The impact of Infection Prevention and control (IPC) bundle implementationon IPC compliance during the Ebola virus outbreak in Mbandaka/Democratic Republic of the Congo: a before and after design (original) (raw)
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BMC public health, 2018
In 2014-2016, West Africa faced the most deadly Ebola Virus Disease (EVD) outbreak in history. A key strategy to overcome this outbreak was continual staff training in Infection Prevention and Control (IPC), with a focus on Ebola. This research aimed to evaluate the impact of IPC training and the quality of IPC performance in health care facilities of one municipality of Conakry, Guinea. This study was conducted in February 2016. All health facilities within Ratoma municipality, Conakry, Guinea, were evaluated based on IPC performance standards developed by the Guinean Ministry of Health. The IPC performance of healthcare facilities was categorised into high or low IPC scores based on the median IPC score of the sample. The Mantel-Haenzsel method and logistic regression were used for statistical analysis. Twenty-five percent of health centres had one IPC-trained worker, 53% had at least two IPC-trained workers, and 22% of health centres had no IPC-trained workers. An IPC score above...
Infection prevention and control training and capacity building during the Ebola epidemic in Guinea
PLOS ONE
Background During the 2014-2016 Ebola epidemic in West Africa, a key epidemiological feature was disease transmission within healthcare facilities, indicating a need for infection prevention and control (IPC) training and support. Methods IPC training was provided to frontline healthcare workers (HCW) in healthcare facilities that were not Ebola treatment units, as well as to IPC trainers and IPC supervisors placed in healthcare facilities. Trainings included both didactic and hands-on components, and were assessed using pre-tests, post-tests and practical evaluations. We calculated median percent increase in knowledge.
Journal of Global Health Reports
Background The Democratic Republic of Congo declared their tenth outbreak of Ebola in North Kivu in 2018, which was the second-largest in the world and took place in an active conflict zone. Transmission of Ebola occurs by direct contact with infected bodily fluids and can occur within facilities when infection prevention and control (IPC) precautions are not strictly practised. Methods To develop infection prevention and control (IPC) standards in health facilities, 45 medical students were trained and placed in 101 health facilities to mentor healthcare workers and support IPC practices between February and October 2019. A mixed-methods retrospective evaluation of quality improvement in North Kivu was conducted in October and November 2019 to capture key lessons from such a pilot IPC project. Five focus groups (N=49) and 42 key-informant interviews were conducted in addition to a secondary analysis of surveillance and programmatic data collected during the intervention. Results Th...
Pan African Medical Journal
Introduction: In August 2014, WHO declared that Ebola outbreak ravaging West Africa including Liberia had become a Public Health Emergency of International Concern (PHEIC). Infection prevention and control (IPC) among healthcare workers was pivotal in reducing healthcare worker infection and containing the recent EVD outbreak. Hard to reach areas (HTRA) presents peculiar challenges in public health emergencies. We present the result of IPC capacity building strategies deployed in Gbarpolu County: an HTRA of Liberia. Methods: Between April to October 2015, we conducted IPC training and mentorship at the county, district and facility levels in a selected HTRA of Liberia using the keep Safe, Keep Serving manual and the WHO core components of infection control. Serial follow-up assessments and mentoring using the Liberian Minimum standard tool for safe care in Liberian health facilities (MST) were done. Results: 180 (100%) facility based healthcare workers were trained: including 59 clinicians (32%) and 121 (67%) non-clinicians. 100% of the healthcare workers in four selected very HTRAs were trained and underwent facility based-mentorship. Compliance with IPC practice increased: the MST score increased from 75% to 90% and for the MST score for waste management and isolation increased 60% to 87%. Conclusion: Strengthening the capacity of healthcare workers for IPC was instrumental for containing the EVD epidemic but also critical for routine safe and quality services. A culture of IPC among healthcare workers in HTRA can be implemented through capacity building and training.
Central African Journal of Public Health, 2020
Health Workers (HWs) are most likely to be infected by the Ebola virus disease (EVD) through mainly nosocomial transmission because they treat patients with EVD; this occurs through close contact with patients when infection prevention and control (IPC) measures are not strictly practiced. This study aimed to assess the level of implementation of infection prevention and control measures as well as challenges in their implementation in the northeastern region of the Democratic Republic of the Congo (DRC). A mixed study was carried out in northeastern of DRC in August 2019. In-depth interviews were conducted with 16 HCW in front-line and with a member of the national coordination team. The quantitative part was focused on the review of the reports of the commission for the prevention and control of infections. Interviews were audiorecorded and transcribed verbatim in Swahili before being translated in French and in English. The IPC packages were implemented in the health Facilities and in the community. We noticed a high proportion of realization of the IPC planned activities. All HCWs interviewed declared to have been trained on IPC and supported with materials and equipment for implementation. Cultural and traditional views of community have been mentioned as the community related factor which impact negatively in IPC implementation by the HCWs. Non-compliance with IPC measures by HCWs has been also mentioned added with the non viability of healthcare facilities. It is urgent to improve communication of importance to comply with IPC measures in community but also among HCWs. Also, Infrastructure of Health Care Facility must be strengthened.
2020
Background: The 10th outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo (DRC) has been ongoing since August 2018. It is the largestever outbreak reported in the country and the world's second largest in history. It has been declared a Public Health Emergency of International Concern on 17 July 2019. The outbreak is ongoing in a densely-populated region, which is also experiencing a long-lasting humanitarian and security crisis. The affected region is characterised by insufficient prevention control practices in many health facilities and persistent reluctance in the community to accept response activities. Infection Prevention and Control and Hand Hygiene programmes were implemented in 10 hospitals to contribute in EVD containment and improving patient and healthcare personnel safety. The study aimed to evaluate whether the implementation of infection prevention and control programme in healthcare facilities improves the level of EVD preparedness and r...
BMJ global health, 2016
Accomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops. We conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015. Quantitative methods administered to HCWs at baseline and follow-up included a survey on attitudes and self-efficacy towards IPC, and structured observations of behaviours. The intervention involved a workshop for HCWs to develop improvement plans for their facility. We analysed the changes between rounds in survey responses and behaviours. We used interviews to explore attitud...
Tropical Medicine and Infectious Disease, 2021
Background: High compliance to infection prevention and control (IPC) is vital to prevent health care-associated infections. In the worst 2014–2015 Ebola-affected district in Sierra Leone (Kenema), we assessed (a) average yearly IPC compliance (2016–2018) using a National IPC assessment tool in the district hospital and peripheral health units (PHUs), and (b) gaps in IPC activities, infrastructure and consumables in 2018. Methods: This was a cross-sectional study using secondary program data. Results: At the district hospital, compliance increased from 69% in 2016 to 73% in 2018 (expected minimal threshold = 70%; desired threshold ≥ 85%). Compliance for screening/isolation facilities and decontamination of medical equipment reached 100% in 2018. The two thematic areas with the lowest compliance were sanitation (44%) and sharps safety (56%). In PHUs (2018), the minimal 70% compliance threshold was not achieved in two (of 10 thematic areas) for Community Health Centers, four for Commu...
Simaya Ladu James, 2024
The third Sustainable Development Goal (SDG3) of the United Nations aims to ensure healthy and well-being of people of all ages. SDG3 is further divided into sub-goals addressing different health challenges, aiming to reduce their global impact by 2030. To combat diseases, SDG3 has sub-goals devoted to communicable diseases. Healthcare professionals are considered a vulnerable group due to the contagious nature of Ebola, which carries a high risk of mortality. This study, aligned with SDG3, aims to assess healthcare workers' comprehension of the Ebola virus disease (EVD) in Yei River County, South Sudan. Since healthcare staff play a vital role in minimizing the risk of transmission in several ways, evaluating their attitude is of utmost importance. Consequently, an empirical study has been conducted. A cross-sectional study on 195 healthcare professionals working in health centres of Yei River County was conducted using a combination of purposive and simple random sampling methods. Data was collected via questionnaires that included demographic information, as well as knowledge, attitude, and practice questions pertaining to EVD. SPSS version 21.0 was utilized for data analysis. The study demonstrates that 93% of respondents possess knowledge regarding EVD, with health workers (43.3%) and radio (56.7%) being the primary sources of information. Regarding symptoms of EVD, 50% of respondents indicated bleeding, while 53% recognised bodily contact with an infected person as a potential transmission route. Notably, there is a significant dearth of positive attitudes among health workers responsible for handling EVD patients. There was a subpar level of compliance with EVD prevention measures amongst health workers, with just 43.3% washing their hands regularly, 46.7% washing them once each day, a mere 30% utilizing hand washing as a preventive measure, and 40% of them using PPE for such purposes. A non-parametric analysis employing the Wilcoxon Signed Ranks Test was performed to investigate the potential link between the educational level of healthcare workers and their Ebola disease knowledge, attitude, and practice. The findings demonstrate a significant association between the level of education of healthcare workers and their knowledge, attitude, and practice of Ebola disease since the t-test statistic is-4.80, which is less than the p-value of 0.001. As health worker knowledge regarding Ebola virus disease (EVD) is currently at a moderate level, it is recommended that training and intervention programmes be implemented for healthcare workers. Particular emphasis should be placed on transmission routes and signs of EVD in order to improve participants' knowledge and attitudes towards the disease.
Infection Prevention and Control for Ebola in Health Care Settings - West Africa and United States
MMWR supplements, 2016
The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa underscores the need for health care infection prevention and control (IPC) practices to be implemented properly and consistently to interrupt transmission of pathogens in health care settings to patients and health care workers. Training and assessing IPC practices in general health care facilities not designated as Ebola treatment units or centers became a priority for CDC as the number of Ebola virus transmissions among health care workers in West Africa began to affect the West African health care system and increasingly more persons became infected. CDC and partners developed policies, procedures, and training materials tailored to the affected countries. Safety training courses were also provided to U.S. health care workers intending to work with Ebola patients in West Africa. As the Ebola epidemic continued in West Africa, the possibility that patients with Ebola could be identified and treated in the United St...