Palliative care for children with communicable illnesses

2021 ◽  
pp. 304-322
Author(s):  
Michelle Meiring ◽  
Tonya Arscott-Mills
Keyword(s):  
Palliative Care ◽  
Ebola Virus ◽  
Virus Disease ◽  
Communicable Disease ◽  
Disease Outbreaks ◽  
Communicable Diseases ◽  
Humanitarian Response ◽  
Care Approach ◽  
Health Related ◽  
Communicable Illness

Whilst non-communicable diseases provided the impetus for the development of children’s palliative care (CPC) in the developed world, it was a single communicable illness human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) that was the catalyst for the development of many CPC programmes in the developing world. Whilst considerable gains have been made in preventing and controlling paediatric AIDS globally, there is still benefit to an integrated palliative care approach to the care of these children and especially for those living in countries without access to anti-retrovirals. Furthermore, there are many other communicable diseases associated with significant health-related suffering in children that could benefit from palliative care. This chapter proposes grouping these diseases using the well-known Association for Children with Terminal Conditions (ACT) categorization and discusses examples of important communicable diseases in each category. The need for improved CPC as part of the humanitarian response to acute communicable disease outbreaks such as Ebola virus disease is also explored.

scholarly journals Risk factors and risk factor cascades for communicable disease outbreaks in complex humanitarian emergencies: a qualitative systematic review

2018 ◽  
Vol 3 (4) ◽  
pp. e000647 ◽  
Author(s):  
Charlotte Christiane Hammer ◽  
Julii Brainard ◽  
Paul R Hunter
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Communicable Disease ◽  
Disease Outbreaks ◽  
Poor Quality ◽  
Communicable Diseases ◽  
Individual Risk ◽  
Humanitarian Emergencies ◽  
General Terms ◽  
Complex Humanitarian Emergencies

BackgroundCommunicable diseases are a major concern during complex humanitarian emergencies (CHEs). Descriptions of risk factors for outbreaks are often non-specific and not easily generalisable to similar situations. This review attempts to capture relevant evidence and explore whether it is possible to better generalise the role of risk factors and risk factor cascades these factors may form.MethodsA systematic search of the key databases and websites was conducted. Search terms included terms for CHEs (United Nations Office for the Coordination of Humanitarian Affairs definition) and terms for communicable diseases. Due to the types of evidence found, a thematic synthesis was conducted.Results26 articles met inclusion criteria. Key risk factors include crowded conditions, forced displacement, poor quality shelter, poor water, sanitation and hygiene, lack of healthcare facilities and lack of adequate surveillance. Most identified risk factors do not relate to specific diseases, or are specific to a group of diseases such as diarrhoeal diseases and not to a particular disease within that group. Risk factors are often listed in general terms but are poorly evidenced, not contextualised and not considered with respect to interaction effects in individual publications. The high level of the inter-relatedness of risk factors became evident, demonstrating risk factor cascades that are triggered by individual risk factors or clusters of risk factors.ConclusionsCHEs pose a significant threat to public health. More rigorous research on the risk of disease outbreaks in CHEs is needed, from a practitioner and from an academic point of view.

scholarly journals A humanitarian response to the West African Ebola virus disease outbreak

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Linda M. Mobula ◽  
Jolene H. Nakao ◽  
Sonia Walia ◽  
Justin Pendarvis ◽  
Peter Morris ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreak ◽  
West African ◽  
Ebola Virus Disease ◽  
The West ◽  
Humanitarian Response

The Epidemiological Presentation Pattern of Ebola Virus Disease Outbreaks: Changes from 1976 to 2019

2020 ◽  
Vol 35 (3) ◽  
pp. 247-253
Author(s):  
Pedro Arcos González ◽  
Ángel Fernández Camporro ◽  
Anneli Eriksson ◽  
Carmen Alonso Llada
Keyword(s):  
At Risk ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Case Fatality ◽  
Ebola Virus Disease ◽  
World Health ◽  
Study Objective ◽  
Population At Risk ◽  
Case Fatality Ratio

AbstractIntroduction:Ebola Virus Disease (EVD) is the international health emergency paradigm due to its epidemiological presentation pattern, impact on public health, resources necessary for its control, and need for a national and international response.Study Objective:The objective of this work is to study the evolution and progression of the epidemiological presentation profile of Ebola disease outbreaks since its discovery in 1976 to the present, and to explore the possible reasons for this evolution from different perspectives.Methods:Retrospective observational study of 38 outbreaks of Ebola disease occurred from 1976 through 2019, excluding laboratory accidents. United Nations agencies and programs; Ministries of Health; the US Centers for Disease Control and Prevention (CDC); ReliefWeb; emergency nongovernmental organizations; and publications indexed in PubMed, EmBase, and Clinical Key have been used as sources of data. Information on the year of the outbreak, date of beginning and end, duration of the outbreak in days, number of cases, number of deaths, population at risk, geographic extension affected in Km2, and time of notification of the first cases to the World Health Organization (WHO) have been searched and analyzed.Results:Populations at risk have increased (P = .024) and the geographical extent of Ebola outbreaks has grown (P = .004). Reporting time of the first cases of Ebola to WHO has been reduced (P = .017) and case fatality (P = .028) has gone from 88% to 62% in the period studied. There have been differences (P = .04) between the outbreaks produced by the Sudan and Zaire strains of the virus, both in terms of duration and case fatality ratio (Sudan strain 74.5 days on average and 62.7% of case fatality ratio versus Zaire strain with 150 days on average and 55.4% case fatality ratio).Conclusion:There has been a change in the epidemiological profile of the Ebola outbreaks from 1976 through 2019 with an increase in the geographical extent of the outbreaks and the population at risk, as well as a significant decrease in the outbreaks case fatality rate. There have been advances in the detection and management capacity of outbreaks, and the notification time to the WHO has been reduced. However, there are social, economic, cultural, and political obstacles that continue to greatly hinder a more efficient epidemiological approach to Ebola disease, mainly in Central Africa.

scholarly journals COVID-19 Outbreak in Africa: Lessons and Insights from the West African Ebola Virus Disease Epidemics

2020 ◽  
Vol 8 (3) ◽  
pp. 96-99
Author(s):  
Oluwafolajimi Adetoye Adesanya
Keyword(s):  
Ebola Virus ◽  
Democratic Republic Of Congo ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Ebola Virus Disease ◽  
African Continent ◽  
Outbreak Response ◽  
African Countries ◽  
Response Strategies ◽  
Past Experiences

Over the years, the African continent has had to battle several outbreaks of infectious diseases in different countries. Some of the most deadly were the Ebola virus disease (EVD) outbreaks that occurred in West Africa between 2014 and 2016 affecting Guinea, Liberia, and Sierra Leone and, more recently, from 2018 to 2020 in the Democratic Republic of Congo (DRC). In the era of the COVID-19 pandemic, it is important that as a continent, we draw lessons and insights from our past experiences to guide outbreak response strategies being deployed to curb the latest onslaught. The Ebola outbreaks have shown that disease outbreaks should not be seen only as medical emergencies, but as full blown humanitarian crises, because oftentimes, their socio-economic impacts are more devastating than the more obvious cost to life. In this mini-review, we explore the possible humanitarian costs of the COVID-19 pandemic on the African continent by looking through the lens of our past experiences with the EVD outbreaks, highlighting how the current pandemic could significantly affect the African economy, food security, and vulnerable demographics, like children and the sexual and reproductive health and rights of women and girls. We then proffer recommendations that could be instrumental in preventing a double tragedy involving the devastating health consequences of the virus itself and the deadly fallout from its multi-sectoral knock-on effects in African countries. Keywords: COVID-19, SARS-CoV-2, Ebola Virus Disease, Coronavirus.

scholarly journals Offering patients more: how the West Africa Ebola outbreak can shape innovation in therapeutic research for emerging and epidemic infections

2017 ◽  
Vol 372 (1721) ◽  
pp. 20160294 ◽  
Author(s):  
Amanda M. Rojek ◽  
Peter W. Horby
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Virus Disease ◽  
Nipah Virus ◽  
Emerging Infectious Diseases ◽  
Disease Outbreaks ◽  
International Travel ◽  
Marburg Virus ◽  
World Health ◽  
The West

Although, after an epidemic of over 28 000 cases, there are still no licensed treatments for Ebola virus disease (EVD), significant progress was made during the West Africa outbreak. The pace of pre-clinical development was exceptional and a number of therapeutic clinical trials were conducted in the face of considerable challenges. Given the on-going risk of emerging infectious disease outbreaks in an era of unprecedented population density, international travel and human impact on the environment it is pertinent to focus on improving the research and development landscape for treatments of emerging and epidemic-prone infections. This is especially the case since there are no licensed therapeutics for some of the diseases considered by the World Health Organization as most likely to cause severe outbreaks—including Middle East respiratory syndrome coronavirus, Marburg virus, Crimean Congo haemorrhagic fever and Nipah virus. EVD, therefore, provides a timely exemplar to discuss the barriers, enablers and incentives needed to find effective treatments in advance of health emergencies caused by emerging infectious diseases. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.

scholarly journals Syndromic Surveillance of Communicable Diseases in Mobile Clinics During the Arbaeenia Mass Gathering in Wassit Governorate, Iraq, in 2014: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Faris Lami ◽  
Wejdan Asi ◽  
Adnan Khistawi ◽  
Iman Jawad
Keyword(s):  
Acute Diarrhea ◽  
Syndromic Surveillance ◽  
Communicable Disease ◽  
Disease Outbreaks ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Mass Gathering ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mobile Clinics

BACKGROUND Arbaeenia is the largest religious mass gathering organized annually in Karbala city, Iraq, and is attended by 8-14 million people. Outbreaks of communicable diseases are a significant risk due to overcrowding and potential food and water contamination. Syndromic surveillance is often used for rapid detection and response to disease outbreaks. OBJECTIVE This study was conducted to identify the main communicable diseases syndromes among pilgrims during the Arbaeenia mass gathering in Wassit governorate, Iraq, in 2014. METHODS This cross-sectional study was conducted in the 40 mobile clinics established within Wassit governorates along the road to Karbala during the Arbaeenia mass gathering. Six communicable disease syndromes were selected: acute watery diarrhea, bloody diarrhea, fever and cough, vomiting with or without diarrhea, fever and bleeding tendency, and fever and rash. A simple questionnaire was used to directly gather basic demographics and the syndromic diagnosis from the attendees. RESULTS A total of 87,865 patients attended the clinics during the 10-day period, with an average of 219 patients/clinic/day. Approximately 5% (3999) of the attendees had communicable diseases syndromes: of these, 1693 (42%) had fever and cough, 1144 (29%) had acute diarrhea, 1062 (27%) presented with vomiting with/without diarrhea, and 100 (2%) had bloody diarrhea. The distribution of the syndromes did not vary by age or gender. Stool specimen cultures for <italic>Vibrio cholerae</italic> performed for 120 patients with acute diarrhea were all negative. CONCLUSIONS Syndromic surveillance was useful in determining the main communicable diseases encountered during the mass gathering. Expansion of this surveillance to other governorates and the use of mobile technology can help in timely detection and response to communicable disease outbreaks.

Ebola and Other Filoviruses

2018 ◽  
Author(s):  
Lisa M. Bebell
Keyword(s):  
Ebola Virus ◽  
Inflammatory Responses ◽  
Virus Disease ◽  
Treatment Strategies ◽  
Disease Outbreaks ◽  
Marburg Virus ◽  
Residual Effects ◽  
Long Term Outcomes ◽  
Pediatric Vaccination

Congenital and pediatric Ebola virus disease (EVD) and Marburg virus disease (MVD) are severe, even lethal infections. Historically, children have been underrepresented in filovirus disease outbreaks, and evidence-based treatment strategies are lacking. Existing data suggest that case fatalities are highest among children under four years of age, which is partially explained by higher virus concentrations in young children. Prevention and aggressive resuscitation, nutrition, and supportive care are the mainstays of management until filovirus-specific therapies can be developed. Differences in pediatric immune and inflammatory responses may necessitate unique approaches to pediatric vaccination and treatment. There are minimal safety or immunogenicity data in children, a crucial knowledge gap that must be addressed in future trials. Studying pediatric survivors of the 2014–2016 West Africa EVD outbreak will provide much-needed data on long-term outcomes and residual effects of filovirus disease while we await effective filovirus-specific vaccines and therapies.

scholarly journals Human activities link fruit bat presence to Ebola virus disease outbreaks

Mammal Review ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jesús Olivero ◽  
John E. Fa ◽  
Miguel Á. Farfán ◽  
Ana L. Márquez ◽  
Raimundo Real ◽  
...  
Keyword(s):  
Human Activities ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Ebola Virus Disease ◽  
Fruit Bat
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