■已知几种虫媒病毒病是地方性的(例如,克里米亚-刚果出血热,裂谷热)或正在出现(登革热,基孔肯雅,O\'nyong-nyong)在毛里塔尼亚的人口中,而其他一些在最近几年变得罕见(例如黄热病)。此外,家畜,尤其是牛,骆驼,山羊,羊,也已知感染了一些虫媒病毒(例如克里米亚-刚果出血热,裂谷热)。由于这些原因,毛里塔尼亚的病毒性出血热监测是综合疾病监测和反应(IDSR)的一部分。然而,关于毛里塔尼亚阿萨巴地区病毒性出血热监测系统有效性的信息有限.本研究的目的是评估监测系统的性能,特别是它的一般效用,简单,灵活性,可接受性,和反应性。
■2022年7月至8月在阿萨巴地区进行了描述性横断面研究,目的是通过采访参与病毒性出血热监测的关键参与者来评估系统的特征,重点是裂谷热和克里米亚-刚果出血热,使用按照疾病控制和预防中心(亚特兰大,格鲁吉亚,美国)。分析了国家公共卫生实验室研究所2020-2022年病毒性出血热的数据。Medians,四分位数范围,和比例使用EpiInfo®7.2.5.0和Excel®2021计算。
■调查问卷由阿萨巴地区病毒性出血热监测系统的所有26人回答。大多数受访者认为该系统有用(51%),简单(63%),可接受(46%),反应灵敏(64%),灵活(46%)。对数据的分析显示,裂谷热的阳性预测值为28%。wilaya地区的每周病例分布表明,Kiffa的moughataa在9月记录了最多的病例,在2020年当月出现明显的每周高峰。根据国家公共卫生研究所数据库的分析,病毒性出血热病例得到迅速处理。调查答复和数据库分析揭示了与数据质量和数据管理机制有关的问题。监测系统的这些限制很可能是由于资源和人员培训不足,特别是在数据收集和管理方面,这反过来又导致不完整或丢失的数据和无效的数据输入。这些弱点可以归因于,至少在某种程度上,财政限制和对虫媒病毒疾病的优先权归属不足。尽管有这些限制,监测系统生成的疾病数据通常是可靠的。
■阿萨巴地区的病毒性出血热监测系统坚持国家病毒性出血热监测系统的组织和功能,这是IDSR的一部分。效用的特点,简单,响应性、响应性病毒性出血热监测系统的灵活性很好,但是可接受性和灵活性需要进一步提高。发现第一例人类或动物虫媒病毒病例越早,更有可能组织积极的干预措施,以应对新出现的流行病或流行病,并防止疾病的传播。有效的病毒监测系统是减少阿萨巴地区虫媒病毒病负面影响的关键。
Several arboviral diseases have been known to be endemic (e.g., Crimean-Congo hemorrhagic fever, Rift Valley fever) or are emerging (dengue fever, chikungunya, O\'nyong-nyong) in human populations in Mauritania, while others have become rare in recent years (e.g. yellow fever). Moreover, domestic animals, especially cattle, camels, goats, and sheep, are also known to be infected with some of these arboviruses (e.g. Crimean-Congo hemorrhagic fever, Rift Valley fever). For these reasons, viral hemorrhagic fever surveillance in Mauritania is part of the Integrated Disease Surveillance and Response (IDSR). However, limited information is available on the efficacy of the viral hemorrhagic fever surveillance system in the Assaba region of Mauritania. The aim of the present study was to assess the performance of the surveillance system, in particular its general utility, simplicity,
flexibility, acceptability, and reactivity.
A descriptive cross-sectional study was conducted from July to August 2022 in the Assaba region with the objective of evaluating the characteristics of the system by interviewing key actors involved in the surveillance of viral hemorrhagic fevers, with a focus on Rift Valley fever and Crimean-Congo hemorrhagic fever, using questionnaires developed following the guidelines of the Centers for Disease Control and Prevention (Atlanta, Georgia, USA). Data from 2020-2022 on viral hemorrhagic fevers from the National Institute of Public Health laboratory were analyzed. Medians, interquartile ranges, and proportions were calculated using Epi Info® 7.2.5.0 and Excel® 2021.
The questionnaire was answered by all twenty-six persons involved in the viral hemorrhagic fever surveillance system in Assaba region. The majority of survey respondents found the system to be useful (51%), simple (63%), acceptable (46%), responsive (64%), and flexible (46%). An analysis of the data revealed a positive predictive value of 28% for Rift Valley Fever. The weekly distribution of cases within the wilaya indicates that the moughataa of Kiffa recorded the highest number of cases in September, with a notable weekly peak during that month in 2020. According to the analysis of the National Institute of Public Health database, cases of viral hemorrhagic fevers were promptly handled. Survey responses and database analysis revealed issues related to data quality and data management mechanisms. These limitations in the surveillance system are likely to be due to insufficient resources and training of the personnel, in particular with regards to data collection and management, which in turn led to incomplete or missing data and invalid data entry. These weak points can be ascribed, at least in part, to financial constraints and inadequate attribution of priority to arboviral diseases. Despite these limitations, disease data generated by the surveillance system were generally reliable.
The viral hemorrhagic fever surveillance system in the Assaba region adheres to the organization and functioning of the national viral hemorrhagic fever surveillance system, which is part of the IDSR. The characteristics of utility, simplicity, responsiveness, and
flexibility of the viral hemorrhagic fever surveillance system are good, but acceptability and
flexibility need further improvement. The earlier the first arboviral human or animal cases are detected, the more likely an active intervention can be organized in response to the emerging epidemic or epizootic and prevent the spread of the disease. An efficient viral surveillance system is the key to reducing the negative impact of arboviral diseases in Assaba region.