Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?
Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?
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DOI：
10.11694/pamj.supp.2015.22.1.6626
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发表时间：
2015-01-01
影响因子：
1.2
通讯作者：
Ngom, Mor
中科院分区：
文献类型：
--
作者：
Thiam, Sylla;Delamou, Alexandre;Ngom, Mor
导言：埃博拉疫情于2013年12月出现在几内亚的一个偏远角落，并在卫生系统薄弱的背景下蔓延到利比里亚和塞拉利昂。在本文中，我们报告了一线卫生服务和社区面临的主要挑战，包括他们对几内亚科亚州和福雷卡里亚州当前埃博拉应对工作的看法和看法。方法：2014年12月进行了一项横断面研究，采用混合方法：(I)案头审查；(Ii)访谈；(Iii)直接观察。结果：西非埃博拉病毒疫情爆发近一年后，利益攸关方的看法和观察到的现实是，这两个卫生区的准备水平较低。该研究确定，协调机制不佳、人力资源培训不足以及外地工作队和保健设施缺乏设备和用品是影响应对的关键因素。在社会经济发展不佳的情况下，由于传播战略不充分、对疾病的误解、对当地文化和习俗的无知以及当地社区没有参与控制战略，情况变得更加糟糕。因此，社区和寻求控制疫情的人之间形成了不信任，这在很大程度上导致社区不愿参与并为努力做出贡献。结论：有必要重新思考在低收入国家设计、规划和实施埃博拉病毒病等紧急情况下的疾病控制干预措施的方式。
Introduction: the Ebola outbreak emerged in a remote corner of Guinea in December 2013, and spread into Liberia and Sierra Leone in the context of weak health systems. In this paper, we report on the main challenges faced by frontline health services and by communities including their perceptions and views on the current Ebola response in the Prefectures of Coyah and Forecariah in Guinea.Methods: a cross-sectional study was conducted in December 2014 using mixed approaches: (i) Desk review; (ii) Interviews; and (iii) Direct observation.Results: almost one year after the beginning of the Ebola virus disease outbreak in West Africa, the perceptions of stakeholders and the observed reality were that the level of preparedness in the two health districts was low. The study identified poor coordination mechanisms, inadequate training of human resources and lack of equipment and supplies to field teams and health facilities as key elements that affected the response. The situation was worsened by the inadequate communication strategy, misconceptions around the disease, ignorance of local culture and customs and lack of involvement of local communities in the control strategies, within the context of poor socioeconomic development. As a result distrust developed between communities and those seeking to control the epidemic and largely contributed to the reluctance of the communities to participate and contribute to the effort.Conclusion: there is a need to rethink the way disease control interventions in the context of an emergency such as Ebola virus disease are designed, planned and implemented in low income countries.