Transcript 3rd-symposium

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SUSTAINING PREVENTIVE MEASURES TO
CONTROL EMERGENT VIRAL INFECTION IN
HEALTH CARE FACILITIES.
ARE WE SO ALERT TO PREEMPT FURTHER
OUTBREAKS?
LESSONS LEARNT FROM LASSA/EBOLA
OUTBREAKS IN BENIN
T.Bognon1, C.Kassa5, E.Azagba3, H.Dokponou1, S.Sesso7, R.Boton1,
M.Bodéoussè4, A.Barre6, R.Mankou8, E.Zitti2, F.Nassouhouede2,
E.Linssoussi2, D.Medebaho2, T.Cheho1, A.Azondekon1
Military Teaching Hospital-Cotonou
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PRESENTATION OUTLINE
 INTRODUCTION
 OBJECTIVE
 METHODS
 RESULTS
 CONCLUSION
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INTRODUCTION 1
• Benin
• Neighboring of Nigeria
were LF is endemic
• Migration : human
• Movement : animals
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INTRODUCTION 2
• Risk of LF outbreaks
Nov2014
2015 Dec 2016
?
Jan 2017
West Africa’s LF outbreaks
overview Before 2014
• LF has become
cyclical in the
past two years
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INTRODUCTION 3
• Community as well as health workers
• 2014: death of 4 Health Workers
• Jan 2016: unexplained fever within HW after care
to Hemorrhagic fever case
• Strength of health system for riposte?
• Easy spreading !!!
• During last two outbreaks: many actions!!!
• WHO, UNICEF, UNFPA, Benin Government
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OBJECTIVE
• “I want to see your face”
• Evaluating state of alert in HCC
• In post epidemics for LF/Ebola as pre-emptive
actions and challenges
• To know get the perspectives of caregivers
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METHODS
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METHODS 1
• From April to Jun 2016
North
• Investigated HC Centers
 Located in the 12 departments
 National, regional and districts
Central
 Public, private and confessional
 Urban and rural area
South
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METHODS 2
• Were assessed comparing to actions taken during
and after the last outbreak (LSV/Ebola)
1- Specific logistic
2- Basics hospital hygiene
provided to control LF
3- knowledge on EID
• Semi-structured interviews with caregivers
• Direct observation of HCC environment
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METHODS 3
• SPSS version 17.0: quantitative analysis
A comparison between outbreaks and postepidemics periods by using Chi2(Fisher)
• Contents analysis: qualitative variables
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RESULTS
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RESULTS 1
• 60 HCC were concerned
• Levels
• National(16%)
• Regional (34%)
• District(50%)
• Types
• Private and confessional(25%)
• Publics (75%)
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RESULTS 2
• 60 caregivers investigated
 Professions
– Doctors 40%,Nurses 60%
– Median Seniority: 10years(3-34)
– None trained on LF
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RESULTS 3
Specific logistic provided to control LF
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RESULTS 4
Specific logistic provided to control LF
X-ray
%
100
90
80
70
60
50
40
30
20
10
0
64
P=0.000
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During Outbreaks Period
Functional washing
devices for patients at
the main entrance of
HC Centers
After Outbreaks Period
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RESULTS 5
Specific logistic provided to control LF
100
90
80
70
60
50
40
30
20
10
0
%
89
P=0.000
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During Outbreaks Period
After Outbreaks Period
Hydro alcoholic solution at
Emergency Rooms or
admission rooms
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RESULTS 6
Specific logistic provided to control LF
72
Presence of
Posters/algorithms
on LF/Ebola
P=0.005
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During outbreaks Period
After Outbreaks Period
%
0
50
100
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RESULTS 7
Basics hospital hygiene
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RESULTS 8
• Basics hospital hygiene
100
%
90
80
78
70
60
50
40
P=0.002
30
20
During outbreaks period
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After Outbreaks period
0
Functional water facilities at
consultation room
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RESULTS 9
• Basics hospital hygiene
%
100
90
80
70
60
50
40
30
20
10
0
90
P=0.005
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During outbreaks period
After Outbreaks period
Hand washing
before/after contact
with patients
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RESULTS 10
Knowledge on Emerging Infectious Disease
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RESULTS 11
• knowledge on Emerging Infectious disease
71
%
100
90
80
70
60
50
40
30
20
10
0
P=0.000
After Outbreaks period
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During outbreaks period
Identify
LVF/Ebola
suspected
case
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RESULTS 12
• knowledge on Emerging Infectious disease
%
100
80
60
35
40
20
P=0.000
0
During Outbreaks period
After Outbreaks period
0
Knowing that LF is
endemic in Benin
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RESULTS 13
•Zika virus
• Unknown up to OG 2016 Rio
0%
Asked once
zika test
0%
suspected zika based
on symptoms
0%
knew How to
prevent Zika
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RESULTS 14
Functional hand washing devices for patients at
the main entrance of HCC:
During outbreaks Period
After outbreaks Period
% Yes
% No
South
60%
40%
Central
50%
50%
North
80%
20%
 No statistical difference in findings
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RESULTS 15
Hand washing before/after contact with patients
During outbreaks
After outbreaks
Period
Period
% Yes
% No
Medical
Doctor
69.2%
30.8%
Nurse
70.4%
29.6%
 No statistical difference in findings
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RESULTS 16
• Propositions from caregivers to preempt
LF spreading in HCC
1. Providing logistics for basic hygiene
2. Training and supervision at levels of health system
3. Introducing EID in basics training content of health
workers and schools
4. Motivating and evaluating impact HCC actions
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CONCLUSION
• Pre-emptive actions of LF spreading in HCC are
quiet low and inadequate
• Despite good knowledge of the disease
• Maintain appropriate and sustain good actions
• To pre-empt spreading of emerging infectious diseases such
LVF/Ebola within HW
• Health authorities have to mobilize resources to
reinforce the health system
• International as well as domestic
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AKNWOLEDGEMENTS
• Health workers
• Collaborators
• Military Teaching Hospital
• Benin Ministry of health and partners
• Organizers of this symposium
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Thanks for your attention
Merci pour votre attention
“The more we are together
the merrier we shall be”
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