Journal of Infectious Diseases and Medicine

A Multi-modal Infection Prevention and Control Approach to Combat COVID-19 in Overcrowded Settings Such as Prisons and Boarding Schools: The Experience from Rwanda

Abstract

Boniface Hakizimana*

Background: Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a new strain of coronavirus that was first recognized in Wuhan, China, in December 2019. COVID-19 spreads via droplets, aerosols, fomites and faeces and it spreads more quickly in overcrowded settings. The aim of the study was to establish a multi-modal approach which is a set of interventions to be implemented together in overcrowded settings to enable effective COVID-19 response by flattening the epi-curve and control the transmission of the disease.

Methods: This was an intervention study. A comprehensive multi-modal approach developed and implemented in 2 prisons and 15 boarding schools in Eastern Province of Rwanda. It started from November 2020 to the end of May 2021. The overall objective of the study was to evaluate the impact of the tailored infection prevention and control interventions on the COVID-19 infection prevention and response in overcrowding settings. The taskforce for COVID-19 prevention and response was established in each institution, members of taskforce trained and community members (students, teachers, inmates, and correctional facility staff) capacitated and assigned roles and responsibilities. Monitoring of the effectiveness of the interventions was pre-determined and regularly conducted. Data was analysed using MS Excel.

Results: The Implementation of the project was sanctioned by a significant decrease of COVID-19 infection in both boarding schools and prisons. The incidence rate decreased from 48.82% to 7.69% at day 10 and to 0.38% at day 14 in boarding schools. The same decrease was observed in Ngoma women prison from 95% to 1.72% at day 10 and to 0.00% at day 14. >98% cases recovered in ≤ 10 days in boarding schools while in prisons 85% recovered in ≤ 10 days. It took on average of 21 days for boarding schools and 37 days for prisons to eliminate COVID-19 outbreak.

Conclusion: The implementation of the multi-modal infection prevention and control approach in 15 boarding schools and 2 prisons in Rwanda came up with the very impactful findings. COVID-19 was eliminated in those settings within a short period of time. The recovery rate increased and the deaths minimized.