Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo

# Background The Democratic Republic of Congo declared their tenth outbreak of Ebola in North Kivu in 2018, which was the second-largest in the world and took place in an active conflict zone. Transmission of Ebola occurs by direct contact with infected bodily fluids and can occur within facilities...

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Main Authors: Kevin Ousman, Meaghan Thumath, Gillian McKay, David Niyukuri, Didier Mwesha Ombeni, Landry Kabego, Berthe Banzua, Samuel Mangala, Robert Tatabod, Patrick Mirindi N., Ambrose Talisuna, Bienvenu Houndjo, Mory Kieta, April Baller
Format: Article
Language:English
Published: Inishmore Laser Scientific Publishing Ltd 2022-09-01
Series:Journal of Global Health Reports
Online Access:https://doi.org/10.29392/001c.36558
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author Kevin Ousman
Meaghan Thumath
Gillian McKay
David Niyukuri
Didier Mwesha Ombeni
Landry Kabego
Berthe Banzua
Samuel Mangala
Robert Tatabod
Patrick Mirindi N.
Ambrose Talisuna
Bienvenu Houndjo
Mory Kieta
April Baller
author_facet Kevin Ousman
Meaghan Thumath
Gillian McKay
David Niyukuri
Didier Mwesha Ombeni
Landry Kabego
Berthe Banzua
Samuel Mangala
Robert Tatabod
Patrick Mirindi N.
Ambrose Talisuna
Bienvenu Houndjo
Mory Kieta
April Baller
author_sort Kevin Ousman
collection DOAJ
description # Background The Democratic Republic of Congo declared their tenth outbreak of Ebola in North Kivu in 2018, which was the second-largest in the world and took place in an active conflict zone. Transmission of Ebola occurs by direct contact with infected bodily fluids and can occur within facilities when infection prevention and control (IPC) precautions are not strictly practised. # Methods To develop infection prevention and control (IPC) standards in health facilities, 45 medical students were trained and placed in 101 health facilities to mentor healthcare workers and support IPC practices between February and October 2019. A mixed-methods retrospective evaluation of quality improvement in North Kivu was conducted in October and November 2019 to capture key lessons from such a pilot IPC project. Five focus groups (N=49) and 42 key-informant interviews were conducted in addition to a secondary analysis of surveillance and programmatic data collected during the intervention. # Results The intervention contributed 1.83 times (95% confidence interval, CI=1.10-3.06) to increased the likelihood of health facilities achieving an IPC score of 80% or above compared with facilities that did not receive the intervention. Overall, we found the odds of Ebola cases declining three times more likely in Butembo and Katwa (odds ratio, OR=3.00, 95% CI=1.87-5.62) relative to ten health zones in the region that were not reached by the intervention. # Conclusions The results are difficult to attribute to any one type of intervention, given the number of other interventions implemented concurrently during the outbreak response. Further evaluations should be conducted to assess the cost-effectiveness of using medical students in conflict resolution and IPC, and to assess the suitability of scaling these approaches to other settings and diseases.
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spelling doaj-art-d16163c663774526962a7886c58d32d62025-08-20T02:07:06ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232022-09-01610.29392/001c.36558Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the CongoKevin OusmanMeaghan ThumathGillian McKayDavid NiyukuriDidier Mwesha OmbeniLandry KabegoBerthe BanzuaSamuel MangalaRobert TatabodPatrick Mirindi N.Ambrose TalisunaBienvenu HoundjoMory KietaApril Baller# Background The Democratic Republic of Congo declared their tenth outbreak of Ebola in North Kivu in 2018, which was the second-largest in the world and took place in an active conflict zone. Transmission of Ebola occurs by direct contact with infected bodily fluids and can occur within facilities when infection prevention and control (IPC) precautions are not strictly practised. # Methods To develop infection prevention and control (IPC) standards in health facilities, 45 medical students were trained and placed in 101 health facilities to mentor healthcare workers and support IPC practices between February and October 2019. A mixed-methods retrospective evaluation of quality improvement in North Kivu was conducted in October and November 2019 to capture key lessons from such a pilot IPC project. Five focus groups (N=49) and 42 key-informant interviews were conducted in addition to a secondary analysis of surveillance and programmatic data collected during the intervention. # Results The intervention contributed 1.83 times (95% confidence interval, CI=1.10-3.06) to increased the likelihood of health facilities achieving an IPC score of 80% or above compared with facilities that did not receive the intervention. Overall, we found the odds of Ebola cases declining three times more likely in Butembo and Katwa (odds ratio, OR=3.00, 95% CI=1.87-5.62) relative to ten health zones in the region that were not reached by the intervention. # Conclusions The results are difficult to attribute to any one type of intervention, given the number of other interventions implemented concurrently during the outbreak response. Further evaluations should be conducted to assess the cost-effectiveness of using medical students in conflict resolution and IPC, and to assess the suitability of scaling these approaches to other settings and diseases.https://doi.org/10.29392/001c.36558
spellingShingle Kevin Ousman
Meaghan Thumath
Gillian McKay
David Niyukuri
Didier Mwesha Ombeni
Landry Kabego
Berthe Banzua
Samuel Mangala
Robert Tatabod
Patrick Mirindi N.
Ambrose Talisuna
Bienvenu Houndjo
Mory Kieta
April Baller
Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo
Journal of Global Health Reports
title Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo
title_full Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo
title_fullStr Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo
title_full_unstemmed Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo
title_short Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo
title_sort evaluation of a health systems strengthening intervention to improve ebola virus disease infection prevention and control in the democratic republic of the congo
url https://doi.org/10.29392/001c.36558
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