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Utilizing the experience of containment of the ebola outbreak in the fight against the coronavirus disease 2019 pandemic: Democratic republic of congo


1 Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission28-Mar-2020
Date of Decision10-Apr-2020
Date of Acceptance23-Apr-2020

Correspondence Address:
Saurabh RamBihariLal Shrivastava,
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) - Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_114_20

  Abstract 


The coronavirus disease 2019 (COVID-19) pandemic continues to increase in number and geographic distribution with each day. The Democratic Republic of Congo (DRC) has reported 161 cases, which amounts to 2.4% of the caseload in the African region, but it is the second leading nation in terms of reported deaths. From the public health perspective, the cause of concern is that local transmission has been reported and the fact that the nation has not yet completely recovered from the outbreak of the Ebola virus disease. The nation has already started its preparedness activities, and they are utilizing the setup, the facilities, and the experience gained by the health personnel for the effective containment of the outbreak of Ebola. In conclusion, the DRC has initiated its outbreak readiness and even implemented the response action plan in the nation against the COVID-19. Although the availability of resources in the nation is a challenging ask, the health personnel have utilized their experiencing of managing the Ebola outbreak and given a positive head start toward the containment of the infection within their settings.

Keywords: Coronavirus disease 2019 pandemic, Democratic Republic of Congo, Ebola virus disease, World Health Organization



How to cite this URL:
Shrivastava SR, Shrivastava PS. Utilizing the experience of containment of the ebola outbreak in the fight against the coronavirus disease 2019 pandemic: Democratic republic of congo. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2021 Jun 13]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=309330




  Introduction Top


The coronavirus disease-2019 (COVID-19) pandemic continues to increase in number and geographic distribution with each day, and the overall scenario has become extremely challenging.[1] The disease has been increasing at a very rapid pace as evidenced by the caseload which is increasing by 100,000 in the last week every 2 days, especially considering the fact that it took 67 days for the number of cases to increase to 100,000 at the start of the outbreak.[2] The current tally stands at 1,210,956 cases and 67,594 deaths across the world and the case-fatality rate of the disease has increased to 5.5%.[2] It is worth noting that in a single day, 77,200 cases and 4819 deaths were reported, which is really alarming and raises serious questions about the preparedness of the nations and also explains the highly contagious nature of the disease.[1],[2]


  African Region-Coronavirus Disease 2019 Top


Till date, the African region has accounted for 6616 cases (0.54% of the global caseload) and 243 deaths (0.36% of the global deaths).[2] Even though these numbers appear extremely less as compared to what the European region or the Western Pacific region is experiencing, it is worth noticing that if the disease caseload increases in the African region at the same pace, the outcome will be disastrous, mainly due to the weak healthcare delivery system and the fact that many nations are already having other competing public health priorities, as well as the ongoing conflicts. A total of 37 nations in the African region have reported cases till now, but the encouraging fact is that only in 12 nations, local transmission has been reported, while in remaining 27 nations, only imported cases have been reported.[2] South Africa remains the most affected nation in the region with 927 cases, but no deaths has been yet reported.[2]


  Democratic Republic of Congo: Coronavirus Disease 2019 and Ebola Virus Disease Top


The Democratic Republic of Congo (DRC) has reported 161 cases, which amounts to 2.4% of the caseload in the African region, but it is the second leading nation in terms of reported deaths (18 deaths), with Algeria being the first with 130 deaths.[2] From the public health perspective, the cause of concern is that local transmission has been reported and the fact that the nation has not yet completely recovered from the outbreak of the Ebola virus disease.[2],[3] The Ebola outbreak has already jeopardized the healthcare delivery system of the nation, and the emergence of another major outbreak in the nation can further outstretch the weaknesses in the health system.

At the same time, the DRC has been marked as one of the 13 nations, which need to intensify their readiness and response activities owing to the high percentage of travel with China.[4] Thus, there is a potential risk for the onset of large-scale community-based transmission, which in turn will outstretch the health system and significantly interfere with the optimal utilization of the scarce resources, considering the competing other public health priorities and the interruption of routine welfare services, due to the reallocation of available resources for the containment of Ebola outbreak in the nation.[3],[4]


  Lessons Learned from the Containment of Ebola Outbreak in Democratic Republic of Congo Top


The containment of the Ebola outbreak essentially requires the active search for cases, subjecting the suspects to diagnostic tests, provision of appropriate treatment, contact tracing, and active engagement of the community.[3] To accomplish these, the surveillance system of the nation has been strengthened, capacity building of the laboratories has been done, and steps have been taken to actively involve the community. The members of the community are involved in activities such as creating awareness about the disease by targeting various community leaders and to facilitating contact tracing, and simultaneously, steps were taken to neutralize the prevailing myths about the disease.[3]

All these measures are very much advocated even to accomplish effective containment of the COVID-19 pandemic, and it is of utmost importance to strengthen all these domains of the infection control.[4],[5] In fact, the surveillance system, laboratory infrastructure, community network, and risk communication system, which were established and scaled up for the prevention and control of Ebola virus disease, can now be used for the containment of the COVID-19 as well.[3],[4],[5] Further, as the disease containment will be eventually determined by the engagement and support of the community, the healthcare professionals can sensitize the community and religious leaders for spreading the information about the disease and thus ensure maximum community engagement.[3],[5]


  Need of the Hour: Outbreak readiness and Response Plan Top


The nation has already started its preparedness activities, and they are utilizing the setup, the facilities, and the experience gained by the health personnel for the effective containment of the outbreak of Ebola.[3],[4] Special emphasis has been given toward the strengthening of screening activities for COVID-19 across airports, seaports, and ground border crossing.[3],[6] As the screening activities for Ebola were already going on in these points of entries, it was easy to start the process, and the team of deployed health personnel has started the practice of screening of both incoming and outgoing travelers.[3]

The practice of isolation of suspected cases has been done in either temporary tents or earmarked facilities, but there is a definite need to improve the infrastructure, especially in terms of improving diagnostic capacity, isolation, and treatment facilities, as the existing places are already occupied by the survivors of Ebola.[5] The encouraging fact is that the nation has the diagnostic facility to identify positive cases, and there is no need for samples to other nations.[3] There is an immense need in the nation to improve the supply of equipment (like ventilators) which are required for the treatment of severe cases of COVID-19.

As respiratory complications were not linked with Ebola, the nation is not presently having much stock, and this issue needs to be addressed on an urgent basis.[3] However, the government authorities have started the work of increasing the awareness of people about the need of practicing handwashing, adherence to cough etiquettes, maintaining social distance, and avoiding unnecessary travel.[3],[5] Even though these measures are just a start, the good sign is that there is extensive support from the political leaders and the team of health personnel is working very hard within the available resources to reduce the probability of a major disease outbreak in the nation.[1],[3]


  Conclusion Top


The DRC has initiated its outbreak readiness and even implemented the response action plan in the nation against the COVID-19. Although the availability of resources in the nation is a challenging ask, the health personnel have utilized their experiencing of managing the Ebola outbreak and given a positive head start toward the containment of the infection within their settings.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ward MP, Li X, Tian K. Novel coronavirus 2019, an emerging public health emergency. Transbound Emerg Dis 2020;67:469-70.  Back to cited text no. 1
    
2.
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report – 77; World Health Organization; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200406-sitrep-77-covid-19.pdf?sfvrsn=21d1e632_2. [Last accessed on 2020 Apr 07].  Back to cited text no. 2
    
3.
Shrivastava SR, Shrivastava PS, Ramasamy J. Ebola disease: An international public health emergency. Asian Pac J Trop Dis 2015;5:253-62.  Back to cited text no. 3
    
4.
World Health Organization. How Ebola is helping the Democratic Republic of the Congo Prepare for Coronavirus Disease. World Health Organization; 2020. Available from: https://www.afro.who.int/photo-story/how-ebola-helping-democratic-republic-congo-?prepare-coronavirus-disease. [Last accessed on 2020 Mar 28].  Back to cited text no. 4
    
5.
World Health Organization. 2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan. Geneva: WHO Press; 2020. p. 1-3.  Back to cited text no. 5
    
6.
Shrivastava SR, Shrivastava PS. Minimizing the risk of international spread of coronavirus disease 2019 (COVID-19) outbreak by targeting travelers. J Acute Dis 2020;9:47-8.  Back to cited text no. 6
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