Accepted Manuscript Healthcare students’ and workers’ knowledge about epidemiology and symptoms of Ebola in one city of Colombia A.M. Patiño-Barbosa, F. Arroyave-Valencia, L.M. García-Ramírez, E. VallejoAtehortúa, M. Arciniegas-Pantoja, A.J. Rodriguez-Morales, A.E. Paniz-Mondolfi PII:
To appear in:
Journal of Hospital Infection
Received Date: 4 May 2015 Accepted Date: 5 May 2015
Please cite this article as: Patiño-Barbosa AM, Arroyave-Valencia F, García-Ramírez LM, VallejoAtehortúa E, Arciniegas-Pantoja M, Rodriguez-Morales AJ, Paniz-Mondolfi AE, Healthcare students’ and workers’ knowledge about epidemiology and symptoms of Ebola in one city of Colombia, Journal of Hospital Infection (2015), doi: 10.1016/j.jhin.2015.05.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT 1 Letter to the Editor Healthcare students’ and workers’ knowledge about epidemiology and symptoms of Ebola in one city of Colombia Sir,
We read with interest the study of Fazekas et al. about the assessment of knowledge of Ebola virus disease (EVD) in junior doctors in hospitals of England.1 They found that that there is currently a deficiency of knowledge about critical aspects of EVD in that population.
EVD has emerged as a global threat due to the widespread epidemic ongoing in several
West African countries as well as its recent advance beyond African borders. Even though many aspects of its natural history remain poorly understood, the historical link of filoviruses to cave exposure has largely provided field evidence to incriminate bats as possible reservoirs for the
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disease.2,3 More recently, according to the World Health Organization, bats belonging to the Pteropodidae family are now considered natural hosts of the virus, further highlighting the zoonotic relevance of the disease, and its potential to extend to other geographic areas.4 Knowledge on the epidemiology and clinical manifestations of EVD, such as abrupt onset of high fever (up to 40°C), malaise, fatigue, headache, and myalgias are familiar to healthcare workers in endemic countries of Africa, but not in other areas of the world, including England and Latin
America, particularly in the latter where signs and symptoms overlap with other acute viral haemorrhagic fevers such as dengue and chikungunya.1,5 Up to December 10th, 2014, a total of 17,942 EVD cases had been reported, including 622 in healthcare personnel working mainly in Guinea, Liberia, and Sierra Leone, with an
accumulated case fatality rate of 71% in active transmission regions.6 Additionally, four countries (Spain, USA, Nigeria, and Senegal) have reported imported cases resulting in secondary cases
due to local transmission. Fortunately, to date no EVD cases have been reported in Latin America; however, the threat remains.7 Assessing knowledge and perceptions among healthcare students and workers about the epidemiology, transmission and clinical manifestations of EVD in a country such as Colombia is important given the non-availability of information through the national public health surveillance programme prior to 2014‒2015. An observational, descriptive, cross-sectional study was conducted among 107 healthcare workers attending the symposium ‘What should we know about Ebola?’ (Organized by the Coffee-Triangle regional chapter of the Colombian Association of Infectious Diseases and the
ACCEPTED MANUSCRIPT 2 Universidad Tecnológica de Pereira) held in October (2014) in the Colombian city of Pereira, Risaralda. Attendees who agreed to be part of the research (convenience sample) filled out a basic knowledge questionnaire, which included aspects on the epidemiology, symptoms, and
prevention of the disease (five questions). Questionnaires were completed before and after the event. Statistical analysis was performed using the SPSS statistical package, version 19.0. A chisquare test (P < 0.05) was run to assess the significance and to compare observed frequencies of correct answers before and after the symposium.
The proportion of correct responses to each of the five questions improved after the event (P < 0.05) (Table I), highlighting the pivotal role of providing information to healthcare workers about emergent infectious diseases.8 However, a lack of experience on how to recognize its signs
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and symptoms as well as how to approach and manage outbreaks still remains a major challenge in unaffected countries. Due to the lack of efficient healthcare policies and systems, Latin American countries are particularly vulnerable to infectious diseases, as has been shown with conditions such as chikungunya and malaria.5
In conclusion, like Fazekas et al. in the UK, we found that knowledge of EVD among South American healthcare workers was poor.1 Informational and educational tools did improve
knowledge about clinical manifestations and disease management in the short term, but it is not clear whether this knowledge is retained in the longer term. Conflict of interest statement None declared.
Fazekas B, Fazekas J, Moledina M, Fazekas B, Karolyhazy K. Ebola virus disease: awareness among junior doctors in England. J Hosp Infect 2015 Apr 11. doi: 10.1016/j.jhin.2015.03.007 [Epub ahead of print].
Olival KJ, Hayman DT. Filoviruses in bats: current knowledge and future directions. Viruses 2014;6:1759‒1788.
Peters CJ. Marburg and Ebola virus hemorrhagic fevers. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2010. p. 2259‒2263.
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Cardona-Ospina JA, Giselle-Badillo A, Calvache-Benavides CE, Rodriguez-Morales AJ. Ebola virus disease: an emerging zoonosis with importance for travel medicine. Travel Med Infect Dis 2014;12:682‒683.
Rodriguez-Morales AJ, Henao DE, Franco TB, Mayta-Tristan P, Alfaro-Toloza P, Paniz-
Mondolfi AE. Ebola: a latent threat to Latin America. Are we ready? Travel Med Infect Dis 2014;12:688‒689. 6.
World Health Organization. Ebola virus disease ‒ Fact sheet 2014. Geneva: WHO; 2014.
Rodriguez-Morales AJ, Marin-Rincon HA, Sepulveda-Arias JC, Paniz-Mondolfi AE.
Assessing the potential migration of people from Ebola affected West African countries to Latin America. Travel Med Infect Dis 2015 Jan 6; doi 10.1016/j.tmaid.2014.12.015 [Epub ahead of print].
Bedoya-Arias JE, Murillo-Garcia DR, Bolanos-Munoz E, et al. Healthcare students and
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workers’ knowledge about epidemiology and symptoms of chikungunya fever in two cities
A.M. Patiño-Barbosaa F. Arroyave-Valenciaa L.M. García-Ramíreza E. Vallejo-Atehortúaa M. Arciniegas-Pantojaa A.J. Rodriguez-Moralesa,b,* A.E. Paniz-Mondolfic
Public Health and Infection Research and Incubator Group, Faculty of Health Sciences,
of Colombia. J Infect Dev Countries 2015;9:330‒332.
Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
Working Group on Zoonoses, International Society for Chemotherapy, Aberdeen, UK
Department of Pathology and Laboratory Medicine, Hospital Internacional, Barquisimeto,
Venezuela and Laboratory of Biochemistry, Instituto de Biomedicina/IVSS, Caracas, Venezuela. *
Corresponding author. Author: Department of Community Medicine, Faculty of Health
Sciences, Universidad Tecnológica de Pereira, La Julita, Pereira 660003, Risaralda, Colombia. Tel.: +57 300 884 7448. E-mail address: [email protected]
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Table I Results of questions about knowledge about transmission, epidemiology, and symptoms of Ebola administered to healthcare students and workers in Pereira, Colombia before (N = 107) and after
(N = 85) an educational symposium Pre N 1. The Ebola virus spreads through: (answer: blood) 70
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symptoms) Correct Incorrect Total
2. The disease is contracted only after: (answer: appear