Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks
Introduction: Viral hemorrhagic fever (VHF) outbreaks, with high mortality rates, have often been amplified in African health institutions due to person-to-person transmission via infected body fluids. By collating and analyzing epidemiological data from documented outbreaks, we observed that diagn...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Journal of Infection in Developing Countries
2014-09-01
|
| Series: | Journal of Infection in Developing Countries |
| Subjects: | |
| Online Access: | https://jidc.org/index.php/journal/article/view/4636 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850193850840121344 |
|---|---|
| author | Iruka N Okeke Robert S Manning Thomas Pfeiffer |
| author_facet | Iruka N Okeke Robert S Manning Thomas Pfeiffer |
| author_sort | Iruka N Okeke |
| collection | DOAJ |
| description | Introduction: Viral hemorrhagic fever (VHF) outbreaks, with high mortality rates, have often been amplified in African health institutions due to person-to-person transmission via infected body fluids. By collating and analyzing epidemiological data from documented outbreaks, we observed that diagnostic delay contributes to epidemic size for Ebola and Marburg hemorrhagic fever outbreaks.
Methodology: We used a susceptible-exposed-infectious-removed (SEIR) model and data from the 1995 outbreak in Kikwit, Democratic Republic of Congo, to simulate Ebola hemorrhagic fever epidemics. Our model allows us to describe the dynamics for hospital staff separately from that for the general population, and to implement health worker-specific interventions.
Results: The model illustrates that implementing World Health Organization/US Centers for Disease Control and Prevention guidelines of isolating patients who do not respond to antimalarial and antibacterial chemotherapy reduces total outbreak size, from a median of 236, by 90% or more. Routinely employing diagnostic testing in post-mortems of patients that died of refractory fevers reduces the median outbreak size by a further 60%. Even greater reductions in outbreak size were seen when all febrile patients were tested for endemic infections or when febrile health-care workers were tested. The effect of testing strategies was not impaired by the 1-3 day delay that would occur if testing were performed by a reference laboratory.
Conclusion: In addition to improving the quality of care for common causes of febrile infections, increased and strategic use of laboratory diagnostics for fever could reduce the chance of hospital amplification of VHFs in resource-limited African health systems.
|
| format | Article |
| id | doaj-art-3da3f85649d44213ae826c2b3cf5ccdb |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2014-09-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-3da3f85649d44213ae826c2b3cf5ccdb2025-08-20T02:14:10ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802014-09-0180910.3855/jidc.4636Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaksIruka N Okeke0Robert S Manning1Thomas Pfeiffer2Haverford College, Haverford, PA, United StatesHaverford College, Haverford, PA, United StatesNZ Institute for Advanced Study, Massey University, Auckland, New ZealandIntroduction: Viral hemorrhagic fever (VHF) outbreaks, with high mortality rates, have often been amplified in African health institutions due to person-to-person transmission via infected body fluids. By collating and analyzing epidemiological data from documented outbreaks, we observed that diagnostic delay contributes to epidemic size for Ebola and Marburg hemorrhagic fever outbreaks. Methodology: We used a susceptible-exposed-infectious-removed (SEIR) model and data from the 1995 outbreak in Kikwit, Democratic Republic of Congo, to simulate Ebola hemorrhagic fever epidemics. Our model allows us to describe the dynamics for hospital staff separately from that for the general population, and to implement health worker-specific interventions. Results: The model illustrates that implementing World Health Organization/US Centers for Disease Control and Prevention guidelines of isolating patients who do not respond to antimalarial and antibacterial chemotherapy reduces total outbreak size, from a median of 236, by 90% or more. Routinely employing diagnostic testing in post-mortems of patients that died of refractory fevers reduces the median outbreak size by a further 60%. Even greater reductions in outbreak size were seen when all febrile patients were tested for endemic infections or when febrile health-care workers were tested. The effect of testing strategies was not impaired by the 1-3 day delay that would occur if testing were performed by a reference laboratory. Conclusion: In addition to improving the quality of care for common causes of febrile infections, increased and strategic use of laboratory diagnostics for fever could reduce the chance of hospital amplification of VHFs in resource-limited African health systems. https://jidc.org/index.php/journal/article/view/4636modelingviral hemorrhagic feverEbola hemorrhagic feveroutbreakhealth workers |
| spellingShingle | Iruka N Okeke Robert S Manning Thomas Pfeiffer Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks Journal of Infection in Developing Countries modeling viral hemorrhagic fever Ebola hemorrhagic fever outbreak health workers |
| title | Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks |
| title_full | Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks |
| title_fullStr | Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks |
| title_full_unstemmed | Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks |
| title_short | Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks |
| title_sort | diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks |
| topic | modeling viral hemorrhagic fever Ebola hemorrhagic fever outbreak health workers |
| url | https://jidc.org/index.php/journal/article/view/4636 |
| work_keys_str_mv | AT irukanokeke diagnosticschemesforreducingepidemicsizeofafricanviralhemorrhagicfeveroutbreaks AT robertsmanning diagnosticschemesforreducingepidemicsizeofafricanviralhemorrhagicfeveroutbreaks AT thomaspfeiffer diagnosticschemesforreducingepidemicsizeofafricanviralhemorrhagicfeveroutbreaks |