Mobilising experience from Ebola to address plague in Madagascar and future epidemics

Sams, Kelley; Desclaux, Alice; Anoko, Julienne Ngoundoung; Akindès, Francis; Egrot, Marc; Sow, Khoudia; Taverne, Bernard; Bila, Blandine; Cros, Michèle; Keïta-Diop, Moustapha; Fribault, Mathieu

doi:10.1016/s0140-6736(17)33088-x

Cited by 10 publications

(8 citation statements)

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“…Accordingly, as a final point highlighted from the Paris workshop, plague research needs an inter-and transdisciplinary approach that involves molecular biologists, immunologists, clinicians, epidemiologists, public health specialists, veterinarians, zoologists, entomologists, mathematical modelling specialists, ecologists, anthropologists, and social scientists. Even in emergency situations, the involvement of anthropologists and social scientists has been considered increasingly relevant [106,107]. An example of such a cross-cutting research could be the identification of reservoir hosts to be targeted for the development and implementation of wildlife vaccination programmes.…”

Section: Discussionmentioning

confidence: 99%

Human plague: An old scourge that needs new answers

et al. 2020

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Yersinia pestis, the bacterial causative agent of plague, remains an important threat to human health. Plague is a rodent-borne disease that has historically shown an outstanding ability to colonize and persist across different species, habitats, and environments while provoking sporadic cases, outbreaks, and deadly global epidemics among humans. Between September and November 2017, an outbreak of urban pneumonic plague was declared in Madagascar, which refocused the attention of the scientific community on this ancient human scourge. Given recent trends and plague's resilience to control in the wild, its high fatality rate in humans without early treatment, and its capacity to disrupt social and PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionmentioning

confidence: 99%

Human plague: An old scourge that needs new answers

et al. 2020

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“…The multinational impact of the 2013–2016 EVD outbreak was unique in scope, but we believe that the key implications of this study might be transferrable to other types of outbreaks. For instance, WHO has acted with greater urgency to contain outbreaks of EVD in Congo (2017), Zika in Brazil (2015) and plague in Madagascar (2017), possibly informed by lessons learnt from the EVD outbreak in West Africa 6 53–55. High-income settings can also be exposed to outbreaks and might face similar challenges to CS or surgical provision.…”

Section: Discussionmentioning

confidence: 99%

“…Human resources are at the core of a resilient health system, and policymakers need to consider that staff have different motivations and fears. Health ministries can prepare for future shocks by ensuring that the health system understands these motivations, because EVD, Lassa fever, and plague resurface cyclically in low-resourced settings 6–8 59. Top-down initiatives can harness the bottom-up resourcefulness displayed by staff during EVD.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the EVD outbreak disrupted non-EVD healthcare services due to fear and reduced provision of health services 2–5. More recent outbreaks of EVD in the Democratic Republic of the Congo and plague in Madagascar have also disrupted routine health services significantly 6–8. This highlights the need for health systems to be resilient and withstand shock in order to manage excess burden of disease caused by the epidemic, in addition to maintaining routine health services 9…”

Section: Introductionmentioning

confidence: 99%

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”For this one, let me take the risk”: why surgical staff continued to perform caesarean sections during the 2014–2016 Ebola epidemic in Sierra Leone

et al. 2019

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IntroductionRoutine health service provision decreased during the 2014–2016 Ebola virus disease (EVD) outbreak in Sierra Leone, while caesarean section (CS) rates at public hospitals did not. It is unknown what made staff provide CS despite the risks of contracting EVD. This study explores Sierra Leonean health worker perspectives of why they continued to provide CS.MethodsThis qualitative study documents the experiences of 15 CS providers who worked during the EVD outbreak. We interviewed surgical and non-surgical CS providers who worked at public hospitals that either increased or decreased CS volumes during the outbreak. Hospitals in all four administrative areas of Sierra Leone were included. Semistructured interviews averaged 97 min and healthcare experience 21 years. Transcripts were analysed by modified framework analysis in the NVivo V.11.4.1 software.ResultsWe identified two themes that may explain why providers performed CS despite EVD risks: (1) clinical adaptability and (2) overcoming the moral dilemmas. CS providers reported being overworked and exposed to infection hazards. However, they developed clinical workarounds to the lack of surgical materials, protective equipment and standard operating procedures until the broader international response introduced formal personal protective equipment and infection prevention and control practices. CS providers reported that dutifulness and sense of responsibility for one’s community increased during EVD, which helped them justify taking the risk of being infected. Although most surgical activities were reduced to minimise staff exposure to EVD, staff at public hospitals tended to prioritise performing CS surgery for women with acute obstetric complications.ConclusionThis study found that CS surgery during EVD in Sierra Leone may be explained by remarkable decisions by individual CS providers at public hospitals. They adapted practically to material limitations exacerbated by the outbreak and overcame the moral dilemmas of performing CS despite the risk of being infected with EVD.

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“…The fight against HIV has shown that the biomedical response is only one aspect, necessary but insufficient, of an effective response to pandemics. The essential role that the humanities and social sciences play in information, reduction of fear and stigma, prevention, screening, treatment adherence, and control policies is well known [ 3 , 4 ]. There can be no effective response if other sectors of society are not also mobilized: financing, education, media and communication, security forces, and diplomacy.…”

Section: Main Textmentioning

confidence: 99%

Toward a global health approach: lessons from the HIV and Ebola epidemics

Raguin¹,

Girard

2018

Global Health

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BackgroundThe imposing burden of non-communicable diseases, emerging infectious diseases, climate change, environmental consequences, migrations, urbanization, and other challenges, faced in a context that strives to make universal health coverage (UHC) a reality, compels global health professionals to ask: how do we construct a “global” roadmap that is both realistic and effective?To move forward and begin to answer this question, we draw on lessons and experiences gained during the “global” health crises triggered by the HIV and Ebola pandemics.Main textImproving the early response and committing to the long haul; developing inter-disciplinary and inter-sectoral responses; designing comprehensive and versatile interventions; and, most importantly, to work closely and effectively with civil society and communities are some of the critical elements that were identified.The health sector has changed dramatically in recent years; new tools and innovative technologies are transforming the culture and practice of public health. This calls for a new vision.Reprioritizing primary health care and community engagement, repositioning approaches to meet people’s needs, applying integrated disease management to respond to problems caused by the silo approach, implementing UHC, and ensuring equity are some of the new strategies.ConclusionThese strategies must all undergo a mandatory revolution in health governance—locally and globally. It should be obvious that nothing can be improved on a global or sustainable scale without re-examining the architecture and governance of major funding and international organizations dedicated to health.Pressing economic, demographic, and climate issues related to health underscore the urgent need for these changes.

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Mobilising experience from Ebola to address plague in Madagascar and future epidemics

Cited by 10 publications

References 0 publications

Human plague: An old scourge that needs new answers

Human plague: An old scourge that needs new answers

”For this one, let me take the risk”: why surgical staff continued to perform caesarean sections during the 2014–2016 Ebola epidemic in Sierra Leone

Toward a global health approach: lessons from the HIV and Ebola epidemics

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