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Ebola and COVID-19 in DR Congo and Guinea
... Furthermore, in March 2020, the DRC experienced its first cases of COVID-19, starting in Kinshasa (Adepoju, 2021;Juma et al., 2020). ...
... Subsequently, the various provinces affected by the EVD were in turn affected by . The resurgence of EDV in Equateur Province in May 2020 put local populations in a state of fear of being infected by the EVD and COVID-19 (Adepoju, 2021). For nearly six months, populations faced the fear and anxiety associated with both diseases (Nachega et al., 2020a;Nachega et al., 2020b). ...
Background
Associated with high mortality rate, fear, and anxiety, Ebola Virus Disease (EVD) is a significant risk factor for mental distress. This longitudinal study aims to investigate the prevalence and predictors associated with mental distress among populations affected by EVD outbreaks in the Province of Equateur in DR Congo.
Methods
Surveys were administered in zones affected by the 2018 EVD outbreak in Equateur Province with a 16-month interval. Measures assessed sociodemographic characteristics, mental distress (GHQ-12), COVID-19 and EVD exposure and related stigmatization, and Resilience. Models of logistic regression and path analysis were used to estimate factors related to mental distress outcomes.
Results
Prevalence of mental distress decreased from Wave 1 to Wave 2 (Mental distress T1= 57.04%, Mental distress T2= 40.29%, x²= 23.981, p<.001). Clinical mental distress score at follow-up was predicted by greater levels of exposure to Ebola at baseline (B= .412, p<.001) and at Wave 2 (B= .453, p<.001) as well as Ebola stigmatization at baseline (B= .752, p<.001), and Protestant religion (B= .474, p=.038). Clinical mental distress score at follow-up was significantly associated with higher levels of exposure to COVID-19 (B= .389, p=.002) and COVID-19 related stigmatization (B= .480, p<.001). COVID-19 related stigmatization partially mediated the association between exposure to EVD (Time 1) and mental distress (B= .409, p<.001).
Conclusions
Although a decrease in mental distress symptoms was observed, its prevalence remains high. The results show that mental health programs need to develop better health and education communication strategies to reduce stigmatization.
... However, given the increasing identification of sexual transmission-related cases within DRC, this and other vaccination modeling strategies will need to factor in the burden of sexual transmission on mpox cases in DRC to address the impacts of targeted vaccination and therapeutic campaigns on key populations. It should be appreciated that the DRC has leading expertise in emerging infectious disease response activities including resurgent Ebola virus disease outbreak which have resulted in rapid vaccine deployment and vaccination campaigns as well as extensive contact tracing, including during the COVID-19 pandemic [14,15]. This has included broad knowledge mobilization campaigns. ...
... Toutefois, si les gains obtenus pour chacune des caractéristiques de la résilience ont certainement permis d'améliorer la riposte face à la COVID-19, la résurgence d'Ebola en février 2021 et d'autres virus comme Marburg en août 2021 en Guinée suggère aujourd'hui de pousser l'analyse pour mieux évaluer la résilience face à de multiples crises en simultané et de la comparer à un autre État comme la République démocratique du Congo qui a vécu une situation similaire. Une double crise complexifie encore davantage la gestion et implique une fatigue des ressources humaines comme le suggère Adepoju [35], c'est pourquoi le renforcement des cinq caractéristiques de la résilience peut permettre d'améliorer la riposte. ...
Introduction : The case of Ebola in Guinea (2013-2016) revealed weaknesses in the resilience of the health system and highlighted the challenge of coordinating all actors in the response. After the epidemic, national authorities and their international partners began to strengthen the health system. In 2021, Guinea faced COVID-19 simultaneously with the resurgence of Ebola and other diseases with epidemic potential.Purpose of research : The objective of this article is to analyze the evolution of the five characteristics of health resilience of Kruk et al. (2015) in the Guinean context. To do this, data triangulation was carried out through a literature review, 41 semi-structured interviews with international, national and local stakeholders, and 37 events observed in the post-Ebola period.Results : Our results show that the characteristic of integration was the most important in our study. This is because of the importance of coordination, communication and information sharing among stakeholders during crises. Then, diversity exposes the need to be able to face several health challenges simultaneously. Efforts were focused on Ebola during the first outbreak, but since the COVID-19 pandemic, Guinea has been able to cope with several health challenges. Raising awareness, on the other hand, necessitates an understanding of the context, its strengths, and weaknesses. Guinea learned lessons from Ebola and implemented a program to strengthen the emergency response system. On self-regulation, the speed of the response relies on mechanisms for early detection, notification, and response. The country is now well resourced and has proven information and response mechanisms. Finally, constant adaptability by taking into account lessons learned allows us to set course and prepare for other potential crises and this is what is being done constantly.Conclusions : Given Guinea’s ubiquitous fragility before Ebola, the health system is still not fully resilient. However, gains in each of the characteristics of resilience improve the response to COVID-19.
... The concomitant emergence of these epidemics overstretched the ANSS, the principal national public health institute, and had an impact on COVID-19 surveillance and response (18,44). It was noted also that the surveillance and response to recurrent epidemics (measles, meningitis, poliomyelitis, etc.) were neglected in favor of Ebola (7). ...
The outbreak of the novel coronavirus (SARS-CoV-2) in December 2019 prompted a response from health systems of countries across the globe. The first case of COVID-19 in Guinea was notified on 12 March 2020; however, from January 2020 preparations at policy and implementation preparedness levels had already begun. This study aimed to assess the response triggered in Guinea between 27th January 2020 and 1st November 2021 and lessons for future pandemic preparedness and response. We conducted a scoping review using three main data sources: policy documents, research papers and media content. For each of these data sources, a specific search strategy was applied, respectively national websites, PubMed and the Factiva media database. A content analysis was conducted to assess the information found. We found that between January 2020 and November 2021, the response to the COVID-19 pandemic can be divided into five phases: (1) anticipation of the response, (2) a sudden boost of political actions with the implementation of strict restrictive measures, (3) alleviation of restrictive measures, (4) multiple epidemics period and (5) the COVID-19 variants phase, including the strengthening of vaccination activities. This study provides several learning points for countries with similar contexts including: (1) the necessity of setting up, in the pre-epidemic period, an epidemic governance framework that is articulated with the country's health system and epidemiological contexts; (2) the importance of mobilizing, during pre-epidemic period, emergency funds for a rapid health system response whenever epidemics hit; (3) each epidemic is a new experience as previous exposure to similar ones does not necessarily guarantee population and health system resilience; (4) epidemics generate social distress because of the restrictive measures they require for their control, but their excessive securitization is counterproductive. Finally, from a political point of view, decision-making for epidemic control is not always disinterested; it is sometimes rooted in political computations, and health system actors should learn to cope with it while, at the same time, safeguarding trusted and efficient health system responses. We conclude that health system actors anticipated the response to the COVID-19 pandemic and (re-) adapted response strategies as the pandemic evolved in the country. There is a need to rethink epidemics governance and funding mechanisms in Guinea to improve the health system response to epidemics.
... Ebola viruses belong to the Filoviridae family like Marburg and Lloviu viruses [4,5]. Currently, five species of Ebola virus have been described: Zaire, Reston, Bundibugyo, Sudan and Taï Forest [6][7][8]. They are highly pathogenic viruses, classified as level 4. They are responsible, for the most part, for viral hemorrhagic fevers (VHF) most often fatal in human and non-human primates, during transmission by contact with biological fluids [9,10]. ...
Despite its high mortality rate of approximately 90%, the Ebola virus disease (EVD) has not received enough attention in terms of in-depth research. This illness has been responsible for over 40 years of epidemics throughout Central Africa. However, during 2014–2015, the Ebola-driven epidemic in West Africa became, and remains, the deadliest to date. Thus, Ebola has been declared one of the major public health issues. This paper aims at exploring the effects of external fluctuations on the prevalence of the Ebola virus. We begin by proposing a sophisticated biological system that takes into account vaccination and quarantine strategies as well as the effect of time lags. Due to some external perturbations, we extend our model to the probabilistic formulation with white noises. The perturbed model takes the form of a system of stochastic differential equations. Based on some non-standard analytical techniques, we demonstrate two main approach properties: intensity and elimination of Ebola virus. To better understand the impact of applied strategies, we deal with the stochastic control optimization approach by using some advanced theories. All of this theoretical arsenal has been numerically confirmed by employing some real statistical data of Ebola virus. Finally, we mention that this work could be a rich basis for further investigations aimed at understanding the complexity of Ebola virus propagation at pathophysiological and mathematics levels.
... The viruses responsible for most outbreaks and highest case fatality rates are Ebola virus (EBOV) and Marburg virus (MARV). In 2021, there were two outbreaks of Ebola virus disease, in the Democratic Republic of the Congo (DRC) and in Guinea, [3,6], with the DRC being Ebola-free for only a few months [3]. 2021 also saw a case of MARV infection in Guinea which is the first time MARV has been identified in West Africa [7]. ...
During outbreaks of virus diseases, many variants may appear, some of which may be of concern. Stability in an aerosol of several Ebola virus and Marburg virus variants was investigated. Studies were performed measuring aerosol survival using the Goldberg drum but no significant difference in biological decay rates between variants was observed. In addition, historic data on virulence in a murine model of different Ebola virus variants were compared to newly presented data for Ebola virus Kikwit in the A129 Interferon alpha/beta receptor-deficient mouse model. Ebola virus Kikwit was less virulent than Ebola virus Ecran in our mouse model. The mouse model may be a useful tool for studying differences in virulence associated with different variants whereas aerosol stability studies may not need to be conducted beyond the species level.
... The need to respond to existing infectious and noninfectious diseases contribute to inadequate COVID-19 surveillance in Africa. 4 For instance, Nigeria has to ensure Lassa fever surveillance, 84 the Democratic Republic of Congo needs to monitor Ebola outbreak, 85 and Ethiopia has to contain the cholera outbreak, 86 amid COVID-19 pandemic. Africa is facing a high burden of many diseases and it is important to formulate measures to respond to them without disrupting COVID-19 surveillance. ...
Background: Surveillance forms the basis for response to disease outbreaks, including COVID-19. Herein, we identified the COVID-19 surveillance systems and the associated challenges in 13 African countries.
Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between January 2020 and April 2021 in PubMed, Medline, PubMed Central, and Google Scholar using predetermined search terms. Relevant studies from the search and other data sources on COVID-19 surveillance strategies and associated challenges in 13 African countries (Mauritius, Algeria, Nigeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Ghana, Ethiopia, South Africa, Kenya, Zambia, Tanzania, and Uganda) were identified and reviewed.
Results: Our findings revealed that the selected African countries have ramped up COVID-19 surveillance ranging from immediate case notification, virological surveillance, hospital-based surveillance to mortality surveillance among others. Despite this, there exist variations in the level of implementation of the surveillance systems across countries. Integrated Disease Surveillance and Response (IDSR) strategy is also being leveraged in some African countries, but the implementation across countries remains uneven. Our study also revealed various challenges facing surveillance which included shortage of skilled human resources resulting in poor data management, weak health systems, complexities of ethical considerations, diagnostic insufficiency, the burden of co-epidemic surveillance, and geographical barriers, among others.
Conclusion: With the variations in the level of implementation of COVID-19 surveillance strategies seen across countries, it is pertinent to ensure proper coordination of the surveillance activities in the African countries and address all the challenges facing COVID-19 surveillance using tailored strategies.
... Strategies that have helped contain the Ebola virus during the 2018-2020 outbreak in the Democratic Republic of Congo include deploying a multidisciplinary rapid response team to support Ebola case management, providing patients with equitable access to advanced therapeutics Mab114, REGN-EB3, and ZMAPP, vaccinating over 303,000 people with the highly effective rVSV-ZEBOV-GP vaccine [85], introducing novel Ebola diagnostic tools as well as applying new technologies such as whole-genome sequencing, and building community engagement alongside new surveillance programs [86]. Along with the advanced therapeutics and approaches, several vaccines and treatments against Ebola virus are under clinical trial, including rVSV-ZEBOV or Ervebo [87], which was proved to be 100% protective against EVD [88]. It can be administered in people of 18 years of age or above [88]. ...
Concurrent waves of coronavirus disease, Ebola virus disease, avian influenza A, and black fungus are jeopardizing lives in some parts of Africa and Asia. From this point of view, this review aims to summarize both the socio-economic and public health implications of these parallel outbreaks along with their best possible management approaches. Online databases (PubMed/PMC/Medline, Publons, ResearchGate, Scopus, Google Scholar, etc.) were used to collect the necessary information regarding these outbreaks. Based on the reports published and analyses performed so far, the long-lasting impacts caused by these simultaneous outbreaks on global socio-economical and public health status can be conceived from the past experiences of outbreaks, especially the COVID-19 pandemic. Moreover, prolonged restrictions by the local government may lead to food insecurity, global recession, and an enormous impact on the mental health of people of all ages, specifically in developing countries. Such overwhelming effects have already been reported to be declining the national growth of the economy as well as increasing political insecurity and shortage of basic needs. Although various actions have already been taken, including vaccination, clinical management and further research, social distancing, lockdown, etc., to improve the situation, the emerging variants and associated genetic mutations may make containment difficult, worsening the situation again. So, considering the current mutational dynamics of the pathogens and past experiences, perpetual preparedness along with updated clinical management backed by epidemiological studies and innovative scientific effort are inevitable to combat the simultaneous waves of multiple infectious diseases.
... Strategies that have helped contain the Ebola virus during the 2018-20 outbreak in Democratic Republic of Congo include deploying a multidisciplinary rapid response team to support Ebola case management, providing patients with equitable access to advanced therapeutics Mab114, REGN-EB3, ZMAPP, vaccinating over 303,000 people with the highly effective rVSV-ZEBOV-GP vaccine [63], introducing novel Ebola diagnostic tools as well as applying new technologies like whole genome sequencing and building community engagement alongside new surveillance programs [64]. Along with the advanced therapeutics and approaches, several vaccines and treatments against Ebola virus are under clinical trial including rVSV-ZEBOV or Ervebo [65] which was proved to be 100% protective against EVD [66]. It can be administered in people of 18 years age or above [66]. ...
Concurrent waves of Coronavirus disease, Ebola virus disease, avian influenza A and black fungus are jeopardizing the lives in some parts of Africa and Asia. From this point of view, this review aims to summarize both socio-economic and public health implications of these parallel outbreaks along with their best possible management approaches. Various online databases were used to collect the necessary information regarding these outbreaks. Based on the reports published and analyses done so far, the long-lasting damages caused by these simultaneous outbreaks on global socio-economical and public health status can be conceived from the past experiences of outbreaks, especially the COVID-19 pandemic. Moreover, prolonged restrictions by the local government may lead to food insecurity, global recession, and an enormous impact on the mental health of people of all ages, specifically in developing countries. Such overwhelming effects already have been reported to be declining national growth of the economy as well as increasing political insecurity and shortage of basic needs. Although various actions have already been taken including vaccination, clinical management, and further research, social distancing, and lockdown, etc. to improve the situation, the emerging variants and associated genetic mutations may make the containment difficult worsening the situation again. Considering the current mutational dynamics of the pathogens and the past experiences, perpetual preparedness along with updated clinical management backed by epidemiological studies and innovating scientific effort are inevitable to combat the simultaneous waves of multiple infectious diseases.
This study examines the archetypal stages of human responses to fear and anxiety during pandemics and epidemics in Edgar Allan Poe’s “The Masque of the Red Death,” Amir Tag Elsir’s Ebola 76, and COVID-19. Pandemics and epidemics elicit a range of psychosocial response mechanisms in individuals due to innate and unmanageable feelings of fear and uncertainty. In the face of chaotic circumstances, the human collective psyche exhibits contagious horrors that are both random and overwhelming. However, these reactions follow historically patterned prototypical stages that significantly disrupt human ontological existence's apparent peace, harmony, and rhythm. The manifestation of this division became apparent during the COVID-19 pandemic, particularly during periods of confinement, when the fear of the virus gradually infiltrated even the smallest aspects of social life. Notably, the selected narratives accurately depict the various stages of human responses to pandemics. The stages are represented in Poe’s story as disapprobation, surprise, horror, and disgust, and in Elsir’s novel as shock, denial, acceptance, and hope. These phases unveil a comprehensive and emotional engagement with the human experience of pandemics and epidemics, offering a descriptive and anticipatory portrayal of the imminent social, psychological, and cultural calamities when the COVID-19 pandemic began to unpredictably ravage the world.
Background
Ebola virus disease (EVD) has been shown to be associated with poor mental health in affected zones. However, no study has yet explored its impact on adolescents’ mental health.
Aims
This study aimed to assess the prevalence and risk factors associated with depression and anxiety symptoms among adolescents in EVD-affected areas in the Equateur Province of the Democratic Republic of the Congo during the COVID-19 pandemic.
Method
A provincial sample of adolescents aged 12–17 years (M = 14.84, s.d. = 1.49) living in the 18 urban and rural areas affected by the 2018 EVD outbreak completed a two-wave longitudinal survey. Surveys assessed symptoms of depression and anxiety, exposure to Ebola, social support and sociodemographic information.
Results
A total of 490 participants completed the baseline and follow-up surveys, 50% of whom were female. Elevated and worsened depressive symptoms were observed among participants from the baseline (56.94%) to the follow-up (91.43%; z = −11.37, P < 0.001), whereas anxiety symptoms decreased from the baseline (36.33%) to follow-up (24.90%; z = 4.06, P < 0.001). The final generalised estimating equation model showed that anxiety symptoms decreased over time (B = −3.92, P < 0.001), while depression symptoms increased (B = 4.79, P < 0.001). Stigmatisation related to Ebola positively predicted anxiety (B = 5.41, P < 0.001) and depression symptoms (B = 0.4452, P = 0.009). Social support negatively predicted anxiety (B = −1.13, P = 0.004) and depression (B = −0.98, P < 0.001) symptoms but only moderated the association between stigmatisation and depression symptoms (B = −0.67, P < 0.001).
Conclusions
Most adolescents living in EVD-affected areas experience mental health issues. Stigmatisation related to EVD and living in urban areas are the most consistent predictors of mental health problems. Nevertheless, social support remains a protective factor for depression and anxiety symptoms and a necessary resource for building resilience.
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