Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic

Hsu, Christopher H.; Champaloux, Steven W; Кейта, Сакоба; Martel, L. M. V.; Bilivogui, Pépé; Knust, Barbara; McCollum, Andrea M.

doi:10.3201/eid2401.161678

Cited by 20 publications

(24 citation statements)

References 21 publications

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“…This supports the previous study stated that 'during busy periods there is an assumption that surveillance is less critical than patient's care and could be 'deferred' and broad variance in the implementation of case de nitions among hospitals and community clinics exists' (23). We assume applying a standard case de nition in all health facilities will boost the overall sensitivity and speci city of CDSS, similar to a study on the Ebola epidemic (24).…”

Section: Discussionsupporting

confidence: 85%

The lessons of COVID-19 pandemic for communicable diseases surveillance system: A qualitative study in the Kurdistan region-Iraq

Hamalaw

Bayati

Babakir‐Mina

et al. 2021

Preprint

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Background Coronavirus disease 2019 (COVID-19) has revealed a series of unprecedented challenges to Communicable Disease Surveillance Systems (CDSS) globally. This study aimed to determine the opportunities of and barriers to CDSS during the COVID-19 pandemic, and the extent to which the disease integrated into the CDSS in the Kurdistan region of Iraq. Methods A descriptive qualitative approach was applied. We conducted 7 semi-structured interviews and one focus group discussions (FGD) with purposefully identified Key Informants (KI) from June to December 2020. All interviews were digitally recorded and transcribed verbatim. We adopted a mixed deductive-inductive approach for thematic analysis of data, facilitated by using MAXQDA20 software for data management. Results Although the CDSS was considered appropriate and flexible, the COVID-19 was interpreted not to be integrated into the system due to political concerns. The lack of epidemic preparedness, timeliness, and partial cessation of training and supervision during the pandemic were the main concerns regarding core and support activities. The existence of reasonable surveillance infrastructure, i.e. trained staff was identified as an opportunity for improvement. The main challenges include: staff deficiency, absence of motivation and financial support for present staff, scarce logistics, managerial and administrative issues, and lack of cooperation, particularly among stakeholders and surveillance staff. Conclusion Our findings revealed that due to political barriers, COVID-19 was not integrated into the CDSS. It also highlighted the main facilitators of and barriers to CDSS in the region. We advocate health authorities and policy-makers to prioritize the surveillance and effective management of communicable diseases.

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Section: Discussionsupporting

confidence: 85%

The lessons of COVID-19 pandemic for communicable diseases surveillance system: A qualitative study in the Kurdistan region-Iraq

Hamalaw

Bayati

Babakir‐Mina

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…In summary, EBOV-infected humans often complain of severe abdominal pain, vomiting, and diarrhea at the time of clinical presentation [ 38 , 39 ]. EBOV related GI pathological changes in the NHP IM rhesus Kikwit model are extensive, occur as early as 5 DPI, and could impact the clinical disease course.…”

Section: Discussionmentioning

confidence: 99%

Ebola Virus Causes Intestinal Tract Architectural Disruption and Bacterial Invasion in Non-Human Primates

Reisler

Zeng

Schellhase

et al. 2018

Viruses

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In the 2014–2016 West Africa Ebola Virus (EBOV) outbreak, there was a significant concern raised about the potential for secondary bacterial infection originating from the gastrointestinal tract, which led to the empiric treatment of many patients with antibiotics. This retrospective pathology case series summarizes the gastrointestinal pathology observed in control animals in the rhesus EBOV-Kikwit intramuscular 1000 plaque forming unit infection model. All 31 Non-human primates (NHPs) exhibited lymphoid depletion of gut-associated lymphoid tissue (GALT) but the severity and the specific location of the depletion varied. Mesenteric lymphoid depletion and necrosis were present in 87% (27/31) of NHPs. There was mucosal barrier disruption of the intestinal tract with mucosal necrosis and/or ulceration most notably in the duodenum (16%), cecum (16%), and colon (29%). In the intestinal tract, hemorrhage was noted most frequently in the duodenum (52%) and colon (45%). There were focal areas of bacterial submucosal invasion in the gastrointestinal (GI) tract in 9/31 (29%) of NHPs. Only 2/31 (6%) had evidence of pancreatic necrosis. One NHP (3%) experienced jejunal intussusception which may have been directly related to EBOV. Immunofluorescence assays demonstrated EBOV antigen in CD68+ macrophage/monocytes and endothelial cells in areas of GI vascular injury or necrosis.

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“…Broader defini-tions are helpful to identify cases when epidemiologic risk factors are unknown (eg, contact with a confirmed case) and for diseases with highly specific symptoms that are rare or difficult to diagnose (eg, internal hemorrhage). 13 Knowledge of the VHF community case definition was higher among community health workers than their facilitylevel counterparts. This could be because the VHF community case definition has fewer symptoms, making it easier to recall.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Surveillance System for Priority Zoonotic Diseases in the Democratic Republic of the Congo, 2017

et al. 2018

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High-functioning communicable disease surveillance systems are critical for public health preparedness. Countries that cannot quickly detect and contain diseases are a risk to the global community. The ability of all countries to comply with the International Health Regulations is paramount for global health security. Zoonotic diseases can be particularly dangerous for humans. We conducted a surveillance system assessment of institutional and individual capacity in Kinshasa and Haut Katanga provinces in the Democratic Republic of the Congo for nationally identified priority zoonotic diseases (eg, viral hemorrhagic fever [VHF], yellow fever, rabies, monkeypox, and influenza monitored through acute respiratory infections). Data were collected from 79 health workers responsible for disease surveillance at 2 provincial health offices, 9 health zone offices, 9 general reference hospitals, and 18 health centers and communities. A set of questionnaires was used to assess health worker training in disease surveillance methods; knowledge of case definitions; availability of materials and tools to support timely case detection, reporting, and data interpretation; timeliness and completeness of reporting; and supervision from health authorities. We found that health workers either had not been recently or ever trained in surveillance methods and that their knowledge of case definitions was low. Timeliness and completeness of weekly notification of epidemic-prone diseases was generally well performed, but the lack of available standardized reporting forms and archive of completed forms affected the quality of data collected. Lessons learned from our assessment can be used for targeted strengthening efforts to improve global health security.

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Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic

Cited by 20 publications

References 21 publications

The lessons of COVID-19 pandemic for communicable diseases surveillance system: A qualitative study in the Kurdistan region-Iraq

The lessons of COVID-19 pandemic for communicable diseases surveillance system: A qualitative study in the Kurdistan region-Iraq

Ebola Virus Causes Intestinal Tract Architectural Disruption and Bacterial Invasion in Non-Human Primates

Assessing the Surveillance System for Priority Zoonotic Diseases in the Democratic Republic of the Congo, 2017

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