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Psychological distress among adults from the urban and rural areas affected by the Ebola virus disease in the Democratic Republic of the Congo
PurposeEbola virus disease (EVD) is associated with high anxiety and multiple bereavement that can induce severe psychological distress (SPD) in individuals living in affected communities. Using data from the EVD and Mental Health project (EboMH), this study assessed the prevalence and determinants of SPD symptoms in a representative sample of adults in communities affected by EVD.MethodsA representative sample of 1614 adults (50% women) aged 18–85 years completed measures assessing exposure level to EVD, stigmatization related to EVD, and psychological distress.ResultsIn total, 45.58% of individuals from the cities and villages affected by EVD reported SPD. Results showed significant differences for residence area, employment, age, education level, and religion, but not for gender. Exposure level to EVD (β = 0.11, p < 0.001; OR = 1.12, 95% CI [1.08–1.16]), stigmatization related to EVD (β = 0.06, p < 0.001; OR = 1.06, 95% CI [1.05–1.07]), and living in rural areas (β = 0.67, p < 0.001; OR = .51, 95% CI [.36–.72]) predicted SPD symptoms.ConclusionsEvidence-based global mental health programs in high-risk mortality epidemic contexts should take into account the high psychological distress in the affected areas.
Journal Article
Necrotizing Scleritis, Conjunctivitis, and Other Pathologic Findings in the Left Eye and Brain of an Ebola Virus-Infected Rhesus Macaque (Macaca mulatta) With Apparent Recovery and a Delayed Time of Death
A 3.5-year-old adult female rhesus macaque (Macaca mulatta) manifested swelling of the left upper eyelid and conjunctiva and a decline in clinical condition 18 days following intramuscular challenge with Ebola virus (EBOV; Kikwit-1995), after apparent clinical recovery. Histologic lesions with strong EBOV antigen staining were noted in the left eye (scleritis, conjunctivitis, and peri-optic neuritis), brain (choriomeningoencephalitis), stomach, proximal duodenum, and pancreas. Spleen, liver, and adrenal glands, common targets for acute infection, appeared histologically normal with no evidence of EBOV immunoreactivity. These findings may provide important insight for understanding sequelae seen in West African survivors of Ebola virus disease.
Journal Article
Ebola
Presents facts about Ebola, including how it spreads, its source, and how it can be treated.
Book
Effect of Recombinant Vesicular Stomatitis Virus–Zaire Ebola Virus Vaccination on Ebola Virus Disease Illness and Death, Democratic Republic of the Congo
We conducted a retrospective cohort study to assess the effect vaccination with the live-attenuated recombinant vesicular stomatitis virus-Zaire Ebola virus vaccine had on deaths among patients who had laboratory-confirmed Ebola virus disease (EVD). We included EVD-positive patients coming to an Ebola Treatment Center in eastern Democratic Republic of the Congo during 2018-2020. Overall, 25% of patients vaccinated before symptom onset died compared with 63% of unvaccinated patients. Vaccinated patients reported fewer EVD-associated symptoms, had reduced time to clearance of viral load, and had reduced length of stay at the Ebola Treatment Center. After controlling for confounders, vaccination was strongly associated with decreased deaths. Reduction in deaths was not affected by timing of vaccination before or after EVD exposure. These findings support use of preexposure and postexposure recombinant vesicular stomatitis virus-Zaire Ebola virus vaccine as an intervention associated with improved death rates, illness, and recovery time among patients with EVD.
Journal Article
Collapse and Resiliency
An insider account of how an African public health leader responded to an unprecedented Ebola outbreak.
Tolbert Nyenswah, LLB, MPH, DrPH, was the assistant minister of health and deputy chief medical officer in Liberia when the 2014 Ebola epidemic struck. Nyenswah, the incident manager who led the response, became known as the \"Ebola Czar\" for his pivotal role in combating the epidemic despite his government's lack of resources. His story underscores the public health strategies that succeeded and those that failed, highlighting important lessons in managing current and future outbreaks.
In Collapse and Resiliency, Nyenswah presents an insider's view of Liberia's response to the deadly Ebola epidemic. Nyenswah describes the fascinating journey from his childhood in a rural Liberian village to leading his country's response to the deadly outbreak, providing a deeply personal account of how the epidemic was finally controlled despite a depleted health care system. Prior to the Ebola epidemic, Liberia suffered from a protracted and ruthless civil war. Despite these challenges, Nyenswah and his team fostered a coordinated, community-based crisis response.
Weaving together stories of effective and ineffective practices with the lived experiences that developed his skills to manage such a high-stress program, Nyenswah details how organizations worked together and what were the best public health methods to fight the spread of the disease. Unlike many books about Ebola in West Africa, Nyenswah provides both an expert account and a local voice. His story highlights the power imbalance during cooperative projects between western and nonwestern collaborators.
In the only Ebola book written by a native African, the key strategist responsible for successfully ending the epidemic, Nyenswah reflects on the impacts of war and disease on the struggle to rebuild a more resilient health system and functioning society. As the world continues to reel from the effects of the COVID-19 pandemic, this look at a terrifying outbreak reminds us that a well-prepared public health system cannot be taken for granted.
eBook
Outbreak culture : the Ebola crisis and the next epidemic
An award-winning genetic researcher and a tenacious journalist examine each phase of the Ebola epidemic in West Africa, the largest and deadliest of its kind. Their postmortem identifies factors that kept key information from reaching doctors, complicated the government's response to the crisis, and left responders unprepared for the next outbreak.-- Provided by publisher
Book
Efficiency of Field Laboratories for Ebola Virus Disease Outbreak during Chronic Insecurity, Eastern Democratic Republic of the Congo, 2018–2020
During the 10th outbreak of Ebola virus disease in the Democratic Republic of the Congo, the Institut National de Recherche Biomédicale strategically positioned 13 decentralized field laboratories with dedicated equipment to quickly detect cases as the outbreak evolved. The laboratories were operated by national staff, who quickly handed over competencies and skills to local persons to successfully manage future outbreaks. Laboratories analyzed ≈230,000 Ebola diagnostic samples under stringent biosafety measures, documentation, and database management. Field laboratories diversified their activities (diagnosis, chemistry and hematology, survivor follow-up, and genomic sequencing) and shipped 127,993 samples from the field to a biorepository in Kinshasa under good conditions. Deploying decentralized and well-equipped laboratories run by local personnel in at-risk countries for Ebola virus disease outbreaks is an efficient response; all activities are quickly conducted in the field.
Journal Article