ABSTRACT
Background: The 20142016 Ebola outbreak exposed the poor laboratory systems in Sierra Leone. Immense needs were recognised across all areas, from facilities, diagnostic capacity, supplies, trained personnel to quality assurance mechanisms.Objective: We aimed to describe the first year of a comprehensive intervention, which started in 2015, in a public hospital's general laboratory serving a population of over 500 000 in a rural district.Methods: The intervention focused on (1)supporting local authorities and healthcare workers in policy implementation and developing procedures to enhance access to services, (2) addressing gaps by investing in infrastructure, supplies, and equipment, (3) development of quality assurance mechanisms via mentorship, bench-side training, and the introduction of quality control and information systems. All work was performed alongside counterparts from the Ministry of Health and Sanitation.Results: We observed a strong increase in patient visits and inpatient and outpatient testing volumes. Novel techniques and procedures were taken up well by staff, leading to improved and expanded service and safety, laying foundations for further improvements.Conclusion: This comprehensive approach was successful and the results suggest an increase in trust from patients and healthcare workers
Subject(s)
Disease Outbreaks , Ebolavirus , Hemorrhagic Fever, Ebola/diagnosis , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/prevention & control , Hospitals, District , Sierra LeoneABSTRACT
BACKGROUND: Five West African countries, including Nigeria are currently experiencing the largest, most severe, most complex outbreak of Ebola virus disease in history. This paper provided a chronology of outbreaks of Ebola virus disease in the West African sub-region and provided an update on efforts at containing the present outbreak. METHODS: Literature from Pubmed (MEDLINE), AJOL, Google Scholar and Cochrane database were reviewed. RESULTS: Outbreaks of Ebola, virus disease had frequently occurred mainly in Central and East African countries. Occasional outbreaks reported from outside of Africa were due to laboratory contamination and imported monkeys in quarantine facilities. The ongoing outbreak in West Africa is the largest and first in the sub-region; the number of suspected cases and deaths from this single current outbreak is already about three times the total of all cases and deaths from previous known outbreaks in 40 years. Prevention and control efforts are hindered not only by lack of a known vaccine and virus-specific treatment, but also by weak health systems, poor sanitation, poor personal hygiene and cultural beliefs and practices, including myths and misconceptions about Ebola virus disease--all of which are prevalent in affected countries. Constrained by this situation, the World Health Organisation departed from the global standard and recommended the use of not yet proven treatments to treat or prevent the disease in humans on ethical and evidential grounds. CONCLUSION: The large number of people affected by the present outbreak in West Africa and the high case-fatality rate calls for accelerated evaluation and development of the investigational medical interventions for life saving and curbing the epidemic. Meanwhile, existing interventions such as early detection and isolation, contact tracing and monitoring, and adherence to rigorous procedures of infection prevention and control should be intensified
Subject(s)
Disease Outbreaks , Hemorrhagic Fever, Ebola/diagnosis , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/prevention & controlABSTRACT
Les symptômes de la fièvre hémorragique à virus Ebola n'ont rien de spécifique; surtout au début de la maladie. La phase prodromale se caractérise par un syndrome grippal; tandis que pendant la phase aigüe; apparaissent une fièvre brutale et prolongée; des céphalées; une asthénie sévère; des arthralgies; des nausées et vomissements. Les symptômes hémorragiques apparaissent plus tard et peuvent consister en : épistaxis; melaena; hématémèse; injection conjonctivale et saignement aux points d'injection. A cause de la ressemblance de ce symptôme avec ceux des infections tropicales les plus courantes telle que le paludisme; la typhoïde et la shigellose; la fièvre hémorragique a virus Ebola (FHE) a été très souvent diagnostiquée avec beaucoup de retard. La diagnostic de laboratoire de la FHE se fait par exclusion de ces maladies et par confirmation du diagnostic par techniques immunologiques; moléculaires (PCR); virologiques (isolement) ou immuno-histochimiques