Evaluation of centralised and decentralised models of care during the 2020 Ebola Virus Disease outbreak in Equateur Province, Democratic Republic of the Congo: A brief report.

Q2 Pharmacology, Toxicology and Pharmaceutics

F1000Research Pub Date : 2024-08-28 eCollection Date: 2024-01-01 DOI:10.12688/f1000research.150755.2

Emmanuel Lampaert, Justus Nsio Mbeta, Divya Nair, Maria Mashako, Anja De Weggheleire, Armand Sprecher, Rebecca M Coulborn, Steve Ahuka-Mundeke

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Abstract

Background: Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC's Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD.

Methods: This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak.

Results: Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p<0.001). Similarly, time from symptom onset to admission was significantly shorter among EVD-suspected patients ultimately diagnosed as EVD-negative.

Conclusions: Since <5% of the EVD-suspected patients admitted were eventually diagnosed with EVD, there is a need for better screening to optimise resource utilization and outbreak control. Only one in seven EVD-suspected patients were admitted to a DTC first, as the DTCs were piloted in a limited and phased manner. However, there is a case to be made for considering decentralized care especially in remote and hard-to-reach areas in places like the DRC to facilitate early access to care, contain viral shedding by patients with EVD and ensure no disrupted provision of non-EVD services.

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对 2020 年刚果民主共和国赤道省爆发埃博拉病毒疾病期间集中和分散护理模式的评估：简要报告。

背景：在刚果民主共和国（DRC），传统上，集中式埃博拉治疗中心（ETC）专门用于疫情爆发期间的埃博拉病毒病（EVD）病例管理。在 2020 年刚果（金）赤道省爆发埃博拉疫情期间，现有的医疗中心被配备为分散治疗中心（DTC），以改善埃博拉疑似病例患者的就医条件。在 ETC 和 DTC 之间，我们比较了疑似 EVD 患者从症状出现到入院和确诊的时间：这是一项队列研究，基于对疫情爆发期间任何一家 EVD 医疗机构收治的疑似 EVD 患者的人口统计学和临床信息的分析：在2359名疑似EVD患者中，363人（15%）首次入住DTC。在最初入住ETC的1996名EVD疑似患者中，72人（4%）被确诊为EVD阳性。在最初入住DTC的363名EVD疑似患者中，有6人（2%）在DTC被确诊为EVD阳性并接受了治疗。在所有EVD疑似患者中，从症状出现到入院的中位时间（四分位数间距）在DTC为2（1-4）天，而在ETC为4（2-7）天（P结论：由于

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来源期刊

F1000Research Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)

CiteScore

5.00

自引率

0.00%

发文量

1646

审稿时长

1 weeks

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