Poor preparedness of congolese healthcare workers for Ebola during the 10th outbreak (2018-2020)

We conducted a hospital-based survey among frontline healthcare workers (HCWs) in Kinshasa, Democratic Republic of Congo (DRC) during the peak of the 2018-2019 Ebola outbreak. This study aimed to assess HCWs' knowledge, preparedness, and practices regarding the management of suspected Ebola cases, considering the challenges faced by hospitals in Kinshasa. A total of 290 HCWs from 72 healthcare facilities participated in the study (response rate: 83.0%). While all HCWs were aware of Ebola, significant knowledge gaps were identified, particularly regarding transmission routes and clinical symptoms. Only 16% of the participants had received formal Ebola training, and those who received training reported greater confidence in managing suspected cases. Notably, only 28% of HCWs were aware that Ebola could be transmitted through traditional funeral ceremonies and 34% were aware of transmission through contact with contaminated clothing. Adherence to standard precautions, such as hand hygiene (72%) and glove use (63%), was suboptimal, and 47% of the healthcare facilities lacked designated triage areas. These findings emphasize the need for targeted training, better adherence to precautions, and reinforced healthcare infrastructure. Addressing knowledge gaps, especially regarding transmission through funeral practices and contaminated clothing, and enhancing frontline HCWs' preparedness are crucial for improving responses to future Ebola outbreaks and other emerging infectious diseases.