World Health Organization, Regional Office for Africa, Brazzaville, Congo.
Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
J Epidemiol Glob Health. 2024 Sep;14(3):699-709. doi: 10.1007/s44197-024-00202-y. Epub 2024 Feb 19.
In 2021, an Ebola virus disease (EVD) outbreak was declared in Guinea, linked to persistent virus from the 2014-2016 West Africa Epidemic. This paper analyzes factors associated with contact tracing reliability (defined as completion of a 21-day daily follow-up) during the 2021 outbreak, and transitively, provides recommendations for enhancing contact tracing reliability in future.
We conducted a descriptive and analytical cross-sectional study using multivariate regression analysis of contact tracing data from 1071 EVD contacts of 23 EVD cases (16 confirmed and 7 probable).
Findings revealed statistically significant factors affecting contact tracing reliability. Unmarried contacts were 12.76× more likely to miss follow-up than those married (OR = 12.76; 95% CI [3.39-48.05]; p < 0.001). Rural-dwelling contacts had 99% lower odds of being missed during the 21-day follow-up, compared to those living in urban areas (OR = 0.01; 95% CI [0.00-0.02]; p < 0.01). Contacts who did not receive food donations were 3× more likely to be missed (OR = 3.09; 95% CI [1.68-5.65]; p < 0.001) compared to those who received them. Contacts in health areas with a single team were 8× more likely to be missed (OR = 8.16; 95% CI [5.57-11.96]; p < 0.01) than those in health areas with two or more teams (OR = 1.00; 95% CI [1.68-5.65]; p < 0.001). Unvaccinated contacts were 30.1× more likely to be missed compared to vaccinated contacts (OR = 30.1; 95% CI [5.12-176.83]; p < 0.001).
Findings suggest that contact tracing reliability can be significantly influenced by various demographic and organizational factors. Considering and understanding these factors-and where possible addressing them-may be crucial when designing and implementing contact tracing strategies during future outbreaks in low-resource settings.
2021 年，在与 2014-2016 年西非疫情相关的持续病毒有关的情况下，在几内亚宣布了埃博拉病毒病（EVD）疫情。本文分析了与 2021 年疫情期间接触者追踪可靠性（定义为完成 21 天每日随访）相关的因素，间接地为今后提高接触者追踪可靠性提供了建议。
我们使用对 23 例埃博拉病毒病病例（16 例确诊和 7 例可能）的 1071 名埃博拉病毒病接触者的接触者追踪数据进行了描述性和分析性的横断面研究，使用多变量回归分析。
研究结果显示，影响接触者追踪可靠性的因素具有统计学意义。与已婚者相比，未婚接触者错过随访的可能性高 12.76 倍（OR=12.76；95%CI[3.39-48.05]；p<0.001）。与居住在城市地区的接触者相比，居住在农村地区的接触者在 21 天随访期间错过的可能性低 99%（OR=0.01；95%CI[0.00-0.02]；p<0.01）。未获得食物捐赠的接触者错过的可能性高 3 倍（OR=3.09；95%CI[1.68-5.65]；p<0.001），而获得食物捐赠的接触者错过的可能性低。在仅有一个小组的卫生区，接触者错过的可能性高 8 倍（OR=8.16；95%CI[5.57-11.96]；p<0.01），而在有两个或更多小组的卫生区，接触者错过的可能性低（OR=1.00；95%CI[1.68-5.65]；p<0.001）。未接种疫苗的接触者错过的可能性比接种疫苗的接触者高 30.1 倍（OR=30.1；95%CI[5.12-176.83]；p<0.001）。
研究结果表明，接触者追踪可靠性可能受到各种人口统计学和组织因素的显著影响。在设计和实施资源匮乏环境下未来疫情中的接触者追踪策略时，考虑并了解这些因素（并在可能的情况下加以解决）可能至关重要。
