1Academic Unit for Infection Prevention and Control, Faculty of Medicine and Health sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa 2 Infection Prevention and Control Unit, WHO Health Emergencies Program, EVD Response, Democratic Republic of the CongoFulltext PDF
Background: The 2018 to 2020 Ebola Virus Disease (EVD) outbreaks in the eastern Democratic Republic of the Congo (DRC) was declared by the Ministry of Health on 01 August 2018. It is the DRC largest ever EVD outbreak and the second biggest Ebola epidemic recorded behind the West Africa outbreak of 2014 to 2016. The weak health systems in DRC, mistrust of the populations to healthcare facilities and insecurity in eastern part of the country constituted big amplifiers of EVD outbreak. We conceptualized infection prevention and control took into account the DRC context and we piloted it in twenty five healthcare facilities to contribute to ensure healthcare facilities are able to effectively prevent and/or respond to EVD cases and avoiding propagation within healthcare facilities and in the communities. Materials and Methods: This quasi experimental intervention pilot study was conducted in twenty five (25) healthcare facilities of Goma EVD sub coordination, North-Kivu province between December 2018 and March 2019. IPC program was tailored to DRC context and IPC approach developed and implemented to strengthen Infection Prevention and Control (IPC) activities in priority HCFs. The study was composed by three phases: Pre-intervention IPC assessment conducted in January 2019, intervention phase in February 2019 and post intervention assessment which we conducted in March 2019. The activities conducted during intervention phase were: Training of healthcare workers and hygienists, donation of HCF with IPC kits, supportive supervision with coaching and mentoring of healthcare workers and hygienists on how perform IPC practices. Pre and post assessment data was analyzed using Ms Excel. Results: Before intervention, the average score of IPC was 37% and 9% of triage and isolation section. After intervention, the average score of IPC increased to 61% and 81% of triage and isolation section. Eighty percent (20/25) healthcare facilities had the IPC score below 50% before intervention, while 20% (5/25) of the HCF their IPC score was between 50% and 79%. There was no HCF with acceptable IPC score (≥ 80%). After intervention, 12% (3/25) of HCF had acceptable IPC score (≥ 80%). 72% (18/25) of the HCF had IPC score between 50% and 79%. The IPC score of 16% (4/25) of HCF remained below 50%. There was an improvement of 24% in terms of IPC and 72% in terms of triage and isolation section. Conclusion: This pilot study demonstrated how is feasible to setup a comprehensive program such as infection prevention and control as part of improving health systems and maintain readiness level prevent or contain outbreaks such as Ebola Virus Disease. Capacity building including training, coaching and mentoring of healthcare workers is a key for effective implementation of IPC program. Building trust between communities and healthcare facilities should be strengthened. More efforts, resources and expertise are needed for community mobilization and community engagement. Community infection prevention and control program should be developed and supported.
Infection prevention and control; Health systems strengthening; Infection prevention and control assessment; IPC score; Alcohol based hand rub; Ebola virus disease, Ebola virus disease outbreak; Healthcare facilities; Healthcare associated infections; Community engagement
Hakizimana B. Conceptualizing Ebola Virus Disease (EDV) Infection Prevention and Control (IPC) Program in the Context of Democratic Republic of the Congo (DRC) During the 2018- 2020 EVD Outbreak: Pilot Study. Int J Fam Med Prim Care. 2020; 1(1): 1005.