Ebolavirus and haemorrhagic syndrome

The Ebola virus is a highly virulent, single-stranded ribonucleic acid virus which affects both humans and apes and has fast become one of the world's most feared pathogens. The virus induces acute fever and death, with haemorrhagic syndrome occurring in up to 90% of patients. The known species within the genus Ebolavirus are Bundibugyo, Sudan, Zaire, Reston and Tai Forest. Although endemic in Africa, Ebola has caused worldwide anxiety due to media hype and concerns about its international spread, including through bioterrorism. The high fatality rate is attributed to unavailability of a standard treatment regimen or vaccine. The disease is frightening since it is characterised by rapid immune suppression and systemic inflammatory response, causing multi-organ and system failure, shock and often death. Currently, disease management is largely supportive, with containment efforts geared towards mitigating the spread of the virus. This review describes the classification, morphology, infective process, natural ecology, transmission, epidemic patterns, diagnosis, clinical features and immunology of Ebola, including management and epidemic containment strategies

The Impact of a Buddy System on the Self-Care Behaviours of Women Living with HIV/AIDS in Botswana

A needs assessment done among HIV-positive (HIV+ve) people in Botswana in 2000 indicated that these people required social support. Based on these results; a buddy system for and by HIV+ve women was instituted in Botswana during 2002. This study examined the impact of the buddy system on the self-care behaviours of 116 HIV+ve women volunteers who used the services of COCEPWA (Coping Centre for People with Aids) during 2002. The convenience sample comprised 39 buddies who completed the buddy training programme; 39 patients assigned to the 39 buddies and 38 controls who lived in areas where the buddy programme did not operate. The results indicate that HIV+ve patients who had buddies showed improved self-care behaviours from April 2002 until November 2002 compared to the controls. These self-care behaviours encompassed informing a number of other people about their HIV+ve status; compliance with tuberculosis treatment; CD4 quantification and adherence to antiretroviral therapy. Although the differences were not always statistically significant; the patients showed greater improvements than the controls in all self-care behaviours. Thus the buddy system might have assisted and empowered the patients to achieve higher levels of self-care behaviours than the controls