Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo.
School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo.
Int J Environ Res Public Health. 2022 Oct 12;19(20):13113. doi: 10.3390/ijerph192013113.
Ebola Virus Disease (EVD) epidemics have been extensively documented and have received large scientific and public attention since 1976. Until July 2022, 16 countries worldwide had reported at least one case of EVD, resulting in 43 epidemics. Most of the epidemics occurred in the Democratic Republic of Congo (DRC) but the largest epidemic occurred from 2014-2016 in Guinea, Sierra Leone and Liberia in West Africa. The indirect effects of EVD epidemics on these countries' health systems, i.e., the consequences beyond infected patients and deaths immediately related to EVD, can be significant. The objective of this review was to map and measure the indirect effects of the EVD epidemics on the health systems of DRC, Guinea, Sierra Leone and Liberia and, from thereon, draw lessons for strengthening their resilience vis-à-vis future EVD outbreaks and other similar health emergencies. A scoping review of published articles from the PubMed database and gray literature was conducted. It was supplemented by interviews with experts. Eighty-six articles were included in this review. The results were structured based on WHO's six building blocks of a health system. During the EVD outbreaks, several healthcare services and activities were disrupted. A significant decline in indicators of curative care utilization, immunization levels and disease control activities was noticeable. Shortages of health personnel, poor health data management, insufficient funding and shortages of essential drugs characterized the epidemics that occurred in the above-mentioned countries. The public health authorities had virtually lost their leadership in the management of an EVD response. Governance was characterized by the development of a range of new initiatives to ensure adequate response. The results of this review highlight the need for countries to invest in and strengthen their health systems, through the continuous reinforcement of the building blocks, even if there is no imminent risk of an epidemic.
埃博拉病毒病（EVD）疫情自 1976 年以来已有大量文献记录，并受到科学界和公众的广泛关注。截至 2022 年 7 月，全球有 16 个国家报告了至少一例 EVD 病例，导致 43 次疫情爆发。大多数疫情发生在刚果民主共和国（DRC），但最大的疫情发生在 2014-2016 年期间的几内亚、塞拉利昂和利比里亚。EVD 疫情对这些国家卫生系统的间接影响，即超出感染患者和与 EVD 直接相关的死亡的后果，可能是重大的。本综述的目的是绘制和衡量 EVD 疫情对 DRC、几内亚、塞拉利昂和利比里亚卫生系统的间接影响，并从中吸取教训，增强其对未来 EVD 爆发和其他类似卫生紧急情况的弹性。对 PubMed 数据库和灰色文献中已发表文章进行了范围综述，并辅以专家访谈。本综述共纳入 86 篇文章。结果根据世卫组织卫生系统的六个组成部分进行构建。在 EVD 爆发期间，多项医疗服务和活动受到干扰。在治疗护理利用、免疫水平和疾病控制活动方面，各项指标显著下降。上述国家爆发的疫情中，卫生人员短缺、卫生数据管理不善、资金不足以及基本药物短缺等问题突出。公共卫生当局在 EVD 应对管理方面几乎失去了领导力。治理的特点是制定了一系列新倡议，以确保有足够的应对措施。本综述的结果强调了各国通过持续加强各组成部分，即使没有迫在眉睫的疫情风险，也需要投资和加强卫生系统。
