SitRep 074

Report date 2026-07-27

Published

July 27, 2026

Caution

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Centre d’Opérations d’Urgence de Santé Publique (COUSP — public health emergency operations centre) « COUSP RDC » Incident Management System MVE (MVE — Ebola virus disease) B-17 Situation Report on the 17th Outbreak of EBOLA Virus Disease /RDC SitRep N°074/MVE B 27/07/2026

Affected provinces (5) HAUT-UELE, ITURI, NORD-KIVU, SUD-KIVU & TSHOPO Affected Health Zones (48) • Haut-Uélé (5/13) : Boma Mangbetu, Isiro, Pawa, Rungu and Wamba • Ituri (28/36) : Aru, Aungba, Bambu, Bunia, Damas, Drodro, Gethy, Kilo, Komanda, Lita, Logo, Mambasa, Mangala, Mongbwalu, Nizi, Nyankunde, Rimba, Rwampara, Tchomia, Kambala, Nia-Nia, Fataki, Mandima, Lolwa, Boga, Ariwara, Mahagi and Adja. • Nord-Kivu (11/34) : Beni, Butembo, Goma, Kalunguta, Katwa, Kyondo, Oicha, Vuhovi, Mabalako, Masereka and Musienene. • Sud-Kivu (1/34) : Miti-Murhesa • Tshopo (3/23) : Lubunga, Makiso-Kisangani and Mangobo Reporting date 27 July 2026 Publication date 28 July 2026

KEY INDICATORS — CUMULATIVE AS OF 27 JULY 2026 CONFIRMED CASES — 5 PROVINCES 3 360 +98 new cases (Ituri 87 · N-Kivu 11) CONFIRMED DEATHS · CASE FATALITY RATE 1 487· (44,3%) +50 deaths (Ituri 31 · Nord-Kivu 19) SUSPECT CASES OF THE DAY 321 Ituri 190 · N-Kivu 105 · Haut-Uélé 25 · Tshopo 1 PATIENTS IN ISOLATION 733 Ituri 544 · N-Kivu 189 RECOVERED — CUMULATIVE 597 +14 recovered (Ituri 13 – Nord-Kivu 1) NATIONAL CONTACT TRACING 78,9 % 13 882/ 17 588 seen · Ituri 77,6 % - Haut-Uele 60,0 % - N-Kivu 82,6 % - Tshopo 100,0% * Harmonisation of the number of deaths by health zone in the province of Nord-Kivu (+ 11 deaths).

1 Epidemiological highlights

• Epidemiological situation : No new health zone affected. The cumulative total remains at 48 health zones affected out of 140 in the five provinces, of which 47 remain in active transmission.

• Trend of cases : Over the past 24 hours, 98 new confirmed cases, 50 confirmed deaths and 14 recoveries were recorded :

o Ituri : 87 new confirmed cases were notified, mainly in Bunia (28), Mongbwalu (22), Rwampara (17), Kilo (5), Lita (4), Mandima (3), Nizi (3), Nia-Nia (2), Komanda (1), Mahagi (1) and Tchomia (1), 31 deaths among which, 51,6% community.

o Nord-Kivu : 11 new confirmed cases were reported (Butembo 2, Katwa 5, Beni 2 and Musienene 2) as well as 19 deaths (after harmonisation with the health zones, see table 2), including 5 community. The provincial cumulative total reaches 325 confirmed cases and 223 deaths, representing a case fatality rate of 68,6%.

o Haut-Uélé : No new confirmed case or death was reported. The provincial cumulative total remains at 39 confirmed cases and 21 deaths, representing a case fatality rate of 53,8 %, distributed across 5 health zones out of 13 in the province.

o Sud-Kivu and Tshopo : No new confirmed case or death was reported. The cumulative totals remain respectively at 5 cases, 4 deaths, 1 recovered for Tshopo and 3 confirmed cases including 1 death and 2 recovered in Sud-Kivu. The health zone of Miti-Murhesa reaches a total of 62 days whilst the province of Tshopo has 13 days without a new confirmed case.

• Analysis : Ituri remains the epicentre of the outbreak, concentrating 88,9 % of cumulative cases and 88,8 % of the new confirmations of the day. Contact tracing performance remains insufficient and requires a strengthening of surveillance activities.

EPIDEMIOLOGICAL AND OPERATIONAL CONTEXT

Declared on 15 May 2026, the 17th outbreak of Ebola virus disease (MVE) due to Bundibugyo ebolavirus continues its course within a complex humanitarian and security context. Initially confined to the health zone of Mongbwalu (Ituri), it spread to five provinces (Ituri, Nord-Kivu, Sud-Kivu, Haut-Uélé and Tshopo), now affecting 48 health zones. Population movements, insecurity, artisanal mining activities and cross-border trade with Uganda and South Sudan continue to promote transmission. Multisectoral coordination remains mobilised in order to strengthen surveillance, intensify response interventions and limit the spread of the outbreak.

[FIGURE: Figure 1 — Chronology of events of the Ebola-Bundibugyo virus disease outbreak]

2 Descriptive epidemiological analysis

2.1 Distribution by province and active foci

TABLE 1 — DISTRIBUTION OF CONFIRMED CASES AND DEATHS BY PROVINCE
Province Confirmed cases Deaths Case fatality rate Affected health zones New cases (24 h)
Ituri 2 988 1 238 41,4 % 28 / 36 (77,8 %) 87
Nord-Kivu* 325 223* 68,6 % 11 / 34 (32,4 %) 11
Haut-Uélé 39 21 52,6 % 5 / 13 (38,5 %) 0
Tshopo 5 4 80,0 % 3 / 23 (13,0 %) 0
Sud-Kivu 3 1 33,3 % 1 / 34 (2,9 %) 0
Total 3 360 1 487 44,3 % 48 sur 140 98
  • Harmonisation of the number of deaths by health zone in the province of Nord-Kivu (+ 11 deaths).

The province of Ituri remains the epicentre of the 17th Ebola virus disease (MVE) outbreak, concentrating 88,9% of confirmed cases (n = 2 988) and 83,3 % of deaths (n = 1 238), representing a case fatality rate of 41,4 %. The health zones of Bunia (801 cases), Rwampara (585), Mongbwalu (528 cases), Nizi (360), Lita (121 cases) and Nyankunde (114) remain the most affected and concentrate approximately 84,0% of cases reported at provincial level and 74,7% at national level.

2.2 Distribution by health zone

TABLE 2 — CONFIRMED CASES AND DEATHS BY PROVINCE AND HEALTH ZONE (CUMULATIVE AND SITUATION OF THE DAY)
Province Health zone Cumulative number Cases (n) Cumulative number Deaths (n) Cumulative number Case fatality rate Situation of the day (24 h) New cases Situation of the day (24 h) Community deaths (Swab+). Situation of the day (24 h) Confirmed deaths intra-CTE Situation of the day (24 h) Total confirmed deaths
Ituri Ituri 2 988 1 238 41,40% 87 16 15 31
Ituri Adja 11 1 9,10% 0 0 0 0
Ituri Aru 5 5 100,00% 0 0 0 0
Ituri Ariwara 7 1 14,30% 0 0 0 0
Ituri Aungba 5 4 80,00% 0 0 0 0
Ituri Bambu 57 12 21,10% 0 0 1 1
Ituri Boga 1 1 100,00% 0 0 0 0
Ituri Bunia 801 232 29,00% 28 5 7 12
Ituri Damas 16 8 50,00% 0 0 0 0
Ituri Drodro 10 5 50,00% 0 0 0 0
Ituri Fataki 17 6 35,30% 0 0 0 0
Ituri Gethy 1 0 0,00% 0 0 0 0
Ituri Kambala 2 0 0,00% 0 0 0 0
Ituri Kilo 28 11 39,30% 5 0 0 0
Ituri Komanda 36 25 69,40% 1 1 0 1
Ituri Lita 121 67 55,40% 4 1 0 1
Ituri Logo 9 3 33,30% 0 0 0 0
Ituri Lolwa 4 1 25,00% 0 0 0 0
Ituri Mahagi 4 1 25,00% 1 0 0 0
Ituri Mambasa 9 4 44,40% 0 0 0 0
Ituri Mandima 16 12 75,00% 3 3 0 3
Ituri Mangala 100 64 64,00% 0 0 0 0
Ituri Mongbwalu 528 252 47,70% 22 5 3 8
Ituri Nia-Nia 92 48 52,20% 2 1 0 1
Ituri Nizi 360 172 47,80% 3 0 1 1
Ituri Nyankunde 114 31 27,20% 0 0 0 0
Ituri Rimba 8 4 50,00% 0 0 0 0
Ituri Rwampara 585 244 41,70% 17 0 3 3
Ituri Tchomia 41 24 58,50% 1 0 0 0
Nord-Kivu* Nord-Kivu* 325 223* 68,60% 11 5 14 19
Nord-Kivu* Beni 46 37 80,40% 2 1 2 3
Nord-Kivu* Butembo 75 61 81,30% 2 1 11 12
Nord-Kivu* Goma 1 0 0,00% 0 0 0 0
Nord-Kivu* Kalunguta 5 3 60,00% 0 0 0 0
Nord-Kivu* Katwa 145 91 62,80% 5 3 0 3
Nord-Kivu* Kyondo 12 7 58,30% 0 0 0 0
Nord-Kivu* Mabalako 1 0 0,00% 0 0 0 0
Nord-Kivu* Masereka 4 0 0,00% 0 0 0 0
Nord-Kivu* Musienene 31 20 64,50% 2 0 1 1
Nord-Kivu* Oicha 4 3 75,00% 0 0 0 0
Nord-Kivu* Vuhovi 1 1 100,00% 0 0 0 0
Sud-Kivu Sud-Kivu 3 1 33,30% — —
Sud-Kivu Miti-Murhesa 3 1 33,30% 0 0 0 0
Haut-Uélé Haut-Uélé 39 21 53,80% — —
Haut-Uélé Boma Mangbetu 7 4 57,10% 0 0 0 0
Haut-Uélé Isiro 12 7 58,30% 0 0 0 0
Haut-Uélé Pawa 8 6 75,00% 0 0 0 0
Haut-Uélé Rungu 1 0 0,00% 0 0 0 0
Haut-Uélé Wamba 11 4 36,40% 0 0 0 0
Tshopo Tshopo 5 4 80,00% — —
Tshopo Lubunga 1 0 0,00% 0 0 0 0
Tshopo Makiso-Kisangani 3 3 100,00% 0 0 0 0
Tshopo Mangobo 1 1 100,00% 0 0 0 0
Total Total 3 360 1 487 44,30% 98 21 29 50
  • Harmonisation of the number of deaths by health zone in the province of Nord-Kivu (+ 11 deaths).

2.3 Mapping of confirmed cases

The spatial distribution confirms transmission mainly concentrated in Ituri, notably in the health zones of Bunia, Rwampara, Mongbwalu, Nizi, Lita and Nyankunde, with transmission continuing in already affected zones, including the health zone of Rungu in Haut-Uélé.

[FIGURE: FIGURE 2 — SPATIAL DISTRIBUTION OF HEALTH ZONES HAVING REPORTED CONFIRMED CASES]

The continuation of transmission in the health zone of Rungu in Haut-Uélé bears witness to the continuation of transmission in already affected zones, underlining the need to maintain simultaneously intensive interventions at the epicentre level and preparedness activities in neighbouring provinces.

2.4 Temporal analysis — epidemic curves

The epidemic curve shows sustained transmission during weeks W25 to W30, with fluctuations linked to notification delays and the progressive consolidation of data.

[FIGURE: FIGURE 3 — EPIDEMIC CURVE BY WEEK OF NOTIFICATION]

[FIGURE: FIGURE 4 EPIDEMIC CURVE BY DATE OF ONSET OF SYMPTOMS (DHIS2 LINE LIST)]

The outbreak remains in a phase of sustained transmission, with a high level of virus circulation. Recent fluctuations must be interpreted with caution due to notification delays and the progressive consolidation of data.

2.5 Demographic characteristics

The age pyramid shows a predominance of working-age adults (18–50 years). Minors under 18 years and elderly persons over 50 years are proportionally less affected.

[FIGURE: FIGURE 5 — CONFIRMED CASES BY SEX AND AGE GROUP]

[FIGURE: FIGURE 6 — DEATHS BY SEX AND AGE GROUP (AMONG CONFIRMED CASES)]

The distribution of cases by sex remains balanced. The predominance of cases among working-age adults reflects more frequent community and occupational exposures, whilst the proportion of paediatric cases bears witness to the persistence of intrafamilial transmission.

3 Surveillance, testing and transmission

3.1 Management and sources of alerts

TABLE 3 — EPIDEMIOLOGICAL ALERT MANAGEMENT
Indicator Ituri Nord-Kivu Haut-Uélé Tshopo Sud-Kivu Total
Carry-over (D-1) 17 130 15 0 ND 162
New alerts received 393 858 10 2 ND 1 263
Total alerts of the day 410 988 25 2 ND 1 425
Alerts investigated 273 842 25 2 ND 1 142
Investigation rate (24 h) 66,6% 85,2% 100,0% 100,0% ND 80,1%
Validated alerts — live 134 57 22 0 ND 213
Validated alerts — deceased (comm.) 56 48 3 1 ND 108
Total suspect cases of the day 190 105 25 1 ND 321

In total, 1 425 alerts (including 1 263 new), 1 142 investigated within 24h (80,1%) and 321 validated (213 live and 108 community deaths). This improvement reflects the reduction of investigation carry-overs and the consolidation of data originating from the affected provinces. The improvement in the investigation rate is linked to the reduction of investigation carry-overs and the strengthening of surveillance teams in the affected provinces.

3.2 Laboratory : testing and positivity

→ Ituri : 206 samples documented in the collection network, including 87 positive (71 live and 16 deaths), representing an apparent positivity of 42,2 %.

→ Nord-Kivu : 100 samples received and analysed, among which 11 positive (6 live and 5 deaths), representing a positivity of 11,0%.

→ Haut-Uélé : No sample received and analysed to date.

→ Tshopo : 3 samples received and analysed. All these samples came back negative after analysis.

3.3 Contact tracing

TABLE 4 — CONTACT TRACING OF CONFIRMED CASES
Province Contacts under follow-up Contacts seen Follow-up rate
Ituri* 12 500 9 706 77,6%
Nord-Kivu* 4 908 4 056 82,6%
Tshopo 30 30 100,0%
Haut-Uélé 150 90 60,0%
Sud-Kivu (end of follow-up) 0 0 NA
Total 17 588 13 882 78,9 %
  • In Ituri and Nord-Kivu, the follow-up rate was calculated only for the ZS (ZS — health zone) having reported. The ZS of Bunia and Mutwanga did not have data available at the time of report consolidation.

Contact tracing remains insufficient at national level (78,9 %), below the operational threshold of 95 %. Ituri only ensured the follow-up of 9 706 contacts out of 12 500 (77,6 %). Nord-Kivu achieved a performance of 4 056 contacts seen out of 4 908 (85,6%). Haut-Uélé followed only 90 contacts out of 150 (60,0%). Tshopo maintains a high performance with a 100,0% follow-up rate. Follow-up is closed in Sud-Kivu.

3.4 Points of entry and points of control (PoE/PoC)

3.4.1 — Alerts at crossing points (24 h)

Ituri — 2 alerts notified Two (2) live alerts were notified and validated : one at PoC Mud’zibala, referred to the CTE (CTE — Ebola treatment centre) of Bunia, and one at PoC DGRPI Nizi, whose transfer to the CTE was refused.

Nord-Kivu — 2 alerts notified Two (2) alerts notified including one validated and one lifeless body intercepted.

Tshopo — 1 alert notified One (1) alert was notified. No validated live alert nor any intercepted lifeless body was reported.

Haut-Uele — 0 alert notified No alert was notified at the various PoE/PoC activated in the province.

3.4.2 Monitoring indicators at PoE/PoC

TABLE 5 — MONITORING OF INDICATORS AT POINTS OF ENTRY AND POINTS OF CONTROL (POE/POC)
Indicators Ituri Nord-Kivu Sud-Kivu Tshopo Haut-Uélé Overall
Proportion of activated PoC and reinforced PoE 100 % (60/60) 100 % (16/16) 100 % (9/9) 21 % (4/19) 30 % 70,2 %**
Number of persons passing through PoE/PoC 112 101 72 711 11 559 ND ND 196 371*
% of travellers screened 94 % 97,86 % 98 % 100 % 100 % 95,4 %*
% of travellers having washed hands 93 % 97,86 % 98 % 98,5 % 100 % 95,4 %*
% of travellers sensitised 98,9 % 97,86 % 100 % 100 % 100 % 98,6 %*
Number of alerts notified 2 2 0 1 0 5
Number of validated live alerts 2 1 0 0 0 3
Number of lifeless bodies intercepted this day 0 1 0 0 0 1
Number of problem contacts intercepted this day 1 0 0 0 0 1
% of validated live alerts referred to the CT/CTE 50,0 % (1/2) 100 % (1/1) NA NA NA 66,7 % (2/3)
% of lifeless bodies swabbed NA 100 % (1/1) NA NA NA 100 % (1/1)
Number of positive results of referred suspect cases 0 0 0 0 0 0

In total, five (5) alerts were notified at PoE/PoC, including three validated live alerts and one intercepted lifeless body. Two live alerts were referred to the CT (CT — transit centre)/CTE (66,7 %) and the lifeless body was swabbed.

4. Case management

TABLE 6 — OCCUPANCY OF CARE FACILITIES (CTE/CT/CI)
Indicator Ituri Nord-Kivu Haut-Uele Tshopo Total
Number of beds 808 141 ND ND 949
Patients in bed (D-1) 538 181 ND ND 719
Total admissions (24 h) 92 48 ND ND 140
Total admissions 630 229 ND ND 859
Discharges Deceased 19 3 ND ND 22
Discharges Non-cases 49 36 ND ND 85
Discharges Recovered 13 1 ND ND 14
Discharges Escaped 5 0 ND ND 5
Discharges Transferred to HGR 0 0 ND ND 0
Total discharges (24 h) 86 40 ND ND 126
Patients in isolation (end of D) 544 189 ND ND 733
of which confirmed 290 23 ND ND 313
of which suspects 254 166 ND ND 420
Occupancy rate 67,3% 134,0 % ND ND 77,3%

In total, 733 patients were in isolation, including 313 confirmed cases and 420 suspect cases, representing an overall bed occupancy rate of 77,3 % (733 patients for 949 beds), for 859 admissions and 126 discharges (14 recovered, 22 deaths, 85 non-cases and 5 escaped). Ituri concentrates the bulk of the burden with 544 patients in isolation (290 confirmed, 254 suspects) for 808 beds, representing 67,3% occupancy. In Nord-Kivu, 189 patients are in isolation (23 confirmed, 166 suspects) representing an occupancy rate of 134,0 % (141 beds). Haut-Uele and Tshopo did not make data available at the time of compilation.

5 Mental health and psychosocial support (SMSPS — mental health and psychosocial support)

TABLE 7 — KEY SMSPS INDICATORS
Key SMSPS indicators Ituri Nord-Kivu
New confirmed cases having benefited from SMSPS interventions 13 (86,7%) 1 (100%)
Confirmed cases undergoing follow-up 127 (68,3%) 2 (100 %)
New suspect cases 32 (47,8%) 12 (100 %)
Suspect cases undergoing follow-up 148 (75,1%) 7 (100 %)
Laboratory results announced (of which positive) 41 (18) 4 (3)
Separated children — crèche / community 3/0 0/0
Accompanying persons at the CTE 291 16
Frontline personnel (PPL) 31 18
Household and community members 33 0
SDB supported (SMSPS) 2 0

6 Frontline personnel (PPL — person released from treatment (discharged patient)) affected

TABLE 8 — FRONTLINE PERSONNEL (PPL) INFECTED BY EVD
Health zone Confirmed cases Recovered In hospitalisation Deaths
Bunia 35 18 2 15
Rwampara 33 24 2 7
Mongbwalu 16 6 2 8
Nyankunde 14 11 1 2
Nia-Nia 10 3 7 0
Lita 4 1 2 1
Nizi 3 0 0 3
Mangala 3 1 1 1
Bambu 2 2 0 0
Kilo 2 1 1 0
Logo 1 0 1 0
Total — case fatality rate 30,1 % 123 67 19 37

PPL = health personnel and frontline providers.

In Nord-Kivu, 11 PPLs are confirmed among whom, 3 deaths.

7 Response activities by pillar

COORDINATION Holding of the coordination meeting with the various partners ; Monitoring of field activities

CONTINUITY OF ESSENTIAL HEALTH SERVICES (CSSE) → Ituri : Continuation of the estimation of PCI (PCI — infection prevention and control) input needs in the framework of continuity of essential services and care ; Analysis of indicators drawn from DHIS2 (in progress) ; Development and Budgeting of the CSSE pillar plan.

LOGISTICS → Ituri : 38 vehicles and 11 Ambulances (PNC, HGR (HGR — general referral hospital) Bunia and 9 ZS) were made available to the various pillars to ensure the transfer of cases and the mobility of pillars in the field).

→ Nord-Kivu : Handover of 2 ambulances to the ZS of Beni for MVE response activities ; Delivery of inputs to the INRB laboratory ; Data collection and Drafting of section reports ; Reception of SDB inputs from partner FHI 369 ; Delivery of nutritional care inputs to the ZS of Beni : (250 boxes) and ZS of Mutwanga (200) ; Reception of the 2nd batch of nutritional care inputs (2411 boxes of plumpy nut, 11 boxes of F100 and 14 boxes of F75 and PCI inputs destined for the ZS of Butembo, Katwa and Beni/donation from UGPDSS

PCI / WASH → Nord-Kivu : Decontamination of 3/31 Households of Confirmed cases including 2 in Katwa and 1 in Butembo ; Decontamination of 10 ESS of stay of cases including 2 in Butembo, 6 in Katwa and 2 in Musienene ; Provision of incomplete PCI kit in 5 ESS in Butembo ; PCI score card assessment in 1 ESS in Butembo with an average score of 22,5% (CS Vutike) ; Follow-up and support of 141 ESS including : 20 in Beni, 32 in Butembo, 7 in Katwa, 4 in Kyondo, 2 in Musienene and 76 in Oicha ; Briefing of 490 ESS providers during supportive supervisions including : 60 in Beni, 113 in Butembo, 35 in Katwa, 23 in Kyondo and 259 in Oicha ; Community deaths having benefited from an SDB : 43 including 6 in Beni, 14 in Butembo, 21 in Katwa, 5 in Kyondo and 2 in Musienene ; Community deaths having been subject to SWAB : 54 including 11 in Beni, 1 in Butembo, 25 in Katwa, 5 in Kyondo, 2 in Musienene

→ Tshopo : Poor waste management, Insufficiency of receptacles, Triage service not functional, Personnel not trained in PCI and Insufficiency of dustbins.

COMMUNICATION (RCCE / CREC) → Ituri : 2088 people were reached by awareness messages delivered by RECO (RECO — community health worker) 54 in households of 1 out of 4 Health Zones (NIA-NIA, NIZI); 256 people were reached on awareness themes during educational talks held by community actors in health zone (NIA-NIA, NIZI).

→ Nord-Kivu : Support to the case management pillar ; Discharge ceremony of a military recovered patient at CTE-Beni : on this occasion, messages were delivered to other military personnel, to representatives of motorcycle taxi drivers present and to the community who came for a guided tour of the CTE.

→ Tshopo : 15 868 people were reached during awareness activities. (ZS Mangobo, Kabondo, Tshopo, Lubunga and Makioso Kisangani) ; people were reached during door-to-door awareness at bloc meteo and and sotraco in the town of Kisangani.

→ Haut-Uélé : Briefing with CREC teams of the ZS of Isiro with a view to intensifying CREC interventions in the affected AS (AS — health area) ; visit of 27 Recos to households aimed at passing messages on the importance of SDB to heads of households.

HOLISTIC CASE MANAGEMENT (PECH) → Ituri : 13 new recovered ; 544 patients in isolation, 92 new admissions and 86 discharges including 19 deaths ; 988 people benefited from hot meals ; Reception of biochemistry equipment (High flow and Picollo + Accessories) at CTE Rwampara in Ituri.

→ Nord-Kivu : Discharge of a military recovered patient at CTE Beni.

→ Tshopo : No new admission ; 2 non-cases discharged and no patient hospitalised. Continuation of experimental treatment of 2 contacts (D10) at CS FEDI of Mangobo.

RESEARCH, INNOVATION & VACCINATION → Ituri : Detection of gaps, halting the spread of the BDBV virus outbreak : protocol validated and preparation for launching surveys (Support Africa CDC) ; Study of the dynamics of interprovincial and cross-border spread from the epicentre : causes : Uncontrolled movements of patients and lifeless bodies, many uncontrolled border points, corruption at intra- and interprovincial checkpoints.

SAFE AND DIGNIFIED BURIALS (EDS) → Ituri : Conclusion of training of the 2 teams (Niania and pk 51) ; D2 of training of the 2 SDB teams in the ZS of Fataki, AS Jina ; Continuation of training of the two teams in Kasenyi : D3 ; Start of training of the 2 ECUMER teams in AS MWANGA and KUNDA in the ZS of RWAMPARA ; Reception of 10 boxes of water by the SDB pillar thanks to support from FHI 360.

→ Nord-Kivu : 37 SDB performed, 39 Bodies Swabbed and secured out of 42 alerts reported escorting during the burial of a confirmed case at the cemetery of Paida ; a disturbance of public order occurring during the burial was contained by security forces

PREVENTION OF SEXUAL EXPLOITATION AND ABUSE (PSEA / PRSEAH) → Ituri : 107 Participants (55 Women and 52 Men) bringing to a cumulative total of 2 597 people including 1482 Men and 1115 women already briefed and having signed codes of conduct in 5 Health zones of Ituri (Bunia, Rwampara, Mongbwalu, Lita and Aru) and revitalisation of the 12 CBCM in Mongbwalu ; 153 Participants (80 W/G and 73 M/B) bringing to a cumulative total of 15 329 people including 7 995 Men/boys and 7 334 women/girls sensitised in the Health zones of Bunia, Rwampara, Aru and Munbgwalu.

8 Main challenges, impacts and actions required

N° Challenges Impact Actions required
1 Reluctance to post-mortem sampling (SDB/swabs), community resistance and insecurity targeting SDB teams (attack at Muchanga bridge, paralysis of activities in Nyankunde) Confirmation delay, underestimation of cases, disruption of key activities Intensify CREC, involve religious and community leaders, secure teams, increase the number of SDB teams
2 Non-payment of providers (strike in the ZS of Bunia and Rwampara ; resumption announced after intervention by the military governor of Ituri) Interruption of response activities, including safe and dignified burials Regularise payment of providers ; secure dedicated funding
3 Insufficient CTE/CT capacity : occupancy of 134,0 % in Nord-Kivu (bed capacity : 141) and 67,3 % in Ituri (544 patients for 808 beds) ; Admission delays, increased risk of nosocomial transmission Accelerate construction and expansion of CTE, deploy temporary facilities, systematically report bed capacity
4 Low contact tracing performance in Ituri 77,6% ; Nord-Kivu 82,6% and Haut-Uele 60,0 Chains of transmission not interrupted Train, deploy and motivate community relays (RECO) ; reinforced supervision ; investigate the observed drop in Ituri
5 Insufficient ambulances and prepositioning at PoC Delays in transfer and isolation Preposition ambulances (including at PoE/PoC), deploy CT by ZS
6 Insufficient supply of MEG and medical inputs Weakening of overall care Advocacy and urgent supply of essential medicines
7 Insufficiency of PCI inputs (PPE, chlorine) and limited functional triage units (175/1 170, or 15 %) High risk of nosocomial infections (123 PPL cases including 37 deaths in Ituri and 11 PPL including 3 deaths in Nord-Kivu) Urgent supply, strengthening of PCI training
8 Geographic extension (Haut-Uélé, Tshopo) and high mobility Risk of urban, river and cross-border diffusion Activate the 23 priority PoE/PoC in Haut-Uélé ; strengthen cross-border coordination
9 Installation of local laboratories (Butembo and Mambasa) Long confirmation delays, undetected transmission Accelerate the deployment of decentralised diagnostic capacities
10 Insufficient financial resources Limitation of pillar implementation Urgent resource mobilisation, advocacy with partners
11 Insecurity and limited access (CODECO, ADF) Restriction of operations Strengthening of security coordination and humanitarian access
12 Continuity of essential services (CEHS) compromised Increase in indirect mortality (non-Ebola) Effective implementation of free healthcare, strengthening of CEHS

9 Photos of field activities

[PHOTO]

Discharge ceremony of a military recovered patient at CTE-Beni in Nord-Kivu

For the Institut National de la Santé Publique (INSP — National Institute of Public Health) of the DRC

The Director-General of the INSP Dr MWAMBA KAZADI Dieudonné E-mail : dieudonne.mwamba@insp.cd Tel. : +243 816 040 145

The COU-SP Coordinator Prof. NGANDU Christian E-mail : Christian.ngandu@insp.cd Tel. : +243998091915

The Incident Manager Prof. AHUKA MUNDEKE Steve E-mail : steve.ahuka@unikin.ac.cd

With technical support from the World Health Organisation (WHO) and Africa CDC

FOR ANY FURTHER INFORMATION, PLEASE CONTACT

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