A comprehensive district-level laboratory intervention after the ebola epidemic in Sierra Leone

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

Strengthening healthcare workforce capacity during and post Ebola outbreaks in Liberia : an innovative and effective approach to epidemic preparedness and response

Introduction: the 2014-2016 Ebola virus disease (EVD) outbreak in Liberia highlighted the importance of robust preparedness measures for a well-coordinated response; the initially delayed response contributed to the steep incidence of cases, infections among health care workers, and a collapse of the health care system. To strengthen local capacity and combat disease transmission, various healthcare worker (HCW) trainings, including the Ebola treatment unit (ETU) training, safe & quality services (SQS) training and rapid response team (RRT), were developed and implemented between 2014 and 2017.Methods: data from the ETU, SQS and RRT trainings were analyzed to determine knowledge and confidence gained.Results: the ETU, SQS and RRT training were completed by a total of 21,248 participants. There were improvements in knowledge and confidence, an associated reduction in HCWs infection and reduced response time to subsequent public health events.Conclusion: no infections were reported by healthcare workers in Liberia since the completion of these training programs. HCW training programmes initiated during and post disease outbreak can boost public trust in the health system while providing an entry point for establishing an Epidemic Preparedness and Response (EPR) framework in resource-limited settings

Review of past and present ebola hemorrhagic fever outbreaks in the Democratic Republic of Congo 1976 -2014

Background: Ebola Hemorrhagic Fever (EHF) has become well known all over the world; especially following the West African outbreak in Guinea; Sierra Leone and Liberia (December 2013). The Ebola virus was first discovered in the Democratic Republic of Congo (DRC); an African country that has continued to register Ebola outbreaks. This study aims to summarize old and new experiences of Ebola in the DRC; in order to propose strategies for better prevention.Materials and Methods: Information was taken from databases such as PubMed and Cochrane library. A total of eleven full text and three abstracts were identified for the data extraction. Results: Since its discovery in the DRC; there have been seven Ebola outbreaks; accounting for a total of 1032 cases and 795 deaths. The presence of Non-Human Primates; also considered as the natural reservoir and susceptible host of Ebola virus; can be one major factor that has contributed to the increased number of Ebola outbreaks and cases in the Equatorial region. The existence of rumors and legends related to Ebola in DRC obscure the the viral nature of the disease; and lead to difficulty for health workers; to easily accomplish their tasks.Conclusion :It is important ;to scale up community education campaigns designed to give more details on the viral nature of the EHF; establish national agencies and institutions specialized in controlling hunting in the Equatorial region; for better prevention; since there is not yet a specific drug or vaccine to the Ebola Virus

A Systems View and Lessons from the Ongoing Ebola Virus Disease (EVD) Outbreak in West Africa

This article analyses the on-going (2014) Ebola Virus Disease (EVD) outbreak in West Africa from a systems perspective; and draws out lessons for West Africa in general and Ghana in particular

Outbreaks-of Ebola virus disease in the West African sub-region

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