Infection prevention and control of highly infectious pathogens in resource-limited countries: an experience from Marburg viral disease outbreak in Kagera Region - Tanzania.

Journal: BMC infectious diseases

Volume: 24

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Health Quality Assurance Unit, Ministry of Health, P. O. Box , Dodoma, Tanzania. kinyenje@gmail.com. Health Quality Assurance Unit, Ministry of Health, P. O. Box , Dodoma, Tanzania. Emergency Preparedness and Response Unit, Ministry of Health, P. O. Box , Dodoma, Tanzania. Department of Pediatrics and Child Health, Bugando Medical Center, P. O. Box , Mwanza, Tanzania. Health Promotion Section, Department of Preventive Services, Ministry of Health, P. O. Box , Dodoma, Tanzania. Department of Internal Medicine, Dodoma Regional Referral Hospital, P. O. Box , Dodoma, Tanzania. Wildlife Research Institute, Kingupira Wildlife Research Centre, P. O. Box , Utete- Rufiji, Tanzania. Epidemiology Section, Department of Preventive Services, Ministry of Health, P. O. Box , Dodoma, Tanzania. Bukoba District Council Hospital, Kagera Region, P. O. Box , Bukoba, Tanzania. Chato Zonal Hospital, P. O. Box , Chato- Geita, Tanzania. Department of Internal Medicine, Iringa Region Referral Hospital, P. O. Box , Iringa, Tanzania. Bukoba Regional Referral Hospital, P. O. Box , Bukoba, Kagera, Tanzania. Regional Secretariat, P.O Box , Kagera, Bukoba, Tanzania. Mirembe National Mental Health Hospital, P. O. Box , Dodoma, Tanzania. Singida Regional Referral Hospital, P. O. Box , Singida, Tanzania. Department Emergency Medicine, Bugando Medical Center, P. O. Box , Mwanza, Tanzania. Amref Health Africa in Tanzania, P. O. Box , Dar es Salaam, Tanzania. Quality Assurance Department, Bugando Medical Center, P. O. Box , Mwanza, Tanzania. President's Office - Regional Administration and Local Government, Dodoma, Tanzania. Department of Clinical Research, National Institute for Medical Research, Tabora Medical Research Centre, P. O. Box , Tabora, Tanzania. National Public Health Laboratory, P. O. Box , Dar es Salaam, Tanzania. Department of Clinical Research, Dodoma Medical Research Centre, National Institute for Medical Research, P. O. Box , Dodoma, Tanzania. National Institute of Medical Research, Head Quarters, P. O. Box , Dar es Salaam, Tanzania. World Health Organization, Dar es Salaam, Tanzania. University of Iringa, P. O. Box , Iringa, Tanzania. World Health Organization Regional Office for Africa, Brazzaville, Congo. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania. Directorate of Curative Services, Ministry of Health, P. O. Box , Dodoma, Tanzania. Unit of Research Coordination, Directorate of Curative Services, Ministry of Health, P. O Box , Dodoma, Tanzania. Office of Permanent Secretary, Ministry of Health, P. O. Box , Dodoma, Tanzania. Office of Chief Medical Officer, Ministry of Health, P. O. Box , Dodoma, Tanzania.

Abstract summary 

Marburg viral disease (MVD) is a highly infectious disease with a case fatality rate of up to 90%, particularly impacting resource-limited countries where implementing Infection Prevention and Control (IPC) measures is challenging. This paper shares the experience of how Tanzania has improved its capacity to prevent and control highly infectious diseases, and how this capacity was utilized during the outbreak of the MVD disease that occurred for the first time in the country in 2023.In 2016 and the subsequent years, Tanzania conducted self and external assessments that revealed limited IPC capacity in responding to highly infectious diseases. To address these gaps, initiatives were undertaken, including the enhancement of IPC readiness through the development and dissemination of guidelines, assessments of healthcare facilities, supportive supervision and mentorship, procurement of supplies, and the renovation or construction of environments to bolster IPC implementation.The official confirmation and declaration of MVD on March 21, 2023, came after five patients had already died of the disease. MVD primarily spreads through contact and presents with severe symptoms, which make patient care and prevention challenging, especially in resource-limited settings. However, with the use of a trained workforce; IPC rapid needs assessment was conducted, identifying specific gaps. Based on the results; mentorship programs were carried out, specific policies and guidelines were developed, security measures were enhanced, all burial activities in the area were supervised, and both patients and staff were monitored across all facilities. By the end of the outbreak response on June 1, 2023, a total of 212 contacts had been identified, with the addition of only three deaths. Invasive procedures like dialysis and Manual Vacuum Aspiration prevented some deaths in infected patients, procedures previously discouraged.In summary, this experience underscores the critical importance of strict adherence to IPC practices in controlling highly infectious diseases. Recommendations for low-income countries include motivating healthcare providers and improving working conditions to enhance commitment in challenging environments. This report offers valuable insights and practical interventions for preparing for and addressing highly infectious disease outbreaks through implementation of IPC measures.

Authors & Co-authors:  Kinyenje Erick E Hokororo Joseph J Ngowi Ruth R Kiremeji Michael M Mnunga Elice E Samwel Angela A Sylvanus Erasto E Mnken Emmanuel E Yango Missana M Mtalika Mikidadi M Mmbaga Vida V Saitoti Noel N Malecha Alex A Kundy Faith F Rwabilimbo Martin M Kaniki Issessanda I Mwisomba Godwin G Charles Erica E Mughanga Patrick P Kitambi Mary M Paul Radenta R Richard Erick E Musyani Atuganile A Rabiel Irene I Haule Gift G Marandu Laura L Mwakapasa Emmanuel E Manasseh Gerald G Sindato Calvin C Beyanga Medard M Kapyolo Eliakimu E Jacob Frank F Mcharo Jonathan J Mayige Mary M Msemwa Faraja F Saguti Grace G Kauki George G Masuma Janeth J Mrema George G Kohi Mugendi M Yoti Zabulon Z Habtu Michael M Mwengee William W Mukurasi Kokuhabwa K Gatei Wangeci W Ruggajo Paschal P Kwesi Elias E Eliakimu Eliudi E Horumpende Pius P Magembe Grace G Nagu Tumaini T

Study Outcome 

Source Link: Visit source

Statistics
Citations :  World Health Organization. Marburg virus disease. 2021; 7 August 2021: https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease . Accessed 28 Sept 2023.
Authors :  51
Identifiers
Doi : 10.1186/s12879-024-09508-5
SSN : 1471-2334
Study Population
Male,Female
Mesh Terms
Tanzania
Other Terms
Infection prevention and control;Kagera;Marburg viral disease;Tanzania;Viral hemorrhagic fever
Study Design
Case Study
Study Approach
Country of Study
Tanzania
Publication Country
England