ABSTRACT
INTRODUCTION: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.
ABSTRACT
Introduction: Since 1998, the African program for onchocerciasis control has been working with ultimate goal of reducing the public health impact associated with onchocerciasis in Equatorial Guinea. Although dedicated community engagement is crucial for the success of this program, there is no information on the levels of community's knowledge, attitude, and practice (KAP) toward onchocerciasis in this country. Methods: A cross-sectional study was carried out in Bioko Island from mid-January to mid-February 2014. Sampling was carried out by multistage cluster survey. Sociodemographic characteristics, KAP, and stigma-related questions were collected through a pretested questionnaire. A bivariate analysis was performed and results were adjusted by sex and age using logistic regression. Results: A total of 140 housekeepers or head of households agreed to participate. Around 54% of the interviewees had heard about the disease, of which more than one-third identified the disease as filariasis (28/68, 41.2%). Overall, 19.3% respondents highlighted the bite of a blackfly as the main mode of transmission. From those who had a familiar affected by onchocerciasis in the past, 21 out of 32 (65.6%) pointed ivermectin as the preferred treatment and 43.8% pointed out the health center as the first choice place to seek for treatment. About 67.1% of individuals believed that having onchocerciasis would not cause any contact avoidance with other members in the community. Conclusions: People's practices toward onchocerciasis tend to be better than disease knowledge in Bioko Island. Increasing awareness through community-based campaigns and educational activities is encouraged in the current onchocerciasis preelimination stage at Bioko Island
