Preventive Measures against Ebola and COVID-19 and Their Impact on Human Dirty-Hand Disease Mitigation in Côte d'Ivoire

Hygiene is the most useful public health measure for preventing infections of important endemic and emerging diseases of global significance. This study aimed to assess the impact of these public health preventive measures on dirty hand diseases. A retrospective survey was conducted in the rural general hospitals of Taabo (south-central Côte d'Ivoire) and Marcory (urban Abidjan) to collect clinical data on dirty hand diseases in the patients' records from 2013 to 2020. In addition, focus group discussions (N = 8) were conducted in the communities in both settings to identify the sociocultural and economic hindering or fostering factors that affected the adoption of and the compliance with handwashing and disinfection practices. A total of 3245 and 8154 patients' records were examined in the general hospitals of Taabo and Marcory, respectively. Compared with women, men were more affected by typhoid fever (OR, 0.68 [95%CI, 0.53–0.88]) and influenza (OR, 0.87 [95%CI, 0.75–1]). Hygiene measures promoted during Ebola and COVID-19 outbreaks had no impact on the prevalence of typhoid fever in both settings;however, a positive impact was observed regarding influenza infections. Populations were aware of the importance of handwashing for public health but had difficulties adhering due to financial constraints, access to drinking water, and the absence or scarcity of handwashing facilities.

Advancing One human-animal-environment Health for global health security: what does the evidence say?

In this Series paper, we review the contributions of One Health approaches (ie, at the human-animal-environment interface) to improve global health security across a range of health hazards and we summarise contemporary evidence of incremental benefits of a One Health approach. We assessed how One Health approaches were reported to the Food and Agricultural Organization of the UN, the World Organisation for Animal Health (WOAH, formerly OIE), and WHO, within the monitoring and assessment frameworks, including WHO International Health Regulations (2005) and WOAH Performance of Veterinary Services. We reviewed One Health theoretical foundations, methods, and case studies. Examples from joint health services and infrastructure, surveillance-response systems, surveillance of antimicrobial resistance, food safety and security, environmental hazards, water and sanitation, and zoonoses control clearly show incremental benefits of One Health approaches. One Health approaches appear to be most effective and sustainable in the prevention, preparedness, and early detection and investigation of evolving risks and hazards; the evidence base for their application is strongest in the control of endemic and neglected tropical diseases. For benefits to be maximised and extended, improved One Health operationalisation is needed by strengthening multisectoral coordination mechanisms at national, regional, and global levels.

Knowledge, Attitudes, and Practices (KAP) Regarding the COVID-19 Outbreak in Côte d'Ivoire: Understanding the Non-Compliance of Populations with Non-Pharmaceutical Interventions.

At the beginning of the COVID-19 outbreak, preventive measures seemed the most appropriate method to control its spread. We assessed the knowledge, attitudes, and practices of the Ivorian public regarding preventive measures, conducting a hybrid survey across the country. Participants were invited to complete a questionnaire online, by phone, or face-to-face. Chi-squared, Fisher's exact, and Kruskal-Wallis tests were used to compare the frequency of responses regarding compliance with preventive measures. Data were validated for 564 individuals. Over one-third of respondents believed that COVID-19 was related to non-natural causes. Though the disease was perceived as severe, respondents did not consider it to be highly infectious. Overall, 35.6% of respondents fully trust health officials in the management of the pandemic, and 34.6% trusted them moderately. Individuals who believed COVID-19 was a disease caused by a pathogen and the well-educated were likely to comply with preventive measures. About 70% of respondents stated that their daily expenses had increased due to preventive measures. The study concludes that beyond unfavorable socioeconomic conditions, the level of knowledge regarding COVID-19 and trust in the government/health system are more likely to influence compliance with preventive measures such as self-reporting, physical distancing, the use of face masks, and eventually the acceptability of vaccines.