Knowledge and practice of Ebola virus disease preventive measures among health workers in a tertiary hospital in Northern Nigeria

Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. The objective of this study was to understand frontline physicians’ and nurses’ perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. Methods: We surveyed frontline physicians and nurses deployed to West Africa between March and September of 2014. Results: We developed the protocol, obtained ethics approval, delivered the survey, analysed the data and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated within eight weeks. Forty-four physicians and nurses responded to the survey. They generally felt at low or extremely low risk of virus transmission with all types of PPE used. Eye protection reduced the ability to provide care, mainly due to impaired visibility because of fogging. Heat and dehydration were a major issue for 76% of the participants using goggles and for 64% using a hood. Both gowns and coveralls were associated with significant heat stress and dehydration. Most participants (59%) were very confident that they were using PPE correctly. Conclusion: Our study demonstrated that it was possible to incorporate primary data on end-users’ preferences into a rapid advice guideline for a public health emergency in difficult field conditions. Health workers perceived a balance between transmission protection and ability to care for patients effectively while wearing PPE. These findings were used by the guideline development expert panel to formulate WHO recommendations on PPE for frontline providers caring for EVD patients in outbreak conditions.

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Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0008872 ◽

2020 ◽

Vol 14 (11) ◽

pp. e0008872

Author(s):

Olushayo Oluseun Olu ◽

Richard Lako ◽

Sudhir Bunga ◽

Kibebu Berta ◽

Matthew Kol ◽

...

Keyword(s):

Management System ◽

Ebola Virus ◽

Health Workers ◽

Virus Disease ◽

South Sudan ◽

Case Definition ◽

Rapid Response ◽

Ebola Virus Disease ◽

Rapid Response Teams ◽

Cross Sectional

South Sudan implemented Ebola virus disease preparedness interventions aiming at preventing and rapidly containing any importation of the virus from the Democratic Republic of Congo starting from August 2018. One of these interventions was a surveillance system which included an Ebola alert management system. This study analyzed the performance of this system. A descriptive cross-sectional study of the Ebola virus disease alerts which were reported in South Sudan from August 2018 to November 2019 was conducted using both quantitative and qualitative methods. As of 30 November 2019, a total of 107 alerts had been detected in the country out of which 51 (47.7%) met the case definition and were investigated with blood samples collected for laboratory confirmation. Most (81%) of the investigated alerts were South Sudanese nationals. The alerts were identified by health workers (53.1%) at health facilities, at the community (20.4%) and by screeners at the points of entry (12.2%). Most of the investigated alerts were detected from the high-risk states of Gbudwe (46.9%), Jubek (16.3%) and Torit (10.2%). The investigated alerts commonly presented with fever, bleeding, headache and vomiting. The median timeliness for deployment of Rapid Response Team was less than one day and significantly different between the 6-month time periods (K-W = 7.7567; df = 2; p = 0.0024) from 2018 to 2019. Strengths of the alert management system included existence of a dedicated national alert hotline, case definition for alerts and rapid response teams while the weaknesses were occasional inability to access the alert toll-free hotline and lack of transport for deployment of the rapid response teams which often constrain quick response. This study demonstrates that the Ebola virus disease alert management system in South Sudan was fully functional despite the associated challenges and provides evidence to further improve Ebola preparedness in the country.

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Knowledge, Attitude, and Practice of Use of Safety Precautions Among Health Care Workers in a Nigerian Tertiary Hospital, 1 Year After the Ebola Virus Disease Epidemic

Annals of Global Health ◽

10.1016/j.aogh.2016.07.004 ◽

2017 ◽

Vol 82 (5) ◽

pp. 897 ◽

Cited By ~ 6

Author(s):

Wasiu Olalekan Adebimpe

Keyword(s):

Health Care ◽

Health Care Workers ◽

Ebola Virus ◽

Virus Disease ◽

Tertiary Hospital ◽

Ebola Virus Disease ◽

Attitude And Practice ◽

Care Workers ◽

Knowledge Attitude And Practice

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A multi-site assessment of knowledge of Ebola virus disease among health workers in south-west Nigeria

Research Journal of Health Sciences ◽

10.4314/rejhs.v5i3.5 ◽

2017 ◽

Vol 5 (3) ◽

pp. 159

Author(s):

A.O. Joseph ◽

A.Y. Mohammed ◽

A Raji ◽

E Atolagbe ◽

A Joseph ◽

...

Keyword(s):

Ebola Virus ◽

Health Workers ◽

Virus Disease ◽

Ebola Virus Disease ◽

Site Assessment ◽

South West

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Economic impact of Ebola Virus Disease outbreak on an extractive firm: a case study

10.14324/111.444/000023.v1 ◽

2019 ◽

Author(s):

Hisham Tariq ◽

Alexander Light ◽

...

Keyword(s):

Economic Impact ◽

Ebola Virus ◽

Preventive Measures ◽

Virus Disease ◽

Ebola Virus Disease ◽

Disease Spread ◽

Humanitarian Response ◽

Cost Impact ◽

Using Data ◽

Relational Costs

Purpose: The Ebola Virus Disease (EVD) outbreak was the most severe public health emergency in modern times. The economic impact of outbreaks has mostly been analysed at the macroeconomic level. Conversely, we aimed to estimate the economic costs of preventive measures of the outbreak to an extractive firm, ArcelorMittal, using data in the outbreak region from March 2014 to December 2015. ArcelorMittal is the worlds largest steel producer and particularly important in West Africa, where the extractive industry is economically crucial. Methods: Qualitative methods, in-depth interviews and focus group discussions, were used to investigate the events and channels of impact of the outbreak on the firm, as perceived by employees and contractors. Quantitative data regarding these costs was also collected. Retrospective cost analysis estimated the actual cost of preventive methods adopted. Results: Most respondents indicated the largest cost impact was suspension of Phase II expansion, a series of projects designed to increase iron ore production in Liberia. The next largest cost was the preventive measures adopted to counter disease spread. Total costs incurred for adopting preventive measures was USD 10.58-11.11 million. The overall direct costs of preventive measures adopted within the fence shared 30-31% of the total costs incurred. The share of external donation supporting humanitarian response was 11-12% of the total costs, followed by 7-12% of relational costs. Conclusions: The firms response during the EVD outbreak focused on its employees and operations, which was later expanded to the wider community and then in supporting the international humanitarian response.

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Enhancing Ebola Virus Disease Surveillance And Prevention In Counties Without Confirmed Cases In Rural Liberia: Experiences From Sinoe County During The Flare-Up In Monrovia, April To June, 2016

10.1101/139154 ◽

2017 ◽

Author(s):

Vera Darling Weah ◽

John S. Doedeh ◽

Samson Q. Wiah ◽

Emmanuel Nyema ◽

Siafa Lombeh ◽

...

Keyword(s):

Community Engagement ◽

Control Strategy ◽

Disease Surveillance ◽

Ebola Virus ◽

Health Workers ◽

Virus Disease ◽

Ebola Virus Disease ◽

Infection Prevention And Control ◽

Cross Sectional ◽

The Impact

AbstractIntroductionDuring the flare-ups of Ebola virus disease (EVD) in Liberia, Sinoe County reactivated the multi-sectorial EVD control strategy in order to be ready to respond to the eventual reintroduction of cases.This paper describes the impacts of the interventions implemented in Sinoe County during the last flare-up in Monrovia, from April 1 to June 9, 2016, using the resources provided during the original outbreak that ended one year back.MethodsWe conducted a descriptive study to describe the key interventions implemented in Sinoe County, the capacity available, the implications for the reactivation of the multi-sectoral EVD control strategy, and the results of the same. We also conducted a cross-sectional study to analyze the impact of the interventions on the surveillance and on infection prevention and control (IPC).ResultsThe attrition of the staff trained during the original outbreak was low, and most of the supplies, equipment, and infrastructure from the original outbreak remained available.With an additional US$1755, improvements were observed in the IPC indicators of triage, which increased from a mean of 60% during the first assessment to 77% (P=0.002). Additionally, personal/staff training improved from 78% to 89% (P=0.04).The percentage of EVD death alerts per expected deaths investigated increased from 26% to 63% (P<0.0001).DiscussionThe small attrition of the trained staff and the availability of most of the supplies, equipment, and infrastructure made the reactivation of the multi-sectoral EVD control strategy fast and affordable. The improvement of the EVD surveillance was possibly affected by the community engagement activities, awareness and mentoring of the health workers, and improved availability of clinicians in the facilities during the flare-up. The community engagement may contribute to the report of community-based events, specifically community deaths. The mentoring of the staff during the supportive supervisions also contributed to improve the IPC indicators.

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Incorporating health workers’ perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak

F1000Research ◽

10.12688/f1000research.12922.1 ◽

2018 ◽

Vol 7 ◽

pp. 45 ◽

Cited By ~ 6

Author(s):

Saskia Den Boon ◽

Constanza Vallenas ◽

Mauricio Ferri ◽

Susan L. Norris

Keyword(s):

Public Health ◽

West Africa ◽

Personal Protective Equipment ◽

Ebola Virus ◽

Expert Panel ◽

Health Workers ◽

Virus Disease ◽

Ebola Virus Disease ◽

World Health ◽

Protective Equipment

Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. The objective of this study was to understand frontline physicians’ and nurses’ perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. Methods: We surveyed frontline physicians and nurses deployed to West Africa between March and September of 2014. Results: We developed the protocol, obtained ethics approval, delivered the survey, analysed the data and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated within eight weeks. Forty-four physicians and nurses responded to the survey. They generally felt at low or extremely low risk of virus transmission with all types of PPE used. Eye protection reduced the ability to provide care, mainly due to impaired visibility because of fogging. Heat and dehydration were a major issue for 76% of the participants using goggles and for 64% using a hood. Both gowns and coveralls were associated with significant heat stress and dehydration. Most participants (59%) were very confident that they were using PPE correctly. Conclusion: Our study demonstrated that it was possible to incorporate primary data on end-users’ preferences into a rapid advice guideline for a public health emergency in difficult field conditions. Health workers perceived a balance between transmission protection and ability to care for patients effectively while wearing PPE. These findings were used by the guideline development expert panel to formulate WHO recommendations on PPE for frontline providers caring for EVD patients in outbreak conditions.

Download Full-text