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The Results of Work of Infectious Disease Specialists and Epidemiologists of the Rospotrebnadzor during the Outbreak of Acute Intestinal Infections in the Republic of the Congo (Brazzaville) in 2023

https://doi.org/10.21055/0370-1069-2024-1-102-112

Abstract

This paper provides an analysis of the results of joint work of Russian and Congolese infectious disease specialists and epidemiologists to decipher the etiology and causes of the outbreak of intestinal infections in Dolisie (Republic of the Congo) in the summer of 2023. It has been found that the increase in the incidence of intestinal infections was caused mainly by the agents of typhoid fever and dysentery; tropical malaria was a combined pathology. No cases of cholera patient detection were registered. Failure of water supply system, domestic disrepair, and low public awareness about prevention of intestinal infections contributed to the active transmission of pathogens. The combination of epidemic process manifestations testified to the aquatic nature of the outbreak. Also, cases of pathogen transmission through contact household route were recorded, food transmission was not excluded. Patients with severe and complicated forms of typhoid fever and shigellosis accounted for 50 % of those hospitalized. There was delay in seeking medical care. The available regimens of antibacterial therapy were ineffective, since there was no possibility of laboratory confirmation of the diagnosis with determination of sensitivity to drugs. Uncontrolled treatment facilitated the emergence of antibiotic resistance in pathogens, prolonged bacterial release and subsequent spread of infection. Infectious disease specialists and epidemiologists of the Rospotrebnadzor provided consulting and practical assistance to Congolese colleagues, developed and presented recommendations for optimizing anti-epidemic and therapeutic measures, taking into account the results of assessment of the causes for onset and development of the outbreak.

About the Authors

N. Yu. Pshenichnaya
Central Research Institute of Epidemiology
Russian Federation

3a, Novogireevskaya St., Moscow, 111123



E. V. Naidenova
Russian Research Anti-Plague Institute “Microbe”
Russian Federation

Ekaterina V. Naidenova, 

46, Universitetskaya St., Saratov, 410005



G. V. Gopatsa
Central Research Institute of Epidemiology
Russian Federation

3a, Novogireevskaya St., Moscow, 111123



D. A. Kuznetsova
Rostov-on-Don Research Anti-Plague Institute
Russian Federation

117/40, M. Gor’kogo St., Rostov-on-Don, 344002



L. N. Dmitrieva
Russian Research Anti-Plague Institute “Microbe”
Russian Federation

46, Universitetskaya St., Saratov, 410005



A. V. Evteev
Rostov-on-Don Research Anti-Plague Institute
Russian Federation

117/40, M. Gor’kogo St., Rostov-on-Don, 344002



A. A. Tushinsky
Rostov-on-Don Research Anti-Plague Institute
Russian Federation

117/40, M. Gor’kogo St., Rostov-on-Don, 344002



S. A. Portenko
Russian Research Anti-Plague Institute “Microbe”
Russian Federation

46, Universitetskaya St., Saratov, 410005



N. Obissa
Ministry of Health and Population of the Republic of the Congo
Congo

Brazzaville



M. Mpompolo
Dolisie General Hospital
Congo

Dolisie



Sh. L. Elenga-Bongo
Adolphe Cissé General Hospital
Congo

Pointe Noire



M. Inana
Department of Health of Niari Province
Congo

Dolisie



J.-C. Mobousse Misse
Ministry of Health and Population of the Republic of the Congo
Congo

Brazzaville



V. V. Kutyrev
Russian Research Anti-Plague Institute “Microbe”
Russian Federation

46, Universitetskaya St., Saratov, 410005



V. Yu. Smolensky
Federal Service for Surveillance on Consumers’ Rights Protection and Human Well-being
Russian Federation

18, Bld. 5 and 7, Vadkovsky Lane, Moscow, 127994



References

1. Burchard G.D., Grobusch M.P. Chapter 7. Central Africa. In: Petersen E., Chen L.H., Schlagenhauf-Lawlor P., editors. Infectious Diseases: A Geographic Guide. 2nd ed. John Wiley & Sons Inc.; 2017. P. 78–92.

2. Mikounou Louya V., Vouvoungui C., KoukouikilaKoussounda F., Veas F., Kobawila S.C., Ntoumi F. Molecular characterization of norovirus infection responsible for acute diarrhea in Congolese hospitalized children under five years old in Brazzaville, Republic of Congo. Int. J. Infect. Dis. 2019; 88:41–8. DOI: 10.1016/j.ijid.2019.07.034.

3. Nguekeng Tsague B., Mikounou Louya V., Ntoumi F., Adedoja A., Vouvoungui C.J., Peko S.M., Abena A.A. Occurrence of human astrovirus associated with gastroenteritis among Congolese children in Brazzaville, Republic of Congo. Int. J. Infect. Dis. 2020; 95:142–7. DOI: 10.1016/j.ijid.2020.02.056.

4. WHO. Health data overview for the Republic of the Congo. (Cited 22 Jan 2024). [Internet]. Available from: https://data.who.int/countries/178.

5. The World Bank. Congo, Rep. (Cited 22 Jan 2024). [Internet]. Available from: https://data.worldbank.org/country/congo-rep?view=chart.

6. Assounga A.G., Assambo-Kieli C., Mafoua A., Moyen G., Nzingoula S. Etiology and outcome of acute renal failure in children in Congo-Brazzaville. Saudi J. Kidney Dis. Transpl. 2000; 11(1):40–3.

7. Brainard J., D’hondt R., Ali E., Van den Bergh R., De Weggheleire A., Baudot Y., Patigny F., Lambert V., Zachariah R., Maes P., Kuma-Kuma Kenge D., Hunter P.R. Typhoid fever outbreak in the Democratic Republic of Congo: Case control and ecological study. PLoS Negl. Trop. Dis. 2018; 12(10):e0006795. DOI: 10.1371/journal.pntd.0006795.

8. Azmatullah A., Qamar F.N., Thaver D., Zaidi A.K., Bhutta Z.A. Systematic review of the global epidemiology, clinical and laboratory profile of enteric fever. J. Glob. Health. 2015; 5(2):020407. DOI: 10.7189/jogh.05.020407.

9. Wain J., Hosoglu S. The laboratory diagnosis of enteric fever. J. Infect. Dev. Ctries. 2008; 2(6):421–5.

10. Wong V.K., Baker S., Pickard D.J., Parkhill J., Page A.J., Feasey N.A., Kingsley R.A., Thomson N.R., Keane J.A., Weill F.X., Edwards D.J., Hawkey J., Harris S.R., Mather A.E., Cain A.K., Hadfield J., Hart P.J., Thieu N.T., Klemm E.J., Glinos D.A., Breiman R.F., Watson C.H., Kariuki S., Gordon M.A., Heyderman R.S., Okoro C., Jacobs J., Lunguya O., Edmunds W.J., Msefula C., Chabalgoity J.A., Kama M., Jenkins K., Dutta S., Marks F., Campos J., Thompson C., Obaro S., MacLennan C.A., Dolecek C., Keddy K.H., Smith A.M., Parry C.M., Karkey A., Mulholland E.K., Campbell J.I., Dongol S., Basnyat B., Dufour M., Bandaranayake D., Naseri T.T., Singh S.P., Hatta M., Newton P., Onsare R.S., Isaia L., Dance D., Davong V., Thwaites G., Wijedoru L., Crump J.A., De Pinna E., Nair S., Nilles E.J., Thanh D.P., Turner P., Soeng S., Valcanis M., Powling J., Dimovski K., Hogg G., Farrar J., Holt K.E., Dougan G. Phylogeographical analysis of the dominant multidrugresistant H58 clade of Salmonella Typhi identifies inter-and intracontinental transmission events. Nat. Genet. 2015; 47(6):632–9. DOI: 10.1038/ng.3281.

11. ReliefWeb. 04 Subject: PRO/EDR> Cholera, diarrhea & dysentery update (19): Africa Archive Number: 20170504.5012967. (Cited 29 Oct 2023). [Internet]. Available from: https://reliefweb.int/ sites/reliefweb.int/files/resources/WCA%20Cholera_Update_W14. pdf. 12. Nkala O. Cholera outbreaks haunt Central and West Africa. (Cited 22 Jan 2024). [Internet]. Available from: https://outbreaknewstoday.com/cholera-outbreaks-haunt-central-west-africa59418/.

12. Kevin N.H., Feng L.J. Health challenges and environmental problems of the city of Pointe-Noire, Republic of Congo. J. Stud. Soc. Sci. 2017; 16(2):105–26.

13. Barkume C., Date K., Saha S.K., Qamar F.N., Sur D., Andrews J.R., Luby S.P., Khan M.I., Freeman A., Yousafzai M.T., Garrett D. Phase I of the Surveillance for Enteric Fever in Asia Project (SEAP): An overview and lessons learned. J. Infect. Dis. 2018; 218(suppl. 4):S188-S194. DOI: 10.1093/infdis/jiy522.

14. Britto C.D., Wong V.K., Dougan G., Pollard A.J. A systematic review of antimicrobial resistance in Salmonella enterica serovar Typhi, the etiological agent of typhoid. PLoS Negl. Trop. Dis. 2018; 12(10):e0006779. DOI: 10.1371/journal.pntd.0006779.

15. Al-Emran H.M., Eibach D., Krumkamp R, , Ali M., Baker S., Biggs H.M., Bjerregaard-Andersen M., Breiman R.F., Clemens J.D., Crump J.A., Cruz Espinoza L.M., Deerin J., Dekker D.M., Gassama Sow A., Hertz J.T., Im J., Ibrango S., von Kalckreuth V., Kabore L.P., Konings F., Løfberg S.V., Meyer C.G., Mintz E.D., Montgomery J.M., Olack B., Pak G.D., Panzner U., Park S.E., Razafindrabe J.L., Rabezanahary H., Rakotondrainiarivelo J.P., Rakotozandrindrainy R., Raminosoa T.M., Schütt-Gerowitt H., Sampo E., Soura A.B., Tall A., Warren M., Wierzba T.F., May J., Marks F. A multicountry molecular analysis of Salmonella enterica serovar Typhi with reduced susceptibility to ciprofloxacin in Sub-Saharan Africa. Clin. Infect. Dis. 2016; 62 Suppl. 1:S42-6. DOI: 10.1093/cid/civ788.

16. International Typhoid Consortium; Wong V.K., Holt K.E., Okoro C., Baker S., Pickard D.J., Marks F., Page A.J., Olanipekun G., Munir H., Alter R., Fey P.D., Feasey N.A., Weill F.-X., Le Hello S., Hart P.J., Kariuki S., Breiman R.F., Gordon M.A., Heyderman R.S., Jacobs J., Lunguya O., Msefula C., MacLennan C.A., Keddy K.H., Smith A.M., Onsare R.S., De Pinna E., Nair S., Amos B., Dougan G., Obaro S. Molecular surveillance identifies multiple transmissions of typhoid in West Africa. PLoS Negl. Trop. Dis. 2016; 10(9):e0004781. DOI: 10.1371/journal.pntd.0004781.

17. Vlieghe E., Phoba M.F., Tamfun J.J., Jacobs J. Antibiotic resistance among bacterial pathogens in Central Africa: a review of the published literature between 1955 and 2008. Int. J. Antimicrob. Agents. 2009; 34(4):295–303. DOI: 10.1016/j.ijantimicag.2009.04.015.

18. WHO. Disease Outbreak News. Suspected triple outbreak of typhoid fever, shigellosis and cholera – Congo 23 September 2023. (Cited 22 Jan 2024). [Internet]. Available from: https://www.who.int/ru/emergencies/disease-outbreak-news/item/2023-DON488.

19. WHO. Weekly bulletin on outbreaks and other emergencies. Week 30: 24–30 July 2023. (Cited 22 Jan 2024). [Internet]. Available from: https://iris.who.int/bitstream/handle/10665/372200/OEW30-2430072023.pdf.

20. SITREP N° 03 DU 19 au 20 JUILLET 2023 Epidémies de Choléra, Shigellose et Salmonellose à Dolisie, département du Niari. (Cited 22 Jan 2024). [Internet]. Available from: https://sante.gouv.cg/sitrep-n-03-du-19-au-20-juillet-2023-epidemies-de-cholerashigellose-et-salmonellose/.


Review

For citations:


Pshenichnaya N.Yu., Naidenova E.V., Gopatsa G.V., Kuznetsova D.A., Dmitrieva L.N., Evteev A.V., Tushinsky A.A., Portenko S.A., Obissa N., Mpompolo M., Elenga-Bongo Sh.L., Inana M., Mobousse Misse J., Kutyrev V.V., Smolensky V.Yu. The Results of Work of Infectious Disease Specialists and Epidemiologists of the Rospotrebnadzor during the Outbreak of Acute Intestinal Infections in the Republic of the Congo (Brazzaville) in 2023. Problems of Particularly Dangerous Infections. 2024;(1):102-112. (In Russ.) https://doi.org/10.21055/0370-1069-2024-1-102-112

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