Points of entry dynamics: understanding the cross-border threats for Ebola virus disease and COVID-19 in Ghana using a logic model approach

Background. The influx of people across the national borders of Ghana has been of interest and concern in the public health and national security community in recent times due to the low capacity for the prevention and management of epidemics and other public health risks. Although the International Health Regulations (IHR) stipulate core public health capacities for designated border facilities such as international airports, seaports, and ground crossings, contextual factors that influence the attainment of effective public health measures and response capabilities remain understudied. Objective. To assess the relationship between contextual factors and COVID-19 procurement to help strengthen infrastructure resources for points of entry (PoE) public health surveillance functions, thereby eliminating gaps in the design, implementation, monitoring, and evaluation of pandemicrelated interventions in Ghana. Materials and Methods. This study employed a mixed-methods design, where quantitative variables were examined for relationships and effect size interactions using multiple linear regression techniques and the wild bootstrap technique. Country-level data was sourced from multiple publicly available sources using the social-ecological framework, logic model, and IHR capacity monitoring framework. The qualitative portion included triangulation with an expert panel to determine areas of convergence and divergence. Results. The most general findings were that laboratory capacity and KIA testing center positively predicted COVID-19 procurement, and public health response and airline boarding rule negatively predicted COVID-19 procurement. Conclusion. Contextual understanding of the COVID-19 pandemic and Ebola epidemic is vital for strengthening PoE mitigation measures and preventing disease importation.

Global Epidemic of Ebola Virus Disease and the Importation Risk into China: An Assessment Based on the Risk Matrix Method / 生物医学与环境科学（英文）

OBJECTIVE@#To analyze the global epidemic status of the Ebola virus disease (EVD) and assess the importation risk into China.@*METHODS@#Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976-2021, and assessed and ranked the importation risk of EVD from the disease-outbreaking countries into China using the risk matrix and Borda count methods, respectively.@*RESULTS@#From 1976-2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases (14,124 cases) in Sierra Leone, and the highest cumulative fatality rate (85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease. The Democratic Republic of the Congo had an extremely high risk (23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone, Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co

Ebola virus disease: a zoonotic disease with an extremely high fatality rate / 中国热带医学

@# Ebola virus disease (EVD) is a severe infectious disease caused by Ebola virus in humans and primates. The main clinical features are fever and bleeding. The disease was first identified in Zaire and Sudan in Africa in 1976. Since then, it has caused many large-scale epidemics in Africa. One of the largest and most complex Ebola outbreaks in history was the 2014-2016 outbreak in West Africa, which caused more cases and deaths than all previous outbreaks combined. As of 2022, about 35 000 EVD cases and 15 000 deaths have been reported. During the African pandemic, EVD also spread to other regions outside the African continent, such as the Americas and Europe, and became a public health issue of worldwide concern. In Africa, the re-emergence of the disease in Uganda and the Republic of Congo in 2022 has attracted much attention from the world. This article systematically summarizes the history, epidemiological distribution, route of infection, clinical symptoms, diagnosis, treatment, prevention and control of Ebola virus disease, so as to provide reference for relevant workers in China.

Caracterización clínico epidemiológica de pacientes con ébola en un centro de tratamiento de Sierra Leona / Clinical-epidemiological characterization of Ebola disease in patients at a treatment center in Sierra Leone

Introducción: La enfermedad del ébola se dio a conocer por primera vez en 1976, con una letalidad muy elevada en todos los brotes detectados. Objetivo: Caracterizar clínica y epidemiológicamente a los pacientes portadores de la enfermedad por el virus del Ébola. Métodos: Se realizó un estudio observacional, descriptivo y transversal en 424 pacientes ingresados en un centro de tratamiento de ébola en la República de Sierra Leona, África occidental, con el diagnóstico confirmado mediante la técnica de reacción en cadena de la polimerasa para virus Ébola, durante el período de noviembre de 2014 hasta marzo de 2015. Resultados: Se muestra que el grupo etario más afectado fue el de 25 a 34 con un 25,9 por ciento. La mayor letalidad se presentó en los pacientes con más de 65 años de edad con un 44,4 por ciento. El síntoma que prevaleció fue la fiebre para un 61,8 por ciento, y el hipo se presentó en el 88,8 por ciento de los fallecidos. Conclusión: Se concluye que la enfermedad no tuvo distinción significativa con el sexo. La mayor letalidad se presentó en las edades geriátricas. Los síntomas más frecuentes fueron la fiebre, diarrea y el decaimiento. El hipo fue el signo que más se presentó en los pacientes que fallecieron(AU)

Introduction: Ebola disease was first reported in 1976 with a very high lethality in all outbreaks. Objective: To clinically and epidemiologically characterize the patients carriers of Ebola virus disease. Methods: we conducted an observational, descriptive and cross-sectional study in 424 patients admitted to an Ebola Treatment Center in the Republic of Sierra Leone, West Africa from November 2014 to March 2015. The polymerase chain reaction technique for Ebola virus confirmed the diagnosis. Medical records provided all data. Results: The age group most affected was 25 to 34 (25.9 percent). The highest lethality occurred in those over 65 years of age (44.4 percent ). Fever was the prevailing symptom (61.8 percent) and hiccups occurred in 88.8 percent of the deceased. Conclusion: Clinical manifestations were variable, although fever was the main symptom. Hiccup was a sign of poor prognosis when associated with a higher percentage of mortality. Lethality was high(AU)

An update on the 2014 Ebola outbreak in Western Africa

The recent Ebola outbreak in Western Africa was the most devastating outbreak witnessed in recent times. There have been remarkable local and international efforts to control the crisis. Ebola Virus Disease is the focus of immense research activity. The progression of events in the region has been evolving swiftly and it is of paramount importance to the medical community to be acquainted with the situation. Over 28000 people were inflicted with the condition, over 11000 have died. Novel data has emerged regarding modes of transmission, providing rationale for recent flare-ups. Similarly, studies on survivors are elucidating the later stages of the disease recovery process. Novel techniques for diagnosis are also discussed. Finally, the current research regarding treatment and vaccine development is reviewed, particularly the implementation of rVSV-ZEBOV vaccination programs.

An update on the 2014 Ebola outbreak in Western Africa

The recent Ebola outbreak in Western Africa was the most devastating outbreak witnessed in recent times. There have been remarkable local and international efforts to control the crisis. Ebola Virus Disease is the focus of immense research activity. The progression of events in the region has been evolving swiftly and it is of paramount importance to the medical community to be acquainted with the situation. Over 28 000 people were inflicted with the condition, over 11 000 have died. Novel data has emerged regarding modes of transmission, providing rationale for recent flare-ups. Similarly, studies on survivors are elucidating the later stages of the disease recovery process. Novel techniques for diagnosis are also discussed. Finally, the current research regarding treatment and vaccine development is reviewed, particularly the implementation of rVSV-ZEBOV vaccination programs.

Medical service and management of pregnant women during the Ebola epidemic / 中华实验和临床病毒学杂志

The Ebola epidemic occurrence during 2014-2016 is the largest-ever Ebola virus outbreak with an unprecedented scale and impact. The difficulties faced by pregnant women living within the epidemic area are complex and multi-factorial which merits our concern. In this review, we aimed to summarize some of the guidelines published by the World Health Organization during the outbreak, and to provide a broad overview of the issues that arise from pregnant women. Based on our own experience in Sierra Leone, we also made an analysis of the complex interaction between the Ebola virus disease, pregnancy, medical staff, public health systems and the society, and intended to afford peers useful information. The management strategies should be prepared in advance to against the potential epidemic threats and ensure the reliability of life-saving maternity services in China.

Avances científicos en las estrategias terapéuticas contra la enfermedad por virus del ébola / Scientific advances in therapeutic strategies against disease by ebola virus

La enfermedad por el virus del Ébola se conoce desde hace treinta años como mortal, contagiosa y de difícil diagnóstico y tratamiento. Numerosos estudios se han realizado para comprender la patogénesis del virus y con ello los posibles tratamientos que puedan generar control de la enfermedad. Sin embargo, no hay hasta la fecha un fármaco o vacuna con licencia para combatir el virus del Ébola. El tratamiento está basado solo en aliviar los síntomas y prevenir el contagio por medio de acciones que ayuden a minimizar el riesgo de infección. En esta revisión, se presentan las diferentes perspectivas del estado actual de la investigación sobre fármacos antivirales y vacunas en fases de desarrollo para la infección del virus del Ébola.

Ebola virus disease has been known for thirty years as a lethal, contagious and difficult to diagnose and treat disease. Numerous studies have been conducted to understand the pathogenesis of the virus and thus the possible treatments that may promote disease control. However, to date there is no licensed vaccine or medicine to fight Ebola virus. The treatment is based only on relieving symptoms and preventing contagion through actions that help minimize the risk of infection. This review presents different perspectives of the current state of research on antiviral medicine and vaccines in development stages for Ebola virus infection.

Information needs and sources for ebola virus disease among staff of a college of medicine in ENUGU, Nigeria

This study was carried out to ascertain the information needs and sources for Ebola among staff of College of Medicine, Enugu State University of Science and Technology (ESUT) Enugu. The study adopted the descriptive survey design. A total of 200 questionnaires were used to elicit information from the respondents. The 200 questionnaire were administered to the respondents and all the responses were retrieved accordingly for data analysis. The data were analyzed using percentages. Findings showed that a good number of the respondents correctly identified best preventive measures against Ebola as avoiding raw foods especially under cooked meat and washing hands regularly with soap or use of hand sanitizers. This show the respondents are aware of the disease. Information is needed most on the causes of Ebola virus and television and radio were major sources of information on Ebola. In conclusion, the study noted that there is need for planned and proper dissemination of information on of Ebola Virus Disease. This will help the citizens to prevent the disease as well as manage any outbreak.

Ebola virus disease: Emerging outbreak.

Ebola Virus Disease or Ebola Haemorrhagic Fever is one of the highly fatal viral disease caused by ebola virus in humans. Mortality rate as high as 90% is reported. Virus is transmitted to humans through bats and other animals infected from bats. Although Ebola Virus Disease is reported since 1976 but currently West Africa is facing the largest outbreak of disease with danger of spread to other parts of the world. More than 5000 cases with mortality of more than 2600 cases has been reported till the end of 3rd quarter of year 2014. There is no specific treatment and vaccination available till date. Mainstay for managing patient is supportive care with early fluid resuscitation and symptomatic treatment. Our main target is to prevent human transmission by educating and supporting the community.

Ebola virus disease and the search for a cure

Ebola virus disease (EVD) was first identified in 1976 in Yambuku, Zaire (now the Democratic Republic of Congo), and is caused by an RNA virus in the filovirus family (Feldmann & Geisbert). The current strain circulation in West Africa is very similar to the original strain (>95% homology). The origin of the current outbreak remains unknown, but it is suspected to be from an animal reservoir with intermediary species (Fauci). Randomized clinical trials with adaptive design are ongoing to evaluate potential new therapies for EVD...

Multiple organ dysfunctions and aggressive supportive therapies in patients with severe Ebola virus disease: A literature analysis / 第二军医大学学报

Objective To analyze and summarize the characteristics of multiple organ dysfunctions and the associated supportive therapies in patients with severe Ebola virus disease (EVD) through a systematic literature review. Methods Medline and EMbase were searched since 2014 for eligible studies on severe EVD patients in ICU. The data of clinical presentations, treatment procedures as well as prognosis of these patients were summarized and analyzed. Results Ten patients from 7 reports were finally enrolled in the present study. Internal environment disturbance, liver injury and thrombocytopenia occurred in almost all of the patients. Respiratory failure was found in 4 patients and 3 of them were also complicated with renal failure. All of the patients received aggressive supportive therapies, such as maintaining the stability of internal environment, transfusion of blood products, mechanical ventilation, renal replacement therapy, antiviral therapy, etc. Of the 10 patients, 9 recovered and 1 died. Conclusion Severe EVD patients are always complicated with multiple organ dysfunctions and effective supportive therapies can improve the organ dysfunctions and prognosis of these patients.

Evaluation of anti-Ebola training system in the PLA Medical Team to Liberia and some suggestion / 第二军医大学学报

Objective To summarize the characteristics of the training system for the Second Medical Team of Chinese People's Liberation Army (PLA) to Liberia for anti-Ebola mission and to give some suggestion. Methods Before going to Liberia, the Second Medical Team of Chinese PLA received pertinent training focusing on Ebola-related theories and practical protection skills. Training on working regulation and procedures, emergency protocol and foreign affair was also given. Theory learning was carried out by combining lectures and self-teaching; protection skills were strengthened by watching video, live demonstration and modular training. Finally, modular situation simulation and supervision assessment were used to integrate the theories, skills, working procedures and urgent drill, making each section coordinate and function well to achieve the designed training goals. Results The pertinent training was effective. We suggested that it is necessary to include general introduction of lemology, principles and rules of protection and control of communicable diseases in theory learning so as to guide the trainees to solve specific problems during their work. In addition, psychological counseling for the purpose of eliminating the members' fear and anxiety and other negative emotions, and learning self-grooming, are also helpful to facilitate the execution of mission in foreign areas. Conclusion The petinent training has laid a solid foundation for achieving the goal of "win the war, zero infection" during emergent medical situation. Modular scenario simulation training method is effective for emergent response training of medical team for communicable diseases, and it should be widely used.

Sanitation and antiepidemic practice in Chinese Ebola Treatment Unit in Liberia / 第二军医大学学报

Objective To summarize the design and implementation of standard work flow of sanitation and epidemic prevention work in the anti-Ebola mission in Liberia, so as to provide reference for treating infectious diseases in the future. Methods The working practice for sanitation and epidemic prevention in Chinese Ebola Treatment Unit in Liberia, including the organizational operation mode, work flow, quality control, and the improvement of the performance were reviewed. Then the importance of sanitation and epidemic prevention was analyzed and the experience and lessons were summarized. Results Deployed in Liberia for the mission of treating Ebola virus disease, the Medical Team of the Chinese People's Liberation Army (PLA) successfully achieved the goal of "win the war, zero infection", in which the sanitary and epidemic prevention work had played an important role. Conclusion The sound organization and management, excellent material preparation, reasonable arrangement of work flow, strict quality control and the continuous improvement of problems were the keys for successful sanitary and epidemic prevention work in the Chinese Ebola Treatment Unit in Liberia.

Ebola virus disease-related fear, stigma and discrimination can not be overlooked / 第二军医大学学报

Ebola virus disease (EVD)-related fear, stigma and discrimination are series of psychological barriers and behaviors during EVD epidemics, which are caused not only by the characters of EVD, such as high fatality rate, high transmission efficiency and clinical similarities to other infectious diseases, but also by the backward economy and educational levels, unsound hospital and health care system, traditional production mode and life style, and political unrest in West Africa countries. As members of the second batch of the Chinese People's Liberation Army (PLA) medical team to Liberia the authors noticed that not only EVD patients and the contacts, but also the medical workers had to face the fear, discrimination, and even the violence from other people, which decreased the effects of the EVD-prevention and control efforts. Prompt publicity and education about EVD in local communities, Ebola-prevention training programs to the local health workers, letting Ebola survivors to participate in the epidemic control mission, and providing more protective equipment should be employed to improve Ebola prevention and eliminate the Ebola-related fear, stigma and discrimination. It is suggested that strengthening the research on the specific vaccines and medicines against Ebola, all-around assistance from the international society and extensive publicity and education about Ebola can help to dismiss the psychological barriers of fear, stigma, and discrimination about EVD.

Multiple physical exercises improving the physical and mental health of PLA medical staffs in Chinese Ebola treatment unit in liberia / 第二军医大学学报

Objective To investigate the effect of multiple physical exercises in improving the physical and mental health of PLA medical staffs in the Chinese Ebola Treatment Unit in Liberia. Methods The subjects were the Chinese medical staffs from People) Liberation Army who worked in the Chinese Ebola Treatment Unit in Liberia. The subjects were organized to participate in a variety of physical exercises during their stay in Liberia. And the effects of exercise on sleep, emotion, fear, physical quality of the subjects were investigated by a self-designed questionnaire. Results More than 60. 29% of the medical staffs believed that multiple physical exercises could improve their sleep quality; more than 80% thought that it could bring joyful mood, relieve anxiety, improve appetite, and enhance the physical quality and immunity; and 76. 47% appeared satisfied with the multiple physical exercises organized by the medical team. Running (25. 00%), fast walking (21. 88%), aerobic gymnastics (17. 19%) and badminton (17. 19%) in order were thought to be the most important exercises for improving the mood and physical fitness. The consistency analysis showed that the Kappa values between table tennis and running, walking were 0. 333 and 0. 381, respectively (P<0. 01), and the Kappa value between football and running was 0. 340 (P<0. 01). Conclusion Multiple physical exercise can improve the physical and mental health of medical staffs working in Chinese Ebola Treatment Unit in Liberia. Whole body exercises including running, walking, aerobics gymnastics and badminton have significant improvement effect, and they may be used to improve the physical health of staffs involved in other similar missions in the future.

The role of a supervising-nurse in self-protection of medical staffs involved in Ebola treatment in liberia / 第二军医大学学报

Objective To investigate the role of supervising-nurse in self-protection of medical staffs treating patients with Ebola virus disease in Liberia. Methods Based on the Standard Procedure of Personal Protection, we designed a Chinese- English bilingual Inspection Table for putting on personal protective equipment (PPE) for Chinese People) Liberation Army medical team to Liberia and another one for takingoff PPE. The supervising-nurse gave supervising tips and psychologically positive implications to all medical staffs working in the observing room and treatment ward. Nurses also recorded and summarized the problems and mental status which have been prevented and stopped, and the efficacy of the supervision was evaluated. Results From Jan. 16, 2015 to Mar. 19, 2015, about 3 000 person-times and 126 000 supervision items for the Chinese and Liberia staffs working in the observing room and treatment ward were involved. A total of 1 532 potential problems were prevented by supervising-nurse. Conclusion A supervising-nurse can effectively ensure the self-protection of medical staffs involved in the frontline treatment of patients with Ebola virus disease, guaranteeing the “zero infection” of medical staffs.

Psychological experience of Chinese nurses during China’s anti-ebola aid in liberia: A qualitative interview / 第二军医大学学报

Objective To understand the psychological experience of Chinese nurses working in Liberia during the aid to fight against Ebola virus disease, so as to lay a foundation for future similar missions. Methods We conducted a qualitative interview study with 11 Chinese nurses who helped to fight against Ebola virus disease in Liberia by semi-structured interview, and then the data collected were analyzed. Results Analysis showed that the psychological experience of Chinese nurses in Liberia could be divided into 4 stages. Stage one was from being informed of the aid mission to going aboard to Liberia, with the psychological experience being panic and having anxiety. Stage two was the first 2 weeks of working in Chinese Ebola Treatment Unit (ETU) in Liberia, with the psychological experience being lost, sad and having anxiety. Stage three was from the third week of working in ETU to before going back to China, with the psychological experience being attached and emotional. And stage four was the quarantine period in China, with the psychological experience being prevailing loneliness. Conclusion Efforts should be made to support, to train and to guide the nurses who work in situations like Ebola according to their psychology in different stages. And the nurses should have an active attitude, improve understanding of Ebola disease, and ensure safe selfprotection during work.

Knowledge, attitude and practice of standard isolation precautions: An investigation among nursing staffs during anti-Ebola mission in liberia / 第二军医大学学报

Objective To know about the levels of knowledge, attitude and practice of standard isolation precautions among nursing staffs during the anti-Ebola mission in Liberia. Methods The participants were Liberia nursing staffs working in the Ebola Treatment Center in Liberia, which was established by the medical team of the Chinese People) Liberation Army (PLA). An English questionnaire was designed based on the international guidelines on standard isolation precautions, which includes 32 items including general situation, knowledge, attitude and practice on standard isolation precautions. The correlation among the knowledge, attitude and practice of standard isolation precautions was analyzed by Spearman correlation analysis. Results A total of 80 nursing staffs finished the questionnaires, with a valid rate of 71. 25%. Their mean scores of knowledge, attitude and practice levels of standard isolation precautions were 7. 4 ± 1. 1, 36. 4 ± 4. 6, and 6. 6 ± 1. 9, respectively. Significant positive correlations were observed between knowledge and attitude (P<0. 05), and practice and attitude (P< 0. 01), but not between knowledge and practice by Spearman correlation analysis. Conclusion The training programs on Ebola virus disease prevention provided by the international health aid organization have improved the isolation precaution behavior levels of the local nursing staffs. However, lack of theoretical training on standard isolation protection and poor supplies from the government lead to enhancement space for attitude improvement on standard isolation precautions in Liberian nursing staff, which may have an impact on the standard isolation precaution behaviors after the international aid staff leaving the country.

Nursing experience of patients with Ebola virus disease in Chinese Ebola treatment unit in liberia / 第二军医大学学报

Objective To discuss the nursing interventions of patients with confirmed Ebola virus disease. Methods and Results We retrospectively analyzed the nursing method and experience of 4 confirmed cases with Ebola virus disease in Chinese Ebola Treatment Unit, which was established by Chinese People7 s Liberation Army medical team in Liberia. Following the strict personal protective process, we provided timely symptomatic care, seamless psychological care, carefully basic care and comprehensive health education for the patients. We also timely summarized our experience of nursing interventions. Through dedicated treatment and nursing, despite 1 case died, 3 cases were cured and discharged. Conclusion Since there have been no specific and effective medications for Ebola virus disease by now, timely and correct symptomatic treatment and dedicated nursing with high efficiency are of great significance for patients to fight against with Ebola virus disease and regain their health.