Forty-two years of responding to Ebola virus outbreaks in Sub-Saharan Africa: a review

Rugarabamu, Sima; Mboera, Leonard E. G.; Rweyemamu, Mark M.; Mwanyika, Gaspary O.; Lutwama, Julius J.; Pawęska, Janusz T.; Misinzo, Gerald

doi:10.1136/bmjgh-2019-001955

Cited by 49 publications

(47 citation statements)

References 59 publications

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“…Engaging with and educating communities is essential to curb transmission of EVD and facilitate confidence and participation in the response. 57 Moreover, research conducted during the outbreak of EVD further indicates that robust, well-coordinated education for HCWs decreased levels of fear 40 and may also increase motivation to provide MHS during outbreaks of EVD. Further, peer support for HCWs, both in person and via social media, increased motivation and confidence in providing health services.…”

Section: Discussionmentioning

confidence: 99%

Barriers to maternal health services during the Ebola outbreak in three West African countries: a literature review

et al. 2020

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IntroductionThe Ebola virus disease (EVD) outbreak in West Africa, affecting Guinea, Liberia and Sierra Leone from 2014 to 2016, was a substantial public health crisis with health impacts extending past EVD itself. Access to maternal health services (MHS) was disrupted during the epidemic, with reductions in antenatal care, facility-based deliveries and postnatal care. We aimed to identify and describe barriers related to the uptake and provision of MHS during the 2014–2016 EVD outbreak in West Africa.MethodsIn June 2020, we conducted a scoping review of peer-reviewed publications and grey literature from relevant stakeholder organisations. Search terms were generated to identify literature that explained underlying access barriers to MHS. Published literature in scientific journals was first searched and extracted from PubMed and Web of Science databases for the period between 1 January 2014 and 27 June 2020. We hand-searched relevant stakeholder websites. A ‘snowball’ approach was used to identify relevant sources uncaptured in the systematic search. The identified literature was examined to synthesise themes using an existing framework.ResultsNineteen papers were included, with 26 barriers to MHS uptake and provision identified. Three themes emerged: (1) fear and mistrust, (2) health system and service constraints, and (3) poor communication. Our analysis of the literature indicates that fear, experienced by both service users and providers, was the most recurring barrier to MHS. Constrained health systems negatively impacted MHS on the supply side. Poor communication and inadequately coordinated training efforts disallowed competent provision of MHS.ConclusionsBarriers to accessing MHS during the EVD outbreak in West Africa were influenced by complex but inter-related factors at the individual, interpersonal, health system and international level. Future responses to EVD outbreaks need to address underlying reasons for fear and mistrust between patients and providers, and ensure MHS are adequately equipped both routinely and during crises.

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Section: Discussionmentioning

confidence: 99%

Barriers to maternal health services during the Ebola outbreak in three West African countries: a literature review

et al. 2020

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“…The peaks observed coincide with important public health events that motivated temporary spikes in research interest, especially the H1N1 pandemic flu in 2009–2010 [ 34 , 37 ]. In the most recent study period (2015–2019), scientific output also increased in response to the outbreaks of Ebola in both West Africa in 2013–2014 [ 43 ] and in the Democratic Republic of the Congo and Uganda in 2018 [ 36 ], Zika in the Americas and Southeast Asia in 2015–2016 [ 44 ], measles in the Democratic Republic of the Congo in 2019, and dengue in the Asian Pacific and Latin America in 2019.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, in other areas of biomedical research, the distribution of research publications is more balanced, for example in pneumonia (42% in North America versus 41% in Europe) [ 45 ]. The participation of Africa (5.6%) and Latin America and the Caribbean (4.3%) is far from ideal, not just because a large portion of epidemic outbreaks with a global projection originate in these regions [ 46 ], but because their countries bear a disproportionate disease burden for both infectious diseases and NCDs, even though the latter are traditionally associated with high-income countries [ 36 , 47 ]. This low level of scientific output reflects the limited public health surveillance systems with a very pronounced disparity among low- and middle-income countries in general [ 48 , 49 ] as well as in the BRIC countries (Brazil, Russia, India, and China) specifically [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

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Systematic analysis of the scientific literature on population surveillance

González‐Alcaide¹,

Llorente²,

Ramos‐Rincón³

2020

Heliyon

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Introduction Population surveillance provides data on the health status of the population through continuous scrutiny of different indicators. Identifying risk factors is essential for the quickly detecting and controlling of epidemic outbreaks and reducing the incidence of cross-infections and non-communicable diseases. The objective of the present study is to analyze research on population surveillance, identifying the main topics of interest for investigators in the area. Methodology We included documents indexed in the Web of Science Core Collection in the period from 2000 to 2019 and assigned with the generic Medical Subject Heading (MeSH) “population surveillance” or its related terms (“public health surveillance,” “sentinel surveillance” or “biosurveillance”). A co-occurrence analysis was undertaken to identify the document clusters comprising the main research topics. Scientific production, collaboration, and citation patterns in each of the clusters were characterized bibliometrically. We also analyzed research on coronaviruses, relating the results obtained to the management of the COVID-19 pandemic. Results We included 39,184 documents, which reflected a steady growth in scientific output driven by papers on “Public, Environmental & Occupational Health” (21.62% of the documents) and “Infectious Diseases” (10.49%). Research activity was concentrated in North America (36.41%) and Europe (32.09%). The USA led research in the area (40.14% of documents). Ten topic clusters were identified, including “Disease Outbreaks,” which is closely related to two other clusters (“Genetics” and “Influenza”). Other clusters of note were “Cross Infections” as well as one that brought together general public health concepts and topics related to non-communicable diseases (cardiovascular and coronary diseases, mental diseases, diabetes, wound and injuries, stroke, and asthma). The rest of the clusters addressed “Neoplasms,” “HIV,” “Pregnancy,” “Substance Abuse/Obesity,” and “Tuberculosis.” Although research on coronavirus has focused on population surveillance only occasionally, some papers have analyzed and collated guidelines whose relevance to the dissemination and management of the COVID-19 pandemic has become obvious. Topics include tracing the spread of the virus, limiting mass gatherings that would facilitate its propagation, and the imposition of quarantines. There were important differences in the scientific production and citation of different clusters: the documents on mental illnesses, stroke, substance abuse/obesity, and cross-infections had much higher citations than the clusters on disease outbreaks, tuberculosis, and especially coronavirus, where these values are substantially lower. Conclusions The role of population surveillance should be strengthened, promoting research and the development of public health surveillance systems in countries whose contribution to the area is limited.

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“…Moreover, civil unrest, improved communication and several socio-determinant factors have been associated with the spread of emerging infectious diseases in Africa [6][7][8]. Unfortunately, the region has a relatively low capacity for risk management of disease epidemics, mainly due to inadequate resources for early detection, identi cation, and prompt response [9].…”

Section: Introductionmentioning

confidence: 99%

Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

Mremi

George

Rumisha

et al. 2020

Preprint

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Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: A search for eligible articles was done through HINARI, PubMed, and advanced Google Scholar databases. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. Using the key search descriptors, 1,809 articles were identified and screened at two stages and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions while 42 studies assessed the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilized and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.

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Forty-two years of responding to Ebola virus outbreaks in Sub-Saharan Africa: a review

Cited by 49 publications

References 59 publications

Barriers to maternal health services during the Ebola outbreak in three West African countries: a literature review

Barriers to maternal health services during the Ebola outbreak in three West African countries: a literature review

Systematic analysis of the scientific literature on population surveillance

Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

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