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The Médecins Sans Frontières intervention in the Marburg epidemic Uige/Angola, 2005: Lessons learnt in the hospital and community Paul Roddy MSF-Spain. Objective. To share future outbreak recommendations…. Methods. Individual semi-structured face-to-face interviews

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The Médecins Sans Frontières interventionin the Marburg epidemic Uige/Angola, 2005: Lessons learnt in the hospital and communityPaul RoddyMSF-Spain


Objective
Objective

To share future outbreak recommendations…


Methods
Methods

  • Individual semi-structured face-to-face interviews

    • available MSF expatriate and local staff directly involved with disease control activities and arriving in Uige before June 3rd, 2005 (n=31)

    • local key informants (n=11)

  • Semi-structured group interviews (n=10)

    • families of MHF patients and local staff of outbreak control teams.


The hospital response included:

  • Case diagnosis

  • Nursing care

  • Psychological care

  • Design of the Marburg ward

  • Case detection in the hospital

  • Medical management

  • Infection control in the hospital


The community response included:

  • Peripheral health facility support

  • Burial and disinfection

  • Home-based risk reduction (HBRR)

  • Epidemiological surveillance

  • Psychosocial support

  • Information and education campaign (IEC)



Burial and disinfection

MSF protocol

Technically sound

Failure:

incorporating local traditions

addressing the psychological and spiritual needs of families

explaining procedures

WHO protocol

Time consuming - execution

Contained the culturally sensitive aspects missing from the MSF protocol

Burial and disinfection


Information and education campaigns

Message 1

‘There is no cure for this disease’

Message 2

‘Come to hospital and receive treatment’

Information and education campaigns


Future outbreak recommendations hospital
Future outbreak recommendations - hospital

  • Give IV fluids

  • Continue symptomatic care

  • Collect quality clinical data

  • Possibly accept the use of injections

  • Use a combination of fencing (mesh and solid) for isolation area

  • Others…


Future outbreak recommendations community
Future outbreak recommendations - community

  • Dress/undress in presence of household

  • Enter household with family member dressed in PPE

  • Outside household – explain procedures

  • Family views corpse before burial

  • Family members know the location of the grave

  • Burial rites reflect traditional ones

  • After disinfection, replaced damaged household items


Future outbreak recommendations community1
Future outbreak recommendations - community

  • Implement psychosocial intervention and IEC programmes from the beginning of intervention

  • Use local staff in psychosocial programme

  • Treatment – albeit limited in its effectiveness – and care by medical professionals is available at the FHF ward

  • Others…


Authors affiliations
Authors & Affiliations

Paul Roddy1, David Weatherill1, Benjamin Jeffs1, Zohra Abaakouk1, Claire Dorion1, Josefa Rodriguez-Martinez1, Pedro Pablo Palma1, Olimpia de la Rosa1, Luis Villa1, Isabel Grovas1, Matthias Borchert1,2

1 Médecins Sans Frontières - Spain

2 Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine

The Journal of Infectious Diseases

Supplement entitled: Filoviruses: Recent Advances and Future Challenges

Roddy et al. The Médecins Sans Frontières intervention in the Marburg epidemic Uige/Angola, 2005 – II: Lessons learned in the community


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