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Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system
Author(s) -
Ashbaugh Hayley R.,
Kuang Brandon,
Gadoth Adva,
Alfonso Vivian H.,
Mukadi Patrick,
Doshi Reena H.,
Hoff Nicole A.,
Sinai Cyrus,
Mossoko Mathias,
Kebela Benoit Ilunga,
Muyembe JeanJacques,
Wemakoy Emile Okitolonda,
Rimoin Anne W.
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12917
Subject(s) - democracy , medicine , political science , geography , law , politics
Background Ebola virus disease ( EVD ) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response ( IDSR ) strategy in the Democratic Republic of Congo ( DRC ) may be a vital tool in improving outbreak response. Methods Using DRC IDSR data from the nation's four EVD outbreak periods from 2007–2014, we assessed trends of Viral Hemorrhagic Fever ( VHF ) and EVD differential diagnoses reportable through IDSR . With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Results Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Conclusion Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co‐morbidities.