media content focused largely on violence/conflicts and cases of polio, whereas social media focused on eradication and vaccination efforts along with celebrations. DISCUSSION Contrary to our hypothesis, our evidence suggests Twitter content differs significantly from English mass media content. Evidence from our study helps inform media monitoring and communications surveillance during global public health crises, such as infectious disease outbreaks, as well as reactions to health promotion campaigns.
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Affiliation(s)
- Braydon J Schaible
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
| | - Kassandra R Snook
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
| | - Jingjing Yin
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
| | - Ashley M Jackson
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
| | - Jennifer O Ahweyevu
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
| | - Muhling Chong
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
| | - Zion Tsz Ho Tse
- School of Electrical Engineering and Computer Engineering, College of Engineering, University of Georgia, Athens
| | - Hai Liang
- Journalism and Media Studies Centre, University of Hong Kong.,School of Journalism and Communication, Chinese University of Hong Kong
| | - King-Wa Fu
- Journalism and Media Studies Centre, University of Hong Kong
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro
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Hugelius K, Adams M, Romo-Murphy E. The Power of Radio to Promote Health and Resilience in Natural Disasters: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2526. [PMID: 31311142 PMCID: PMC6679034 DOI: 10.3390/ijerph16142526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/04/2019] [Accepted: 07/11/2019] [Indexed: 11/29/2022]
Abstract
Humanitarian radio has been used in humanitarian aid efforts and after natural disasters over the last 15 years. However, the effects have barely been evaluated, and there are few scientific reports on the impact of radio as a disaster health response intervention. Therefore, this study aimed to provide an overview of the use and impact of humanitarian radio in natural disasters from a health perspective. A literature review of 13 scientific papers and grey literature resources was conducted. The results show that humanitarian radio could be used to promote both physical and psychosocial wellbeing by providing health-related information, advice and psychosocial support in natural disasters. Community resilience can be enhanced by the promotion of community engagement and can strengthen self-efficacy and community efficacy. Radio also has the potential to cost-effectively reach a large number of affected people in areas with severely damaged infrastructure. Radio could, therefore, contribute to health recovery and wellbeing from both individual and community perspectives. As such, health professionals; crises communication professionals, including radio journalists; and disaster-managing stakeholders should be prepared and trained to use humanitarian radio as an integrated part of the disaster health response in natural disasters.
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Affiliation(s)
- Karin Hugelius
- School of Health Sciences, Örebro University, 70182 Örebro, Sweden.
| | - Mike Adams
- First Response Radio, Frome BA11 2SX, UK
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Gamma AE, Slekiene J, Mosler HJ. The Impact of Various Promotional Activities on Ebola Prevention Behaviors and Psychosocial Factors Predicting Ebola Prevention Behaviors in the Gambia Evaluation of Ebola Prevention Promotions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16112020. [PMID: 31174301 PMCID: PMC6603859 DOI: 10.3390/ijerph16112020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 11/25/2022]
Abstract
The outbreak of the Ebola virus disease (EVD) from 2014 to 2016 is over. However, several outbreaks of contagious diseases have already arisen and will recur. This paper aims to evaluate the effectiveness of EVD prevention promotions in the Gambia and to assess the psychosocial factors that steer three behaviors: handwashing with soap, calling the Ebola Hotline, and not touching a person who might be suffering from EVD. In 2015, data were gathered from 498 primary care providers. The questionnaire was based on psychosocial factors from the risks, attitudes, norms, abilities, and self-regulation (RANAS) model. Three promotional activities were significantly associated with psychosocial factors of handwashing and, thus, with increased handwashing behavior: the home visit, posters, and info sheets. Norm factors, especially the perception of what other people do, had a great impact on handwashing with soap and on calling the Ebola Hotline. The perceived certainty that a behavior will prevent a disease was a predictor for all three protection behaviors. Commitment to the behavior emerged as especially relevant for the intention to call the Ebola Hotline and for not touching a person who might be suffering from EVD. Health behavior change programs should rely on evidence to target the right psychosocial factors and to maximize their effects on prevention behaviors, especially in emergency contexts.
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Affiliation(s)
- Anna E Gamma
- EAWAG, Swiss Federal Institute of Aquatic Science & Technology, Ueberlandstrasse 133, CH-8600 Duebendorf, Switzerland.
| | - Jurgita Slekiene
- EAWAG, Swiss Federal Institute of Aquatic Science & Technology, Ueberlandstrasse 133, CH-8600 Duebendorf, Switzerland.
| | - Hans-Joachim Mosler
- EAWAG, Swiss Federal Institute of Aquatic Science & Technology, Ueberlandstrasse 133, CH-8600 Duebendorf, Switzerland.
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Sumo J, George G, Weah V, Skrip L, Rude JM, Clement P, Naiene JD, Luwaga L, Okeibunor JC, Talisuna A, Yahaya AA, Rajatonirina S, Fallah M, Nyenswah T, Dahn B, Gasasira A, Fall IS. Risk communication during disease outbreak response in post-Ebola Liberia: experiences in Sinoe and Grand Kru counties. Pan Afr Med J 2019; 33:4. [PMID: 31402964 PMCID: PMC6675579 DOI: 10.11604/pamj.supp.2019.33.2.16877] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 02/22/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction Lessons learned from the Ebola virus disease (EVD) outbreak enabled Liberia to develop a health plan for strengthening public health capacity against potential public health threats. risk communication is one of the core pillars that provide life-saving information and knowledge for the public to take preventive and proactive actions against public health threats. These were applied in response to the post-ebola meningococcal septicemia and meningitis outbreaks in Sinoe and Grand Kru counties. This paper documents risk communication experiences in these post-ebola outbreaks in Liberia. Methods Risk Communication and health promotion strategies were deployed in developing response plans and promptly disseminating key messages to affected communities to mitigate the risks. Other strategies included engagement of community leaders, partnership with the media and dissemination of messages through the community radios, active monitoring community risk perceptions and compliance, rumor management, mobile stage and interpersonal communication (IPC) during the Meningococcal disease outbreaks in Sinoe and Grand Kru counties. Results In Sinoe, about 36,891 households or families in 10 health districts were reached through IPC and dialogue. Circulating rumors such as “Ebola” was the cause of deaths was timely and promptly mitigated. There was increased trust and adherence to health advice including prompt reporting of sick people to the nearest health facility in the two counties. Conclusion Risk communication and health promotion encouraged community support and involvement in any response to public threats and events. No doubt, risk communication and health promotion play an important role in preparedness and response to public health emergencies.
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Affiliation(s)
- John Sumo
- Health Promotion Division, Ministry of Health, Monrovia, Liberia
| | - Geraldine George
- Health Promotion Division, Ministry of Health, Monrovia, Liberia
| | - Vera Weah
- Health Promotion Division, Ministry of Health, Monrovia, Liberia
| | - Laura Skrip
- National Public Health Institute, Monrovia, Liberia
| | | | | | | | | | | | - Ambrose Talisuna
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | | | | | - Bernice Dahn
- National Public Health Institute, Monrovia, Liberia
| | | | - Ibrahima Socé Fall
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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Enhancing Epidemiology Capacity During the 2014-15 West Africa Ebola Outbreak: An Assessment of the Role of Applied Public Health Epidemiologists. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 26:595-601. [PMID: 30747796 DOI: 10.1097/phh.0000000000000982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT In late 2014, the Centers for Disease Control and Prevention requested the support of the Council of State and Territorial Epidemiologists to enhance epidemiologic capacity in the West African countries impacted or threatened by an outbreak of Ebola virus disease. In response, the Council of State and Territorial Epidemiologists recruited 36 senior epidemiologists who, collectively, made 45 deployments to West Africa, averaging 42 days each. OBJECTIVE To assess the self-reported experiences and contributions of the deployed epidemiologists, as well as the role of nonprofit public health organizations in large-scale emergency response. DESIGN Electronic assessment of the deployed epidemiologists. PARTICIPANTS Experienced applied public health epidemiologists who volunteered to participate in the response to the West Africa Ebola virus disease emergency. MAIN OUTCOME MEASURES Descriptive data. RESULTS The chief, reported functional contributions made during deployments include improving surveillance processes (reported by 73.3% of respondents), building meaningful relationships to facilitate response activities (66.7%), improving data quality (53.3%), and improving understanding of the disease/outbreak (40.0%). Among the professional benefits of deployment to West Africa to assist with Ebola virus disease outbreak response are stimulating enthusiasm for public health work (93.3%, n = 30), broadened perspective of global health (86.7%), and sharpened epidemiological skills (56.7%). CONCLUSIONS Owing to their ability to access experienced, senior professionals, the Council of State and Territorial Epidemiologists and other nonprofit public health associations can play a meaningful role boosting surge capacity in a sustained, large-scale emergency response.
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Use of Obstetric Practice Web Sites to Distribute Zika Virus Information to Pregnant Women During a Zika Virus Outbreak. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23:608-613. [PMID: 28125540 PMCID: PMC5636051 DOI: 10.1097/phh.0000000000000537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is Available in the Text. Objective: To describe the current use of obstetric practice Web sites to disseminate Zika virus information to patients. Design: Review of 913 randomly selected practice Web sites and associated social media accounts in January and August 2016. Setting: Obstetric practice Web sites and associated social media accounts, United States of America. Participants: N/A. Main Outcome Measures: Proportion of obstetric practice Web sites and linked social media accounts providing Zika virus information. Results: Twenty-five percent and 35% of obstetric practice Web sites had information posted about Zika virus in January 2016 and August 2016, respectively. Between the 2 time points, the proportion of practices posting Zika virus content on Facebook and Twitter declined (Facebook: 15% in January, 9% in August; Twitter: 12% in January, 8% in August). In August, the most frequently observed Zika virus–related content themes were the use of insect repellent (14%) and travel advisories (14%). At both time points, practices affiliated with large university hospitals were more likely to have posted information on Zika virus than independent OB/GYN-only practices: January: odds ratio (OR) (95% confidence interval [CI]) = 5.68 (3.50-9.20); August: OR (95% CI) = 8.37 (5.31-13.17). Similarly, practices associated with nonuniversity hospitals were more likely to have posted information than independent OB/GYN-only practices: January: OR (95% CI) = 2.71 (1.88-3.92); August: OR (95% CI) = 6.75 (4.75-9.60). Conclusion: Obstetric care practices are not fully utilizing their practice Web sites to relay Zika virus information to their patients. Since practitioner-sponsored Web sites have the capacity to directly reach the populations at greatest risk for Zika virus complications, public health professionals should consider adapting their materials and provider outreach campaigns to more easily accommodate Web site–based information dissemination during this type of public health emergency. There must be greater recognition of the value information gains in the eyes of the patient when it is validated by their own provider, especially when that patient is part of the highest-risk population for a given emergency. Public health organizations should strive to minimize the burden it takes for providers to relay useful resources to patients in order to maximize the impact that those resources can have.
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Fung ICH, Jackson AM, Mullican LA, Blankenship EB, Goff ME, Guinn AJ, Saroha N, Tse ZTH. Contents, Followers, and Retweets of the Centers for Disease Control and Prevention's Office of Advanced Molecular Detection (@CDC_AMD) Twitter Profile: Cross-Sectional Study. JMIR Public Health Surveill 2018; 4:e33. [PMID: 29610112 PMCID: PMC5902693 DOI: 10.2196/publichealth.8737] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 12/30/2017] [Accepted: 01/12/2018] [Indexed: 11/13/2022] Open
Abstract
Background The Office of Advanced Molecular Detection (OAMD), Centers for Disease Control and Prevention (CDC), manages a Twitter profile (@CDC_AMD). To our knowledge, no prior study has analyzed a CDC Twitter handle’s entire contents and all followers. Objective This study aimed to describe the contents and followers of the Twitter profile @CDC_AMD and to assess if attaching photos or videos to tweets posted by @CDC_AMD would increase retweet frequency. Methods Data of @CDC_AMD were retrieved on November 21, 2016. All followers (N=809) were manually categorized. All tweets (N=768) were manually coded for contents and whether photos or videos were attached. Retweet count for each tweet was recorded. Negative binomial regression models were applied to both the original and the retweet corpora. Results Among the 809 followers, 26.0% (210/809) were individual health professionals, 11.6% (94/809) nongovernmental organizations, 3.3% (27/809) government agencies’ accounts, 3.3% (27/809) accounts of media organizations and journalists, and 0.9% (7/809) academic journals, with 54.9% (444/809) categorized as miscellaneous. A total of 46.9% (360/768) of @CDC_AMD’s tweets referred to the Office’s website and their current research; 17.6% (135/768) referred to their scientists’ publications. Moreover, 80% (69/86) of tweets retweeted by @CDC_AMD fell into the miscellaneous category. In addition, 43.4% (333/768) of the tweets contained photos or videos, whereas the remaining 56.6% (435/768) did not. Attaching photos or videos to original @CDC_AMD tweets increases the number of retweets by 37% (probability ratio=1.37, 95% CI 1.13-1.67, P=.002). Content topics did not explain or modify this association. Conclusions This study confirms CDC health communicators’ experience that original tweets created by @CDC_AMD Twitter profile sharing images or videos (or their links) received more retweets. The current policy of attaching images to tweets should be encouraged.
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Affiliation(s)
- Isaac Chun-Hai Fung
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | - Ashley M Jackson
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | - Lindsay A Mullican
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | - Elizabeth B Blankenship
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | - Mary Elizabeth Goff
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | - Amy J Guinn
- Office of Advanced Molecular Detection, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nitin Saroha
- Department of Computer Science, The University of Georgia, Athens, GA, United States
| | - Zion Tsz Ho Tse
- School of Electrical and Computer Engineering, College of Engineering, The University of Georgia, Athens, GA, United States
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Nuriddin A, Jalloh MF, Meyer E, Bunnell R, Bio FA, Jalloh MB, Sengeh P, Hageman KM, Carroll DD, Conteh L, Morgan O. Trust, fear, stigma and disruptions: community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015. BMJ Glob Health 2018; 3:e000410. [PMID: 29629189 PMCID: PMC5884263 DOI: 10.1136/bmjgh-2017-000410] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/06/2022] Open
Abstract
Social mobilisation and risk communication were essential to the 2014–2015 West African Ebola response. By March 2015, >8500 Ebola cases and 3370 Ebola deaths were confirmed in Sierra Leone. Response efforts were focused on ‘getting to zero and staying at zero’. A critical component of this plan was to deepen and sustain community engagement. Several national quantitative studies conducted during this time revealed Ebola knowledge, personal prevention practices and traditional burial procedures improved as the outbreak waned, but healthcare system challenges were also noted. Few qualitative studies have examined these combined factors, along with survivor stigma during periods of ongoing transmission. To obtain an in-depth understanding of people’s perceptions, attitudes and behaviours associated with Ebola transmission risks, 27 focus groups were conducted between April and May 2015 with adult Sierra Leonean community members on: trust in the healthcare system, interactions with Ebola survivors, impact of Ebola on lives and livelihood, and barriers and facilitators to ending the outbreak. Participants perceived that as healthcare practices and facilities improved, so did community trust. Resource management remained a noted concern. Perceptions of survivors ranged from sympathy and empathy to fear and stigmatisation. Barriers included persistent denial of ongoing Ebola transmission, secret burials and movement across porous borders. Facilitators included personal protective actions, consistent messaging and the inclusion of women and survivors in the response. Understanding community experiences during the devastating Ebola epidemic provides practical lessons for engaging similar communities in risk communication and social mobilisation during future outbreaks and public health emergencies.
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Affiliation(s)
- Azizeh Nuriddin
- Program Performance and Evaluation Office, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mohamed F Jalloh
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Erika Meyer
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca Bunnell
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Franklin A Bio
- Research and Evaluation, FOCUS 1000, Freetown, Sierra Leone
| | | | - Paul Sengeh
- Research and Evaluation, FOCUS 1000, Freetown, Sierra Leone
| | - Kathy M Hageman
- Epidemiology and Strategic Information Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Dianna D Carroll
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lansana Conteh
- Health Education Division, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Oliver Morgan
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
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Jalloh MF, Bunnell R, Robinson S, Jalloh MB, Barry AM, Corker J, Sengeh P, VanSteelandt A, Li W, Dafae F, Diallo AA, Martel LD, Hersey S, Marston B, Morgan O, Redd JT. Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July-August 2015. Philos Trans R Soc Lond B Biol Sci 2017; 372:rstb.2016.0304. [PMID: 28396475 DOI: 10.1098/rstb.2016.0304] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 11/12/2022] Open
Abstract
The border region of Forécariah (Guinea) and Kambia (Sierra Leone) was of immense interest to the West Africa Ebola response. Cross-sectional household surveys with multi-stage cluster sampling procedure were used to collect random samples from Kambia (n = 635) in July 2015 and Forécariah (n = 502) in August 2015 to assess public knowledge, attitudes and practices related to Ebola. Knowledge of the disease was high in both places, and handwashing with soap and water was the most widespread prevention practice. Acceptance of safe alternatives to traditional burials was significantly lower in Forécariah compared with Kambia. In both locations, there was a minority who held discriminatory attitudes towards survivors. Radio was the predominant source of information in both locations, but those from Kambia were more likely to have received Ebola information from community sources (mosques/churches, community meetings or health workers) compared with those in Forécariah. These findings contextualize the utility of Ebola health messaging during the epidemic and suggest the importance of continued partnership with community leaders, including religious leaders, as a prominent part of future public health protection.This article is part of the themed issue 'The 2013-2016 West African Ebola epidemic: data, decision-making and disease control'.
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Affiliation(s)
- Mohamed F Jalloh
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Rebecca Bunnell
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Susan Robinson
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | | | | | | | | | - Amanda VanSteelandt
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Wenshu Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Foday Dafae
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Lise D Martel
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Sara Hersey
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Barbara Marston
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Oliver Morgan
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - John T Redd
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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Jalloh MF, Sengeh P, Monasch R, Jalloh MB, DeLuca N, Dyson M, Golfa S, Sakurai Y, Conteh L, Sesay S, Brown V, Li W, Mermin J, Bunnell R. National survey of Ebola-related knowledge, attitudes and practices before the outbreak peak in Sierra Leone: August 2014. BMJ Glob Health 2017; 2:e000285. [PMID: 29259820 PMCID: PMC5728302 DOI: 10.1136/bmjgh-2017-000285] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 05/16/2017] [Accepted: 05/17/2017] [Indexed: 11/07/2022] Open
Abstract
Background The 2014–2015 Ebola epidemic in West Africa was the largest ever to occur. In the early phases, little was known about public knowledge, attitudes and practices (KAP) relating to Ebola virus disease (Ebola). Data were needed to develop evidence-driven strategies to address gaps in knowledge and practice. Methods In August 2014, we conducted interviews with 1413 randomly selected respondents from 9 out of 14 districts in Sierra Leone using multistage cluster sampling. Where suitable, Ebola-related KAP questions were adapted from other internationally validated questionnaires related to infectious diseases. Results All respondents were aware of Ebola. When asked unprompted, 60% of respondents could correctly cite fever, diarrhoea and vomiting as signs/symptoms of Ebola. A majority of respondents knew that avoiding infected blood and bodily fluids (87%) and contact with an infected corpse (85%) could prevent Ebola. However, there were also widespread misconceptions such as the belief that Ebola can be prevented by washing with salt and hot water (41%). Almost everyone interviewed (95%) expressed at least one discriminatory attitude towards Ebola survivors. Unprompted, self-reported actions taken to avoid Ebola infection included handwashing with soap (66%) and avoiding physical contact with patients with suspected Ebola (40%). Conclusion Three months into the 2014 Ebola outbreak in Sierra Leone, our findings suggest there was high awareness of the disease but misconceptions and discriminatory attitudes toward survivors remained common. These findings directly informed the development of a national social mobilisation strategy and demonstrated the importance of KAP assessment early in an epidemic.
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Affiliation(s)
- Mohamed F Jalloh
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Research and Evaluation Department, FOCUS 1000, Freetown, Western Area, Sierra Leone.,Public Health Sciences Department, Karolinska Institutet, Stockholm, Sweden
| | - Paul Sengeh
- Research and Evaluation Department, FOCUS 1000, Freetown, Western Area, Sierra Leone
| | - Roeland Monasch
- Sierra Leone Country Office, UNICEF, Freetown, Western Area, Sierra Leone
| | - Mohammad B Jalloh
- Office of the Chief Executive Officer, FOCUS 1000, Freetown, Western Area, Sierra Leone
| | - Nickolas DeLuca
- Division of HIV/AIDS Prevention, Prevention Communication Branch, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Meredith Dyson
- Sierra Leone Country Office, Catholic Relief Services, Freetown, Western Area, Sierra Leone
| | - Sheku Golfa
- Sierra Leone Country Office, UNICEF, Freetown, Western Area, Sierra Leone
| | - Yukiko Sakurai
- Sierra Leone Country Office, UNICEF, Freetown, Western Area, Sierra Leone
| | - Lansana Conteh
- Health Education Division, Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
| | - Samuel Sesay
- Health Education Division, Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
| | - Vance Brown
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wenshu Li
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonathan Mermin
- Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca Bunnell
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Naimoli JF, Saxena S, Hatt LE, Yarrow KM, White TM, Ifafore-Calfee T. Health system strengthening: prospects and threats for its sustainability on the global health policy agenda. Health Policy Plan 2017; 33:85-98. [DOI: 10.1093/heapol/czx147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 11/15/2022] Open
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Fung ICH, Jackson AM, Ahweyevu JO, Grizzle JH, Yin J, Tse ZTH, Liang H, Sekandi JN, Fu KW. #Globalhealth Twitter Conversations on #Malaria, #HIV, #TB, #NCDS, and #NTDS: a Cross-Sectional Analysis. Ann Glob Health 2017; 83:682-690. [PMID: 29221545 DOI: 10.1016/j.aogh.2017.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Advocates use the hashtag #GlobalHealth on Twitter to draw users' attention to prominent themes on global health, to harness their support, and to advocate for change. OBJECTIVES We aimed to describe #GlobalHealth tweets pertinent to given major health issues. METHODS Tweets containing the hashtag #GlobalHealth (N = 157,951) from January 1, 2014, to April 30, 2015, were purchased from GNIP Inc. We extracted 5 subcorpora of tweets, each with 1 of 5 co-occurring disease-specific hashtags (#Malaria, #HIV, #TB, #NCDS, and #NTDS) for further analysis. Unsupervised machine learning was applied to each subcorpus to categorize the tweets by their underlying topics and obtain the representative tweets of each topic. The topics were grouped into 1 of 4 themes (advocacy; epidemiological information; prevention, control, and treatment; societal impact) or miscellaneous. Manual categorization of most frequent users was performed. Time zones of users were analyzed. FINDINGS In the entire #GlobalHealth corpus (N = 157,951), there were 40,266 unique users, 85,168 retweets, and 13,107 unique co-occurring hashtags. Of the 13,087 tweets across the 5 subcorpora with co-occurring hashtag #malaria (n = 3640), #HIV (n = 3557), #NCDS (noncommunicable diseases; n = 2373), #TB (tuberculosis; n = 1781), and #NTDS (neglected tropical diseases; n = 1736), the most prevalent theme was prevention, control, and treatment (4339, 33.16%), followed by advocacy (3706, 28.32%), epidemiological information (1803, 13.78%), and societal impact (1617, 12.36%). Among the top 10 users who tweeted the highest number of tweets in the #GlobalHealth corpus, 5 were individual professionals, 3 were news media, and 2 were organizations advocating for global health. The most common users' time zone was Eastern Time (United States and Canada). CONCLUSIONS This study highlighted the specific #GlobalHealth Twitter conversations pertinent to malaria, HIV, tuberculosis, noncommunicable diseases, and neglected tropical diseases. These conversations reflect the priorities of advocates, funders, policymakers, and practitioners of global health on these high-burden diseases as they presented their views and information on Twitter to their followers.
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Affiliation(s)
- Isaac Chun-Hai Fung
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA.
| | - Ashley M Jackson
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
| | - Jennifer O Ahweyevu
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
| | - Jordan H Grizzle
- Department of Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
| | - Jingjing Yin
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
| | - Zion Tsz Ho Tse
- School of Electrical and Computer Engineering, The University of Georgia, Athens, GA
| | - Hai Liang
- School of Journalism and Communication, Chinese University of Hong Kong, Hong Kong
| | - Juliet N Sekandi
- Global Health Institute, The University of Georgia, Athens, GA; Department of Epidemiology and Biostatistics, The University of Georgia, Athens, GA
| | - King-Wa Fu
- Journalism and Media Studies Centre, The University of Hong Kong, Hong Kong; MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA
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Jalloh MF, Robinson SJ, Corker J, Li W, Irwin K, Barry AM, Ntuba PN, Diallo AA, Jalloh MB, Nyuma J, Sellu M, VanSteelandt A, Ramsden M, Tracy L, Raghunathan PL, Redd JT, Martel L, Marston B, Bunnell R. Knowledge, Attitudes, and Practices Related to Ebola Virus Disease at the End of a National Epidemic - Guinea, August 2015. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:1109-1115. [PMID: 29049279 PMCID: PMC5689093 DOI: 10.15585/mmwr.mm6641a4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Irwin KL, Jalloh MF, Corker J, Alpha Mahmoud B, Robinson SJ, Li W, James NE, Sellu M, Jalloh MB, Diallo AA, Tracy L, Hajjeh R, VanSteelandt A, Bunnell R, Martel L, Raghunathan PL, Marston B. Attitudes about vaccines to prevent Ebola virus disease in Guinea at the end of a large Ebola epidemic: Results of a national household survey. Vaccine 2017; 35:6915-6923. [PMID: 28716555 DOI: 10.1016/j.vaccine.2017.06.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 05/22/2017] [Accepted: 06/09/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In 2014-2016, an Ebola epidemic devastated Guinea; more than 3800 cases and 2500 deaths were reported to the World Health Organization. In August 2015, as the epidemic waned and clinical trials of an experimental, Ebola vaccine continued in Guinea and neighboring Sierra Leone, we conducted a national household survey about Ebola-related knowledge, attitudes, and practices (KAP) and opinions about "hypothetical" Ebola vaccines. METHODS Using cluster-randomized sampling, we selected participants aged 15+ years old in Guinea's 8 administrative regions, which had varied cumulative case counts. The questionnaire assessed socio-demographic characteristics, experiences during the epidemic, Ebola-related KAP, and Ebola vaccine attitudes. To assess the potential for Ebola vaccine introduction in Guinea, we examined the association between vaccine attitudes and participants' characteristics using categorical and multivariable analyses. RESULTS Of 6699 persons invited to participate, 94% responded to at least 1 Ebola vaccine question. Most agreed that vaccines were needed to fight the epidemic (85.8%) and that their family would accept safe, effective Ebola vaccines if they became available in Guinea (84.2%). These measures of interest and acceptability were significantly more common among participants who were male, wealthier, more educated, and lived with young children who had received routine vaccines. Interest and acceptability were also significantly higher among participants who understood Ebola transmission modes, had witnessed Ebola response teams, knew Ebola-affected persons, believed Ebola was not always fatal, and would access Ebola treatment centers. In multivariable analyses of the majority of participants living with young children, interest and acceptability were significantly higher among those living with vaccinated children than among those living with unvaccinated children. DISCUSSION The high acceptability of hypothetical vaccines indicates strong potential for introducing Ebola vaccines across Guinea. Strategies to build public confidence in use of Ebola vaccines should highlight any similarities with safe, effective vaccines routinely used in Guinea.
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Affiliation(s)
- Kathleen L Irwin
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Mohamed F Jalloh
- Focus 1000, 15 Main Motor Road, Brookfields, Freetown, Sierra Leone.
| | - Jamaica Corker
- Consultant to the Centers for Disease Control and Prevention, Atlanta, 1600 Clifton Road NE, Atlanta, GA 30329, USA.
| | | | - Susan J Robinson
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Wenshu Li
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Nyuma E James
- Focus 1000, 15 Main Motor Road, Brookfields, Freetown, Sierra Leone.
| | - Musa Sellu
- Focus 1000, 15 Main Motor Road, Brookfields, Freetown, Sierra Leone.
| | - Mohammad B Jalloh
- Focus 1000, 15 Main Motor Road, Brookfields, Freetown, Sierra Leone.
| | | | - LaRee Tracy
- Food and Drug Administration, Center for Drug Evaluation and Research, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA.
| | - Rana Hajjeh
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Amanda VanSteelandt
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Rebecca Bunnell
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Lise Martel
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Pratima L Raghunathan
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Barbara Marston
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
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Berenson AB, Trinh HN, Hirth JM, Guo F, Fuchs EL, Weaver SC. Knowledge and Prevention Practices among U.S. Pregnant Immigrants from Zika Virus Outbreak Areas. Am J Trop Med Hyg 2017; 97:155-162. [PMID: 28719291 PMCID: PMC5508920 DOI: 10.4269/ajtmh.17-0062] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/13/2017] [Indexed: 11/07/2022] Open
Abstract
We administered an anonymous survey to assess knowledge, attitudes, and prevention practices related to the Zika virus among pregnant women residing in Texas. Multivariate logistic regression models controlling for age, race/ethnicity, education, and number of years in the United States assessed differences between women born in outbreak areas (N = 390) versus those born in the United States (N = 249). Results demonstrated that most women wanted more information on the Zika virus and desired to obtain it from their physician. The majority did not know that the Zika virus could be spread through sex with an asymptomatic partner or how often those infected were symptomatic. Few women took precautions to avoid mosquito bites. Only 40% reported frequently using repellent; 21% stated that cost was problematic and almost half were concerned about use during pregnancy. Three-fourths stated they would agree to vaccination, if available. Compared with U.S.-born women, those born in outbreak areas were more likely to have already discussed the Zika virus with their doctor (adjusted odds ratio [aOR] = 1.86, 95% confidence interval [CI] = 1.27, 2.71) and identify microcephaly as the most common birth defect (aOR = 2.59, 95% CI = 1.78, 3.76). Moreover, women born in outbreak areas were less likely to desire to keep it a secret if they became infected (aOR = 0.47, 95% CI = 0.31, 0.71). This study found that, regardless of birthplace, pregnant women need more education on the Zika virus disease and assurance regarding the safety of using repellent during pregnancy. They also need financial assistance for repellent, especially if living in states where transmission by mosquitos has been reported.
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Affiliation(s)
- Abbey B. Berenson
- Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, Texas
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Ha N. Trinh
- Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, Texas
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Jacqueline M. Hirth
- Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, Texas
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Fangjian Guo
- Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, Texas
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Erika L. Fuchs
- Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, Texas
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Scott C. Weaver
- Department of Pathology, Institute of Human Infections and Immunology, University of Texas Medical Branch, Galveston, Texas
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
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Hennenfent A, McGee S, Dassie K, Grant J, Li K, Zamore K, Davies-Cole J, Johnson-Clarke F. Experiences and perceptions of the United States Ebola Active Monitoring Program: results from a survey of Former Persons Under Monitoring in Washington, DC. Public Health 2017; 144:70-77. [PMID: 28274387 DOI: 10.1016/j.puhe.2016.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/21/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess Former Persons Under Monitoring (FPUM)s' experiences and perceptions of the United States (US) Ebola Active Monitoring Program. STUDY DESIGN Retrospective assessment survey of FPUM. METHODS An electronic survey was distributed to FPUMs monitored in Washington, DC, during October 2014-September 2015 (n = 830). RESULTS Most FPUMs (>70%) had a favourable perception of the program. Less than 5% avoided future travel or participation in outbreak response activities as a result of their monitoring experience. Approximately 29% experienced a negative consequence in the US due to their travel history. Only 19.2% reported that the Check and Report Ebola (CARE) phone was their only means of communication and 56.5% never used it for daily reporting. Experiences and perceptions varied significantly by citizenship with citizens of Ebola-affected countries more likely to have a favourable perception of the program, use CARE phones and express concern about Ebola transmission and development. CONCLUSIONS FPUMs perceived the program as beneficial and undergoing monitoring was not a barrier to future travel. Negative consequences resulting from travel were frequent. Targeted distribution of resources (e.g. CARE phones) should be considered for future programs.
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Affiliation(s)
- A Hennenfent
- CDC/CSTE Applied Epidemiology Fellowship Program, District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA.
| | - S McGee
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
| | - K Dassie
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
| | - J Grant
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
| | - K Li
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
| | - K Zamore
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
| | - J Davies-Cole
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
| | - F Johnson-Clarke
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, Washington, DC, USA
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