Ensuring On-site Ebola Patient Monitoring and Follow-up: Development of a Laboratory Structure Embedded in an Ebola Treatment Center

2019 ◽  
Vol 13 (5-6) ◽  
pp. 1028-1034
Author(s):  
Anita Williams ◽  
Mathieu Amand ◽  
Rafael Van den Bergh ◽  
Hilde De Clerck ◽  
Annick Antierens ◽  
...  

ABSTRACTThe capacity to rapidly distinguish Ebola virus disease from other infectious diseases and to monitor biochemistry and viremia levels is crucial to the clinical management of suspected Ebola virus disease cases. This article describes the design and practical considerations of a laboratory straddling the high- and low-risk zones of an Ebola treatment center to produce timely diagnostic and clinical results for informed case management of Ebola virus disease in real-life conditions. This innovation may be of relevance for actors requiring flexible laboratory implementation in contexts of high-communicability, high-lethality disease outbreaks.

Author(s):  
Nicki L Boddington ◽  
Sophia Steinberger ◽  
Richard G Pebody

Abstract Background In response to the outbreak of Ebola Virus Disease (EVD) in West Africa in 2014 and evidence of spread to other countries, pre-entry screening was introduced by PHE at five major ports of entry in the England. Methods All passengers that entered the England via the five ports returning from Liberia, Guinea and Sierra Leonne were required to complete a Health Assessment Form and have their temperature taken. The numbers, characteristics and outcomes of these passengers were analysed. Results Between 14 October 2014 and 13 October 2015, a total of 12 648 passengers from affected countries had been screened. The majority of passengers were assessed as having no direct contact with EVD cases or high-risk events (12 069, 95.4%), although 535 (4.2%) passengers were assessed as requiring public health follow-up. In total, 39 passengers were referred directly to secondary care, although none were diagnosed with EVD. One high-risk passenger was later referred to secondary care and diagnosed with EVD. Conclusions Collection of these screening data enabled timely monitoring of the numbers and characteristics of passengers screened for EVD, facilitated resourcing decisions and acted as a mechanism to inform passengers of the necessary public health actions.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Célestin Kaputu-Kalala-Malu ◽  
Eric Mafuta Musalu ◽  
Tim Walker ◽  
Olga Ntumba-Tshitenge ◽  
Steve Ahuka-Mundeke

Abstract Background Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town’s general hospital. Methods A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors who came for follow up from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics were used to summarized data and Pearson’s or likelihood chi-square were used to test association between psychiatric disorders and associated factors. Results The prevalence of PTSD, depression and anxiety was 24.3, 24.3 and 33.3% respectively. Being male (OR = 0.42, 95% CI: 0.16, 0.95, p = 0.049), suffering from persistent headache (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014), losing a loved one because of EVD (OR: 2.60, 95% CI: 1.11, 6.15, p = 0. 015) and being young − 18-24 years - (OR: 0. 261, 95% CI: 0. 08, 0.82, p = 0,026) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (OR = 2.44, 95% CI: 1.03, 5.82, p = 0.026); (OR = 2.24, 95% CI: 1.04, 4.85, p = 0.025); (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014); (OR = 2.31, 95% CI: 1.06, 5.01, p = 0.020). Conclusion The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC.


2020 ◽  
Vol 35 (3) ◽  
pp. 247-253
Author(s):  
Pedro Arcos González ◽  
Ángel Fernández Camporro ◽  
Anneli Eriksson ◽  
Carmen Alonso Llada

AbstractIntroduction:Ebola Virus Disease (EVD) is the international health emergency paradigm due to its epidemiological presentation pattern, impact on public health, resources necessary for its control, and need for a national and international response.Study Objective:The objective of this work is to study the evolution and progression of the epidemiological presentation profile of Ebola disease outbreaks since its discovery in 1976 to the present, and to explore the possible reasons for this evolution from different perspectives.Methods:Retrospective observational study of 38 outbreaks of Ebola disease occurred from 1976 through 2019, excluding laboratory accidents. United Nations agencies and programs; Ministries of Health; the US Centers for Disease Control and Prevention (CDC); ReliefWeb; emergency nongovernmental organizations; and publications indexed in PubMed, EmBase, and Clinical Key have been used as sources of data. Information on the year of the outbreak, date of beginning and end, duration of the outbreak in days, number of cases, number of deaths, population at risk, geographic extension affected in Km2, and time of notification of the first cases to the World Health Organization (WHO) have been searched and analyzed.Results:Populations at risk have increased (P = .024) and the geographical extent of Ebola outbreaks has grown (P = .004). Reporting time of the first cases of Ebola to WHO has been reduced (P = .017) and case fatality (P = .028) has gone from 88% to 62% in the period studied. There have been differences (P = .04) between the outbreaks produced by the Sudan and Zaire strains of the virus, both in terms of duration and case fatality ratio (Sudan strain 74.5 days on average and 62.7% of case fatality ratio versus Zaire strain with 150 days on average and 55.4% case fatality ratio).Conclusion:There has been a change in the epidemiological profile of the Ebola outbreaks from 1976 through 2019 with an increase in the geographical extent of the outbreaks and the population at risk, as well as a significant decrease in the outbreaks case fatality rate. There have been advances in the detection and management capacity of outbreaks, and the notification time to the WHO has been reduced. However, there are social, economic, cultural, and political obstacles that continue to greatly hinder a more efficient epidemiological approach to Ebola disease, mainly in Central Africa.


Author(s):  
Alyssa J. Young ◽  
Allison Connolly ◽  
Adam Hoar ◽  
Brooke Mancuso ◽  
John Mark Esplana ◽  
...  

Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "live alert" system to refer suspect cases from the community to specialized Ebola treatment centers. As EVD case burden declined in Port Loko District, Sierra Leone so did the number of reported alerts. Because EVD presents similarly to malaria, the number of alerts should remain consistent with malaria prevalence in malaria-endemic areas, irrespective of the reduction in true EVD cases. A community-based EVD surveillance system with improved symptom recording and follow-up of malaria-confirmed patients at PHUs was implemented in order to strengthen the sensitivity of EVD reporting.


2020 ◽  
Vol 8 (3) ◽  
pp. 96-99
Author(s):  
Oluwafolajimi Adetoye Adesanya

Over the years, the African continent has had to battle several outbreaks of infectious diseases in different countries. Some of the most deadly were the Ebola virus disease (EVD) outbreaks that occurred in West Africa between 2014 and 2016 affecting Guinea, Liberia, and Sierra Leone and, more recently, from 2018 to 2020 in the Democratic Republic of Congo (DRC). In the era of the COVID-19 pandemic, it is important that as a continent, we draw lessons and insights from our past experiences to guide outbreak response strategies being deployed to curb the latest onslaught. The Ebola outbreaks have shown that disease outbreaks should not be seen only as medical emergencies, but as full blown humanitarian crises, because oftentimes, their socio-economic impacts are more devastating than the more obvious cost to life. In this mini-review, we explore the possible humanitarian costs of the COVID-19 pandemic on the African continent by looking through the lens of our past experiences with the EVD outbreaks, highlighting how the current pandemic could significantly affect the African economy, food security, and vulnerable demographics, like children and the sexual and reproductive health and rights of women and girls. We then proffer recommendations that could be instrumental in preventing a double tragedy involving the devastating health consequences of the virus itself and the deadly fallout from its multi-sectoral knock-on effects in African countries. Keywords: COVID-19, SARS-CoV-2, Ebola Virus Disease, Coronavirus.


2019 ◽  
Vol 220 (2) ◽  
pp. 195-202 ◽  
Author(s):  
Romy Kerber ◽  
Eva Lorenz ◽  
Sophie Duraffour ◽  
Daouda Sissoko ◽  
Martin Rudolf ◽  
...  

Abstract Background In 2015, the laboratory at the Ebola treatment center in Coyah, Guinea, confirmed Ebola virus disease (EVD) in 286 patients. The cycle threshold (Ct) of an Ebola virus–specific reverse transcription–polymerase chain reaction assay and 13 blood chemistry parameters were measured on admission and during hospitalization. Favipiravir treatment was offered to patients with EVD on a compassionate-use basis. Methods To reduce biases in the raw field data, we carefully selected 163 of 286 patients with EVD for a retrospective study to assess associations between potential risk factors, alterations in blood chemistry findings, favipiravir treatment, and outcome. Results The case-fatality rate in favipiravir-treated patients was lower than in untreated patients (42.5% [31 of 73] vs 57.8% [52 of 90]; P = .053 by univariate analysis). In multivariate regression analysis, a higher Ct and a younger age were associated with survival (P < .001), while favipiravir treatment showed no statistically significant effect (P = .11). However, Kaplan-Meier analysis indicated a longer survival time in the favipiravir-treated group (P = .015). The study also showed characteristic changes in blood chemistry findings in patients who died, compared with survivors. Conclusions Consistent with the JIKI trial, this retrospective study revealed a trend toward improved survival in favipiravir- treated patients; however, the effect of treatment was not statistically significant, except for its influence on survival time.


Mammal Review ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jesús Olivero ◽  
John E. Fa ◽  
Miguel Á. Farfán ◽  
Ana L. Márquez ◽  
Raimundo Real ◽  
...  

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0131398 ◽  
Author(s):  
Maria Vittoria Barbarossa ◽  
Attila Dénes ◽  
Gábor Kiss ◽  
Yukihiko Nakata ◽  
Gergely Röst ◽  
...  

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