Ebola Virus Disease in sub-Saharan Africa: Addressing Gaps to Handle Future Outbreaks

Between 2014 and 2016, the three West African countries of Guinea, Liberia and Sierra Leone experienced the deadliest Ebola virus disease (EVD) outbreak in sub-Saharan Africa. Two years later, a tenth epidemic recurred in the Democratic Republic of Congo (DRC), specifically in the North Kivu and Ituri provinces, which lasted until June 2020. Though they occurred in different countries, a review of how the EVD outbreaks in Guinea, Liberia, Sierra Leone, and the DRC were handled by the respective country governments, reveal gaps in disease detection, response and action due to lack of surveillance, an EVD preparedness plan, and weak health systems. This perspective discusses the EVD outbreaks in Guinea, Liberia, Sierra Leone, and the DRC, their effects, and draws attention to gaps that need to be addressed by these countries in order to be better prepared to handle future outbreaks. Acting on the proposed recommendations will not only benefit Guinea, Liberia, Sierra Leone, and the DRC in the future, but will be of benefit to EVD susceptible countries in sub-Saharan Africa, as we live in a global community where diseases are no respecters of boundaries.

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Mobile laboratories for rapid deployment and their contribution to the containment of emerging diseases in Sub-Saharan Africa, illustrated by the example of Ebola virus disease

Médecine et Santé Tropicales ◽

10.1684/mst.2015.0485 ◽

2015 ◽

Vol 25 (3) ◽

pp. 229-233 ◽

Cited By ~ 2

Author(s):

J. Diers ◽

B. Kouriba ◽

L. Ladan Fofana ◽

E. Fleischmann ◽

M. Starke ◽

...

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Emerging Diseases ◽

Sub Saharan Africa ◽

Ebola Virus Disease ◽

Sub Saharan ◽

Rapid Deployment

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COVID-19 Response in Sub-Saharan Africa: Lessons From Uganda

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.248 ◽

2020 ◽

Vol 14 (3) ◽

pp. e46-e48 ◽

Cited By ~ 1

Author(s):

Ivan Lumu

Keyword(s):

Decision Making ◽

Ebola Virus ◽

Virus Disease ◽

Sub Saharan Africa ◽

Disease Spread ◽

East African ◽

Limited Disease ◽

African Countries ◽

Response Team ◽

Sub Saharan

ABSTRACTThe prolongation of the Ebola epidemic may have allowed some countries to prepare and respond to the coronavirus disease (COVID-19) outbreak. In Uganda, the surveillance structure built for Ebola virus disease (EVD) has become a pillar in the COVID-19 response. This testing and tracing apparatus has limited disease spread to clusters with zero mortality compared with the neighboring East African countries. As more sub-Saharan countries implement social distancing to contain the outbreak, the interventions should be phased and balanced with health risk and socioeconomic situation. However, having a decision-making matrix would better guide the response team. These initial lessons from EVD-experienced Uganda may be helpful to other countries in the region.

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Ebola virus disease in West Africa: a call to overhaul health systems in sub-Saharan Africa

International Journal of Medical Science and Public Health ◽

10.5455/ijmsph.2015.03022015216 ◽

2015 ◽

Vol 4 (7) ◽

pp. 873 ◽

Cited By ~ 1

Author(s):

Samuel Munjita ◽

Mwaba Chileshe ◽

Sikaniso Mutemwa

Keyword(s):

West Africa ◽

Health Systems ◽

Ebola Virus ◽

Virus Disease ◽

Sub Saharan Africa ◽

Ebola Virus Disease ◽

Sub Saharan

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

International Journal of Travel Medicine and Global Health ◽

10.34172/ijtmgh.2020.17 ◽

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.

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Emergence of ebola virus disease and its devastating impact in poor-resourced areas of sub-Saharan Africa

Bayero Journal of Pure and Applied Sciences ◽

10.4314/bajopas.v9i1.5 ◽

2016 ◽

Vol 9 (1) ◽

pp. 25

Author(s):

O. Azeez-Akande

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Sub Saharan Africa ◽

Ebola Virus Disease ◽

Sub Saharan

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Bibliometric Analysis of Ebola Research Indexed in Web of Science and Scopus (2010-2020)

BioMed Research International ◽

10.1155/2020/5476567 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Joseph Kawuki ◽

Xiaojin Yu ◽

Taha Hussein Musa

Keyword(s):

Infectious Diseases ◽

Bibliometric Analysis ◽

Ebola Virus ◽

Web Of Science ◽

Democratic Republic Of Congo ◽

Virus Disease ◽

Ebola Virus Disease ◽

African Countries ◽

Double Blind ◽

Effective Prevention

Background. Within the past decade, Africa has faced several recurrent outbreaks of Ebola virus disease (EVD), including the 2014-2016 outbreak in West Africa and the recent 2018-2020 Kivu outbreak in the Democratic Republic of Congo. The study thus aimed at quantifying and mapping the scientific output of EVD research published within 2010-2020 though a bibliometric perspective. Methods. EVD-related publications from 2010 to 2020 were retrieved from the Web of Science (WoS) and Scopus databases by using the keywords ‘Ebola’, ‘Ebola Virus Disease’, ‘Ebolas’, and ‘ebolavirus’. Biblioshiny software (using R-studio cloud) was used to categorise and evaluate authors’, countries’ and journals’ contribution. VOSviewer was used for network visualisation. Results. According to the used search strategy, a total of 3865 and 3848 EVD documents were published in WoS and Scopus, respectively. The average citation per document was 16.1 (WoS) and 16.3 (Scopus). The results show an overall increase in the publication trend within the study period. The leading countries in EVD research were the USA and UK, with over 100 papers in both databases, including Nigeria and South Africa. NIAID and CDC-USA were the most influential institutions, while “Infectious Diseases” and “Medicine” were the most decisive research fields. The most contributing authors included Feldmann H and Qiu XG with over 60 papers in each database, while Journal of Infectious Diseases was the most crucial journal. The most cited article was from Aylward et al. published in 2014, while recent years displayed a keyword focus on “double-blind”, “efficacy”, “ring vaccination” and “drug effect”. Conclusion. This bibliometric analysis provides an updated historical perspective of progress in EVD research and has highlighted the role played by various stakeholders. However, the contribution of African countries and institutions is not sufficiently reflected, implying a need for increased funding and focus on EVD research for effective prevention and control.

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Syndromic detectability of haemorrhagic fever outbreaks

10.1101/2020.03.28.20019463 ◽

2020 ◽

Author(s):

Emma E. Glennon ◽

Freya L. Jephcott ◽

Alexandra Oti ◽

Colin J. Carlson ◽

Fausto A. Bustos Carillo ◽

...

Keyword(s):

Syndromic Surveillance ◽

Ebola Virus ◽

Virus Disease ◽

Sub Saharan Africa ◽

Ebola Virus Disease ◽

Published Data ◽

Case Definitions ◽

Clinical Criteria ◽

Health Infrastructure ◽

Sub Saharan

AbstractLate detection of emerging viral transmission allows outbreaks to spread uncontrolled, the devastating consequences of which are exemplified by recent epidemics of Ebola virus disease. Especially challenging in places with sparse healthcare, limited diagnostic capacity, and public health infrastructure, syndromes with overlapping febrile presentations easily evade early detection. There is a clear need for evidence-based and context-dependent tools to make syndromic surveillance more efficient. Using published data on symptom presentation and incidence of 21 febrile syndromes, we develop a novel algorithm for aetiological identification of case clusters and demonstrate its ability to identify outbreaks of dengue, malaria, typhoid fever, and meningococcal disease based on clinical data from past outbreaks. We then apply the same algorithm to simulated outbreaks to systematically estimate the syndromic detectability of outbreaks of all 21 syndromes. We show that while most rare haemorrhagic fevers are clinically distinct from most endemic fevers in sub-Saharan Africa, VHF detectability is limited even under conditions of perfect syndromic surveillance. Furthermore, even large clusters (20+ cases) of filoviral diseases cannot be routinely distinguished by the clinical criteria present in their case definitions alone; we show that simple syndromic case definitions are insensitive to rare fevers across most of the region. We map the estimated detectability of Ebola virus disease across sub-Saharan Africa, based on geospatially mapped estimates of malaria, dengue, and other fevers with overlapping syndromes. We demonstrate “hidden hotspots” where Ebola virus is likely to spill over from wildlife and also transmit undetected for many cases. Such places may represent both the locations of past unobserved outbreaks and potential future origins for larger epidemics. Finally, we consider the implications of these results for improved locally relevant syndromic surveillance and the consequences of syndemics and under-resourced health infrastructure for infectious disease emergence.

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Leveraging investments in Ebola preparedness for COVID-19 in Sub-Saharan Africa

AAS Open Research ◽

10.12688/aasopenres.13052.1 ◽

2020 ◽

Vol 3 ◽

pp. 3 ◽

Cited By ~ 4

Author(s):

Rodgers Ayebare ◽

Peter Waitt ◽

Stephen Okello ◽

Mubaraka Kayiira ◽

Maureen Atim Ajok ◽

...

Keyword(s):

Ebola Virus ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Central Africa ◽

Sub Saharan Africa ◽

African Countries ◽

Point Of Entry ◽

Sub Saharan ◽

Imminent Threat ◽

Clinical Case Management

The emergence of SARS-CoV-2 in China and transmission to more than 80 territories worldwide, including nine countries in Africa, presents a delicate situation for low-resource settings. Countries in Eastern and Central Africa have been on high alert since mid-2018 in anticipation of regional spread of the Ebola virus from the Democratic Republic of Congo. Significant investment has been made to support enhanced surveillance at point of entry and hospitals, infection control practices, clinical case management, and clinical research. With a new threat on the horizon, African countries have an opportunity to leverage the existing capacities for Ebola preparedness to brace for the imminent threat.

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