Source : INDIA TODAY NEWS
Authorities in eastern Congo are shifting to a village-centred approach to tackle the Ebola outbreak as the virus continues to spread faster than efforts to track and contain it, Africa’s top public health agency said on Thursday. The Africa Centres for Disease Control and Prevention said the outbreak has likely not yet peaked.
Since the outbreak was declared in mid-May, it has spread from three health zones to 60, with 6,250 cases and 3,039 deaths, according to government data. The spread has been driven largely by insecurity, displacement and intense population movements. Compared with the 2014-2016 Ebola outbreak in West Africa, which killed more than 11,000 people, the current outbreak has recorded six times as many confirmed cases and five times as many deaths, the Africa CDC said.
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A report this week by the US Centres for Disease Control and Prevention said one major gap in the response is the limited community-based surveillance system needed to quickly investigate alerts and detect, track and slow the spread of the virus. Delays in detection, reluctance to report cases and weak community engagement are contributing to preventable deaths. Africa CDC data showed that at least 63 per cent of deaths recorded in the past week took place outside Ebola treatment centres.
Authorities are now using a “village-centred approach”, working with community leaders to build trust and improve cooperation with residents, said Yap Boum, head of emergency preparedness and response at Africa CDC. Ituri province, where the outbreak is concentrated, is also at the centre of the rebel conflict in eastern Congo, making trust-building more difficult. “Building that trust in the middle of an outbreak is quite complex,” Boum said.
Quickly identifying and tracing people who came into contact with Ebola patients remains a challenge across the six affected provinces. While 81 per cent of contacts have been followed up by surveillance teams, that figure covers only listed contacts and not those still to be traced. Africa CDC estimates that cases confirmed in the last three weeks should have generated 97,600 contacts, based on an average of 60 contacts per confirmed case, but only 19 per cent of those expected contacts have been traced.
Health data showed treatment centres had expanded capacity to more than 1,300 beds in late August, with 869 patients and an occupancy rate of 67 per cent. Even so, experts have called for more treatment and isolation centres and more beds in affected health zones to prepare for cases that have not yet been detected. Boum said some health zones are in areas where cases go undetected or unreported because of several factors, including distrust of health authorities, while some areas are also not accessible to surveillance teams or health workers.
Experts also said laboratory testing capacity needs to be expanded so cases can be identified quickly and patients treated without delay. The World Health Organisation said last month that several treatment and transit centres in Ituri, the outbreak’s epicentre, were “saturated”, while North Kivu, the second-most affected province, did not have enough options to refer patients to specialised facilities. Health workers at existing treatment centres are also exhausted, said Jeannot Krikeija, who works at an Ebola treatment centre in Bunia, Ituri’s capital. “Ebola is tiring us all the more because we don’t know when this scourge will end. This ordeal is unbearable for me,” Krikeija said.
The US health agency also pointed to gaps in how burials are being carried out in affected health zones. Authorities have deployed safe and dignified burial teams for the more than 3,000 people who have died from Ebola, but problems remain. Experts have warned that Ebola can spread through direct contact with the blood or other bodily fluids of someone who is ill or has died from the disease, and that victims’ bodies can still carry large amounts of active virus. In Ituri and other affected areas, burial teams have been attacked several times, often by families trying to protect relatives who died of Ebola, and it is also common for people to gather around graves during burials, sometimes within a few metres of the coffins.
Overall, health agencies said the outbreak in eastern Congo is still expanding, with major gaps remaining in surveillance, contact tracing, treatment capacity, testing and safe burials, even as authorities move towards a village-centred strategy to improve trust and cooperation.
With PTI Inputs
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SOURCE :- TIMES OF INDIA
