scholarly journals 1666. Community Beliefs about Ebola and Implications for Disease Control in Eastern Democratic Republic of the Congo

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S609-S609
Author(s):  
Qaasim Mian ◽  
Kasereka Masumbuko Claude ◽  
Michael Hawkes

Abstract Background The current Ebola epidemic in Eastern Democratic Republic of the Congo (DRC) has surpassed 1,300 cases and 800 deaths. Social resistance is a major barrier to control efforts, and invites an exploration of community beliefs around Ebola and its origins. Methods Mixed-methods study, using focus group discussions (FGDs) with key community informants and a 19-item survey questionnaire broadly sampling the outbreak zone. Results Between 4 to 17 August, 2018, we conducted 4 FGDs (20 participants) and surveyed 286 community members across Eastern DRC. FGDs revealed a widespread rumor in Mangina early in the epidemic of two twins bewitched by their aunt after eating her cat, who developed bleeding symptoms and triggered the epidemic. However, this myth appeared to dissipate as the epidemic progressed and biomedical transmission became generally accepted (medical syncretism). In our survey, 6% of respondents endorsed supernatural origins of Ebola. This subgroup did not differ from other respondents in terms of knowledge of biomedical modes of transmission or resistant attitudes toward infection control measures, but was more likely to believe that traditional healers could cure Ebola. Wild animals of the forest were recognized as sources of the Ebola virus by 53% of survey respondents. Our findings suggest that skepticism and/or denial of the biomedical discourse, coupled with and mistrust and fear of ETUs may fuel “underground” transmission of Ebola outside western-style medical facilities, as patients seek care from traditional healers, who are ill-equipped to deal with a highly contagious biohazard. Conclusion A deeper understanding of beliefs around Ebola origins may illuminate strategies to engage communities in control efforts. Disclosures All authors: No reported disclosures.

2019 ◽  
Vol 4 (4) ◽  
pp. e001529 ◽  
Author(s):  
Sarah L Dalglish ◽  
Sarah Straubinger ◽  
Justine A Kavle ◽  
Lacey Gibson ◽  
Evariste Mbombeshayi ◽  
...  

Recent years have seen increasing momentum towards task shifting of basic health services, including using community health workers (CHW) to diagnose and treat common childhood illnesses. Yet few studies have examined the role of traditional healers in meeting families’ and communities’ health needs and liaising with the formal health system. We examine these issues in Tshopo Province in the Democratic Republic of the Congo, a country with high rates of child mortality (104 deaths per 1000 live births). We conducted 127 in-depth interviews and eight focus group discussions with a range of community members (mothers, fathers and grandmothers of children under 5 years of age) and health providers (CHWs, traditional healers, doctors and nurses) on topics related to care seeking and case management for childhood illness and malnutrition, and analysed them iteratively using thematic content analysis. We find significant divergence between biomedical descriptions of child illness and concepts held by community members, who distinguished between local illnesses and so-called ‘white man’s diseases.’ Traditional healers were far less costly and more geographically accessible to families than were biomedical health providers, and usually served as families’ first recourse after home care. Services provided by traditional healers were also more comprehensive than services provided by CHWs, as the traditional medicine sphere recognised and encompassed care for ‘modern’ diseases (but not vice versa). Meanwhile, CHWs did not receive adequate training, supervision or supplies to provide child health services. Considering their accessibility, acceptability, affordability and ability to recognise all domains of illness (biomedical and spiritual), traditional healers can be seen as the de facto CHWs in Tshopo Province. National and international health policymakers should account for and involve this cadre of health workers when planning child health services and seeking to implement policies and programmes that genuinely engage with community health systems.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Célestin Kaputu-Kalala-Malu ◽  
Eric Mafuta Musalu ◽  
Tim Walker ◽  
Olga Ntumba-Tshitenge ◽  
Steve Ahuka-Mundeke

Abstract Background Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town’s general hospital. Methods A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors who came for follow up from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics were used to summarized data and Pearson’s or likelihood chi-square were used to test association between psychiatric disorders and associated factors. Results The prevalence of PTSD, depression and anxiety was 24.3, 24.3 and 33.3% respectively. Being male (OR = 0.42, 95% CI: 0.16, 0.95, p = 0.049), suffering from persistent headache (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014), losing a loved one because of EVD (OR: 2.60, 95% CI: 1.11, 6.15, p = 0. 015) and being young − 18-24 years - (OR: 0. 261, 95% CI: 0. 08, 0.82, p = 0,026) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (OR = 2.44, 95% CI: 1.03, 5.82, p = 0.026); (OR = 2.24, 95% CI: 1.04, 4.85, p = 0.025); (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014); (OR = 2.31, 95% CI: 1.06, 5.01, p = 0.020). Conclusion The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC.


Author(s):  
Anand Marya ◽  
Mohmed Isaqali Karobari ◽  
Siddharthan Selvaraj ◽  
Abdul Habeeb Adil ◽  
Ali A. Assiry ◽  
...  

Objective: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a face-to-face contact area. Methods: A structured self-administered questionnaire was developed at Najran University and provided to the participants for data collection. The data collected included information on risk perception and incorporation of measures for protection against COVID-19 to gauge the attitude of dentists during this period. Also, clinical implementation of various protective measures was reviewed. Results: Of the n = 322 dentists that answered the questions, 50% were general dentists and 28.9% were dentists working at specialist clinics, while the remaining 21.1% of dentists were employed in academic institutions. Among the newer additions to the clinic, 36.3% of dentists answered that they had added atomizers to their practices, followed by 26.4% of dentists that had incorporated the use of UV lamps for sterilization. We found that 18.9% dentists were using HEPA filters in their clinics, while 9.9% of dentists were making use of fumigation devices to control the risk of infection. One-way ANOVA was also carried out to demonstrate that there was a statistically significant difference (p = 0.049) between groups of dentists utilizing HEPA filters, UV lamps, atomizers, and fumigation devices to prevent the spread of SARS-CoV2 across their workplaces. Conclusion: Dentists are aware of recently updated knowledge about the modes of transmission of COVID-19 and the recommended infection control measures in dental settings. A better understanding of the situation and methods to prevent it will ensure that the dental community is able to provide healthcare services to patients during the pandemic.


2021 ◽  
pp. 0734242X2110481
Author(s):  
Gabriel Kalombe Kyomba ◽  
Joêl Nkiama Numbi Konde ◽  
Diafuka Saila-Ngita ◽  
Thomas Kuanda Solo ◽  
Guillaume Mbela Kiyombo

Incineration is the most used healthcare waste (HCW) disposal method. Disease outbreaks due to Ebola virus and SARS-CoV2 require attention to HCW management to avoid pathogens spread and spillover. This study describes HCW management prior to incineration and hospital incinerators performance by analysing bottom ashes from hospitals in Kinshasa, Democratic Republic of Congo. We used semi-structured interviews to capture information on pre-incineration waste management and analysed the chemical composition of 27 samples of incinerator bottom ashes using the energy dispersive X-ray fluorescence. Neither sorting nor waste management measures were applied at hospitals surveyed. Incinerator operators were poorly equipped and their knowledge was limited. The bottom ash concentrations of cadmium, chromium, nickel and lead ranged between 0.61–10.44, 40.15–737.01, 9.11–97.55 and 16.37–240.03 mg kg−1, respectively. Compared to Chinese incinerator performance, the concentrations of some elements were found to be lower than those from China. This discrepancy may be explained by the difference in the composition of HCW. The authors conclude that health care waste in Kinshasa hospitals is poorly managed, higher concentrations of heavy metals are found in incinerator bottom ashes and the incinerators quality is poor. They recommend the strict application of infection prevention control measures, the training of incinerator operators and the use of high-performance incinerators.


2020 ◽  
Vol 8 ◽  
Author(s):  
Kathryn E. L. Grimes ◽  
Bonaventure Fuamba Ngoyi ◽  
Kristen B. Stolka ◽  
Jennifer J. Hemingway-Foday ◽  
Leopold Lubula ◽  
...  

2020 ◽  
Vol 222 (12) ◽  
pp. 2021-2029
Author(s):  
John Daniel Kelly ◽  
Sarah Rae Wannier ◽  
Cyrus Sinai ◽  
Caitlin A Moe ◽  
Nicole A Hoff ◽  
...  

Abstract Background Our understanding of the different effects of targeted versus nontargeted violence on Ebola virus (EBOV) transmission in Democratic Republic of the Congo (DRC) is limited. Methods We used time-series data of case counts to compare individuals in Ebola-affected health zones in DRC, April 2018–August 2019. Exposure was number of violent events per health zone, categorized into Ebola-targeted or Ebola-untargeted, and into civilian-induced, (para)military/political, or protests. Outcome was estimated daily reproduction number (Rt) by health zone. We fit linear time-series regression to model the relationship. Results Average Rt was 1.06 (95% confidence interval [CI], 1.02–1.11). A mean of 2.92 violent events resulted in cumulative absolute increase in Rt of 0.10 (95% CI, .05–.15). More violent events increased EBOV transmission (P = .03). Considering violent events in the 95th percentile over a 21-day interval and its relative impact on Rt, Ebola-targeted events corresponded to Rt of 1.52 (95% CI, 1.30–1.74), while civilian-induced events corresponded to Rt of 1.43 (95% CI, 1.21–1.35). Untargeted events corresponded to Rt of 1.18 (95% CI, 1.02–1.35); among these, militia/political or ville morte events increased transmission. Conclusions Ebola-targeted violence, primarily driven by civilian-induced events, had the largest impact on EBOV transmission.


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