Bolstering Community Cooperation in Ebola Resurgence Protocols: Combining Field Blood Draw and Point-of-Care Diagnosis

Fallah, Mosoka; Skrip, Laura; Raftery, Philomena; Kullie, Miata; Borbor, Watta M; Laney, A. Scott; Blackley, David J.; Christie, Athalia; Dokubo, E. Kainne; Lo, Terrence; Coulter, Stewart; Baller, April; Vonhm, Benjamin; Bemah, Philip; Lomax, Sowillie; Yeiah, Adolphus; Wapoe-Sackie, Yatta; Mann, Jennifer; Clement, Peter; Davies-Wayne, Gloria; Hamblion, Esther; Wolfe, Caitlin; Williams, Desmond E.; Gasasira, Alex; Kateh, Francis; Nyenswah, Tolbert; Galvani, Alison P.

doi:10.1371/journal.pmed.1002227

Cited by 15 publications

(17 citation statements)

References 27 publications

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Section: Discussionmentioning

confidence: 99%

“…Constant communication and timely sharing of information between the surveillance teams operating in the response zones and the laboratory coordination team facilitated efficient testing of suspect cases supporting contact tracing during both responses [ 14 , 37 ]. Results of priority specimens requested on suspect cases could be reported within 2–3 hours enabling implementation of effective response measures [ 14 , 37 ]. On many occasions, short turn-around-time to results prevented the need to transfer suspect cases to the ETU allowing patients to remain in the community or health care facility until a negative result was received [ 14 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Results of priority specimens requested on suspect cases could be reported within 2–3 hours enabling implementation of effective response measures [ 14 , 37 ]. On many occasions, short turn-around-time to results prevented the need to transfer suspect cases to the ETU allowing patients to remain in the community or health care facility until a negative result was received [ 14 , 37 ]. This reduced disruption to lives of the patients and subsequent costs for transport and ETU admission [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nucleic acid and viral antigen can be detected in blood within 3–10 days after the onset of symptoms [ 7 ]. In addition to case confirmation, EVD laboratory data informs contact tracing and emergency response interventions as well as patient management, clinical treatment and discharge decisions [ 5 , 7 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Raftery¹,

Condell²,

Wasunna

et al. 2018

PLoS Negl Trop Dis

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The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be integrated into other national diagnostic algorithms. The technology has on average a 2-hour sample-to-result time and allows for single specimen testing to overcome potential delays of batching. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Raftery¹,

Condell²,

Wasunna

et al. 2018

PLoS Negl Trop Dis

Self Cite

View full text Add to dashboard Cite

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“…To address the need for capacity strengthening in Liberia, Guinea, and Sierra Leone, Fogarty recently funded five grants in these countries (Table S2). These programs are desperately required to control Ebola resurgences, as have occurred multiple times in West Africa (4) since the World Health Organization declared these countries “Ebola free” following the 2014–2015 outbreak.…”

Section: Main Textmentioning

confidence: 99%

Fund global health: Save lives and money

Galvani

Fitzpatrick

Vermund³

et al. 2017

Science

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The Fogarty International Center of the National Institutes of Health (NIH) equips low and middle income countries with the expertise to contain epidemics at their source, concomitantly minimizing risk of spread to the U.S. Considering the comparative cost of a public health emergency response, such as Congressional appropriations during the Ebola outbreak, the Fogarty budget is overwhelmingly cost-effective. Nonetheless, the White House has proposed abolishing this crucial program. Support of the Fogarty Center should be a priority for the current Administration to secure the health of the American people.

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Empowering health systems research to engage with technical, organizational, social and economic forces: Lessons from the 2014 Ebola epidemic

Sambo

Jackson

2021

Syst Res Behav Sci

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This paper draws lessons from the Ebola Virus Disease epidemic to suggest how health systems research can be strengthened to assist better with preparedness for and mitigation of future public health emergencies. The epidemic killed more than 11 000 people in West Africa between February 2014 and January 2016. The causes of the epidemic and the response to the outbreak harbour many lessons concerning how health systems were overwhelmed and need to be re‐designed in order to cope with future public health emergencies and limit their escalation. From these lessons, it is possible to identify the most significant systemic issues that must be addressed to ensure health systems can exhibit greater resilience in the face of similar events in the future. The paper goes on to consider the current capacity of health systems research (HSR) to assist with the management of these issues and to suggest that critical systems thinking and practice could empower health systems researchers and practitioners in a manner that would give them much greater potency. The research has additional importance now that Covid‐19 has demonstrated that pandemics are not ‘black swan’ events.

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Bolstering Community Cooperation in Ebola Resurgence Protocols: Combining Field Blood Draw and Point-of-Care Diagnosis

Abstract: Alison Galvani and colleagues describe a community-based protocol to improve cooperation with Ebola testing as well as contact tracing, quarantining, and treatment.

Cited by 15 publications

References 27 publications

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Fund global health: Save lives and money

Empowering health systems research to engage with technical, organizational, social and economic forces: Lessons from the 2014 Ebola epidemic

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