A practical community-based response strategy to interrupt Ebola transmission in sierra Leone, 2014-2015

被引：16

作者：

Li, Zhong-Jie ^{[1
]}

Tu, Wen-Xiao ^{[2
]}

Wang, Xiao-Chun ^{[3
]}

Shi, Guo-Qing ^{[4
]}

Yin, Zun-Dong ^{[5
]}

Su, Hai-Jun ^{[6
]}

Shen, Tao ^{[4
]}

Zhang, Da-Peng ^{[3
]}

Li, Jian-Dong ^{[7
]}

Lv, Shan ^{[8
]}

Cao, Chun-Li ^{[8
]}

Xie, Rui-Qian ^{[9
]}

Lu, Hong-Zhou ^{[10
]}

Jiang, Rong-Meng ^{[11
]}

Cao, Zheng ^{[12
]}

An, Zhi-Jie ^{[5
]}

Li, Lei-Lei ^{[2
]}

Xu, Jie ^{[3
]}

Xiong, Yan-Wen ^{[13
]}

Zang, Wei ^{[8
]}

Zhang, Wei ^{[14
]}

Zhang, Hong-Wei ^{[15
]}

Chen, Wen-Sen ^{[16
]}

Ling, Hua ^{[17
]}

Xu, Wen ^{[18
]}

Cai, Jian ^{[19
]}

Luo, Huan-Jin ^{[20
]}

Xing, Xue-Sheng ^{[21
]}

Zheng, Can-Jun ^{[1
]}

Wei, Qiang ^{[22
]}

Li, Xin-Xu ^{[23
]}

Li, Mei ^{[8
]}

Jiang, Hai ^{[13
]}

Deng, Li-Quan ^{[24
]}

Chen, Ming-Quan ^{[25
]}

Huo, Xiang ^{[26
]}

Xu, Feng ^{[27
]}

Lai, Xue-Hui ^{[28
]}

Bai, Xi-Chen ^{[29
]}

Ye, Long-Jie ^{[12
]}

Yao, Jian-Yi ^{[2
]}

Yin, Wen-Wu ^{[1
]}

Sun, Jiao-Jin ^{[5
]}

Xiao, Lin ^{[30
]}

Liu, Fu-Qiang ^{[31
]}

Liu, Xiao-Qiang ^{[18
]}

Fan, Hong-Wei ^{[32
]}

Kou, Zeng-Qiang ^{[33
]}

Zhou, Ji-Kun ^{[34
]}

Zhang, Hao ^{[12
]}

机构：

[1] Chinese Ctr Dis Control & Prevent, Key Lab Surveillance & Early Warning Infect Dis, Div Infect Dis, Beijing, Peoples R China

[2] Chinese Ctr Dis Control & Prevent, Publ Hlth Emergency Ctr, Beijing, Peoples R China

[3] Chinese Ctr Dis Control & Prevent, Natl Ctr AIDS STD Control & Prevent, Beijing, Peoples R China

[4] Chinese Ctr Dis Control & Prevent, Chinese Field Epidemiol Training Program, Beijing, Peoples R China

[5] Chinese Ctr Dis Control & Prevent, Natl Immunizat Program, Beijing, Peoples R China

[6] Natl Hlth & Family Planning Commiss Peoples Repub, Bur Dis Prevent & Control, Beijing, Peoples R China

[7] Chinese Ctr Dis Control & Prevent, Natl Inst Viral Dis Control & Prevent, Beijing, Peoples R China

[8] Chinese Ctr Dis Control & Prevent, Natl Inst Parasit Dis, Shanghai, Peoples R China

[9] Chinese Ctr Hlth Educ, Beijing, Peoples R China

[10] Shanghai Publ Hlth Clin Ctr, Dept Infect Dis, Shanghai, Peoples R China

[11] Capital Med Univ, Beijing Ditan Hosp, Beijing, Peoples R China

[12] Hlth News, Beijing, Peoples R China

[13] Chinese Ctr Dis Control & Prevent, Natl Inst Communicable Dis Control & Prevent, Beijing, Peoples R China

[14] Chinese Ctr Hlth Educ, Dept Training, Beijing, Peoples R China

[15] Capital Med Univ, Beijing Youan Hosp, Ctr Infect Dis, Beijing, Peoples R China

[16] Nanjing Med Univ, Affiliated Hosp 1, Infect Management, Nanjing, Jiangsu, Peoples R China

[17] Chongqing Municipal Ctr Dis Control & Prevent, Chongqing, Peoples R China

[18] Yunnan Prov Ctr Dis Control & Prevent, Kunming, Peoples R China

[19] Zhejiang Prov Ctr Dis Control & Prevent, Div Infect Dis Control & Prevent, Hangzhou, Zhejiang, Peoples R China

[20] Guangdong Prov Ctr Dis Control & Prevent, Guangzhou, Guangdong, Peoples R China

[21] Hubei Prov Ctr Dis Control & Prevent, Div Acute Infect Dis Control & Prevent, Wuhan, Peoples R China

[22] Chinese Ctr Dis Control & Prevent, Off Lab Management, Beijing, Peoples R China

[23] Chinese Ctr Dis Control & Prevent, Natl Ctr TB Control & Prevent, Beijing, Peoples R China

[24] Jilin Prov Ctr Dis Control & Prevent, Changchun, Peoples R China

[25] Fudan Univ, Dept Infect Dis, Huashan Hosp, Shanghai, Peoples R China

[26] Jiangsu Prov Ctr Dis Control & Prevent, Dept Acute Infect Dis, Nanjing, Jiangsu, Peoples R China

[27] Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Infect Dis, Hangzhou, Zhejiang, Peoples R China

[28] Zhongshan Ctr Dis Control & Prevent, Zhongshan, Guangdong, Peoples R China

[29] China Populat Commun Ctr, Beijing, Peoples R China

[30] Jingzhou Ctr Dis Control & Prevent, Jingzhou, Hubei Province, Peoples R China

[31] Hunan Prov Ctr Dis Control & Prevent, Changsha, Hunan, Peoples R China

[32] Peking Union Med Coll Hosp, Beijing, Peoples R China

[33] Shandong Prov Ctr Dis Control & Prevent, Jinan, Peoples R China

[34] Shijiazhuang Ctr Dis Control & Prevent, Shijiazhuang, Hebei Province, Peoples R China

[35] Dist Hlth Management Team, Western Area, Sierra Leone

[36] Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China

来源：

INFECTIOUS DISEASES OF POVERTY | 2016年 / 5卷

关键词：

Ebola virus disease; Community engagement; Health education; Outbreak control; HEALTH-CARE WORKERS; VIRUS DISEASE; LIBERIA; VILLAGE; OUTBREAK; CLUSTER; COUNTY;

D O I：

10.1186/s40249-016-0167-0

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: The Ebola virus disease spread rapidly in West Africa in 2014, leading to the loss of thousands of lives. Community engagement was one of the key strategies to interrupt Ebola transmission, and practical community level measures needed to be explored in the field and tailored to the specific context of communities. Methods: First, community-level education on Ebola virus disease (EVD) prevention was launched for the community's social mobilizers in six districts in Sierra Leone beginning in November 2014. Then, from January to May of 2015, in three pilot communities, local trained community members were organized to engage in implementation of EVD prevention and transmission interruption measures, by involving them in alert case report, contact tracing, and social mobilization. The epidemiological indicators of transmission interruption in three study communities were evaluated. Results: A total of 6 016 community social mobilizers from 185 wards were trained by holding 279 workshops in the six districts, and EVD message reached an estimated 631 680 residents. In three pilot communities, 72 EVD alert cases were reported, with 70.8 % of them detected by trained local community members, and 14 EVD cases were finally identified. Contact tracing detected 64.3 % of EVD cases. The median duration of community infectivity for the cases was 1 day. The secondary attack rate was 4.2 %, and no third generation of infection was triggered. No health worker was infected, and no unsafe burial and noncompliance to EVD control measures were recorded. The community-based measures were modeled to reduce 77 EVD cases, and the EVD-free goal was achieved four months earlier in study communities than whole country of Sierra Leone. Conclusions: The community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission in a country with weak health system. The successfully practical experience to reduce the risk of Ebola transmission in the community with poor resources would potentially be helpful for the global community to fight against the EVD and the other diseases in the future.

引用

页数：10

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