Contact Tracing during an Outbreak of Ebola Virus Disease in the Western Area Districts of Sierra Leone: Lessons for Future Ebola Outbreak Response.
Contact Tracing during an Outbreak of Ebola Virus Disease in the Western Area Districts of Sierra Leone: Lessons for Future Ebola Outbreak Response.
复制标题
在塞拉利昂西部地区的埃博拉病毒疾病爆发期间接触追踪：未来的埃博拉疫情反应的教训。
DOI：
10.3389/fpubh.2016.00130
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发表时间：
2016
影响因子：
5.2
通讯作者：
Mugume J
中科院分区：
文献类型：
--
作者：
Olu OO;Lamunu M;Nanyunja M;Dafae F;Samba T;Sempiira N;Kuti-George F;Abebe FZ;Sensasi B;Chimbaru A;Ganda L;Gausi K;Gilroy S;Mugume J
接触者追踪是及时预防和控制埃博拉病毒病（EVD）暴发所需的一项关键战略。现有证据表明，接触者追踪不力是西非（包括塞拉利昂）EVD疫情的驱动因素。在这篇文章中，我们回答了2014年至2015年在塞拉利昂西部地区（WA）实施的EVD接触者追踪是否有效的问题。目标是描述接触者追踪并确定有效实施的障碍。混合方法包括对2014年至2015年期间从西澳收集的EVD病例和接触者追踪数据集的二级数据分析，接触者追踪者及其主管的关键线人访谈，以及对现有接触者追踪报告的审查，以获得本研究的数据。在研究期间，3，838例确诊病例和32，706名接触者被列入该地区的病毒性出血热和接触者数据库（平均每个病例8.5名接触者）。在研究地区，只有22.1%（852例）的确诊病例在发病时被列为接触者，这表明对接触者的识别和追踪不完整。与有效接触者追踪相关的挑战包括缺乏社区信任、隐瞒暴露信息、政治干预追踪人员的招募、接触者追踪人员的培训不足以及EVD病例和接触者数据库不完整。虽然追踪者指出社区隔离有助于促进他们的工作，但他们也报告说，食物和水等基本需求的供应出现延误或不正常，这引起了社区的抵制。接触者追踪中的多个缺口归因于与实施者相关的各种因素，社区被确定为阻碍及时控制塞拉利昂西澳EVD疫情的障碍。在未来的疫情中，建议社区尽早参与接触者追踪，建立适当的机制来选择、充分培训和监督合格的接触者追踪人员，建立管理良好和完整的接触者追踪数据库，并向隔离接触者提供基本需求，作为加强有效接触者追踪的措施。
Contact tracing is a critical strategy required for timely prevention and control of Ebola virus disease (EVD) outbreaks. Available evidence suggests that poor contact tracing was a driver of the EVD outbreak in West Africa, including Sierra Leone. In this article, we answered the question as to whether EVD contact tracing, as practiced in Western Area (WA) districts of Sierra Leone from 2014 to 2015, was effective. The goal is to describe contact tracing and identify obstacles to its effective implementation. Mixed methods comprising secondary data analysis of the EVD case and contact tracing data sets collected from WA during the period from 2014 to 2015, key informant interviews of contact tracers and their supervisors, and a review of available reports on contact tracing were implemented to obtain data for this study. During the study period, 3,838 confirmed cases and 32,706 contacts were listed in the viral hemorrhagic fever and contact databases for the district (mean 8.5 contacts per case). Only 22.1% (852) of the confirmed cases in the study area were listed as contacts at the onset of their illness, which indicates incomplete identification and tracing of contacts. Challenges associated with effective contact tracing included lack of community trust, concealing of exposure information, political interference with recruitment of tracers, inadequate training of contact tracers, and incomplete EVD case and contact database. While the tracers noted the usefulness of community quarantine in facilitating their work, they also reported delayed or irregular supply of basic needs, such as food and water, which created resistance from the communities. Multiple gaps in contact tracing attributed to a variety of factors associated with implementers, and communities were identified as obstacles that impeded timely control of the EVD outbreak in the WA of Sierra Leone. In future outbreaks, early community engagement and participation in contact tracing, establishment of appropriate mechanisms for selection, adequate training and supervision of qualified contact tracers, establishment of a well-managed and complete contact tracing database, and provision of basic needs to quarantined contacts are recommended as measures to enhance effective contact tracing.