• Infection Prevention and Control in Health Facilities in Post-Ebola Liberia: Don't Forget the Private Sector!

      Tremblay, N; Musa, E; Cooper, C; Van den Bergh, R; Owiti, P; Baller, A; Siafa, T; Woldeyohannes, D; Shringarpure, K; Gasasira, A (International Union Against Tuberculosis and Lung Disease, 2017-06-21)
      Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC.
    • Outcomes of cholera and measles outbreak alerts in the Democratic Republic of Congo

      Makelele, JPK; Ade, S; Takarinda, KC; Manzi, M; Cuesta, JG; Acma, A; Yepez, MM; Mashak, M (International Union Against Tuberculosis and Lung Disease, 2020-09-21)
      Setting: In 1995, a rapid response project for humanitarian and medical emergencies, including outbreak responses, named ‘Pool d’Urgence Congo’ (PUC), was implemented in the Democratic Republic of Congo by Médecins Sans Frontières. Objective: To assess the outcomes of cholera and measles outbreak alerts that were received in the PUC surveillance system between 2016 and 2018. Design: This was a retrospective cross-sectional study. Results: Overall, 459 outbreak alerts were detected, respectively 69% and 31% for cholera and measles. Of these, 32% were actively detected and 68% passively detected. Most alerts (90%) required no intervention and 10% of alerts had an intervention. There were 25% investigations that were not carried out despite thresholds being met; 17% interventions were not performed, the main reported reason being PUC operational capacity was exceeded. Confirmed cholera and measles outbreaks that met an investigation threshold comprised respectively 90% and 76% of alerts; 59% of measles investigations were followed by a delayed outbreak response of 14 days (n = 10 outbreaks). Conclusion: Some alerts for cholera and measles outbreaks that were detected in the PUC system did not lead to a response even when required; the main reported reason was limited operational capacity to respond to all of them.
    • Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

      Edwards, J. K.; Thiongó, A.; Van den Bergh, R.; Kizito, W.; Kosgei, R. J.; Sobry, A.; Vandenbulcke, A.; Zuniga, I.; Reid, A. J. (International Union Against Tuberculosis and Lung Disease, 2014-08-12)
    • Tuberculosis treatment in a refugee and migrant population: 20 years of experience on the Thai-Burmese border.

      Minetti, A; Camelique, O; Hsa Thaw, K; Thi, S; Swaddiwudhipong, W; Hewison, C; Pinoges, L; Bonnet, M; Guerin, P J; Médecins Sans Frontières, Paris, France. andrea.minetti@epicentre.msf.org (International Union Against Tuberculosis and Lung Disease, 2010-12)
      Although tuberculosis (TB) is a curable disease, it remains a major global health problem and an important cause of morbidity and mortality among vulnerable populations, including refugees and migrants.