Knowledge, attitude and practice of medical laboratory practitioners in the fight against Ebola virus disease

Health literacy affected the residents' knowledge, attitude, practice for prevention and control of COVID-19 in Shanxi Province, China

Multistage stratified random sampling was used to explore the relationship of health literacy with novel coronavirus disease 2019 (COVID-19) prevention and control knowledge, attitude and practice (KAP) in residents aged 15-69 years old in Shanxi Province. The questionnaire, which was issued by the Chinese Center for Health Education, consisted of a health literacy questionnaire and a COVID-19 prevention and control KAP questionnaire. According to the national unified scoring method, the participants were divided into two groups: those who with adequate health literacy and those who with inadequate health literacy. The results of the answer to each KAP question were compared between the two groups by Chi-square test or Wilcoxon rank sum test. Binary logistic regression was used to control confounding effects of socio-demographic characteristics to draw relatively reliable conclusions. A total of 2700 questionnaires were distributed, and 2686 valid questionnaires were returned, with an efficiency rate of 99.5%. Health literacy qualified was identified for 18.32% (492/2686) in Shanxi Province. Compared with the inadequate health literacy group, people with adequate health literacy had a higher corrected answer rate in 11 knowledge-related questions (all P < 0.001); showed more positive answer to each attitude-related question in the three aspects, namely, responsibility for the prevention and control of infectious disease transmission, evaluation for COVID-19-related information release and reporting, and evaluation for the government's COVID-19 prevention and control results (all P < 0.001); and acted more actively in the practice concerning appropriate self-prevention and control behaviors during the COVID-19 outbreak (all P < 0.001). Logistic regression analyses confirmed that with adequate health literacy played a positive role in each of the contents of COVID-19 prevention and control KAP (ORs were between 1.475 and 4.862, all P < 0.001). Health literacy is closely related to COVID-19 prevention and control KAP in the general population of Shanxi Province. People with high score of health literacy were generally better able to grasp COVID-19 prevention and control knowledge, have more positive attitudes toward prevention and control, and perform better prevention and control behaviors. Promoting residents' health literacy by targeted health education can play an important and positive role in dealing with the threat of major infectious diseases outbreaks.

Knowledge, attitudes and practices of healthcare workers within an Australian tertiary hospital to managing high-consequence infectious diseases

BACKGROUND

Adequate preparation and support for healthcare workers (HCWs) managing high-consequence infectious diseases (HCIDs) is critical to the overall clinical management of HCIDs. Qualitative studies examining how well prepared and supported HCWs feel are lacking despite their key role. This study investigated how prepared and supported front-line HCWs at an Australian tertiary hospital felt about managing HCIDs such as viral haemorrhagic fever (VHF).

METHODS

A qualitative research approach was used to undertake interviews with 45 Royal Melbourne Hospital medical and nursing staff from emergency, intensive care and infectious diseases. Interview questions captured data on HCWs' role, familiarity with using protocols, psychological attributes and training for scenarios related to VHF patient management. Interviews were recorded and transcribed. Categorical responses were analysed quantitatively and open-ended responses were analysed thematically.

RESULTS

Ninety-eight percent of participants indicated feeling capable of undertaking their role in managing VHF patients; 77% felt supported through personnel/resources. However, 69% indicated barriers to managing these patients effectively; and 68% felt anxious at the prospect of managing VHF patients. Themes emerging from participants' observations included concerns about training frequency, miscommunication, difficulty with uncertainty, feeling underprepared, and fear of transmitting infection to others.

CONCLUSION

Although the majority of HCWs feel confident about their ability to care for VHF patients, they also have a moderately-high degree of anxiety. Perceptions of interviewed staff have fed into recommendations to increase HCW preparedness and reduce anxiety, which include investigating support services, and exploring training options that create multi-departmental groups of highly specialised medical officers and nurses.

Forty-two years of responding to Ebola virus outbreaks in Sub-Saharan Africa: a review

Introduction

Ebola virus disease (EVD) is one of the deadliest haemorrhagic fevers affecting humans and non-human primates. Thirty-four outbreaks have been reported in Africa since it was first recognised in 1976. This review analysed 42 years of EVD outbreaks and identified various challenges and opportunities for its control and prevention in Sub-Saharan Africa.

Methods

A literature search of relevant articles on EVD was done in PubMed, Web of Science and Google Scholar electronic databases. Articles published from 1976 to 2019 were reviewed to document reports of EVD outbreaks in Sub-Saharan Africa. Data extraction focused on the year of outbreak, geographical spread, virus strain involved, number of cases and deaths, case fatality, and outbreak management. Analyses of trends in case fatality were performed by calculating ORs between times.

Results

In the past four decades, a total of 34 EVD outbreaks affecting 34 356 cases and causing 14 823 deaths were reported in 11 countries in Sub-Saharan Africa. The overall case fatality rate (95% CI) was 66% (62 to 71) and did not change substantially over time (OR in 2019 vs 1976=1.6 (95% CI 1.5 to 1.8), p<0.001). The results of this review indicate that challenges to control EVD outbreaks are related to epidemiological, sociocultural and health system factors.

Conclusions

Sub-Saharan Africa continues to face considerable challenges in EVD control, whereby there are no significant changes in case fatality rates observed during the past four decades. Socioeconomic and cultural processes need to be critically considered to shape the community behaviours that lead to exposure to EVD outbreaks. Areas that need to be addressed to prevent future EVD outbreaks include a broad-based, one-health approach, effective communication, social mobilisation, and strengthening of the health systems.

A Rapid Screen for Host-Encoded miRNAs with Inhibitory Effects against Ebola Virus Using a Transcription- and Replication-Competent Virus-Like Particle System

MicroRNAs (miRNAs) may become efficient antiviral agents against the Ebola virus (EBOV) targeting viral genomic RNAs or transcripts. We previously conducted a genome-wide search for differentially expressed miRNAs during viral replication and transcription. In this study, we established a rapid screen for miRNAs with inhibitory effects against EBOV using a tetracistronic transcription- and replication-competent virus-like particle (trVLP) system. This system uses a minigenome comprising an EBOV leader region, luciferase reporter, VP40, GP, VP24, EBOV trailer region, and three noncoding regions from the EBOV genome and can be used to model the life cycle of EBOV under biosafety level (BSL) 2 conditions. Informatic analysis was performed to select up-regulated miRNAs targeting the coding regions of the minigenome with the highest binding energy to perform inhibitory effect screening. Among these miRNAs, miR-150-3p had the most significant inhibitory effect. Reverse transcription polymerase chain reaction (RT-PCR), Western blot, and double fluorescence reporter experiments demonstrated that miR-150-3p inhibited the reproduction of trVLPs via the regulation of GP and VP40 expression by directly targeting the coding regions of GP and VP40. This novel, rapid, and convenient screening method will efficiently facilitate the exploration of miRNAs against EBOV under BSL-2 conditions.