scholarly journals Implementation of the Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) study: Lessons learned for vision health systems strengthening in Sierra Leone

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0252905
Author(s):  
Jessica G. Shantha ◽  
Ian Crozier ◽  
Colleen S. Kraft ◽  
Donald G. Grant ◽  
Augustine Goba ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Sierra Leone ◽  
Ebola Virus ◽  
Democratic Republic Of Congo ◽  
Lessons Learned ◽  
Infection Prevention And Control ◽  
Ocular Tissues ◽  
Virus Persistence ◽  
Virus Rna ◽  
And Control

Background Following the West African Ebola virus disease (EVD) outbreak of 2013–2016 and more recent EVD outbreaks in the Democratic Republic of Congo, thousands of EVD survivors are at-risk for sequelae including uveitis, which can lead to unremitting inflammation and vision loss from cataract. Because of the known risk of Ebola virus persistence in ocular fluid and the need to provide vision-restorative, safe cataract surgery, the Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study was implemented in Sierra Leone. During implementation of this multi-national study, challenges included regulatory approvals, mobilization, community engagement, infection prevention and control, and collaboration between multiple disciplines. In this report, we address the multifacted approach to address these challenges and the impact of implementation science research to address an urgent clinical subspecialty need in an outbreak setting. Methodology/Principal findings Given the patient care need to develop a protocol to evaluate ocular fluid for Ebola virus RNA persistence prior to cataract surgery, as well as protocols to provide reassurance to ophthalmologists caring for EVD survivors with cataracts, the EVICT study was designed and implemented through the work of the Ministry of Health, Sierra Leone National Eye Programme, and international partnerships. The EVICT study showed that all 50 patients who underwent ocular fluid sampling at 19 and 34 months, respectively, tested negative for Ebola virus RNA. Thirty-four patients underwent successful cataract surgery with visual acuity improvement. Here we describe the methodology for study implementation, challenges encountered, and key issues that impacted EVD vision care in the immediate aftermath of the EVD outbreak. Key aspects of the EVICT study included defining the pertinent questions and clinical need, partnership alignment with key stakeholders, community engagement with EVD survivor associations, in-country and international regulatory approvals, study site design for infection prevention and control, and thorough plans for EVD survivor follow-up care and monitoring. Challenges encountered included patient mobilization owing to transportation routes and distance of patients in rural districts. Strong in-country partnerships and multiple international organizations overcame these challenges so that lessons learned could be applied for future EVD outbreaks in West and Central Africa including EVD outbreaks that are ongoing in Guinea and Democratic Republic of Congo. Conclusions/Significance The EVICT Study showed that cataract surgery with a protocol-driven approach was safe and vision-restorative for EVD survivors, which provided guidance for EVD ophthalmic surgical care. Ophthalmologic care remains a key aspect of the public health response for EVD outbreaks but requires a meticulous, yet partnered approach with international and local in-country partners. Future efforts may build on this framework for clinical care and to improve our understanding of ophthalmic sequelae, develop treatment paradigms for EVD survivors, and strengthen vision health systems in resource-limited settings.

scholarly journals Infection Prevention and Control Capacity Building During 2018–2019 Democratic Republic of Congo Ebola Virus Disease Outbreak

2020 ◽  
Vol 41 (S1) ◽  
pp. s300-s300
Author(s):  
April Baller ◽  
Kevin Ousman ◽  
Maria Clara Padoveze ◽  
Charles Basilubo ◽  
Rodrigue Bobwa ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Ebola Virus ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Infection Prevention And Control ◽  
And Control ◽  
Level Training

Background: As of July 1, 2019, ~18% of all cases in the Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo (DRC) were healthcare-associated (ie, nosocomial) infections (HAIs) and healthcare worker (HCW) infections. Although progress has been achieved, gaps remained in infection prevention and control (IPC), specifically, a need to reinforce standardized, evidence-based IPC practices to effectively address HAIs. The Ministry of Health (MOH), in collaboration with partners, developed an IPC tool kit consisting of >70 documents (ie, terms of reference, standard operating procedures, training modules, etc) to improve HCW IPC knowledge and practices at healthcare facilities among staff. The tool kit incorporated international IPC standards, DRC-specific experiences, and best practices. Thus, it serves as a technical and operational package, covering general guidance (standard precautions) and EVD specific issues. Methods: A decentralized rollout approach was used to disseminate the tool kit content at the various health-system levels over several months. Initially, national-level training of trainers was held, followed by subnational-level training of IPC supervisors and key IPC implementers, and lastly, training of healthcare facility (HCF) IPC focal persons. The 5-day training adhered to the MOH standard of 60% theory and 40% practice. Participants completed evaluations before and after training; changes in knowledge between the pre- and posttraining tests were analyzed and the results of the statistical tests were reported (P < .05 was considered statistically significant). Results: In total, 294 IPC supervisors were trained across 7 subnational commissions. Data were analyzed for 138 participants. Participants were 60.9% IPC supervisors, 8% WASH supervisors, and 31% others. MOH representation was 52.9% The average results before the test were 66% (19.8 of 30), the average posttest results were 72% (21.6 of 30)—a significant improvement. The worst-performing pretest IPC domain was IPC approach, and facility closure was the worst performing for posttest. As of November 11, 15.7% of all cases were HAIs. Conclusions: The IPC training program initiated during an outbreak can increase knowledge and potentially improve practices and confidence. An association with the downward HAI trend is yet to be validated. The MOH anticipates that this tool kit will be the go-to resource for future Ebola outbreaks and that it will be incorporated into the preservice medical curriculum to ensure a resilient heath system.Funding: NoneDisclosures: None

scholarly journals Implementation of a study to examine the persistence of Ebola virus in the body fluids of Ebola virus disease survivors in Sierra Leone: Methodology and lessons learned

2017 ◽  
Vol 11 (9) ◽  
pp. e0005723 ◽  
Author(s):  
Gibrilla Fadlu Deen ◽  
Suzanna L. R. McDonald ◽  
Jaclyn E. Marrinan ◽  
Foday R. Sesay ◽  
Elizabeth Ervin ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Ebola Virus ◽  
Virus Disease ◽  
Body Fluids ◽  
Lessons Learned ◽  
The Body ◽  
Ebola Virus Disease

Understanding the Predictors that Contribute to Liberian Health Care Workers Feeling Protected From Ebola While at Work

2020 ◽  
pp. 1-6
Author(s):  
Kayla Enriquez ◽  
Kanagasabai Udhayashankar ◽  
Michelle Niescierenko
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Ebola Virus ◽  
Virus Disease ◽  
Infection Prevention And Control ◽  
Care Workers ◽  
Before And After ◽  
Returning To Work ◽  
Care Worker ◽  
And Control

ABSTRACT Objective: To assess Liberian health care workers’ feelings around safety in returning to work in the setting of the Ebola virus disease outbreak of 2014–2015 after receiving infection prevention and control (IPC) training. Methods: Academic Consortium Combating Ebola in Liberia (ACCEL) training surveys were done at 21 public, Liberian hospitals to understand health care workers’ attitudes surrounding Ebola and whether they felt safe while at work based on multiple factors. Logistic regression was used for analysis. Results: We found that health care workers feeling safe at work during the Ebola outbreak was primarily predicted by the number of IPC/Ebola trainings received pre-ACCEL interventions. Health care workers felt increasingly safer and motivated to return to work as trainings approached 3 (OR 8, p-value < 0.001); however, more than 3 trainings resulted in decreased safety and motivation. In addition, health care workers who reported washing their hands before and after patient contact were 3.4 times more likely to understand how to protect themselves from Ebola. Conclusions: These results help to better understand the utility of repeated trainings on health care worker practice attitudes and the importance of IPC policies within hospitals, such as hand hygiene promotion and education, when coordinating humanitarian efforts.

scholarly journals Mathematical modeling and comparative analysis of the Ebola epidemic reveal effective control measures

2019 ◽  
Author(s):  
Junlong Li ◽  
Caiping Song ◽  
Jingya Yang ◽  
Jingmin Zheng ◽  
Lina Zhou ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Comparative Analysis ◽  
Sierra Leone ◽  
Development Process ◽  
Ebola Virus ◽  
Virus Disease ◽  
Control Measures ◽  
Effective Control ◽  
Epidemic Outbreak ◽  
And Control

Abstract The Ebola virus disease (EVD) is a highly contagious disease which is caused by the Ebola virus . Various measures were used to prevent and control the spread of EVD. The aim of this study was to find out the most critical measures to prevent and control the spread of EVD. Both mathematical modeling and comparative analysis were used to explore the development process of EVD outbreak in Guinea, Liberia and Sierra Leone. The results of comparative analysis showed quarantined individuals before infection (R 2 = 0.848, ε = 1.012), safe burial teams (R 2 = 0.772, ε = 0.385), and the Ebola treatment units (ETU) bed (R 2 = 0.690, ε = 0.432) could significantly influence the incidence of EVD which were consistent with the results of mathematical modeling. These findings indicted that a timely and effective quarantine played a significant role in preventing and controlling the spread of EVD, and the findings would help us prevent and control the epidemic outbreak of new infectious disease in the future.

scholarly journals Covid-19 pandemic: chronicle of responses and experiences of the infection prevention and control committee at a tertiary hospital in southwest Nigeria

2021 ◽  
Vol 21 (3) ◽  
pp. 1093-1099
Author(s):  
Akinwumi Ayodeji Akinbodewa ◽  
Michael Simidele Odimayo ◽  
Olorunfemi Akinbode Ogundele ◽  
Tosin Oluwapelumi Ogunleye ◽  
Olanrewaju Olayinka Johnson ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Virus Disease ◽  
Healthcare Delivery ◽  
Healthcare Management ◽  
Lessons Learned ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
And Control

Since the advent of 2019-Corona virus Disease (COVID-19) in Nigeria in February 2020, the number of confirmed cases has risen astronomically to over 61,307 cases within 8 months with more than 812 healthcare workers infected and some recorded deaths within their ranks. Infection prevention and control is a key component in ensuring safety of healthcare workers in the hospital as health- care-associated infection is one of the most common complications of healthcare management. Unbridled transmission of infection can lead to shortage of healthcare personnel, reduced system efficiency, increased morbidity and mortality among patients and in some instances, total collapse of healthcare delivery services. The Infection Prevention and Control Committee is a recognised group by the Centre for Disease Control and Prevention with their core programmes including drawing up activities, procedures and policies designed to achieve above-stated objectives before, during and after any disease outbreak, especially emerging and re-emerging ones such as the 2019 Coronavirus Disease. In this report, we highlight the roles played by the Infection Prevention and Control Committee of the University of Medical Sciences Teaching Hospital to prevent the spread of COVID-19 within and outside the hospital community and the lessons learned to date. Keywords: COVID-19; infection prevention; infection control; Nigeria.

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