Evaluation of contact tracing performance during an Ebola virus disease outbreak in a complex security environment: the case of North Kivu province, Democratic Republic of the Congo, 2018-2020.

IF 3.1 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Willy Ngalamulume, Harry César Kayembe, Guy Mutombo, Mathias Mossoko, Annie Mutombo, Didier Bompangue
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Abstract

Background: Contact tracing remains a pillar public health strategy for containing Ebola virus disease (EVD). During the 2018-2020 EVD outbreak in the Democratic Republic of the Congo (DRC), contact tracing was implemented on an unprecedented scale. Here, we assessed performance of contact tracing implemented in affected health zones, and identified risk factors associated with incomplete follow-up.

Methods: We performed a retrospective descriptive data analysis of 129,749 contacts in the contact line lists of North Kivu province between August 1, 2018 to June 25, 2020. Coverage, completeness, timeliness, and duration of contact tracing were determined to assess the performance of contact tracing implemented by field actors. Bivariate and multivariate logistic regression models were used to identify factors associated with incomplete contact tracing.

Results: Overall, more than 90% of all contacts initially identified and listed were monitored. However, 9.1% of contacts who had monitoring initiated had completed the 21 days follow-up. The median days between identification and the start of follow-up and duration contact follow-up were 3 (1-6) and 17 (12-19), respectively. The risk of incomplete follow-up was higher among contacts from urban and conflict-affected health zones.

Conclusion: Our findings indicate the necessity of prioritizing contact tracing in urban areas. This can be achieved by engaging locally trusted stakeholders to build community confidence. Furthermore, integrating digital contact tracing solutions may enhance the efficacy of traditional manual contact tracing.

复杂安全环境下埃博拉病毒疫情期间接触者追踪绩效评估:以2018-2020年刚果民主共和国北基伍省为例
背景:接触者追踪仍然是遏制埃博拉病毒病的一项支柱公共卫生战略。2018-2020年刚果民主共和国埃博拉病毒病暴发期间,以前所未有的规模开展了接触者追踪工作。在这里,我们评估了在受影响卫生区实施的接触者追踪的绩效,并确定了与不完整随访相关的风险因素。方法:对北基伍省2018年8月1日至2020年6月25日接触者名单中的129749名接触者进行回顾性描述性数据分析。确定接触者追踪的覆盖范围、完整性、及时性和持续时间,以评估现场参与者实施的接触者追踪的绩效。使用双变量和多变量逻辑回归模型来确定与不完全接触者追踪相关的因素。结果:总体而言,最初确定和列出的所有接触者中有90%以上得到了监测。然而,9.1%开始监测的接触者完成了21天的随访。确诊至随访开始和接触随访时间的中位天数分别为3(1-6)天和17(12-19)天。来自城市和受冲突影响卫生区的接触者随访不完全的风险更高。结论:我们的研究结果表明,有必要在城市地区优先开展接触者追踪工作。这可以通过与当地值得信赖的利益相关者合作来建立社区信心来实现。此外,集成数字接触追踪解决方案可以提高传统人工接触追踪的效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Conflict and Health
Conflict and Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
6.10
自引率
5.60%
发文量
57
审稿时长
18 weeks
期刊介绍: Conflict and Health is a highly-accessed, open access journal providing a global platform to disseminate insightful and impactful studies documenting the public health impacts and responses related to armed conflict, humanitarian crises, and forced migration.
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