Assessment of the integrated disease surveillance and response system implementation in health zones at risk for viral hemorrhagic fever outbreaks in North Kivu, Democratic Republic of the Congo, following a major Ebola outbreak, 2021.

BACKGROUND: The Democratic Republic of the Congo (DRC) experienced its largest Ebola Virus Disease Outbreak in 2018-2020. As a result of the outbreak, significant funding and international support were provided to Eastern DRC to improve disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy has been used in the DRC as a framework to strengthen public health surveillance, and full implementation could be critical as the DRC continues to face threats of various epidemic-prone diseases. In 2021, the DRC initiated an IDSR assessment in North Kivu province to assess the capabilities of the public health system to detect and respond to new public health threats. METHODS: The study utilized a mixed-methods design consisting of quantitative and qualitative methods. Quantitative assessment of the performance in IDSR core functions was conducted at multiple levels of the tiered health system through a standardized questionnaire and analysis of health data. Qualitative data were also collected through observations, focus groups and open-ended questions. Data were collected at the North Kivu provincial public health office, five health zones, 66 healthcare facilities, and from community health workers in 15 health areas. RESULTS: Thirty-six percent of health facilities had no case definition documents and 53% had no blank case reporting forms, limiting identification and reporting. Data completeness and timeliness among health facilities were 53% and 75% overall but varied widely by health zone. While these indicators seemingly improved at the health zone level at 100% and 97% respectively, the health facility data feeding into the reporting structure were inconsistent. The use of electronic Integrated Disease Surveillance and Response is not widely implemented. Rapid response teams were generally available, but functionality was low with lack of guidance documents and long response times. CONCLUSION: Support is needed at the lower levels of the public health system and to address specific zones with low performance. Limitations in materials, resources for communication and transportation, and workforce training continue to be challenges. This assessment highlights the need to move from outbreak-focused support and funding to building systems that can improve the long-term functionality of the routine disease surveillance system.

Factors associated with the use of insecticide-treated nets: analysis of the 2018 Burkina Faso Malaria Indicator Survey.

BACKGROUND: Sleeping under an ITN reduces contact with mosquitoes through the combination of a physical barrier and an insecticidal effect, which reduces the incidence of malaria. The 2016-2020 Burkina Faso National Malaria Strategic Plan aims to have at least 90% of the population, 100% of children under age 5, and 100% of pregnant women sleep under an ITN. METHODS: The analysis examines individual, household, and community-level factors associated with ITN usage. According to the 2017-18 Burkina Faso MIS, 58% of individuals in households that own at least one ITN reported that they slept under an ITN on the night before the survey. RESULTS: The use of ITNs was significantly associated with individual, household, and community-level variables that included age, gender, age of household head, number of sleeping rooms, wealth, malaria prevalence, residence, and region. CONCLUSIONS: The results highlight areas of intervention at the individual, household, and community levels that can increase ITN use.

[Prevalence and factors associated with stunting among schoolchildren in Dori in the Sahel region of Burkina Faso]. / Prévalence et facteurs associés au retard de croissance chez des écoliers à Dori, Burkina Faso.

OBJECTIVES: To study the factors associated with stunted physical growth in primary school children and adolescents in the Burkina Faso Sahel. MATERIALS AND METHODS: This was a secondary analysis of the data from the survey conducted by the Directorate of Nutrition in June 2016 in 13 primary schools. The baseline study was conducted from May 15 to 24, 2016. This secondary analysis of the database took place from March to August 2017. The study participants were made up of male and female students from public primary schools and who were beneficiaries of the school canteens of the Dori municipality at the time of the survey. Logistic regression was used to identify the factors associated with a 5% significance level. RESULTS: The analysis involved a sample of 568 students aged 5 to 15 years. Girls accounted for 52% of students. The prevalence of stunting was 32.92% (95% CI [29-36%]), it was 28.93% (95 % CI [23.84-34.62%]) among boys and 36.61 % (95% CI [31.28-42.28%]) in girls. Among primary students, age (ORa = 4.38, P = 0.00), anemia (ORa = 0.24, P = 0.01) and latrine use (ORa = 0.58 with P = 0.02) were the factors statistically associated with stunting (P < 0.05). CONCLUSIONS: The prevalence of stunting among primary school students in the commune of Dori remains high. Associated factors were age, anemia and latrine use. Promotion of latrine use in households and prevention of anemia in children under 5 years of age would be necessary for the reduction of stunting among adolescents.