Extending the boundaries of ‘urban society’: The urban political ecologies and pathologies of Ebola Virus Disease in West Africa

A disease outbreak is an emergent product of social and ecological processes. To more fully understand disease outbreaks and their response, we must therefore consider how these dual processes interact in specific locales within the context of an increasingly urbanized world. As such, in this paper we examine the Ebola Virus Disease (EVD) outbreak and its response in West Africa by adopting the lenses of two approaches that are usually treated separately – namely, urban political ecology (UPE) and urban political pathology (UPP). The UPE approach sheds light on how the material/biophysical basis of the EVD outbreak was influenced by the socio-political-economic and vice versa. The UPP approach gives us insight into how the EVD response was influenced by broader socio-political-economic forces, particularly the historical legacy of colonialism. Through the adoption of this dual lens we are able to gain greater insights and a more comprehensive understanding of the EVD outbreak and response in West Africa.

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A meta-analysis of clinical studies conducted during the West Africa Ebola virus disease outbreak confirms the need for randomized control groups

Science Translational Medicine ◽

10.1126/scitranslmed.aaw1049 ◽

2019 ◽

Vol 11 (520) ◽

pp. eaaw1049 ◽

Cited By ~ 9

Author(s):

Lori E. Dodd ◽

Dean Follmann ◽

Michael Proschan ◽

Jing Wang ◽

Denis Malvy ◽

...

Keyword(s):

West Africa ◽

Mortality Risk ◽

Clinical Studies ◽

Ebola Virus ◽

Virus Disease ◽

Disease Outbreaks ◽

Ebola Virus Disease ◽

Control Group ◽

Control Groups ◽

Randomized Control

Recent Ebola virus disease outbreaks affirm the dire need for treatments with proven efficacy. Randomized controlled clinical trials remain the gold standard but, during disease outbreaks, may be difficult to conduct due to ethical concerns and challenging field conditions. In the absence of a randomized control group, statistical modeling to create a control group could be a possibility. Such a model-based reference control would only be credible if it had the same mortality risk as that of the experimental group in the absence of treatment. One way to test this counterfactual assumption is to evaluate whether reasonable similarity exists across nonrandomized control groups from different clinical studies, which might suggest that a future control group would be similarly homogeneous. We evaluated similarity across six clinical studies conducted during the 2013–2016 West Africa outbreak of Ebola virus disease. These studies evaluated favipiravir, the biologic ZMapp, the antimalarial drug amodiaquine, or administration of convalescent plasma or convalescent whole blood. We compared the nonrandomized control groups of these six studies comprising 1147 individuals infected with Ebola virus. We found considerable heterogeneity, which did not disappear after statistical modeling to adjust for prognostic variables. Mortality risk varied widely (31 to 66%) across the nonrandomized control arms of these six studies. Models adjusting for baseline covariates (age, sex, and cycle threshold, a proxy for viral load) failed to sufficiently recalibrate these studies and showed that heterogeneity remained. Our findings highlight concerns about making invalid conclusions when comparing nonrandomized control groups to cohorts receiving experimental treatments.

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Characterisation of the T-cell response to Ebola virus glycoprotein amongst survivors of the 2013–16 West Africa epidemic

Nature Communications ◽

10.1038/s41467-021-21411-0 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

T. R. W. Tipton ◽

Y. Hall ◽

J. A. Bore ◽

A. White ◽

L. S. Sibley ◽

...

Keyword(s):

T Cell ◽

West Africa ◽

Cell Response ◽

Ebola Virus ◽

Medical Condition ◽

Virus Disease ◽

T Cell Response ◽

Ebola Virus Disease ◽

Cell Phenotype ◽

T Cell Epitopes

AbstractZaireebolavirus (EBOV) is a highly pathogenic filovirus which can result in Ebola virus disease (EVD); a serious medical condition that presents as flu like symptoms but then often leads to more serious or fatal outcomes. The 2013–16 West Africa epidemic saw an unparalleled number of cases. Here we show characterisation and identification of T cell epitopes in surviving patients from Guinea to the EBOV glycoprotein. We perform interferon gamma (IFNγ) ELISpot using a glycoprotein peptide library to identify T cell epitopes and determine the CD4+ or CD8+ T cell component response. Additionally, we generate data on the T cell phenotype and measure polyfunctional cytokine secretion by these antigen specific cells. We show candidate peptides able to elicit a T cell response in EBOV survivors and provide inferred human leukocyte antigen (HLA) allele restriction. This data informs on the long-term T cell response to Ebola virus disease and highlights potentially important immunodominant peptides.

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Comparative phylogeography of African fruit bats (Chiroptera, Pteropodidae) provide new insights into the outbreak of Ebola virus disease in West Africa, 2014–2016

Comptes Rendus Biologies ◽

10.1016/j.crvi.2016.09.005 ◽

2016 ◽

Vol 339 (11-12) ◽

pp. 517-528 ◽

Cited By ~ 14

Author(s):

Alexandre Hassanin ◽

Nicolas Nesi ◽

Julie Marin ◽

Blaise Kadjo ◽

Xavier Pourrut ◽

...

Keyword(s):

West Africa ◽

Ebola Virus ◽

Virus Disease ◽

Ebola Virus Disease ◽

Fruit Bats ◽

Comparative Phylogeography

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Seroprevalence of Ebola virus infection in Bombali District, Sierra Leone

Journal of Public Health in Africa ◽

10.4081/jphia.2017.732 ◽

2017 ◽

Cited By ~ 5

Author(s):

Nadege Goumkwa Mafopa ◽

Gianluca Russo ◽

Raoul Emeric Guetiya Wadoum ◽

Emmanuel Iwerima ◽

Vincent Batwala ◽

...

Keyword(s):

Immune Response ◽

Virus Infection ◽

West Africa ◽

Sierra Leone ◽

Ebola Virus ◽

Virus Disease ◽

Asymptomatic Infection ◽

Ebola Virus Disease ◽

Efficient Immune Response ◽

Ebola Virus Infection

A serosurvey of anti-Ebola Zaire virus nucleoprotein IgG prevalence was carried out among Ebola virus disease survivors and their Community Contacts in Bombali District, Sierra Leone. Our data suggest that the specie of Ebola virus (Zaire) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response.

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