Efficiency of Field Laboratories for Ebola Virus Disease Outbreak during Chronic Insecurity, Eastern Democratic Republic of the Congo, 2018–2020

Mukadi-Bamuleka, Daniel; Mambu-Mbika, Fabrice; Weggheleire, Anja De; Edidi-Atani, François; Bulabula-Penge, Junior; Mfumu, Meris Matondo Kua; Legand, Anaïs; Nkuba-Ndaye, Antoine; N’kasar, Yannick Tutu Tshia; Mbala-Kingebeni, Placide; Klena, John D.; Muyembe‐Tamfum, Jean‐Jacques; Formenty, Pierre; Griensven, Johan van; Ariën, Kevin K.; Ahuka‐Mundeke, Steve

doi:10.3201/eid2901.221025

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…The cornerstone of EVD control is through identifying cases and reducing contact with infected bodily fluids (and vaccination) [ 8 , 10 ]. Conflict can impact these control measures in multiple ways.…”

Section: Discussionmentioning

confidence: 99%

“…EVD control is achieved through identifying cases and interventions which reduce the risk of contact with infected people, via biosecurity in EVD treatment centres, safe burial practices, reducing sexual transmission [ 7 ], timely detection (via strategically positioned decentralized laboratories) [ 8 ], contact tracing and post-mortem testing to identify EVD-related deaths, genomic sequencing (to infer spatiotemporal transmission dynamics) [ 9 , 10 ], and more recently with the rVSVΔG-ZEBOV-GP Ebola virus envelope glycoprotein vaccine and monoclonal antibody therapeutics [ 11 , 12 ]. Conflict can impact these control measures, reducing the capacity to identify and respond to outbreaks [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo

Charnley,

Green,

Kelman

et al. 2024

BMC Public Health

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Background Reducing Ebola virus transmission relies on the ability to identify cases and limit contact with infected bodily fluids through biosecurity, safe sex practices, safe burial and vaccination. Armed conflicts can complicate outbreak detection and interventions due to widespread disruption to governments and populations. Guinea and the Democratic Republic of the Congo (DRC) have historically reported the largest and the most recent Ebola virus outbreaks. Understanding if conflict played a role in these outbreaks may help in identifying key risks factors to improve disease control. Methods We used data from a range of publicly available data sources for both Ebola virus cases and conflict events from 2018 to 2021 in Guinea and the DRC. We fitted these data to conditional logistic regression models using the Self-Controlled Case Series methodology to evaluate the magnitude in which conflict increased the risk of reported Ebola virus cases in terms of incidence rate ratio. We re-ran the analysis sub-nationally, by conflict sub-event type and tested any lagged effects. Results Conflict was significantly associated with an increased risk of reported Ebola virus cases in both the DRC and Guinea in recent outbreaks. The effect was of a similar magnitude at 1.88- and 1.98-times increased risk for the DRC and Guinea, respectively. The greatest effects (often higher than the national values) were found in many conflict prone areas and during protest/riot-related conflict events. Conflict was influential in terms of Ebola virus risk from 1 week following the event and remained important by 10 weeks. Conclusion Extra vigilance is needed following protests and riot-related conflict events in terms of Ebola virus transmission. These events are highly disruptive, in terms of access to transportation and healthcare and are often in urban areas with high population densities. Additional public health messaging around these types of conflict events, relating to the risks and clinical symptoms may be helpful in reducing transmission. Future work should aim to further understand and quantify conflict severity and intensity, to evaluate dose–response relationships in terms of disease risk.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo

Charnley,

Green,

Kelman

et al. 2024

BMC Public Health

View full text Add to dashboard Cite

show abstract

“…The control of EVD is through identifying cases and interventions which reduce the risk of contact with infected people’s body fluids, via biosecurity in EVD treatment centres, safe burial practices, reducing sexual transmission [7], timely detection (via strategically positioned decentralized laboratories) [8], contact tracing and post-mortem testing to identify EVD-related deaths, genomic sequencing (to infer spatiotemporal transmission dynamics) [9,10] and more recently with the rVSVΔG-ZEBOV-GP Ebola virus envelope glycoprotein vaccine and monoclonal antibody therapeutics [11,12]. Conflict can impact these control measures, reducing the capacity to identify and respond to outbreaks [13].…”

Section: Introductionmentioning

confidence: 99%

“…Targeted attacks on healthcare centres and workers are not limited to specific diseases or geographic regions [15] and there have been several reported attacks on Ebola treatment centres, creating fear and avoidance in accessing them [16]. To protect staff and patients, security forces and military personnel are often required to carry out healthcare activities [10,15,17]. Additionally, fear and mistrust can lead to further attacks, sabotage and disruption of healthcare facilities and services.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Risk of Conflict on Recent Ebola Outbreaks in Guinea and the Democratic Republic of the Congo

Charnley

Kelman

Malembaka

et al. 2023

Preprint

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Background Reducing Ebola virus transmission relies on the ability to limit contact with infected bodily fluids through biosecurity, safe sex practices, safe burial and vaccination. However, armed conflicts can complicate outbreak interventions due to the widespread disruption they cause to the government and the population. Guinea and the Democratic Republic of Congo have historically reported the largest and the most recent Ebola virus outbreaks, and understanding if conflict has played a role in these outbreaks may help in identifying key risks factors which can be used to improve disease control. Methods We used data from a range of publicly available data sources for both Ebola virus cases and conflict events for 2018 to 2021 in Guinea and the DRC. We fitted these data to conditional logistic regression models using the Self-Controlled Case Series methodology, to quantify the magnitude in which conflict increased the risk of reported Ebola virus cases in terms of incidence rate ratio. We re-ran our analysis sub-nationally, by conflict sub-event type and tested the effect of lag. Results Conflict was significantly associated with an increased risk of reported EVD cases in both the DRC and Guinea in recent outbreaks. The effect was of a similar magnitude at 1.88 and 1.98 for the DRC and Guinea, respectively. The greatest effects (often higher than the national values) were found in the most conflict prone areas and during protest/riot-related conflict events. Conflict was influential in terms of Ebola virus risk from 1 week following the event and remained important and, in some cases, more so by 10 weeks. Conclusion Extra vigilance is needed following protests and riot-related conflict events in terms of Ebola virus transmission. These events are highly disruptive in nature, in terms of access to transportation and healthcare and are often in dense urban areas, with high population densities. Additional public health messaging around these types of conflict events, relating to the risks and clinical symptoms may be helpful in reducing transmission. Future work should aim to further understand and quantify conflict severity and intensity, to evaluate a dose-response relationships in terms of disease risk.

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Prevention and post-exposure management of occupational exposure to Ebola virus

Moso,

Lim,

Williams

et al. 2024

The Lancet Infectious Diseases

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Efficiency of Field Laboratories for Ebola Virus Disease Outbreak during Chronic Insecurity, Eastern Democratic Republic of the Congo, 2018–2020

Cited by 4 publications

References 13 publications

Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo

Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo

Evaluating the Risk of Conflict on Recent Ebola Outbreaks in Guinea and the Democratic Republic of the Congo

Prevention and post-exposure management of occupational exposure to Ebola virus

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