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刚果民主共和国埃博拉病毒病的国家负担:采取行动的紧迫性。

National burden of Ebola virus disease in Democratic Republic of the Congo: the urgency to act.

作者信息

Ahmad Bilal, Sagide Martin, Ntamwinja Sylivia, Byiringiro Elysée, Kihanduka Elie, Rugendabanga Excellent, Hangi Samson, Bhattacharjee Priyadarshini, Ali Babar, Nkundakozera Marie, Kanda Michée Sanza, Guruka Lucie, Onesime Jones, Tague Christian, Langat Amos Kipkorir, Akilimali Aymar

机构信息

Department of Community Medicine and Public Health, Shaikh Khalifa bin Zayed Al Nahyan Medical and Dental College.

Jomo Kenyatta University of Agriculture and Technology, Juja.

出版信息

Ann Med Surg (Lond). 2024 Jun 21;86(8):4579-4585. doi: 10.1097/MS9.0000000000002213. eCollection 2024 Aug.

Abstract

Ebola virus disease (EVD) has long been a major public health concern for Democratic Republic of the Congo (DR Congo). First identified in DR Congo in 1976, the country has witnessed more than 25 outbreaks of this deadly disease, which has a case fatality rate of nearly 90% and manifesting with symptoms such as diarrhoea, vomiting, stomachache and haemorrhagic fever. African fruit bats have been speculated to be the reservoir of this virus. DR Congo is currently facing another EVD outbreak simultaneously with other communicable diseases, rendering it vulnerable to a shortage of medical and paramedical staff along with distrust among remote communities towards local authorities due to armed conflict and political instability. Moreover, lack of ring vaccinations and inefficient surveillance of suspected individuals are some other significant hurdles in disease control. Despite the availability of rVSV-ZEBOV/Erbevo vaccine and many antibody-based vaccines, challenges including politicization, low access to remote communities, and illiteracy have limited their effectiveness. Recently, the Congolese govt. has put in efforts such as building local capacities at the health zone level, outbreak control intervention, community engagement and social mobilization to counter the rising EVD cases. Four successive Strategic Response Plans have been implemented to increase resource mobilization by DR Congo and her partners. The Spread of zoonotics such as EVD can be confronted by implementing the One Health approach, which involves medical staff, veterinarians and public health officials.

摘要

埃博拉病毒病(EVD)长期以来一直是刚果民主共和国(DR Congo)主要的公共卫生问题。1976年在刚果民主共和国首次发现该病毒,该国已见证了25多次这种致命疾病的爆发,其病死率接近90%,症状包括腹泻、呕吐、胃痛和出血热。据推测,非洲果蝠是这种病毒的宿主。刚果民主共和国目前正同时面临埃博拉病毒病疫情以及其他传染病的爆发,这使其容易出现医护人员短缺的情况,而且由于武装冲突和政治不稳定,偏远社区对地方当局也不信任。此外,缺乏环状疫苗接种以及对疑似病例监测不力是疾病控制中的其他重大障碍。尽管有重组水疱性口炎病毒载体埃博拉疫苗(rVSV-ZEBOV/Erbevo)和许多基于抗体的疫苗,但包括政治化、偏远社区难以获得疫苗以及文盲等挑战限制了它们的有效性。最近,刚果政府已做出努力,如在卫生区层面建设当地能力、进行疫情控制干预、开展社区参与和社会动员,以应对不断增加的埃博拉病毒病病例。已实施了四项连续的战略应对计划,以增加刚果民主共和国及其合作伙伴的资源调动。通过实施“同一健康”方法,可以应对埃博拉病毒病等人畜共患病的传播,该方法涉及医务人员、兽医和公共卫生官员。

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