Lessons learned for surveillance system strengthening through capacity building and partnership engagement in post-Ebola Guinea, 2015-2019.

The 2014-2016 Ebola outbreak in Guinea revealed systematic weaknesses in the existing disease surveillance system, which contributed to delayed detection, underreporting of cases, widespread transmission in Guinea and cross-border transmission to neighboring Sierra Leone and Liberia, leading to the largest Ebola epidemic ever recorded. Efforts to understand the epidemic's scale and distribution were hindered by problems with data completeness, accuracy, and reliability. In 2017, recognizing the importance and usefulness of surveillance data in making evidence-based decisions for the control of epidemic-prone diseases, the Guinean Ministry of Health (MoH) included surveillance strengthening as a priority activity in their post-Ebola transition plan and requested the support of partners to attain its objectives.

Evaluation of the first two Frontline cohorts of the field epidemiology training program in Guinea, West Africa.

Background: The 2014-2016 Ebola virus disease outbreak in West Africa revealed weaknesses in the health systems of the three most heavily affected countries, including a shortage of public health professionals at the local level trained in surveillance and outbreak investigation. In response, the Frontline Field Epidemiology Training Program (FETP) was created by CDC in 2015 as a 3-month, accelerated training program in field epidemiology that specifically targets the district level. In Guinea, the first two FETP-Frontline cohorts were held from January to May, and from June to September 2017.

Implementation of DHIS2 for Disease Surveillance in Guinea: 2015-2020.

A robust epidemic-prone disease surveillance system is a critical component of public health infrastructure and supports compliance with the International Health Regulations (IHR). One digital health platform that has been implemented in numerous low- and middle-income countries is the District Health Information System Version 2 (DHIS2). In 2015, in the wake of the Ebola epidemic, the Ministry of Health in Guinea established a strategic plan to strengthen its surveillance system, including adoption of DHIS2 as a health information system that could also capture surveillance data.

Public health emergency management capacity building in Guinea: 2014-2019.

Before the Ebola virus disease (EVD) outbreak of 2014-2016, Guinea did not have an emergency management system in place. During the outbreak, Global Health Security Agenda (GHSA) 2014-2019 funds made it possible to rapidly improve the country's capacity to manage epidemics through the development of public health emergency operation centres (PHEOCs) at the national and district levels. Since the end of the response, the infrastructure, staff, and systems of these PHEOCs have been further reinforced and well-integrated in the daily activities of Guinea's National Agency for Health Security, the entity responsible for the management of epidemics.

Leveraging Partnerships to Maximize Global Health Security Improvements in Guinea, 2015-2019.

In response to the 2014-2016 West Africa Ebola virus disease (EVD) outbreak, a US congressional appropriation provided funds to the US Centers for Disease Control and Prevention (CDC) to support global health security capacity building in 17 partner countries, including Guinea. The 2014 funding enabled CDC to provide more than 300 deployments of personnel to Guinea during the Ebola response, establish a country office, and fund 11 implementing partners through cooperative agreements to support global health security engagement efforts in 4 core technical areas: workforce development, surveillance systems, laboratory systems, and emergency management. This article reflects on almost 4 years of collaboration between CDC and its implementing partners in Guinea during the Ebola outbreak response and the recovery period.

Creating a National Specimen Referral System in Guinea: Lessons From Initial Development and Implementation.

In the wake of the 2014-2016, West Africa Ebola virus disease (EVD) outbreak, the Government of Guinea recognized an opportunity to strengthen its national laboratory system, incorporating capacity and investments developed during the response. The Ministry of Health (MOH) identified creation of a holistic, safe, secure, and timely national specimen referral system as a priority for improved detection and confirmation of priority diseases, in line with national Integrated Disease Surveillance and Response guidelines. The project consisted of two parts, each led by different implementing partners working collaboratively together and with the Ministry of Health: the development and approval of a national specimen referral policy, and pilot implementation of a specimen referral system, modeled on the policy, in three prefectures.

Assessing health systems in Guinea for prevention and control of priority zoonotic diseases: A One Health approach.

To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014-2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases - rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza - as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries.

Operational evaluation of rapid diagnostic testing for Ebola Virus Disease in Guinean laboratories.

Background: Rapid Diagnostic Tests (RDTs) for Ebola Virus Disease (EVD) at the point of care have the potential to increase access and acceptability of EVD testing and the speed of patient isolation and secure burials for suspect cases. A pilot program for EVD RDTs in high risk areas of Guinea was introduced in October 2015. This paper presents concordance data between EVD RDTs and PCR testing in the field as well as an assessment of the acceptability, feasibility, and quality assurance of the RDT program.

Risk factors for long-term post-traumatic stress disorder among medical rescue workers appointed to the 2008 Wenchuan earthquake response in China.

This study aims to determine the risk factors for clinically-significant post-traumatic stress disorder (PTSD) among Chinese medical rescue workers one year after the response to the Wenchuan earthquake on 12 May 2008. A sample of 337 medical workers who performed response work within the first three months of the event completed an online questionnaire, which included information on demographics, social support, the management and organisation of the disaster response, and an assessment of PTSD. Symptoms consistent with PTSD were prevalent in 17 per cent of the rescue workers.

Notes from the Field: Baseline Assessment of the Use of Ebola Rapid Diagnostic Tests--Forécariah, Guinea, October-November 2015.

The Ebola virus disease (Ebola) epidemic in West Africa began in Guinea in early 2014. The reemergence of Ebola and risk of ongoing, undetected transmission continues because of the potential for sexual transmission and other as yet unknown transmission pathways. On March 17, 2016, two new cases of Ebola in Guinea were confirmed by the World Health Organization.

Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015.

The epidemic of Ebola virus disease (Ebola) in West Africa began in Guinea in late 2013 (1), and on August 8, 2014, the World Health Organization (WHO) declared the epidemic a Public Health Emergency of International Concern (2). Guinea was declared Ebola-free on December 29, 2015, and is under a 90 day period of enhanced surveillance, following 3,351 confirmed and 453 probable cases of Ebola and 2,536 deaths (3). Passive surveillance for Ebola in Guinea has been conducted principally through the use of a telephone alert system.

Ebola Virus Disease--Sierra Leone and Guinea, August 2015.

The Ebola virus disease (Ebola) outbreak in West Africa began in late 2013 in Guinea (1) and spread unchecked during early 2014. By mid-2014, it had become the first Ebola epidemic ever documented. Transmission was occurring in multiple districts of Guinea, Liberia, and Sierra Leone, and for the first time, in capital cities (2).

Guatemala's ministry of health rapid response team manuals.

The function of public health rapid response teams (RRTs) is to quickly identify, investigate, and control an outbreak before it can spread. The Central America Regional Office in Guatemala provided assistance to the Guatemalan Ministry of Health and Social Assistance (MSPAS) to develop RRT manuals at the district and regional levels. The manuals are divided into 4 sections: background, activity lists, standard operating procedures, and annexes.

Informal Convergence at Major Emergency Incidents in Kenya.

"Convergence behavior" is the informal, spontaneous movement of people, messages, and supplies toward a major emergency incident area. This form of movement brings needed aid to many victims, but at the same time the resultant congestion makes organization and control of the rescue and relief efforts more difficult. Whenever a major emergency incident occurs in Kenya, typically a huge crowd of sightseers and personnel converge at the scene.

The role of minor and adult children in the adjustment of women living with HIV.

The present study examined how having children can relate to the psychological functioning of HIV-positive women, and the place and function children have in their mother's social support and social burden networks. As part of initial face-to-face interviews with 46 HIV-positive women enrolled in a longitudinal study, participants indicated their maternal status, the nature of their social support and burden (with a modified Multidimensional Social Support Inventory) and their levels of depressive symptoms (Brief Symptom Inventory). Using Analysis of Variance (ANOVA) and non-parametric analyses when statistical assumptions were not met, findings indicate that women with minor children reported fewer depressive symptoms and more confidence in regulating social support than women without children.

HIV and women in Hawaii: risk and protective factors in HIV/AIDS prevention.

Using semi-structured interviews with adults living with or at-risk for HIV and interviews and focus groups with key informants, the present study examined risk for HIV transmission among women living in Hawaii. Key research findings suggest that women in Hawaii are at risk for HIV infection primarily through sexual contact with their male sex partners, including bisexual and injection drug using (IDU) men. A significant factor in women's HIV risk is sex and gender role dynamics in the context of their relationships with men.