DRC Ebola total grows by 2 cases to reach 104, with 44 deaths
Two more people in the Democratic Republic of the Congo (DRC) have tested positive for Ebola, raising the number of cases in the Equateur province outbreak to 104, the World Health Organization (WHO) African regional office said on Twitter today.
No new deaths were reported, keeping the fatality county at 44.
The outbreak began in early June and affects the same area of a short-lived event in 2018, which resulted in 54 cases, including 33 deaths.
Health officials are concerned about the current outbreak, because it is occurring across a broad area, some of it remote, but with a number of cases reported in Mbandaka, the regional capital, which has travel connections to Kinshasa and neighboring countries. Outbreak responders are grappling with the COVID-19 pandemic and scarce resources for battling Ebola.
Aug 26 WHO African regional office tweet
Study highlights impact of fluoroquinolone restriction initiative
A quality improvement initiative to restrict fluoroquinolone prescribing in high-risk patients reduced fluoroquinolone use without negative impacts, researchers from the University of Wisconsin School of Medicine and Public Health reported yesterday in PLOS One.
The initiative was implemented in the intensive care unit (ICU) and solid-organ transplant unit at the University of Wisconsin Hospital in July 2016 in an attempt to decrease the rate of hospital-onset Clostridioides difficile infection (HO-CDI), which is associated with fluoroquinolone use. The restriction required antimicrobial stewardship pre-approval for fluoroquinolone prescribing. In the study, the researchers compared rates of HO-CDI in the 24 months before and after the initiative, along with fluoroquinolone and alternative antibiotic days of therapy (DOT), length of hospital stay, readmissions, and mortality.
The results showed that HO-CDI rates did not decrease significantly after the initiative, but fluoroquinolone use fell from 111.6 to 19.8 DOT per 1,000 patient-days without negatively impacting length of stay, readmissions, or mortality.
In contrast, use of third-generation cephalosporins, aminoglycosides, and piperacillin-tazobactam increased post-intervention. Interviews with hospital staff (residents, attending physicians, advanced practice providers, and pharmacists) identified the strength of the hospital's antimicrobial stewardship program (ASP) and pharmacy involvement as key facilitators of the restriction program, and patient complexity and lack of provider education as barriers.
"Lessons from our initiative, particularly those learned from exploring the perspectives of front line providers, can be applied to larger-scale ASP interventions," the authors of the study wrote. "Future studies should confirm safety and efficacy of restriction policies among critically ill and immunocompromised patients with particular attention to the impact on prescribing of alternative agents and explore other opportunities for optimization of antimicrobial prescribing, such as at the time of hospital discharge."
Aug 25 PLOS One study
DRC declares end to measles outbreak
The DRC yesterday announced the end of its measles outbreak, a massive event that sickened more than 380,000 people, about 7,000 fatally, over a 2-year period. Health Minister Eteni Longondo, MD, MPH, announced the development yesterday at a news briefing, according to media reports.
The country's outbreak occurred as it was juggling several other health crises, including Ebola, cholera, vaccine-derived polio, and COVID-19. The measles response involved mass vaccination efforts that immunized more than 18 million children, though health officials have warned that coverage is still low in some areas.
The WHO African regional office said in its latest weekly outbreaks and health emergencies report that for the week ending Aug 9, officials reported 418 cases and 7 deaths across the country, with most cases reported in Sankuru and South Ubangi provinces. It added that since 2019 a total of 380,766 cases and 7,018 deaths had been reported.
Aug 25 Al Jazeera report
Aug 25 WHO African regional office weekly report
