Conditions inside the Water Closet of the Index Case Residence during a Typhoid Outbreak in Cite Roche Bois, Mauritius

<div><p>Salmonella typhi–contaminated sewage was aspirated into the main water distribution system after Hurricane Claudette's flooding, evidenced by high water marks on the walls. Note the leaking water pipe on the rear wall, and general unsanitary conditions.</p> <p>(Photo: CDC)</p></div

Flooding on the East Coast of Sri Lanka after the Tsunami

<p>(Photo: Copyright, Aur lie Gr maud/MSF)</p

All SPSS Tables and Outputs from Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July–August 2015

The border region of Forécariah (Guinea) and Kambia (Sierra Leone) was of immense interest to the West Africa Ebola response. Cross-sectional household surveys with multi-stage cluster sampling procedure were used to collect random samples from Kambia (<i>n</i> = 635) in July 2015 and Forécariah (<i>n</i> = 502) in August 2015 to assess public knowledge, attitudes and practices related to Ebola. Knowledge of the disease was high in both places, and handwashing with soap and water was the most widespread prevention practice. Acceptance of safe alternatives to traditional burials was significantly lower in Forécariah compared with Kambia. In both locations, there was a minority who held discriminatory attitudes towards survivors. Radio was the predominant source of information in both locations, but those from Kambia were more likely to have received Ebola information from community sources (mosques/churches, community meetings or health workers) compared with those in Forécariah. These findings contextualize the utility of Ebola health messaging during the epidemic and suggest the importance of continued partnership with community leaders, including religious leaders, as a prominent part of future public health protection.This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’

Components of the different study visits.

<p>Components of the different study visits.</p

Site design and layout.

<p>(A) Schematic of specimen collection tent and toilets. Not to scale. Specimen collection tent: The area was divided into two separate zones; an anteroom (used for storage and a blood draw area), and a private specimen collection room. The second room had a privacy screen for intimate specimen collection. Toilets: The structures (compliant with IPC standards) were clearly identified for either participant use only or staff/visitor use only. At one site portable toilets were utilized and at the other, permanent structures were constructed. (B) Panoramic photograph of the specimen collection room compliant with IPC standards, Lungi Government Hospital site. A). Doffing area (defined with a permanent wooden screen once the site was operational), B). Assisted-collection area (tears, sweat swab, saliva (oral swab), C). Intimate specimen collection area (semen, vaginal/menstrual fluid swabs, rectal fluid swab, breast milk), 1). Hand-washing station, 2). Wipe-clean specimen collection trolley, 3). Privacy screen (which also displayed wipe-clean illustrative posters on specimen collection procedures), 4). Wipe-clean hospital bed, 5). Television set with DVD player, displayed on a wipe-clean table. Tarpaulin flooring used throughout. Photograph by Antoine Coursier. (C) Schematic of site layout and demarcation of work spaces for each staff position. 1). Consultation and coordination area. Reception area: This area was located at the entrance of the study site so the receptionist could greet the participants upon arrival. Waiting area: This area consists of chairs and a television. Community Liaison Officers used this space to informally speak with participants about study questions. Coordination area: Area used for storage of all paper documents (locked filing cabinets), study supervision and data entry. Consultation rooms: These provided audio and visual privacy. To maximize efficiency of participant flow, two rooms were used by nurses to obtain written informed consent and administer questionnaires; one was used for counselling sessions. 2). Specimen collection area. See Fig 1A for details. 3). Toilets. Water tanks supplied the site toilets which were connected to the hospital septic tank at MH34 site; and a purpose built septic tank at LGH site. (D) Photographs documenting the development of the second site at Lungi Government Hospital. (D-I) Separate Rubb Hall tents used for clinic and specimen collection areas. Photograph by Antoine Coursier. (D-II) Measures put in place to maximise privacy and to shield the site from the sun. Photograph by Antoine Coursier.</p

World Health Organization (WHO) criteria for selecting potential signals.

World Health Organization (WHO) criteria for selecting potential signals.</p

World Health Organization (WHO) criteria for initiating a rapid risk assessment.

World Health Organization (WHO) criteria for initiating a rapid risk assessment.</p

Framework of public health intelligence activities at WHO.

Framework of public health intelligence activities at WHO.</p

World Health Organization public health intelligence information flow, associated outputs, and activities.

World Health Organization public health intelligence information flow, associated outputs, and activities.</p

Roles necessary for conducting public health intelligence, by activity.

Roles necessary for conducting public health intelligence, by activity.</p