Ebola Response in Guinea Bolstered by Its Field Epidemiology Training Program (FETP)

Guinea FETP participants conduct Ebola vaccination activities in Conakry. (Photo courtesy of the Guinea FETP)

In Guinea, efforts to strengthen the country’s capacity for outbreak detection and response by training field epidemiologists through a Field Epidemiology Training Program (FETP) accelerated in response to the 2014-2016 Ebola epidemic, which claimed 2,544 lives in Guinea and 11,325 worldwide, predominantly in West Africa.

Today, the Guinea Field Epidemiology Training Program (FETP) is providing critical support to help control a new Ebola outbreak. On February 14, 2021, the Ministry of Health (MOH) of Guinea reported to the World Health Organization (WHO) a cluster of Ebola cases in the sub-prefecture of Gouécké, Nzérékoré Region. As of April 13, 2021, Guinea has confirmed 16 cases of Ebola, including five deaths and nine recoveries.

“Despite some challenges, the outbreak has been successfully contained within four sub-districts of Nzérékoré,” the program reported to TEPHINET.

FETP-Frontline participants from Nzérékoré, as well as intermediate and advanced FETP participants from other regions, have made vital contributions to slowing the Nzérékoré outbreak, particularly in the areas of coordination and epidemiological surveillance.

FETP participants have led the development of documentation needed for conducting Ebola surveillance, including the country’s Ebola response plan, contact tracing guides, case definitions, and terms of reference for the unit analyzing outbreak data.

Trainees and graduates of the Guinea FETP have constituted the leading MOH workforce deployed in the field to conduct Ebola-related surveillance across the Nzérékoré Region’s 17 health areas. Working directly with local health facility leaders in these areas, the FETP has helped strengthen these facilities’ capacity for understanding and using case definitions to identify suspected Ebola cases among their patients.

Thanks to the involvement of the FETP, the vast majority of reports of suspected cases are being investigated. From March 4 to April 4, the FETP investigated 83 percent of 1,271 alerts.

“Most of the alerts that were not investigated were due to reticence of the population, which remains an important challenge for the outbreak response,” the program shared. FETP teams deployed to the response are working closely with local health authorities and partners to identify the best strategies for increasing community trust and cooperation.

A key difference in the fight against Ebola today, compared to five years ago, is the existence of a vaccine. As of April 13, more than 6,500 people in Guinea have received the Ebola vaccine. The FETP team has contributed to the listing of 949 contacts of confirmed and probable cases in the sub-prefectures of Koueke, Nzérékoré, and Soulouta. Vaccination teams have utilized this list to ensure vaccination of at-risk populations.

The FETP has noted improvements when comparing Guinea’s 2014-2016 and 2021 Ebola responses, including a significant increase in the known number of contacts traced. Ninety-five (95) percent of contacts have been traced in the current response; in the 2014-2016 response, the percentage of contacts traced was unknown.

The positive impact of the FETP on the Ebola response has been recognized publicly by the leadership of Guinea's National Agency for Health Security (ANSS). As an investment in strengthening the country's health system, the FETP has proven vital in reinforcing local epidemiological capacity to fight Ebola and in providing much-needed leadership in the areas of coordination and surveillance.