தொற்று நோய்கள் மற்றும் மருத்துவ இதழ்

Background: The 10th outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo (DRC) has been ongoing since August 2018. It is the largestever outbreak reported in the country and the world's second largest in history. It has been declared a Public Health Emergency of International Concern on 17 July 2019. The outbreak is ongoing in a densely-populated region, which is also experiencing a long-lasting humanitarian and security crisis. The affected region is characterised by insufficient prevention control practices in many health facilities and persistent reluctance in the community to accept response activities. Infection Prevention and Control and Hand Hygiene programmes were implemented in 10 hospitals to contribute in EVD containment and improving patient and healthcare personnel safety. The study aimed to evaluate whether the implementation of infection prevention and control programme in healthcare facilities improves the level of EVD preparedness and response. Methods: This quasi-experimental intervention study was conducted in ten hospitals of Goma EVD sub coordination, north Kivu Province between April and October 2019. Infection Prevention and Control and Hand Hygiene programmes were implemented in 10 hospitals in North-Kivu province in DRC. The main activities were: baseline and impact assessments of IPC and hand hygiene programmes, baseline and impact assessments of hand hygiene practices (direct observation) for frontline healthcare workers, setting up hospital IPC committee and nomination of hospital IPC focal point, briefing of the IPC committee members and IPC focal point on their roles and responsibilities, a 5 day IPC training workshop for hospital senior managers, IPC committee members and IPC focal point. Data was analysed using Ms Excel. Results: IPC programme baseline assessment demonstrated that 80% (8/10) of hospitals were at inadequate level, 20% (2/10) of hospitals were at basic level. Regarding hand hygiene programme, 80% (8/10) of hospitals were at inadequate level and 20% (2/10) of hospitals were at basic level. The findings from Hand hygiene practice baseline were: overall hand hygiene compliance was 33.1% (898/2713). All the 10 hospitals improved their hospital IPC level from inadequate level (8 hospitals) and basic level (2 hospitals) to intermediate level. Regarding hand hygiene programme, there were 4 hospitals that achieved advanced level, 5 hospitals achieved intermediate level and one hospital achieved basic level. During post-intervention assessment, hand hygiene practices among healthcare professionals improved significantly, whereby overall hand hygiene compliance improved from 33.1 (898/2713) to 70.5% (4368/6197). Conclusion: The best way to combat outbreaks including EVD in any country of the world is to strengthen its health systems with focus on Infection Prevention and Control (IPC) programme. Implementation of IPC and hand hygiene programmes in healthcare facilities in North-Kivu Province in DRC helped was a key in defeating EVD outbreak in Goma and it proved how important is to invest on health systems strengthening and IPC programme. IPC and Hand hygiene programmes should be integrated into preservice training for all health professionals. Communities should be engaged in IPC and hand hygiene programmes to ensure sustainability and ownship.

Hantaviruses are rodent-borne virus infection manifested as haemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome. HCPS is a severe, fatal, respiratory disease caused by infection with hanta viruses. Anyone who comes in contact with rodents that carry hanta-viruses is at risk of HCPS. Rodent infestation in and around the home remains the primary risk for hanta-virus exposure. Clinical presentation of hanta-virus infections is not very much clear, sero-conversion and rising anti-hantavirus IgG titers were taken as evidence. Here we present a case of a 46-year-old male diagnosed to have hanta virus pulmonary syndrome treated successfully