1
|
Pare BC, Camara AM, Camara A, Kourouma M, Enogo K, Camara MS, Akilimali L, Sani S, de Sainte Fare EB, Lame P, Mouly N, Castro-Rial ML, Sivahera B, Cherif MS, Beavogui AH, Muamba D, Tamba JB, Moumié B, Kojan R, Lang HJ. Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease. S Afr J Infect Dis 2023; 38:454. [PMID: 36756241 PMCID: PMC9900378 DOI: 10.4102/sajid.v38i1.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/05/2022] [Indexed: 02/04/2023] Open
Abstract
Background Experience from the Zaire Ebolavirus epidemic in the eastern Democratic Republic of the Congo (2018-2020) demonstrates that early initiation of essential critical care and administration of Zaire Ebolavirus specific monoclonal antibodies may be associated with improved outcomes among patients with Ebola virus disease (EVD). Objectives This series describes 13 EVD patients and 276 patients with suspected EVD treated during a Zaire Ebolavirus outbreak in Guinea in 2021. Method Patients with confirmed or suspected EVD were treated in two Ebola treatment centres (ETC) in the region of N'zérékoré. Data were reviewed from all patients with suspected or confirmed EVD hospitalised in these two ETCs during the outbreak (14 February 2021 - 19 June 2021). Ebola-specific monoclonal antibodies, were available 2 weeks after onset of the outbreak. Results Nine of the 13 EVD patients (age range: 22-70 years) survived. The four EVD patients who died, including one pregnant woman, presented with multi-organ dysfunction and died within 48 h of admission. All eight patients who received Ebola-specific monoclonal antibodies survived. Four of the 13 EVD patients were health workers. Improvement of ETC design facilitated implementation of WHO-recommended 'optimized supportive care for EVD'. In this context, pragmatic clinical training was integrated in routine ETC activities. Initial clinical manifestations of 13 confirmed EVD patients were similar to those of 276 patients with suspected, but subsequently non confirmed EVD. These patients suffered from other acute infections (e.g. malaria in 183 of 276 patients; 66%). Five of the 276 patients with suspected EVD died. One of these five patients had Lassa virus disease and a coronavirus disease 2019 (COVID-19) co-infection. Conclusion Multidisciplinary outbreak response teams can rapidly optimise ETC design. Trained clinical teams can provide WHO-recommended optimised supportive care, including safe administration of Ebola-specific monoclonal antibodies. Pragmatic training in essential critical care can be integrated in routine ETC activities. Contribution This article describes clinical realities associated with implementation of WHO-recommended standards of 'optimized supportive care' and administration of Ebola virus specific treatments. In this context, the importance of essential design principles of ETCs is underlined, which allow continuous visual contact and verbal interaction of health workers and families with their patients. Elements that may contribute to further quality of care improvements for patients with confirmed or suspected EVD are discussed.
Collapse
Affiliation(s)
- Boyo C. Pare
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Alseny M. Camara
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Aminata Camara
- Ministry of Health, Agence Nationale de Sécurité Sanitaire, N’zérékoré, Guinea,Ministry of Health, Hôpital Régionale de N’zérékoré, N’zérékoré, Guinea
| | - Moussa Kourouma
- Ministry of Health, Agence Nationale de Sécurité Sanitaire, N’zérékoré, Guinea,Ministry of Health, Hôpital Régionale de N’zérékoré, N’zérékoré, Guinea
| | - Koivogui Enogo
- Ministry of Health, Agence Nationale de Sécurité Sanitaire, N’zérékoré, Guinea
| | | | | | - Sayadi Sani
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | | | - Papys Lame
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Nicolas Mouly
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | | | - Billy Sivahera
- Alliance for International Medical Action (ALIMA), Dakar, Senegal,World Health Organization (WHO), Geneva, Switzerland
| | - Mahamoud S. Cherif
- Centre National de Formation et de Recherche en Santé Rural de Maferinyah, Maferenya, Guinea
| | - Abdoul H. Beavogui
- Centre National de Formation et de Recherche en Santé Rural de Maferinyah, Maferenya, Guinea
| | - Dally Muamba
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Joachim B. Tamba
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Barry Moumié
- Ministry of Health, Agence Nationale de Sécurité Sanitaire, N’zérékoré, Guinea
| | - Richard Kojan
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Hans-Joerg Lang
- Alliance for International Medical Action (ALIMA), Dakar, Senegal,Witten/Herdecke- University, Global Child Health, Witten, Germany
| |
Collapse
|