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Objective

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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Objective

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

  2. Objective To share future outbreak recommendations…

  3. 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.

  4. 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

  5. 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)

  6. The initial outbreak response What happened?

  7. 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

  8. Message 1 ‘There is no cure for this disease’ Message 2 ‘Come to hospital and receive treatment’ Information and education campaigns

  9. 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…

  10. 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

  11. 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…

  12. 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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