The Ebola outbreak in the Democratic Republic of the Congo: why there is no ‘silver bullet’

Rohan, Hana; McKay, Gillian

doi:10.1038/s41590-020-0675-8

Cited by 33 publications

(40 citation statements)

References 8 publications

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“…Displaced populations are often served by weak, fragmented and donor-dependent health systems that grapple with a multitude of health needs, many of which have been complicated or exacerbated by the COVID-19 pandemic 8 . These include outbreaks of communicable disease, such as the simultaneous outbreaks of measles and Ebola besetting the Democratic Republic of the Congo and Guinea, malaria, malnutrition, routine childhood immunization programs, sexual and reproductive health, mental health, and chronic conditions such as HIV infection and tuberculosis 8,[10][11][12] . Weak health infrastructures, including limited cold-chain capabilities, shortages of trained healthcare workers 10 and fragmented health-information systems 10 , pose perennial problems, particularly in remote areas where refugee camps are often located, and these challenges will complicate any future vaccine rollout.…”

Section: Ensuring Equitable Access In a Context Of Vaccine Scarcitymentioning

confidence: 99%

Leave no one behind: ensuring access to COVID-19 vaccines for refugee and displaced populations

Zärd

Lau

Bowser

et al. 2021

Nat Med

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Section: Ensuring Equitable Access In a Context Of Vaccine Scarcitymentioning

confidence: 99%

Leave no one behind: ensuring access to COVID-19 vaccines for refugee and displaced populations

Zärd

Lau

Bowser

et al. 2021

Nat Med

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“…Numerous factors contributed to the 2-year-long EVD outbreak in the eastern DRC, including a fragile and fragmented health system, population displacement, movement of contacts, disenfranchisement of the community, mistrust, and ongoing armed conflicts. 8 The DRC continues to face the challenge of having back-to-back EVD outbreaks with limited funding for existing needs.…”

Section: The Collision Of Ebola Virus Disease and Covid-19mentioning

confidence: 99%

“…Among reported confirmed cases, a total of 1,176 (44.2%) were symptomatic ( Figure 2 ). 7 , 8 Various organizations involved in the COVID-19 fight across the country, supported by the U.S. Health Resources and Services Administration, are implementing multidisciplinary teams of physicians, nurses, midwives, pharmacists, medical students, and CHCWs for COVID-19 sensitization, screening, and testing activities endorsed by the Ministry of Health, the community, and faith leaders. When a suspect case of COVID-19 is identified based on the presence of signs or symptoms, epidemiological links, or being a high-risk contact, CHCWs send a COVID-19 alert notification to the emergency operations center, and a surveillance team is deployed to investigate.…”

Section: Community-based Covid-19 Screening Testing and Contact-tramentioning

confidence: 99%

Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo—Priorities for Achieving Control

Nachega

Mbala-Kingebeni

Otshudiema³

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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As of June 11, 2020, the Democratic Republic of the Congo (DRC) has reported 4,258 COVID-19 cases with 90 deaths. With other African countries, the DRC faces the challenge of striking a balance between easing public health lockdown measures to curtail the spread of SARS-CoV-2 and minimizing both economic hardships for large sectors of the population and negative impacts on health services for other infectious and noninfectious diseases. The DRC recently controlled its tenth Ebola virus disease (EVD) outbreak, but COVID-19 and a new EVD outbreak beginning on June 1, 2020 in the northwestÉquateur Province have added an additional burden to health services. Although the epidemiology and transmission of EVD and COVID-19 differ, leveraging the public health infrastructures and experiences from coordinating the EVD response to guide the public health response to COVID-19 is critical. Building on the DRC's 40 years of experience with 10 previous EVD outbreaks, we highlight the DRC's multi-sectoral public health approach to COVID-19, which includes community-based screening, testing, contact-tracing, risk communication, community engagement, and case management. We also highlight remaining challenges and discuss the way forward for achieving control of both COVID-19 and EVD in the DRC.

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“…In DR Congo, pregnant and lactating women were initially excluded from the Merck EVD vaccine compassionate use protocol used in North Kivu, out of concerns that women could spontaneously abort or that infants could be harmed. Some of the excluded women were highrisk contacts, but were not permitted to receive the vaccine, despite operational research showing that they understood the risks and would prefer to be given the choice about whether to take the vaccine (Rohan & McKay, 2020).…”

Section: Prevent Maternal Mortality and Morbidity And Stillbirthmentioning

confidence: 99%

Social Inclusion and Immunisation

Tull¹

2021

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The current COVID-19 epidemic is both a health and societal issue; therefore, groups historically excluded and marginalised in terms of healthcare will suffer if COVID-19 vaccines, tests, and treatments are to be delivered equitably. This rapid review is exploring the social and cultural challenges related to the roll-out, distribution, and access of COVID-19 vaccines, tests, and treatments. It highlights how these challenges impact certain marginalised groups. Case studies are taken from sub-Saharan Africa (the Democratic Republic of Congo, South Africa), with some focus on South East Asia (Indonesia, India) as they have different at-risk groups. Lessons on this issue can be learned from previous pandemics and vaccine roll-out in low- and mid-income countries (LMICs). Key points to highlight include successful COVID-19 vaccine roll-out will only be achieved by ensuring effective community engagement, building local vaccine acceptability and confidence, and overcoming cultural, socio-economic, and political barriers that lead to mistrust and hinder uptake of vaccines. However, the literature notes that a lot of lessons learned about roll-out involve communication - including that the government should under-promise what it can do and then over-deliver. Any campaign must aim to create trust, and involve local communities in planning processes.

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The Ebola outbreak in the Democratic Republic of the Congo: why there is no ‘silver bullet’

Cited by 33 publications

References 8 publications

Leave no one behind: ensuring access to COVID-19 vaccines for refugee and displaced populations

Leave no one behind: ensuring access to COVID-19 vaccines for refugee and displaced populations

Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo—Priorities for Achieving Control

Social Inclusion and Immunisation

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