32 results on '"Justus Nsio"'
Search Results
2. Knowledge, attitudes, practices, and perception of COVID-19 preventive measures among adult residents of Matadi (Democratic Republic of the Congo) after the third epidemic wave
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Yannick Munyeku-Bazitama, Patient Okitale-Talunda, Justus Nsio-Mbeta, Patrick Mpingabo-Ilunga, Paul Tshiminyi-Munkamba, Aimé Umba-Phuati, Jacques Kimfuta, Ferdinand Ango-Phukuta, Goethe Makindu, Raymond Mufwaya-Nsene, Ryoko Asari, Saeda Makimoto, Steve Ahuka-Mundeke, Mitsuo Isono, Sheila Makiala-Mandanda, and Jean-Jacques Muyembe-Tamfum
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COVID-19 ,knowledge ,attitudes ,practices ,perception ,prevention ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundSeveral governments from African countries, including the Democratic Republic of the Congo (DRC), implemented stringent public health measures to curb COVID-19 transmission in the early phases of the pandemic. While these restrictive measures are believed to have contributed to lowering case incidence and related mortality in DRC, data on the population’s knowledge and adherence are limited. This study aimed to assess the knowledge, perception, attitudes, and practices of COVID-19 preventive measures and associated factors among adult residents of Matadi, thereby generating evidence for a strategy adjustment as the COVID-19 response is transitioning from emergency to control status.MethodsWe used data from a population-based cross-sectional study conducted in October 2021. Consenting participants were enrolled through a multi-stage cluster sampling approach and administered a pre-tested structured questionnaire using a mobile application (Epicollect 5). We analyzed adult participants’ data using STATA 15.1. Univariable and multivariable analyses were applied to identify factors associated with good knowledge, good perception, positive attitude and good practice.ResultsWe included 1,269 adult respondents for the secondary analysis. One respondent in six was female. The median age was 36 years (IQR 24–50). Most respondents (76.5%) had good knowledge. Respondents aged 40–49 years and those with vocational education level were 1.7 time (AOR 1.75, 95% CI 1.07–2.87) and twice as likely (AOR 2.06, 95% CI 1.01–4.21) to have good knowledge. Preventive measures were perceived as efficient by 45% of respondents. Good perception was associated with education level, profession, average household monthly income and good knowledge. Only 40% of respondents had a positive attitude. A positive attitude was associated with age, education level, and good knowledge. Respondents having good practice represented 5.8%. Good practice was associated with good knowledge, attitude and perception.ConclusionMost respondents were knowledgeable, had a good perception of government-related COVID-19 preventive measures, a moderately positive attitude and an extremely low level of good practice. Current COVID-19 preventive strategies, including vaccination rollout, need adjustment into high-efficiency, context-based and risk group-specific interventions. Evidence generated by this study will improve preparedness and response to future outbreaks.
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- 2024
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3. The implementation of infection prevention and control measures and health care utilisation in ACF-supported health facilities during the COVID-19 pandemic in Kinshasa, Democratic Republic of the Congo, 2020
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Chiara Altare, Linda Matadi Basadia, Natalya Kostandova, Justus Nsio Mbeta, Sophie Bruneau, Caroline Antoine, and Marie Petry
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covid-19 ,infection prevention and control ,kinshasa ,democratic republic of the congo ,routine health services ,Public aspects of medicine ,RA1-1270 - Abstract
Background Infection prevention and control (IPC) was a central component of the Democratic Republic of the Congo’s COVID-19 response in 2020, aiming to prevent infections and ensure safe health service provision. Objectives We aimed to assess the evolution of IPC capacity in 65 health facilities supported by Action Contre la Faim in three health zones in Kinshasa (Binza Meteo (BM), Binza Ozone (BO), and Gombe), investigate how triage and alert validation were implemented, and estimate how health service utilisation changed in these facilities (April–December 2020). Methods We used three datasets: IPC Scorecard data assessing health facilities’ IPC capacity at baseline, monthly and weekly triage data, and monthly routine data on eight health services. We examined factors associated with triage and isolation capacity with a mixed-effects negative binomial model and estimated changes in health service utilisation with a mixed-model with random intercept and long-term trend for each health facility. We reported incidence rate ratios (IRRs) for level change when the pandemic began, for trend change, and for lockdown and post-lockdown periods (Gombe). We estimated cumulative and monthly percent differences with expected consultations. Results IPC capacity reached an average score of 90% by the end of the programme. A one-point increase in the IPC score was associated with +6% and +5% increases in triage capacity in BO and Gombe, respectively, and with +21% and +10% increases in isolation capacity in the same zones. When the pandemic began, decreases were seen in outpatient consultations (IRR: 0.67, 95% confidence interval (CI) [0.48–0.95] BM&BO-combined; IRR: 0.29, 95%CI [0.16–0.53] Gombe), consultations for respiratory tract infections (IRR: 0.48, 95%CI [0.28–0.87] BM&BO-combined), malaria (IRR: 0.60, 95%CI [0.43–0.84] BM&BO-combined, IRR: 0.33, 95%CI [0.18–0.58] Gombe), and vaccinations (IRR: 0.27, 95%CI [0.10–0.71] Gombe). Maternal health services decreased in Gombe (ANC1: IRR: 0.42, 95%CI [0.21–0.85]). Conclusions The effectiveness of the triage and alert validation process was affected by the complexity of implementing a broad clinical definition in limited-resource settings with a pre-pandemic epidemiological profile characterised by infectious diseases with symptoms like COVID-19. Readily available testing capacity remains key for future pandemic response to improve the disease understanding and maintain health services.
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- 2023
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4. Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020
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Mory Keita, Héloïse Lucaccioni, Michel Kalongo Ilumbulumbu, Jonathan Polonsky, Justus Nsio-Mbeta, Gaston Tshapenda Panda, Pierre Celeste Adikey, John Kombe Ngwama, Michel Kasereka Tosalisana, Boubacar Diallo, Lorenzo Subissi, Adama Dakissaga, Iris Finci, Maria Moitinho de Almeida, Debarati Guha-Sapir, Ambrose Talisuna, Alexandre Delamou, Stephanie Dagron, Olivia Keiser, and Steve Ahuka-Mundeke
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Ebola ,Ebola virus infection ,viruses ,Early Warning Alert and Response System ,EWARS ,surveillance ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
The 10th and largest Ebola virus disease epidemic in the Democratic Republic of the Congo (DRC) was declared in North Kivu Province in August 2018 and ended in June 2020. We describe and evaluate an Early Warning, Alert and Response System (EWARS) implemented in the Beni health zone of DRC during August 5, 2018–June 30, 2020. During this period, 194,768 alerts were received, of which 30,728 (15.8%) were validated as suspected cases. From these, 801 confirmed and 3 probable cases were detected. EWARS showed an overall good performance: sensitivity and specificity >80%, nearly all (97%) of alerts investigated within 2 hours of notification, and good demographic representativeness. The average cost of the system was US $438/case detected and US $1.8/alert received. The system was stable, despite occasional disruptions caused by political insecurity. Our results demonstrate that EWARS was a cost-effective component of the Ebola surveillance strategy in this setting.
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- 2021
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5. Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018–2020
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Jonathan A. Polonsky, Dankmar Böhning, Mory Keita, Steve Ahuka-Mundeke, Justus Nsio-Mbeta, Aaron Aruna Abedi, Mathias Mossoko, Janne Estill, Olivia Keiser, Laurent Kaiser, Zabulon Yoti, Patarawan Sangnawakij, Rattana Lerdsuwansri, and Victor J. Del Rio Vilas
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Ebola ,Ebolavirus ,viruses ,contact tracing ,disease outbreaks ,Democratic Republic of the Congo ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Despite its critical role in containing outbreaks, the efficacy of contact tracing, measured as the sensitivity of case detection, remains an elusive metric. We estimated the sensitivity of contact tracing by applying unilist capture-recapture methods on data from the 2018–2020 outbreak of Ebola virus disease in the Democratic Republic of the Congo. To compute sensitivity, we applied different distributional assumptions to the zero-truncated count data to estimate the number of unobserved case-patients with any contacts and infected contacts. Geometric distributions were the best-fitting models. Our results indicate that contact tracing efforts identified almost all (n = 792, 99%) of case-patients with any contacts but only half (n = 207, 48%) of case-patients with infected contacts, suggesting that contact tracing efforts performed well at identifying contacts during the listing stage but performed poorly during the contact follow-up stage. We discuss extensions to our work and potential applications for the ongoing coronavirus pandemic.
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- 2021
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6. Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017
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Helene M. De Nys, Placide Mbala Kingebeni, Alpha K. Keita, Christelle Butel, Guillaume Thaurignac, Christian-Julian Villabona-Arenas, Thomas Lemarcis, Mare Geraerts, Nicole Vidal, Amandine Esteban, Mathieu Bourgarel, François Roger, Fabian Leendertz, Ramadan Diallo, Simon-Pierre Ndimbo-Kumugo, Justus Nsio-Mbeta, Nikki Tagg, Lamine Koivogui, Abdoulaye Toure, Eric Delaporte, Steve Ahuka-Mundeke, Jean-Jacques Muyembe Tamfum, Eitel Mpoudi-Ngole, Ahidjo Ayouba, and Martine Peeters
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Ebola ,bats ,Africa ,Guinea ,Cameroon ,the Democratic Republic of the Congo ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
To clarify the role of bats in the ecology of Ebola viruses, we assessed the prevalence of Ebola virus antibodies in a large-scale sample of bats collected during 2015–2017 from countries in Africa that have had previous Ebola outbreaks (Guinea, the Democratic Republic of the Congo) or are at high risk for outbreaks (Cameroon). We analyzed 4,022 blood samples of bats from >12 frugivorous and 27 insectivorous species; 2–37 (0.05%–0.92%) bats were seropositive for Zaire and 0–30 (0%–0.75%) bats for Sudan Ebola viruses. We observed Ebola virus antibodies in 1 insectivorous bat genus and 6 frugivorous bat species. Certain bat species widespread across Africa had serologic evidence of Zaire and Sudan Ebola viruses. No viral RNA was detected in the subset of samples tested (n = 665). Ongoing surveillance of bats and other potential animal reservoirs are required to predict and prepare for future outbreaks.
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- 2018
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7. Accounting for population structure reveals ambiguity in the Zaire Ebolavirus reservoir dynamics.
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Bram Vrancken, Tony Wawina-Bokalanga, Bert Vanmechelen, Joan Martí-Carreras, Miles W Carroll, Justus Nsio, Jimmy Kapetshi, Sheila Makiala-Mandanda, Jean-Jacques Muyembe-Tamfum, Guy Baele, Kurt Vermeire, Valentijn Vergote, Steve Ahuka-Mundeke, and Piet Maes
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Ebolaviruses pose a substantial threat to wildlife populations and to public health in Africa. Evolutionary analyses of virus genome sequences can contribute significantly to elucidate the origin of new outbreaks, which can help guide surveillance efforts. The reconstructed between-outbreak evolutionary history of Zaire ebolavirus so far has been highly consistent. By removing the confounding impact of population growth bursts during local outbreaks on the free mixing assumption that underlies coalescent-based demographic reconstructions, we find-contrary to what previous results indicated-that the circulation dynamics of Ebola virus in its animal reservoir are highly uncertain. Our findings also accentuate the need for a more fine-grained picture of the Ebola virus diversity in its reservoir to reliably infer the reservoir origin of outbreak lineages. In addition, the recent appearance of slower-evolving variants is in line with latency as a survival mechanism and with bats as the natural reservoir host.
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- 2020
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8. Urban yellow fever outbreak-Democratic Republic of the Congo, 2016: Towards more rapid case detection.
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Brecht Ingelbeen, Nadine A Weregemere, Harold Noel, Gaston P Tshapenda, Mathias Mossoko, Justus Nsio, Axelle Ronsse, Steve Ahuka-Mundeke, Sandra Cohuet, and Benoît I Kebela
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundBetween December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of cases in future urban outbreaks.Methodology/principal findingsIn DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever onset and was confirmed by either IgM serology or PCR for YF viral RNA. We used case investigation and hospital admission forms. Comparing clinical signs between confirmed and discarded suspected YF cases, we calculated the predictive values of each sign for confirmed YF and the diagnostic accuracy of several suspected YF case definitions. Fifty seven of 78 (73%) confirmed cases had travelled from Angola: 88% (50/57) men; median age 31 years (IQR 25-37). 15 (19%) confirmed cases were infected locally in urban settings in DRC. Median time from symptom onset to healthcare consultation was 7 days (IQR 6-9), to appearance of jaundice 8 days (IQR 7-11), to sample collection 9 days (IQR 7-14), and to hospitalization 17 days (IQR 11-26). A case definition including fever or jaundice, combined with myalgia or a negative malaria test, yielded an improved sensitivity (100%) and specificity (57%).Conclusions/significanceAs jaundice appeared late, the majority of cases were diagnosed too late for supportive care and prompt vector control. In areas with known local YF transmission, a suspected case definition without jaundice as essential criterion could facilitate earlier YF diagnosis, care and control.
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- 2018
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9. Evaluation of centralised and decentralised models of care during the 2020 Ebola Virus Disease outbreak in Equateur Province, Democratic Republic of the Congo: A brief report [version 2; peer review: 1 approved, 1 approved with reservations]
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Emmanuel Lampaert, Justus Nsio Mbeta, Divya Nair, Maria Mashako, Anja De Weggheleire, Armand Sprecher, Rebecca M. Coulborn, and Steve Ahuka-Mundeke
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Brief Report ,Articles ,Viral Haemorrhagic Fever ,Central Africa ,SORT IT ,Outbreak ,Epidemic response ,Decentralized care ,Operational Research ,Ebola - Abstract
Background Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC’s Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD. Methods This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak. Results Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p Conclusions Since
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- 2024
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10. Evaluation of centralised and decentralised models of care during the 2020 Ebola Virus Disease outbreak in Equateur Province, Democratic Republic of the Congo: A brief report [version 1; peer review: awaiting peer review]
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Emmanuel Lampaert, Justus Nsio Mbeta, Divya Nair, Maria Mashako, Anja De Weggheleire, Armand Sprecher, Rebecca M. Coulborn, and Steve Ahuka-Mundeke
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Brief Report ,Articles ,Viral Haemorrhagic Fever ,Central Africa ,SORT IT ,Outbreak ,Epidemic response ,Decentralized care ,Operational Research ,Ebola - Abstract
Background Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC’s Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD. Methods This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak. Results Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p Conclusions Since
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- 2024
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11. High Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence After the Third Epidemic Wave (May–October 2021) in Matadi, Democratic Republic of the Congo
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Yannick Munyeku-Bazitama, Patient Okitale-Talunda, Patrick Mpingabo-Ilunga, Marc K Yambayamba, Paul M Tshiminyi, Aimé Umba-Phuati, Jacques Kimfuta, Ferdinand A Phukuta, Goethe Makindu, Raymond Mufwaya-Nsene, Ryoko Asari, Saeda Makimoto, Lionel K Baketana, Steve Ahuka-Mundeke, Mitsuo Isono, Justus Nsio-Mbeta, Sheila Makiala-Mandanda, and Jean-Jacques Muyembe-Tamfum
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Infectious Diseases ,Oncology - Abstract
Background By the end of the third wave of the coronavirus disease 2019 (COVID-19) epidemic (May–October 2021), only 3130 of the 57 268 confirmed cases of coronavirus disease 2019 (COVID-19) in the Democratic Republic of the Congo (DRC) were reported in Kongo Central. This province, and especially its capital city, Matadi, has essential trade and exchanges with Kinshasa, the epicenter of the COVID-19 epidemic in DRC. Kinshasa accounted for 60.0% of all cases during the same period. The true burden of COVID-19 in Matadi is likely underestimated. In this study, we aimed to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and associated risk factors after the third wave in Matadi. Methods We conducted a population-based cross-sectional study in October 2021. Consenting participants were interviewed and tested using an enzyme-linked immunosorbent assay commercial kit. We applied univariable and multivariable analysis to evaluate factors associated with seropositivity and adjusted the seroprevalence for the test kit performance. Results We included 2210 participants from 489 households. Female participants represented 59.1%. The median age was 27 years (interquartile range, 16–45 years). The crude SARS-CoV-2 seroprevalence was 82.3%. Age was identified as the main risk factor as younger age decreased the seropositivity odds. Accounting for clustering at the household level increased the seroprevalence to 83.2%. The seroprevalence increased further to 88.1% (95% confidence interval, 86.2%–90.1%) after correcting for the laboratory test kit performance. Conclusions The SARS-CoV-2 seroprevalence was very high, contrasting with reported cases. Evidence generated from this population-based survey remains relevant in guiding the local COVID-19 response, especially vaccination strategies.
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- 2023
12. Differential symptomology of possible and confirmed Ebola virus disease infection in the Democratic Republic of the Congo: a retrospective cohort study
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Justus Nsio, Denis-Luc Ardiet, Rebecca M Coulborn, Emmanuel Grellety, Manuel Albela, Francesco Grandesso, Richard Kitenge, Dolla L Ngwanga, Bibiche Matady, Guyguy Manangama, Mathias Mossoko, John Kombe Ngwama, Placide Mbala, Francisco Luquero, Klaudia Porten, and Steve Ahuka-Mundeke
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Infectious Diseases - Abstract
In its earliest phases, Ebola virus disease's rapid-onset, high fever, and gastrointestinal symptoms are largely indistinguishable from other infectious illnesses. We aimed to characterise the clinical indicators associated with Ebola virus disease to improve outbreak response.In this retrospective analysis, we assessed routinely collected data from individuals with possible Ebola virus disease attending 30 Ebola health facilities in two provinces of the Democratic Republic of the Congo between Aug 1, 2018, and Aug 28, 2019. We used logistic regression analysis to model the probability of Ebola infection across 34 clinical variables and four types of possible Ebola virus disease exposures: contact with an individual known to have Ebola virus disease, attendance at any funeral, health facility consultation, or consultation with an informal health practitioner.Data for 24 666 individuals were included. If a patient presented to care in the early symptomatic phase (ie, days 0-2), Ebola virus disease positivity was most associated with previous exposure to an individual with Ebola virus disease (odds ratio [OR] 11·9, 95% CI 9·1-15·8), funeral attendance (2·1, 1·6-2·7), or health facility consultations (2·1, 1·6-2·8), rather than clinical parameters. If presentation occurred on day 3 or later (after symptom onset), bleeding at an injection site (OR 33·9, 95% CI 12·7-101·3), bleeding gums (7·5, 3·7-15·4), conjunctivitis (2·4, 1·7-3·4), asthenia (1·9, 1·5-2·3), sore throat (1·8, 1·3-2·4), dysphagia (1·8, 1·4-2·3), and diarrhoea (1·6, 1·3-1·9) were additional strong predictors of Ebola virus disease. Some Ebola virus disease-specific signs were less prevalent among vaccinated individuals who were positive for Ebola virus disease when compared with the unvaccinated, such as dysphagia (-47%, p=0·0024), haematemesis (-90%, p=0·0131), and bleeding gums (-100%, p=0·0035).Establishing the exact time an individual first had symptoms is essential to assessing their infection risk. An individual's exposure history remains of paramount importance, especially in the early phase. Ebola virus disease vaccination reduces symptom severity and should also be considered when assessing the likelihood of infection. These findings about symptomatology should be translated into practice during triage and should inform testing and quarantine procedures.Médecins Sans Frontières and its research affiliate Epicentre.
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- 2022
13. A community-based confinement strategy to reduce the spread of Ebola Virus Disease: An analysis of the 2018-2020 outbreak in the DRC
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Mory Keita, Jonathan A. Polonsky, Steve Ahuka-Mundeke, Michel Kalongo Ilumbulumbu, Adama Dakissaga, Hamadou Boiro, Julienne Ngoundoung Anoko, Lamine Diassy, John Kombe Ngwama, Michel Kasereka Tosalisana, Justus Nsio, Ibrahima Sory Chérif, Samuel T. Boland, Alexandre Delamou, Abdoulaye Yam, Abdou Salam Gueye, Antoine Flahault, Stephanie Dagron, Olivia Keiser, and Ibrahima Socé Fall
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BackgroundDespite tremendous progress on Ebola Virus Disease (EVD), challenges remain in the implementation of holistic strategies to quickly stop outbreaks. We investigated the effectiveness of a community-based confinement strategy to limit the spread of EVD during the tenth documented EVD outbreak in the Democratic Republic of the Congo (DRC), 2018 - 2020.MethodsWe did a community-based, open-label, two-group, unrandomized controlled intervention. Eligible participants were EVD contacts registered by epidemiological surveillance teams from November 2019 to May 2020 in the two last hotspots (Beni and Mabalako Health Zones). Intervention group participants were confined in specific community sites of their preference for the duration of their follow-up. Control group participants underwent CT without confinement and were allowed to continue their daily activities. The primary outcome was the number of confirmed secondary cases in the two groups. Secondary outcomes included delay between symptom onset and isolation, case fatality rate, survival rate, and vaccination rate. Data were analyzed using various quantitative methods.FindingsA total of 27,324 EVD contacts were included in the study. 585 contacts were confined and followed up (‘the intervention group’), and 26,739 were followed up without confinement. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the control group generated just 87 (0.3%). However, the 32 confirmed cases from the intervention contacts did not generate any onward transmission (R=0.00), whereas the 87 confirmed cases from the non-intervention group generated 99 secondary cases (R = 1.14). Results for the secondary outcomes showed significant difference between the two groups. The delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; pInterpretationThe community-based confinement strategy used in DRC is effective for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, innovative and community-oriented control strategies.
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- 2022
14. Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo
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Michel P Hermans, Stéphane Mukendi, Nadia A. Sam-Agudu, Marie Claire Kolié, John Otshudiema Otokoye, Gerald Smith, Michel Tshiasuma Pipo, Justus Nsio, Alimuddin Zumla, Daniel Katuashi Ishoso, Lynne M. Mofenson, John W. Mellors, Placide Mbala-Kingebeni, Steve Ahuka-Mundeke, Edith Nkwembe, Jean B. Nachega, Rhoderick Machekano, Jean-Jacques Muyembe-Tamfum, Didier Mukeba Tshialala, Joule Ntwan Madinga, Jean-Marie Ntumba Kayembe, Gisele Mbuyi, Edward J Mills, Don Jethro Mavungu Landu, and Christian Bongo-Pasi Nswe
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Male ,Azithromycin ,Severity of Illness Index ,Lopinavir ,law.invention ,Interquartile range ,law ,Risk Factors ,Hospital Mortality ,Hazard ratio ,Chloroquine ,Articles ,Middle Aged ,Intensive care unit ,Hospitals ,Patient Discharge ,Hospitalization ,Drug Combinations ,Intensive Care Units ,Infectious Diseases ,Treatment Outcome ,Democratic Republic of the Congo ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Virology ,Internal medicine ,Severity of illness ,medicine ,Humans ,Obesity ,Enoxaparin ,Renal Insufficiency, Chronic ,Pandemics ,Retrospective Studies ,Ritonavir ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Odds ratio ,medicine.disease ,COVID-19 Drug Treatment ,Asymptomatic Diseases ,Parasitology ,business ,Kidney disease - Abstract
Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa. We conducted a retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven hospitals in Kinshasa, Democratic Republic of the Congo (DRC). Outcomes included clinical improvement within 30 days (primary) and in-hospital mortality (secondary). Of 766 confirmed COVID-19 cases, 500 (65.6%) were male, with a median (interquartile range [IQR]) age of 46 (34–58) years. One hundred ninety-one (25%) patients had severe/critical disease requiring admission in the intensive care unit (ICU). Six hundred twenty patients (80.9%) improved and were discharged within 30 days of admission. Overall in-hospital mortality was 13.2% (95% CI: 10.9–15.8), and almost 50% among those in the ICU. Independent risk factors for death were age < 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI: 1.85–23.64), 40–59 years (aHR = 4.45, 95% CI: 1.83–10.79), and ≥ 60 years (aHR = 13.63, 95% CI: 5.70–32.60) compared with those aged 20–39 years, with obesity (aHR = 2.30, 95% CI: 1.24–4.27), and with chronic kidney disease (aHR = 5.33, 95% CI: 1.85–15.35). In marginal structural model analysis, there was no statistically significant difference in odds of clinical improvement (adjusted odds ratio [aOR] = 1.53, 95% CI: 0.88–2.67, P = 0.132) nor risk of death (aOR = 0.65, 95% CI: 0.35–1.20) when comparing the use of chloroquine/azithromycin versus other treatments. In this DRC study, the high mortality among patients aged < 20 years and with severe/critical disease is of great concern, and requires further research for confirmation and targeted interventions.
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- 2020
15. Development and Evaluation of a Rapid Decision Algorithm for the Triage of Patients During Ebola Outbreaks
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Denis-Luc Ardiet, Justus Nsio, Gaston Komanda, Rebecca M. Coulborn, Emmanuel Grellety, Francesco Grandesso, Richard Kitenge, Dolla L. Ngwanga, Bibiche Matady, Guyguy Manangama, Mathais Mossoko, John Kombe Ngwama, Placide Mbala, Francisco Luquero, Klaudia Porten, and Steve Ahuka-Mundeke
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History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
16. Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo—Priorities for Achieving Control
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Wolfgang Preiser, John O Otshudiema, Jean Jacques Muyembe Tamfum, Joel G. Breman, Justus Nsio, Oscar Kallay, Jean B. Nachega, Anne W. Rimoin, Susan Michaels-Strasser, Alimuddin Zumla, Steve Ahuka-Mundeke, Linda M. Mobula, and Placide Mbala-Kingebeni
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Economic growth ,medicine.medical_specialty ,030231 tropical medicine ,Population ,Pneumonia, Viral ,medicine.disease_cause ,Perspective Piece ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Virology ,Political science ,Epidemiology ,medicine ,Humans ,education ,Health communication ,Pandemics ,education.field_of_study ,Ebola virus ,Community engagement ,SARS-CoV-2 ,Public health ,Outbreak ,COVID-19 ,Hemorrhagic Fever, Ebola ,Infectious Diseases ,Health Communication ,Democratic Republic of the Congo ,Parasitology ,Contact Tracing ,Coronavirus Infections ,Case Management ,Delivery of Health Care ,Contact tracing - Abstract
As of June 11, 2020, the Democratic Republic of the Congo (DRC) has reported 4,258 COVID-19 cases with 90 deaths. With other African countries, the DRC faces the challenge of striking a balance between easing public health lockdown measures to curtail the spread of SARS-CoV-2 and minimizing both economic hardships for large sectors of the population and negative impacts on health services for other infectious and noninfectious diseases. The DRC recently controlled its tenth Ebola virus disease (EVD) outbreak, but COVID-19 and a new EVD outbreak beginning on June 1, 2020 in the northwest Équateur Province have added an additional burden to health services. Although the epidemiology and transmission of EVD and COVID-19 differ, leveraging the public health infrastructures and experiences from coordinating the EVD response to guide the public health response to COVID-19 is critical. Building on the DRC’s 40 years of experience with 10 previous EVD outbreaks, we highlight the DRC’s multi-sectoral public health approach to COVID-19, which includes community-based screening, testing, contact-tracing, risk communication, community engagement, and case management. We also highlight remaining challenges and discuss the way forward for achieving control of both COVID-19 and EVD in the DRC.
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- 2020
17. Ebola Virus Disease Outbreak — Democratic Republic of the Congo, August 2018–November 2019
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Gaston Tshapenda, Felix Mulangu, Jean Christophe Shako, Laetycia Kabange, Yannick Tutu, Annie Mutombo, Steve Ahuka-Mundeke, Jonathan Makengo, Celestin Mwanzembe, Richard Kitenge, Cdc Ebola Response, Daniel Mukadi, Justus Nsio, Aaron Aruna, Dorothée Bulemfu, Fortunat Tshibinkufua, Gisele Mbuyi, Mathias Mossoko, John Kombe, Emilia Sana, Placide Mbala, Junior Bulabula, Jean-Jacques Muyembe, Leopold Lubula, Franck Edidi, Ebola Response Cdc, and Luigi Minikulu
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Male ,medicine.medical_specialty ,Health (social science) ,Epidemiology ,Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,medicine.disease_cause ,Disease cluster ,01 natural sciences ,World health ,Disease Outbreaks ,West africa ,03 medical and health sciences ,0302 clinical medicine ,Health Information Management ,medicine ,Humans ,030212 general & internal medicine ,0101 mathematics ,Socioeconomics ,media_common ,Ebolavirus ,Ebola virus ,Outbreak Report ,business.industry ,Public health ,010102 general mathematics ,Outbreak ,General Medicine ,Hemorrhagic Fever, Ebola ,Democracy ,Democratic Republic of the Congo ,Public Health Practice ,Female ,Laboratories ,business - Abstract
On August 1, 2018, the Democratic Republic of the Congo Ministry of Health (DRC MoH) declared the tenth outbreak of Ebola virus disease (Ebola) in DRC, in the North Kivu province in eastern DRC on the border with Uganda, 8 days after another Ebola outbreak was declared over in northwest Equateur province. During mid- to late-July 2018, a cluster of 26 cases of acute hemorrhagic fever, including 20 deaths, was reported in North Kivu province.* Blood specimens from six patients hospitalized in the Mabalako health zone and sent to the Institut National de Recherche Biomedicale (National Biomedical Research Institute) in Kinshasa tested positive for Ebola virus. Genetic sequencing confirmed that the outbreaks in North Kivu and Equateur provinces were unrelated. From North Kivu province, the outbreak spread north to Ituri province, and south to South Kivu province (1). On July 17, 2019, the World Health Organization designated the North Kivu and Ituri outbreak a public health emergency of international concern, based on the geographic spread of the disease to Goma, the capital of North Kivu province, and to Uganda and the challenges to implementing prevention and control measures specific to this region (2). This report describes the outbreak in the North Kivu and Ituri provinces. As of November 17, 2019, a total of 3,296 Ebola cases and 2,196 (67%) deaths were reported, making this the second largest documented outbreak after the 2014-2016 epidemic in West Africa, which resulted in 28,600 cases and 11,325 deaths.† Since August 2018, DRC MoH has been collaborating with partners, including the World Health Organization, the United Nations Children's Fund, the United Nations Office for the Coordination of Humanitarian Affairs, the International Organization of Migration, The Alliance for International Medical Action (ALIMA), Medecins Sans Frontieres, DRC Red Cross National Society, and CDC, to control the outbreak. Enhanced communication and effective community engagement, timing of interventions during periods of relative stability, and intensive training of local residents to manage response activities with periodic supervision by national and international personnel are needed to end the outbreak.
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- 2019
18. Nouvel épisode de la maladie à virus Ebola à Bikoro
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Ahuka-Mundeke, Steve, Makiala, Sheila, Mbeta, Justus Nsio, and Mbala, Placide
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No Abstract
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- 2021
19. Maladie virale à Ebola à Mangina, en République Démocratique du Congo: Une épidémie bien différente des précédentes: Ebola virus disease in Mangina, the Democratic Republic of the Congo: An other history
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Ahuka-Mundeke, Steve, Makiala, Sheila, Mbeta, Justus Nsio, and Mbala, Placide
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No Abstract
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- 2021
20. 2018 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation
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Moussa Moïse Diagne, Ousmane Faye, Sophie Duraffour, Shanmuga Sozhamannan, John Kombe, Oumar Faye, Martine Peeters, Daniel Mukadi, Anastasie Mulumba, Nicole Vidal, Maggie L. Bartlett, Eric F. Donaldson, Eric Delaporte, Elisabeth Pukuta, Mariano Sanchez-Lockhart, Patrick Mukadi, Sheila Makiala-Mandanda, Timothy D. Minogue, Mamadou Diop, Amadou A. Sall, Catherine B. Pratt, Jeanette Gonzalez, Amuri Aziza, Justus Nsio, Stephen M. Gross, Placide Mbala-Kingebeni, Steve Ahuka-Mundeke, Stormy Karhemere, Jacques Likofata, Jens H. Kuhn, Felix Mulangu, Nicholas Di Paola, Joseph A. Chitty, Jean Jacques Muyembe-Tamfum, Ahidjo Ayouba, Michael R. Wiley, Gary P. Schroth, Katie Caviness, Aaron Aruna, Gustavo Palacios, Institut National de Recherche Biomédicale [Kinshasa] (INRB), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Institut de Recherche pour le Développement (IRD [France-Sud]), Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM), University of Nebraska Medical Center, University of Nebraska System, Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Aiello, Mélisande, Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM)
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0301 basic medicine ,[SDV]Life Sciences [q-bio] ,viruses ,030106 microbiology ,Genomics ,ZMapp ,Biology ,medicine.disease_cause ,Antiviral Agents ,Genome ,Disease Outbreaks ,03 medical and health sciences ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN] ,[SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology ,medicine ,Humans ,[SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology ,Ebola Vaccines ,Retrospective Studies ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Ebola virus ,Phylogenetic tree ,Outbreak ,Hemorrhagic Fever, Ebola ,Biological product ,Ebolavirus ,Virology ,3. Good health ,[SDV] Life Sciences [q-bio] ,030104 developmental biology ,Infectious Diseases ,GenBank ,Democratic Republic of the Congo ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN] ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,medicine.drug - Abstract
Summary Background The 2018 Ebola virus disease (EVD) outbreak in Equateur Province, Democratic Republic of the Congo, began on May 8, and was declared over on July 24; it resulted in 54 documented cases and 33 deaths. We did a retrospective genomic characterisation of the outbreak and assessed potential therapeutic agents and vaccine (medical countermeasures). Methods We used target-enrichment sequencing to produce Ebola virus genomes from samples obtained in the 2018 Equateur Province outbreak. Combining these genomes with genomes associated with known outbreaks from GenBank, we constructed a maximum-likelihood phylogenetic tree. In-silico analyses were used to assess potential mismatches between the outbreak strain and the probes and primers of diagnostic assays and the antigenic sites of the experimental rVSVΔG-ZEBOV-GP vaccine and therapeutics. An in-vitro flow cytometry assay was used to assess the binding capability of the individual components of the monoclonal antibody cocktail ZMapp. Findings A targeted sequencing approach produced 16 near-complete genomes. Phylogenetic analysis of these genomes and 1011 genomes from GenBank revealed a distinct cluster, confirming a new Ebola virus variant, for which we propose the name “Tumba”. This new variant appears to have evolved at a slower rate than other Ebola virus variants (0·69 × 10−3 substitutions per site per year with “Tumba” vs 1·06 × 10−3 substitutions per site per year without “Tumba”). We found few sequence mismatches in the assessed assay target regions and antigenic sites. We identified nine amino acid changes in the Ebola virus surface glycoprotein, of which one resulted in reduced binding of the 13C6 antibody within the ZMapp cocktail. Interpretation Retrospectively, we show the feasibility of using genomics to rapidly characterise a new Ebola virus variant within the timeframe of an outbreak. Phylogenetic analysis provides further indications that these variants are evolving at differing rates. Rapid in-silico analyses can direct in-vitro experiments to quickly assess medical countermeasures. Funding Defense Biological Product Assurance Office .
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- 2019
21. Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018-2020
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Patarawan Sangnawakij, Laurent Kaiser, Jonathan A. Polonsky, Steve Ahuka-Mundeke, Aaron Aruna Abedi, Victor J. Del Rio Vilas, Olivia Keiser, Mory Keita, Dankmar Böhning, Janne Estill, Zabulon Yoti, Rattana Lerdsuwansri, Mathias Mossoko, and Justus Nsio-Mbeta
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Microbiology (medical) ,Epidemiology ,capture-recapture ,Infectious and parasitic diseases ,RC109-216 ,medicine.disease_cause ,contact tracing ,Mark and recapture ,Contact tracing ,Zoonoses ,Statistics ,Pandemic ,medicine ,Humans ,viruses ,Disease outbreaks ,ddc:613 ,Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018–2020 ,Ebola virus ,Case detection ,Research ,Outbreak ,Hemorrhagic Fever, Ebola ,Capture-recapture ,Ebolavirus ,zoonoses ,Infectious Diseases ,Geography ,disease outbreaks ,Ebola ,Viruses ,Democratic Republic of the Congo ,Medicine ,Completeness (statistics) ,Count data - Abstract
Despite its critical role in containing outbreaks, the efficacy of contact tracing, measured as the sensitivity of case detection, remains an elusive metric. We estimated the sensitivity of contact tracing by applying unilist capture-recapture methods on data from the 2018-2020 outbreak of Ebola virus disease in the Democratic Republic of the Congo. To compute sensitivity, we applied different distributional assumptions to the zero-truncated count data to estimate the number of unobserved case-patients with any contacts and infected contacts. Geometric distributions were the best-fitting models. Our results indicate that contact tracing efforts identified almost all (n = 792, 99%) of case-patients with any contacts but only half (n = 207, 48%) of case-patients with infected contacts, suggesting that contact tracing efforts performed well at identifying contacts during the listing stage but performed poorly during the contact follow-up stage. We discuss extensions to our work and potential applications for the ongoing coronavirus pandemic.
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- 2021
22. Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020
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John Kombe Ngwama, Gaston Tshapenda Panda, Pierre Celeste Adikey, Steve Ahuka-Mundeke, Mory Keita, Stephanie Dagron, Boubacar Diallo, Debarati Guha-Sapir, Justus Nsio-Mbeta, Michel Kalongo Ilumbulumbu, Iris Finci, Ambrose Talisuna, Héloïse Lucaccioni, Olivia Keiser, Jonathan A. Polonsky, Alexandre Delamou, Maria Moitinho de Almeida, Michel Kasereka Tosalisana, Adama Dakissaga, Lorenzo Subissi, and UCL - SSS/IRSS - Institut de recherche santé et société
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Microbiology (medical) ,EWARS ,Epidemiology ,Disease ,Infectious and parasitic diseases ,RC109-216 ,medicine.disease_cause ,Disease Outbreaks ,Ebola virus infection ,medicine ,Humans ,viruses ,Epidemics ,ddc:613 ,Ebola virus ,Warning system ,outbreak ,business.industry ,Outbreak ,DRC ,Hemorrhagic Fever, Ebola ,medicine.disease ,Early Warning Alert and Response System ,Infectious Diseases ,ddc:340 ,Ebola ,ddc:320 ,Synopsis ,Democratic Republic of the Congo ,surveillance ,Medicine ,Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020 ,Medical emergency ,business ,Response system - Abstract
The 10th and largest Ebola virus disease epidemic in the Democratic Republic of the Congo (DRC) was declared in North Kivu Province in August 2018 and ended in June 2020. We describe and evaluate an Early Warning, Alert and Response System (EWARS) implemented in the Beni health zone of DRC during August 5, 2018-June 30, 2020. During this period, 194,768 alerts were received, of which 30,728 (15.8%) were validated as suspected cases. From these, 801 confirmed and 3 probable cases were detected. EWARS showed an overall good performance: sensitivity and specificity >80%, nearly all (97%) of alerts investigated within 2 hours of notification, and good demographic representativeness. The average cost of the system was US $438/case detected and US $1.8/alert received. The system was stable, despite occasional disruptions caused by political insecurity. Our results demonstrate that EWARS was a cost-effective component of the Ebola surveillance strategy in this setting.
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- 2021
23. The cost of insecurity: from flare-up to control of a major Ebola virus disease hotspot during the outbreak in the Democratic Republic of the Congo, 2019
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Boubacar Diallo, W. John Edmunds, Richy Ngombo, Christopher I Jarvis, Steve Ahuka-Mundeke, Ibrahima Socé Fall, Michel Yao, Aaron Aruna Abedi, Abdou Salam Gueye, Luigino Minikulu Mpia, Nabil Tabal, Mathias Mossoko, Justus Nsio, Abdoulaye Yam, Ekokobe Elias Forbin, Xavier de Radiguès, Thibaut Jombart, Sonia Chene, Yannick Tutu, Madeleine Crowe, Samuel Mesfin, Flavio Finger, and Marie Roseline Darnycka Belizaire
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Vaccination Coverage ,Epidemiology ,media_common.quotation_subject ,Disease ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,Response strategy ,Virology ,medicine ,Flare up ,Humans ,030212 general & internal medicine ,Socioeconomics ,media_common ,Ebola virus ,Community engagement ,Public Health, Environmental and Occupational Health ,Outbreak ,Hemorrhagic Fever, Ebola ,Ebolavirus ,Democracy ,3. Good health ,Geography ,Democratic Republic of the Congo ,Public Health Practice ,Ring vaccination ,outbreak control transmissibility model response viral hemorrhagic fever ,Rapid Communication - Abstract
The ongoing Ebola outbreak in the eastern Democratic Republic of the Congo is facing unprecedented levels of insecurity and violence. We evaluate the likely impact in terms of added transmissibility and cases of major security incidents in the Butembo coordination hub. We also show that despite this additional burden, an adapted response strategy involving enlarged ring vaccination around clusters of cases and enhanced community engagement managed to bring this main hotspot under control.
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- 2020
24. Medical countermeasures during the 2018 Ebola virus disease outbreak in the North Kivu and Ituri Provinces of the Democratic Republic of the Congo: a rapid genomic assessment
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Aaron Aruna, Ousmane Faye, Martine Peeters, Stomy Karhemere, Jean Jacques Muyembe-Tamfum, Amadou A. Sall, Ibrahima Socé Fall, Audrey Lacroix, Katie Caviness, Daniel Mukadi, Mariano Sanchez-Lockhart, Moussa Moïse Diagne, Bathe Ndjoloko, Christian Julian Villabona-Arenas, Elisabeth Pukuta, Jeffrey R. Kugelman, Felix Mulangu, Karla Prieto, Nicholas Di Paola, Joseph A. Chitty, Sheila Makiala-Mandanda, Anastasie Mulumba, Nicole Vidal, Steve Ahuka-Mundeke, Brett Beitzel, Gary P. Schroth, Patrick Mukadi, Eric Delaporte, Maggie L. Bartlett, Jason T. Ladner, Junhua J. Zhao, Boubacar Diallo, Mathias Mossoko, Catherine B. Pratt, Jens H. Kuhn, Amuri Aziza, Michael R. Wiley, Peter A. Larson, John Kombe, Martin Faye, Michel Yao, Jeanette Gonzalez, Roger Tim, Placide Mbala-Kingebeni, Ahidjo Ayouba, Gustavo Palacios, Shanmuga Sozhamannan, Justus Nsio, Mamadou Diop, Stephen M. Gross, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Institut de Recherche pour le Développement (IRD [France-Sud]), Université de Montpellier (UM), Institut National de Recherche Biomédicale [Kinshasa] (INRB), Institut National de la Santé et de la Recherche Médicale (INSERM), University of Nebraska Medical Center, University of Nebraska System, Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Army Medical Research Institute of Infectious Diseases [USA] (USAMRIID), This work was supported by the Defense Biological Product Assurance Office through a task order award to the National Strategic Research Institute (FA4600-12-D-9000). We thank Laura Bollinger (National Institute of Allergy and Infectious Diseases, Frederick, MD, USA) for critically editing this manuscript. This work was funded in part through Battelle Memorial Institute's prime contract with the US National Institute of Allergy and Infectious Diseases under contract number HHSN272200700016I., Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), and Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)
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0301 basic medicine ,viruses ,[SDV]Life Sciences [q-bio] ,Genomics ,Biology ,ZMapp ,medicine.disease_cause ,Antiviral Agents ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,medicine ,Humans ,030212 general & internal medicine ,Ebola Vaccines ,Pathogen ,Retrospective Studies ,Ebola virus ,GeneXpert MTB/RIF ,Transmission (medicine) ,Antibodies, Monoclonal ,Outbreak ,Hemorrhagic Fever, Ebola ,Biological product ,Ebolavirus ,Virology ,3. Good health ,030104 developmental biology ,Infectious Diseases ,Medical Countermeasures ,Democratic Republic of the Congo ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,medicine.drug - Abstract
Summary Background The real-time generation of information about pathogen genomes has become a vital goal for transmission analysis and characterisation in rapid outbreak responses. In response to the recently established genomic capacity in the Democratic Republic of the Congo, we explored the real-time generation of genomic information at the start of the 2018 Ebola virus disease (EVD) outbreak in North Kivu Province. Methods We used targeted-enrichment sequencing to produce two coding-complete Ebola virus genomes 5 days after declaration of the EVD outbreak in North Kivu. Subsequent sequencing efforts yielded an additional 46 genomes. Genomic information was used to assess early transmission, medical countermeasures, and evolution of Ebola virus. Findings The genomic information demonstrated that the EVD outbreak in the North Kivu and Ituri Provinces was distinct from the 2018 EVD outbreak in Equateur Province of the Democratic Republic of the Congo. Primer and probe mismatches to Ebola virus were identified in silico for all deployed diagnostic PCR assays, with the exception of the Cepheid GeneXpert GP assay. Interpretation The first two coding-complete genomes provided actionable information in real-time for the deployment of the rVSVΔG-ZEBOV-GP Ebola virus envelope glycoprotein vaccine, available therapeutics, and sequence-based diagnostic assays. Based on the mutations identified in the Ebola virus surface glycoprotein (GP12) observed in all 48 genomes, deployed monoclonal antibody therapeutics (mAb114 and ZMapp) should be efficacious against the circulating Ebola virus variant. Rapid Ebola virus genomic characterisation should be included in routine EVD outbreak response procedures to ascertain efficacy of medical countermeasures. Funding Defense Biological Product Assurance Office.
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- 2019
25. Rapid Confirmation of the Zaire Ebola Virus in the Outbreak of the Equateur Province in the Democratic Republic of Congo: Implications for Public Health Interventions
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Christian Julian Villabona-Arenas, Ahidjo Ayouba, Patrick Mukadi, Jean-Jacques Muyembe Tamfum, Charles Kumakamba, Jacques Likofata, Bathe Djokolo, Nicole Vidal, Justus Nsio-Mbeta, Sheila Makiala-Mandanda, Daniel Mukadi, Martine Peeters, Steve Ahuka-Mundeke, Placide Mbala-Kingebeni, Eric Delaporte, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
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0301 basic medicine ,Microbiology (medical) ,media_common.quotation_subject ,viruses ,030106 microbiology ,Public health interventions ,Vesicular stomatitis Indiana virus ,medicine.disease_cause ,Disease Outbreaks ,03 medical and health sciences ,Vesicular Stomatitis ,0302 clinical medicine ,Medicine ,Humans ,030212 general & internal medicine ,Ebola Vaccines ,Phylogeny ,media_common ,Ebola virus ,business.industry ,Outbreak ,virus diseases ,Hemorrhagic Fever, Ebola ,Ebolavirus ,Democratic Republic of Congo ,Virology ,Democracy ,3. Good health ,Vaccination ,Infectious Diseases ,nanopore sequencing ,Ebola ,Democratic Republic of the Congo ,Brief Reports ,Zaire Ebola Virus ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Ten days after the declaration of the Ebola outbreak in the Democratic Republic of Congo, rapid identification of the species Zaire Ebola virus using partial gene amplification and nanopore sequencing backed up the use of the recombinant vesicular stomatitis virus-Zaire Ebola virus vaccine in the recommended ring vaccination strategy.
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- 2019
26. Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015-2017
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Guillaume Thaurignac, Mare Geraerts, Eric Delaporte, Thomas Lemarcis, Simon-Pierre Ndimbo-Kumugo, Eitel Mpoudi-Ngole, Abdoulaye Touré, Hélène M. De Nys, Ramadan Diallo, Amandine Esteban, Alpha Kabinet Keita, Placide Mbala Kingebeni, Jean-Jacques Muyembe Tamfum, Lamine Koivogui, Martine Peeters, Mathieu Bourgarel, Christelle Butel, Nicole Vidal, Justus Nsio-Mbeta, Christian-Julian Villabona-Arenas, Ahidjo Ayouba, François Roger, Steve Ahuka-Mundeke, Fabian H. Leendertz, Nikki Tagg, ROGER, François, Laboratoires d'excellence - From Genome and Epigenome to Molecular Medicine: turning new paradigms in biology into the therapeutic strategies of tomorrow - - EpiGenMed2010 - ANR-10-LABX-0012 - LABX - VALID, MUSE - - MUSE2016 - ANR-16-IDEX-0006 - IDEX - VALID, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), National Institute of Biomedical Research [Congo Kinshasa], Cliniques Universitaires de Kinshasa [Congo], Centre National de Formation et de Recherche en Santé Rurale [Maférinyah, Guinée] (CNFRSR), Animal, Santé, Territoires, Risques et Ecosystèmes (UMR ASTRE), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA), Robert Koch Institute [Berlin] (RKI), Ministère de L'Elevage et des Productions Animales [Conakry, Guinée], Direction de la Lutte contre la Maladie [Kinshasa, Cameroun], Ministère de la Santé Publique du Cameroun, Royal Zoological Society of Antwerp (RZSA), Institut National de Santé Publique [Conakry, Guinée] (INSP), Ministère de la Santé [Conakry, Guinea], Université Gamal Abdel Nasser de Conakry, Institut de Recherches Médicales et d’Études des Plantes Médicinales [Yaoundé, Cameroon] (IMPM), Centre Pasteur du Cameroun, Réseau International des Instituts Pasteur (RIIP), This work was supported in part by grants from Institut National de la Santé et de la Recherche Médicale, the Ebola Task Force, REACTing, EBO-SURSY project funded by the European Union, Institut de Recherche pour le Développement (IRD), and Christophe Mérieux Prize 2015 (to J.-J.M.T.). A.K.K. was supported by a fellowship from the IRD and the University of Montpellier (MUSE, ANR-16-IDEX-0006). C.-J.V.-A. was supported by a fellowship from IRD, Labex EpiGenMed via the National Research Agency, Programme for Future Investment (ANR-10-LABX-12-01), and the University of Montpellier., We thank the staffs from the Ministry of Health and Ministry of Environment and the national ethics committees from the DRC, Cameroon, and Guinea for permission to perform this study. We thank all the field staff from the DRC (Guy Midingi and Servet Kimbonza), Guinea (Souana Goumou, Mamadou Kalif Diallo, Pépé Justin Beavogui, Philippe Kolié, Michel Guilavogui), and Cameroon (Innocent Ndong Bass, Aime Mebenga, Joseph Moudindo, Thomas Atemkem) for the collection of bat samples. We thank the staffs of the National Institute of Biomedical Research (Kinshasa, the DRC), the Kongo Central Provincial Government (Matadi, the DRC), and Projet PRESICA, Donald Mbohli from Project Grand Singes, and the staff of the Institut National de Santé Publique (Conakry, Guinea) for logistical support in the field. We thank Seny Mane for his involvement and support in the implementation of this project and Daouda Bangoura for his constant support for this project and the facilitation of field missions. We thank the veterinary staff from the Parc Zoologique de Montpellier and Wilhelma Zoo and Botanical Garden for providing control samples., ANR-10-LABX-0012,EpiGenMed,From Genome and Epigenome to Molecular Medicine: turning new paradigms in biology into the therapeutic strategies of tomorrow(2010), ANR-16-IDEX-0006,MUSE,MUSE(2016), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), ANR-10-LABX-0012/10-LABX-0012,EpiGenMed,From Genome and Epigenome to Molecular Medicine: turning new paradigms in biology into the therapeutic strategies of tomorrow(2010), ANR-16-IDEX-0006 Initiatives d'excellence (IDEX/ISITE),MUSE,Ecosystèmes d'excellence, Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad), and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)
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MESH: Ebolavirus*/genetics ,Epidemiology ,serology ,MESH: Animal Diseases/epidemiology ,Africa ,Cameroon ,EVD ,Ebola ,Ebola virus ,Ebola virus disease ,Ebola virus infection ,Eidolon helvum ,Epomophorus gambianus ,Guinea ,Hypsignathus monstrosus ,Lissonycteris angolensis ,Luminex ,Micropteropus pusillus ,Mops sp ,Rousettus aegyptiacus ,Sudan strain ,Zaire strain ,bats ,cross-reactivity ,cutoff ,ecology ,frugivorous bats ,insectivorous bats ,seroprevalence ,survey ,the Democratic Republic of the Congo ,viruses ,zoonoses ,Antibodies, Viral ,Disease Outbreaks ,Seroepidemiologic Studies ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Chiroptera ,MESH: Animals ,Geography, Medical ,MESH: Ebolavirus*/classification ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,virus diseases ,Ebolavirus ,3. Good health ,MESH: Animal Diseases/immunology ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,MESH: Cameroon/epidemiology ,MESH: Animal Diseases/virology ,MESH: History, 21st Century ,Microbiology (medical) ,MESH: Hemorrhagic Fever, Ebola/veterinary ,Zoology ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,MESH: Chiroptera/virology ,MESH: Democratic Republic of the Congo/epidemiology ,MESH: Seroepidemiologic Studies ,lcsh:R ,Outbreak ,Hemorrhagic Fever, Ebola ,030104 developmental biology ,MESH: Antibodies, Viral ,0301 basic medicine ,MESH: Animal Diseases/history ,MESH: Ebolavirus*/immunology ,lcsh:Medicine ,L73 - Maladies des animaux ,medicine.disease_cause ,Animal Diseases ,Serology ,Public Health Surveillance ,MESH: Disease Outbreaks ,[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,MESH: Public Health Surveillance ,Infectious Diseases ,Democratic Republic of the Congo ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Veterinary medicine and animal Health ,MESH: Guinea/epidemiology ,animal structures ,Biology ,History, 21st Century ,MESH: Geography, Medical ,Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017 ,medicine ,Animals ,Seroprevalence ,lcsh:RC109-216 ,Research ,Insectivore ,biology.organism_classification ,Médecine vétérinaire et santé animal ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie - Abstract
International audience; To clarify the role of bats in the ecology of Ebola viruses, we assessed the prevalence of Ebola virus antibodies in a large-scale sample of bats collected during 2015-2017 from countries in Africa that have had previous Ebola outbreaks (Guinea, the Democratic Republic of the Congo) or are at high risk for outbreaks (Cameroon). We analyzed 4,022 blood samples of bats from >12 frugivorous and 27 insectivorous species; 2-37 (0.05%-0.92%) bats were seropositive for Zaire and 0-30 (0%-0.75%) bats for Sudan Ebola viruses. We observed Ebola virus antibodies in 1 insectivorous bat genus and 6 frugivorous bat species. Certain bat species widespread across Africa had serologic evidence of Zaire and Sudan Ebola viruses. No viral RNA was detected in the subset of samples tested (n = 665). Ongoing surveillance of bats and other potential animal reservoirs are required to predict and prepare for future outbreaks.
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- 2018
27. 2017 Outbreak of Ebola Virus Disease in Northern Democratic Republic of Congo
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Roberta Petrucci, Vital Mondonge, Benoit Kebela Ilunga, Jean-Jacques Muyembe, Guido Benedetti, Oly Ilunga Kalenga, Michel Van Herp, Frédéric Raymond, Musa Kiyele, Sheila Makiala, Antoine Okitandjate, Gisele Mbuyi, Philippe Barboza, Nancy Boucher, Steve Ahuka, Jimmy Kapetshi, Jacques Corbeil, Gary P. Kobinger, Baby Muyembe Muzinga, Marie Jose Kikoo, Justus Nsio, Gaston Tshapenda, Hugues Fausther-Bovendo, and Pierre Formenty
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,viruses ,Population ,Disease ,Biology ,medicine.disease_cause ,Virus ,Serology ,Disease Outbreaks ,Young Adult ,Epidemiology ,medicine ,Immunology and Allergy ,Humans ,Serologic Tests ,education ,Phylogeny ,education.field_of_study ,Ebola virus ,Transmission (medicine) ,Reverse Transcriptase Polymerase Chain Reaction ,Outbreak ,High-Throughput Nucleotide Sequencing ,Hemorrhagic Fever, Ebola ,Middle Aged ,Ebolavirus ,Virology ,Infectious Diseases ,Democratic Republic of the Congo ,RNA, Viral ,Female - Abstract
BACKGROUND In 2017, the Democratic Republic of the Congo (DRC) recorded its eighth Ebola virus disease (EVD) outbreak, approximately 3 years after the previous outbreak. METHODS Suspect cases of EVD were identified on the basis of clinical and epidemiological information. Reverse transcription-polymerase chain reaction (RT-PCR) analysis or serological testing was used to confirm Ebola virus infection in suspected cases. The causative virus was later sequenced from a RT-PCR-positive individual and assessed using phylogenetic analysis. RESULTS Three probable and 5 laboratory-confirmed cases of EVD were recorded between 27 March and 1 July 2017 in the DRC. Fifty percent of cases died from the infection. EVD cases were detected in 4 separate areas, resulting in > 270 contacts monitored. The complete genome of the causative agent, a variant from the Zaireebolavirus species, denoted Ebola virus Muyembe, was obtained using next-generation sequencing. This variant is genetically closest, with 98.73% homology, to the Ebola virus Mayinga variant isolated from the first DRC outbreaks in 1976-1977. CONCLUSION A single spillover event into the human population is responsible for this DRC outbreak. Human-to-human transmission resulted in limited dissemination of the causative agent, a novel Ebola virus variant closely related to the initial Mayinga variant isolated in 1976-1977 in the DRC.
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- 2018
28. Contribution of Environment Sample-Based Detection to Ebola Outbreak Management
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Jimmy Kapetshi, Benoit Kebela Ilunga, Aaron Aruna, Gary P. Kobinger, Anders Leung, Pierre Formenty, Hugues Fausther-Bovendo, Justus Nsio, Jean-Jacques Muyembe, Kamal Ait-Ikhlef, and Cindi R. Corbett
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0301 basic medicine ,030106 microbiology ,Biology ,medicine.disease_cause ,law.invention ,Disease Outbreaks ,03 medical and health sciences ,law ,medicine ,Immunology and Allergy ,Humans ,Reference standards ,Polymerase chain reaction ,Ebola virus ,Outbreak ,Hemorrhagic Fever, Ebola ,Ebolavirus ,Virology ,Bundibugyo virus ,Body Fluids ,Reverse transcription polymerase chain reaction ,Infectious Diseases ,Transmission (mechanics) ,Democratic Republic of the Congo ,RNA, Viral ,Genomic rna - Abstract
Detection of chains of transmission is critical to interrupt Ebola virus (EBOV) outbreaks. For >25 years, quantitative reverse transcription polymerase chain reaction performed on biological fluids has been the reference standard for EBOV detection and identification. In the current study, we investigated the use of environmental sampling to detect EBOV shed from probable case patients buried without the collection of bodily fluids. During the 2012 Bundibugyo virus (BDBV) outbreak in the Democratic Republic of the Congo, environmental samples were screened for BDBV RNA by means of real-time polymerase chain reaction. Low levels of BDBV genomic RNA were detected in a hospital and in a house. Detection of BDBV RNA in the house led to the identification of the last chain of transmission still active, which resulted in the safe burial of the person with the last laboratory-confirmed case of this outbreak. Overall, environmental sampling can fill specific gaps to help confirm EBOV positivity and therefore be of value in outbreak management.
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- 2018
29. Accounting for population structure reveals ambiguity in the Zaire Ebolavirus reservoir dynamics
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Steve Ahuka-Mundeke, Joan Martí-Carreras, Guy Baele, Sheila Makiala-Mandanda, Miles W. Carroll, Jean-Jacques Muyembe-Tamfum, Justus Nsio, Valentijn Vergote, Kurt Vermeire, Bram Vrancken, Tony Wawina-Bokalanga, Jimmy Kapetshi, Piet Maes, and Bert Vanmechelen
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RNA viruses ,0301 basic medicine ,Zaire ebolavirus ,Disease reservoir ,RC955-962 ,Pathology and Laboratory Medicine ,medicine.disease_cause ,Animal Diseases ,Coalescent theory ,Geographical Locations ,0302 clinical medicine ,Chiroptera ,Arctic medicine. Tropical medicine ,Medicine and Health Sciences ,Genome Evolution ,Phylogeny ,Viral Genomics ,Population size ,Genomics ,Ebolavirus ,Viral Persistence and Latency ,Infectious Diseases ,Geography ,Medical Microbiology ,Filoviruses ,Viral Pathogens ,Viral evolution ,Viruses ,Evolutionary Rate ,Pathogens ,Public aspects of medicine ,RA1-1270 ,Ebola Virus ,Research Article ,Evolutionary Processes ,Genotype ,Population Size ,030231 tropical medicine ,Microbial Genomics ,Microbiology ,Viral Evolution ,Molecular Evolution ,03 medical and health sciences ,Population Metrics ,Virology ,Genetics ,medicine ,Animals ,Humans ,Natural reservoir ,Microbial Pathogens ,Disease Reservoirs ,Evolutionary Biology ,Ebola virus ,Population Biology ,Hemorrhagic Fever Viruses ,Organisms ,Public Health, Environmental and Occupational Health ,Biology and Life Sciences ,Computational Biology ,Hemorrhagic Fever, Ebola ,Organismal Evolution ,030104 developmental biology ,Evolutionary biology ,Africa ,Microbial Evolution ,People and Places - Abstract
Ebolaviruses pose a substantial threat to wildlife populations and to public health in Africa. Evolutionary analyses of virus genome sequences can contribute significantly to elucidate the origin of new outbreaks, which can help guide surveillance efforts. The reconstructed between-outbreak evolutionary history of Zaire ebolavirus so far has been highly consistent. By removing the confounding impact of population growth bursts during local outbreaks on the free mixing assumption that underlies coalescent-based demographic reconstructions, we find—contrary to what previous results indicated—that the circulation dynamics of Ebola virus in its animal reservoir are highly uncertain. Our findings also accentuate the need for a more fine-grained picture of the Ebola virus diversity in its reservoir to reliably infer the reservoir origin of outbreak lineages. In addition, the recent appearance of slower-evolving variants is in line with latency as a survival mechanism and with bats as the natural reservoir host., Author summary Because of its implications for awareness, surveillance and risk assessment of EBOV transmission to humans, the origin of emerging Zaire ebolavirus is investigated at each outbreak. To reliably do so requires a good understanding of the circulation dynamics of Zaire ebolavirus in its reservoir, which has yet to be determined. Here, we analyzed available full-length Zaire ebolavirus genomes from past and current outbreaks to infer the between-outbreak circulation dynamics while avoiding model misspecification by downsampling the data.
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- 2020
30. Identification of Dengue and Chikungunya Cases Among Suspected Cases of Yellow Fever in the Democratic Republic of the Congo
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Steve Ahuka-Mundeke, Justus Nsio-Mbeta, Eric M. Leroy, Jean-Jacques Muyembe-Tamfum, Sheila Makiala-Mandanda, Jessica L. Abbate, Elisabeth Pukuta-Simbu, Nicolas Berthet, Pierre Becquart, Centre International de Recherches Médicales de Franceville (CIRMF), Cliniques Universitaires de Kinshasa [Congo], Institut National de Recherche Biomédicale [Kinshasa] (INRB), Unité de modélisation mathématique et informatique des systèmes complexes [Bondy] (UMMISCO), Université de Yaoundé I-Institut de la francophonie pour l'informatique-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Université Gaston Bergé (Saint-Louis, Sénégal)-Université Cadi Ayyad [Marrakech] (UCA)-Sorbonne Université (SU)-Institut de Recherche pour le Développement (IRD [France-Nord]), Direction de la Lutte contre la Maladie [Kinshasa, Cameroun], Ministère de la Santé Publique du Cameroun, Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Institut Pasteur [Paris] (IP), Institut de Recherche pour le Développement (IRD), We also acknowledge the Agence universitaire de la francophonie for contributing funds to this project. This study was supported by the Centre International de Recherches Medicales de Franceville (CIRMF), which is funded by the Gabonese Government, Total Gabon and The French Foreign Ministry in collaboration with the the Institut National de Recherche Biomédicale (INRB) of Kinshasa, DRC. Postdoctoral support for J.L.A. was provided by ANR JC 'STORY' granted to Benjamin Roche., We thank the Ministry of Public Health of the DRC, particularly the head of the Direction de lutte contre la maladie for allowing us to work on samples from the yellow fever surveillance program. We are also grateful to the medical staff who participated in the yellow fever surveillance program in the DRC, without whom we could not have obtained the samples included in this study., and ANR-14-CE14-0020,STORY,Communautés de pathogènes: une association de malfaiteurs(2014)
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Male ,viruses ,[SDV]Life Sciences [q-bio] ,MESH: Dengue ,MESH: Chikungunya Fever ,Dengue virus ,Antibodies, Viral ,medicine.disease_cause ,MESH: Dengue Virus ,Dengue fever ,0302 clinical medicine ,MESH: Arboviruses ,MESH: Child ,Prospective Studies ,030212 general & internal medicine ,Chikungunya ,Rift Valley fever ,Child ,MESH: Yellow Fever ,MESH: Aged ,Disease surveillance ,MESH: Middle Aged ,Coinfection ,Yellow fever ,Middle Aged ,MESH: Infant ,Infectious Diseases ,[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology ,MESH: Young Adult ,Child, Preschool ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Democratic Republic of the Congo ,Female ,Viral disease ,Chikungunya virus ,Adult ,Adolescent ,030231 tropical medicine ,Microbiology ,yellow fever ,Young Adult ,03 medical and health sciences ,Virology ,parasitic diseases ,medicine ,Humans ,Serologic Tests ,Aged ,MESH: Adolescent ,MESH: Humans ,business.industry ,MESH: Serologic Tests ,MESH: Child, Preschool ,Infant ,Outbreak ,DRC ,MESH: Adult ,MESH: Chikungunya virus ,MESH: Democratic Republic of the Congo ,Dengue Virus ,medicine.disease ,dengue ,MESH: Male ,MESH: Prospective Studies ,MESH: Coinfection ,Chikungunya Fever ,business ,MESH: Female ,Arboviruses ,MESH: Antibodies, Viral - Abstract
International audience; For more than 95% of acute febrile jaundice cases identified through surveillance for yellow fever, a reemerging arthropod-borne viral disease, no etiological exploration is ever done. The aim of this study was to test for other arthropod-borne viruses that can induce the same symptoms in patients enrolled in the yellow fever surveillance in the Democratic Republic of the Congo (DRC). Of 652 patients included in the surveillance of yellow fever in DRC from January 2003 to January 2012, 453 patients that tested negative for yellow fever virus (YFV) immunoglobulin M (IgM) antibodies were selected for the study. Real-time polymerase chain reaction was performed for the detection of dengue, West Nile, Chikungunya, O'nyong-nyong, Rift Valley fever, Zika, and YFV. The average age of patients was 22.1 years. We reported 16 cases (3.5%; confidence interval [CI]: 0.8-5.2) of dengue (serotypes 1 and 2) and 2 cases (0.4%; CI: 0.0-1.0) of Chikungunya. Three patients were co-infected with the two serotypes of dengue virus. Three cases of dengue were found in early July 2010 from the city of Titule (Oriental province) during a laboratory-confirmed outbreak of yellow fever, suggesting simultaneous circulation of dengue and yellow fever viruses. This study showed that dengue and Chikungunya viruses are potential causes of acute febrile jaundice in the DRC and highlights the need to consider dengue and Chikungunya diagnosis in the integrated disease surveillance and response program in the DRC. A prospective study is necessary to establish the epidemiology of these diseases.
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- 2018
31. Outbreak of Ebola virus disease in the Democratic Republic of the Congo, April–May, 2018: an epidemiological study
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Daniel Mukadi-Bamuleka, Emerencienne Kibangou, Vital Mondonge Makuma, Ibrahima Socé Fall, Etienne Yuma, Guylain Kabongo, Oliver Morgan, Franck Mboussou, Katy A. M. Gaythorpe, Pierre Nouvellet, Boubacar Diallo, Anne Cori, Guillaume Ngoy, Ousmane Ly, Zabulon Yoti, Augustin Mamba, Roland Ngom, Yokouide Allarangar, Benido Impouma, Neil M. Ferguson, Patricia Ndumbi Ngamala, Richard G. FitzJohn, Jean de Dieu Lukwesa Mwati, Yahaya Ali Ahmed, Maria D. Van Kerkhove, Oly Ilunga Kalenga, Aaron Aruna Abedi, Pierre Formenty, Oscar Mavila, Théophile Bokenge, Natsuko Imai, Alpha Forna, Ahmadou Barry, Yyonne Lay, Tini Garske, Tamayi Mlanda, Anny Mutombo, Anne Fortin, Annika Wendland, Theresa M. Lee, Charles Okot Lukoya, Rodney Towner, Amadou Mouctar Diallo, Ernest Dabire, Sheila Makiala-Mandanda, Michael J. Ryan, Christopher Haskew, Steve Ahuka-Mundeke, Guy Kalambayi Kabamba, Julienne Anoko, Tshewang Choden Dorji, Jean Jaques Muyembe, Emma Kitenge, Celine Gurry, Gaston Tshapenda, Gisele Mbuy, Mamoudou Harouna Djingarey, Emanuele Bruni, Marie Roseline Darnycka Belizaire, Aura Rocio Escobar Corado Waeber, N'Da Konan Michel Yao, Justus Nsio, Patrick Mukadi Kakoni, Reinhilde Van De Weerdt, Esther L Hamblion, Kevin Babila Ousman, Ndjoloko Tambwe Bathé, Sangeeta N. Bhatia, Brett Nicholas Archer, Alhassane Touré, Jayshree Bagaria, Christl A. Donnelly, Placide Mbala-Kingebeni, Emilie Peron, Ilaria Dorigatti, Gervais Leon Folefack Tengomo, Leopold Lubula, Stéphane Hugonnet, Jonathan A. Polonsky, Anastasie Mujinga Mulumba, Medical Research Council (MRC), Bill & Melinda Gates Foundation, National Institute for Health Research, National Institutes of Health, and USAID
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Adult ,Diarrhea ,Male ,0301 basic medicine ,Zaire ebolavirus ,medicine.medical_specialty ,Adolescent ,Fever ,Vomiting ,Health Personnel ,Appetite ,Disease ,medicine.disease_cause ,Disease Outbreaks ,Young Adult ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,General & Internal Medicine ,Case fatality rate ,Epidemiology ,Humans ,Medicine ,030212 general & internal medicine ,Sex Distribution ,Child ,Fatigue ,Aged ,Aged, 80 and over ,Ebola virus ,business.industry ,Incidence (epidemiology) ,Vaccination ,Outbreak ,Nausea ,General Medicine ,11 Medical And Health Sciences ,Hemorrhagic Fever, Ebola ,Middle Aged ,Abdominal Pain ,3. Good health ,Hospitalization ,Early Diagnosis ,030104 developmental biology ,Democratic Republic of the Congo ,Female ,business ,Contact tracing ,Demography - Abstract
Background\ud \ud On May 8, 2018, the Government of the Democratic Republic of the Congo reported an outbreak of Ebola virus disease in Équateur Province in the northwest of the country. The remoteness of most affected communities and the involvement of an urban centre connected to the capital city and neighbouring countries makes this outbreak the most complex and high risk ever experienced by the Democratic Republic of the Congo. We provide early epidemiological information arising from the ongoing investigation of this outbreak.\ud Methods\ud \ud We classified cases as suspected, probable, or confirmed using national case definitions of the Democratic Republic of the Congo Ministère de la Santé Publique. We investigated all cases to obtain demographic characteristics, determine possible exposures, describe signs and symptoms, and identify contacts to be followed up for 21 days. We also estimated the reproduction number and projected number of cases for the 4-week period from May 25, to June 21, 2018.\ud Findings\ud \ud As of May 30, 2018, 50 cases (37 confirmed, 13 probable) of Zaire ebolavirus were reported in the Democratic Republic of the Congo. 21 (42%) were reported in Bikoro, 25 (50%) in Iboko, and four (8%) in Wangata health zones. Wangata is part of Mbandaka, the urban capital of Équateur Province, which is connected to major national and international transport routes. By May 30, 2018, 25 deaths from Ebola virus disease had been reported, with a case fatality ratio of 56% (95% CI 39–72) after adjustment for censoring. This case fatality ratio is consistent with estimates for the 2014–16 west African Ebola virus disease epidemic (p=0·427). The median age of people with confirmed or probable infection was 40 years (range 8–80) and 30 (60%) were male. The most commonly reported signs and symptoms in people with confirmed or probable Ebola virus disease were fever (40 [95%] of 42 cases), intense general fatigue (37 [90%] of 41 cases), and loss of appetite (37 [90%] of 41 cases). Gastrointestinal symptoms were frequently reported, and 14 (33%) of 43 people reported haemorrhagic signs. Time from illness onset and hospitalisation to sample testing decreased over time. By May 30, 2018, 1458 contacts had been identified, of which 746 (51%) remained under active follow-up. The estimated reproduction number was 1·03 (95% credible interval 0·83–1·37) and the cumulative case incidence for the outbreak by June 21, 2018, is projected to be 78 confirmed cases (37–281), assuming heterogeneous transmissibility.\ud Interpretation\ud \ud The ongoing Ebola virus outbreak in the Democratic Republic of the Congo has similar epidemiological features to previous Ebola virus disease outbreaks. Early detection, rapid patient isolation, contact tracing, and the ongoing vaccination programme should sufficiently control the outbreak. The forecast of the number of cases does not exceed the current capacity to respond if the epidemiological situation does not change. The information presented, although preliminary, has been essential in guiding the ongoing investigation and response to this outbreak.
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- 2018
32. New filovirus disease classification and nomenclature
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Tonny Seikikongo Musoke, Clarence J. Peters, Carolina Nanclares, Francois Lamontagne, Jean-Jacques Muyembe-Tamfum, Angela L. Hewlett, Tom Fletcher, Gary P. Kobinger, H Cliff Lane, David A. Wohl, Alie H. Wurie, Jens H. Kuhn, Janusz T. Paweska, Leslie Lobel, Arne Broch Brantsæter, Rafael Delgado, Mosoka Fallah, Andre C. Kalil, Vital Mondonge Makuma, Peter Piot, Werner Slenczka, Julius J. Lutwama, Anja Wolz, Shevin T. Jacob, John S. Schieffelin, Timo Wolf, Timothy Burgess, Miriam Nanyunja, Richard T. Davey, Laurent Kaiser, Thomas A Massaquoi, Zabulon Yoti, Rashidatu F Kamara, G. Marshall Lyon, Moses J Soka, Takuya Adachi, Robert Jakob, Tim O'Dempsey, Thomas Kratz, Jimmy Kapetshi, David M. Brett-Major, Andy I. M. Hoepelman, Moses Massaquoi, Mark G. Kortepeter, Hans-Dieter Klenk, Michael Jacobs, Jose R. Arribas, Henry S Kyobe Bosa, William A. Fischer, Srinivas Murthy, Phiona Nakyeyune, Pardis C. Sabeti, Pauline Vetter, Hilde De Clerck, Catherine F Houlihan, Ian Crozier, Thomas Grünewald, Robert A. Fowler, Bruce S. Ribner, Aneesh K. Mehta, Justus Nsio-Mbeta, Frederique Jacquerioz, James E. Strong, Nahid Bhadelia, Ibrahima Elhadj Bah, Andy Hall, Timothy M. Uyeki, Christopher G. Chute, Daniel G. Bausch, Laura Evans, Neill K. J. Adhikari, Colleen S. Kraft, Giuseppe Ippolito, Armand Sprecher, Matthias Borchert, Robert Swanepoel, Robert Colebunders, Daniel S. Chertow, Christophe Rapp, Michel Van Herp, Marta Lado, Bertrand Renaud, and Theodore J. Cieslak
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viruses ,Filoviridae / classification ,Disease ,Filoviridae / pathogenicity ,Biology ,medicine.disease_cause ,World Health Organization ,Microbiology ,Article ,03 medical and health sciences ,Immunology and Microbiology(all) ,Filoviridae Infections ,medicine ,Journal Article ,Humans ,Nomenclature ,ddc:616 ,0303 health sciences ,Ebola virus ,General Immunology and Microbiology ,030306 microbiology ,Filoviridae Infections / classification ,Outbreak ,Disease classification ,Hemorrhagic Fever, Ebola ,Filoviridae ,Virology ,Infectious Diseases ,Hemorrhagic Fever, Ebola / classification - Abstract
The recent large outbreak of Ebola virus disease (EVD) in Western Africa resulted in greatly increased accumulation of human genotypic, phenotypic and clinical data, and improved our understanding of the spectrum of clinical manifestations. As a result, the WHO disease classification of EVD underwent major revision.
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- 2019
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