Lessons learned from implementation of a national hotline for Ebola virus disease emergency preparedness in South Sudan

Abstract

Background The world’s second largest Ebola outbreak occurred in the Democratic Republic of Congo from 2018 to 2020. At the time, risk of cross-border spread into South Sudan was very high. Thus, the South Sudan Ministry of Health scaled up Ebola preparedness activities in August 2018, including implementation of a 24-h, toll-free Ebola virus disease (EVD) hotline. The primary purpose was the hotline was to receive EVD alerts and the secondary goal was to provide evidence-based EVD messages to the public. Methods To assess whether the hotline augmented Ebola preparedness activities in a protracted humanitarian emergency context, we reviewed 22 weeks of call logs from January to June 2019. Counts and percentages were calculated for all available data. Results The hotline received 2114 calls during the analysis period, and an additional 1835 missed calls were documented. Callers used the hotline throughout 24-h of the day and were most often men and individuals living in Jubek state, where the national capital is located. The leading reasons for calling were to learn more about EVD (68%) or to report clinical signs or symptoms (16%). Common EVD-related questions included EVD signs and symptoms, transmission, and prevention. Only one call was documented as an EVD alert, and there was no documentation of reported symptoms or whether the person met the EVD case definition. Conclusions Basic surveillance information was not collected from callers. To trigger effective outbreak investigation from hotline calls, the hotline should capture who is reporting and from where, symptoms and travel history, and whether this information should be further investigated. Electronic data capture will enhance data quality and availability of information for review. Additionally, the magnitude of missed calls presents a major challenge. When calls are answered, there is potential to provide health communication, so risk communication needs should be considered. However, prior to hotline implementation, governments should critically assess whether their hotline would yield actionable data and if other data sources for surveillance or community concerns are available.

How Does Risk-Information Communication Affect the Rebound of Online Public Opinion of Public Emergencies in China?

“…Due to the longer duration of public health emergencies, the degree of harm is larger, and development trends and disposal information receive more attention. During public health emergencies, people pay more attention to information related to the identification, transmission and prevention of diseases [61]. Furthermore, in order to draw more attention, some network users often post false information, and widely spreading false information is easy to arouse people's negative emotions, then inducing the rebound of online public opinion.…”

Key Considerations: Cross-Border Dynamics between Uganda and South Sudan in the Context of the Outbreak of Ebola, 2022

“…Suggestions to improve the hotline include better documentation of missed calls and greater efforts to encourage hotline use amongst surveillance officers throughout the country. 42 Another study noted similar challenges including inadequate numbers of staff to run the hotline 24 hours a day, inadequate numbers of dedicated lines, and unstable mobile network. 38…”

“…The hotline is staffed by PHEOC watch officers, who received several rounds of training. 42 An analysis of call logs between January and June 2019 yielded a number of insights. 2,114 calls were received during this period, and there were an additional 1,835 missed calls (including calls dropped due to poor network).…”

“…2,114 calls were received during this period, and there were an additional 1,835 missed calls (including calls dropped due to poor network). 42 The majority of callers to the hotline were male (67%) and most lived in what was then Jubek state (34%). Only 10% of calls were from the border states that had the greatest risk of EVD transmission from the DRC, perhaps partly because cellular network coverage is poor in these areas.…”

“…A hotline can provide realtime, accurate information to the public, allow open channels of communication with those responsible for preparedness activities, and potentially build trust, as well as supplementing rumour tracking. 42 However, this requires continual training for staff to keep them updated on new emerging issues, and to ensure they can effectively respond to misperceptions. Suggestions to improve the hotline include better documentation of missed calls and greater efforts to encourage hotline use amongst surveillance officers throughout the country.…”