2020 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation

Kinganda-Lusamaki, Eddy; Whitmer, Shannon; Lokilo-Lofiko, Emmanuel; Amuri-Aziza, Adrienne; Muyembe-Mawete, Francisca; Makangara-Cigolo, Jean Claude; Makaya, Gerry; Mbuyi, Francis; Whitesell, Amy; Kallay, Ruth; Choi, Mary; Pratt, Catherine; Mukadi-Bamuleka, Daniel; Kavunga-Membo, Hugo; Matondo-Kuamfumu, Meris; Mambu-Mbika, Fabrice; Ekila-Ifinji, Richard; Shoemaker, Trevor; Stewart, Miles; Eng, Julia; Rajan, Abraham; Soke, Gnakub N; Fonjungo, Peter N; Otshudiema, John Otokoye; Folefack, Gervais Léon Tengomo; Pukuta-Simbu, Elisabeth; Talundzic, Emir; Shedroff, Elizabeth; Bokete, Jacques Likofata; Legand, Anaïs; Formenty, Pierre; Mores, Christopher N; Porzucek, Abigail J; Tritsch, Sarah R; Kombe, John; Tshapenda, Gaston; Mulangu, Felix; Ayouba, Ahidjo; Delaporte, Eric; Peeters, Martine; Wiley, Michael R; Montgomery, Joel M; Klena, John D; Muyembe-Tamfum, Jean-Jacques; Ahuka-Mundeke, Steve; Mbala-Kingebeni, Placide

doi:10.1016/s2666-5247(23)00259-8

“…3A ). Then, we applied the MCMC method to disease incidence data from a larger outbreak of 130 EVD cases in Équateur province in 2020 ( 18 – 20 ) ( Fig. 3B ).…”

Section: Resultsmentioning

confidence: 99%

“…The second outbreak occurred in Équateur province in 2020 and comprised 130 EVD cases occurring between 9 May and 12 September ( 18 – 20 ). The outbreak was declared over on 18 November, 42 days after the final case recovered ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

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Optimizing the timing of an end-of-outbreak declaration: Ebola virus disease in the Democratic Republic of the Congo

Hart,

Buckingham,

Keita

et al. 2024

Sci. Adv.

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Following the apparent final case in an Ebola virus disease (EVD) outbreak, the decision to declare the outbreak over must balance societal benefits of relaxing interventions against the risk of resurgence. Estimates of the end-of-outbreak probability (the probability that no future cases will occur) provide quantitative evidence that can inform the timing of an end-of-outbreak declaration. An existing modeling approach for estimating the end-of-outbreak probability requires comprehensive contact tracing data describing who infected whom to be available, but such data are often unavailable or incomplete during outbreaks. Here, we develop a Markov chain Monte Carlo–based approach that extends the previous method and does not require contact tracing data. Considering data from two EVD outbreaks in the Democratic Republic of the Congo, we find that data describing who infected whom are not required to resolve uncertainty about when to declare an outbreak over.

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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

Lampaert,

Nsio Mbeta,

Nair

et al. 2024

F1000Res

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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.

show abstract

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

Lampaert,

Nsio Mbeta,

Nair

et al. 2024

F1000Res

1

0

View full text Add to dashboard Cite

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.

show abstract

2020 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation

Cited by 4 publications

References 25 publications

Optimizing the timing of an end-of-outbreak declaration: Ebola virus disease in the Democratic Republic of the Congo

Optimizing the timing of an end-of-outbreak declaration: Ebola virus disease in the Democratic Republic of the Congo

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

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

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