Abstract
Purpose: On November 22th, 2017, the people from Cafunfu municipality in Lunda-Norte Province, alerted through the media, “the occurrence of unidentified disease, manifested mainly by high fevers, among other symptoms”. After verification of the alert, a multidisciplinary outbreak investigation team was sent to the town in December to investigate this public health event. Methods & Materials: In order to investigate the etiology of this public health event, 370 febrile children were randomly selected for testing with rapid diagnostic tests (RDT) for malaria. Further, 25 RDT for dengue and chikunguya were performed. In order to evaluate the factors associated with the disease, a 1:2 age-matched case-control study was conducted in the neighborhoods of Elevação and Bala bala. The target population were children under 15 years old. The sample size was calculated using the EPI Info Calculator: 60 cases and 120 controls were recruited. Significance level was set at p < 0.05 for all hypothesis tests. Results: The RDT positivity rate was 70% for malaria. Of the 60 cases analyzed, 39 (65%) were male; 34 (57%)> 5 years, 36 (60%) lived in Bala bala. The epidemic curve was typical of vector-borne disease and revealed the occurrence of underreporting with the arrival of the external teams and the beginning of the outbreak investigation. Logistic regression identified the following associated factors for contracting malaria: having an open dump close to home, OR of 11.3 [4.54–28.32] (p < 0.001); not sleeping under mosquito net, OR = 16.3 [6.23–42.49] (p < 0.001). Conclusion: The upsurge in malaria cases was the trigger for the rumor that circulated through the media by the population of Cafunfo. Control measures taken included: distribution of LLITNs; vector control strategies, improved case management. It was further recommended that local health authorities strengthen the epidemiological surveillance system, improve basic sanitation, maintain vector control strategies and develop risk communication strategies.
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