Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea

Keïta, Mory; Chérif, Mahamoud Sama; Sivahera, Billy; Boland, Samuel; Banza-Mutoka, Freddy; Kourouma, Mamadou; Camara, A.; Sidibe, Youssouf; Kimenyi, Jean Paul; Diassy, Lamine; Loua, Angelo; Fofana, Ibrahima; Kandako, Youba; Onivogui, Dobo; Koivogui, Enogo; Millimono, Tamba Jacques; Diakite, Fode; Baldé, Mamadou Oury; Houndjo, Bienvenu; Nsenga, Ngoy; Talisuna, Ambrose; Délamou, Alexandre; Keiser, Olivia; Ki-Zerbo, Georges; Guèye, Abdou Salam

doi:10.4269/ajtmh.21-0713

Cited by 3 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, PCR testing of a 23-year-old man with suspected, but nonconfirmed EVD revealed Lassa virus disease and a COVID-19 co-infection ( Table 3 and Online Appendix 1 48 ). 43 This patient presented with comparable symptoms to EVD patients. On Day 2, he left the ECT against medical advice.…”

Section: Resultsmentioning

confidence: 67%

“…This patient had clinical and biochemical characteristics similar to EVD patients (Online Appendix 1 48 ). 3 , 4 , 43 Acute kidney injury was the predominant organ dysfunction in this patient, accompanied by elevated transaminases and signs of rhabdomyolysis, which then progressed to terminal multi-organ failure (MOF). 43 It can only be speculated if a COVID-19 co-infection contributed to this patient’s MOF.…”

Section: Discussionmentioning

confidence: 88%

“…Lassa and Marburg virus testing was included in the testing panel of patients with suspected EVD from the beginning of May 2021. 43 , 44…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease

Paré

Camara

et al. 2023

Southern African Journal of Infectious Diseases

Self Cite

View full text Add to dashboard Cite

Background: Experience from the Zaire Ebolavirus epidemic in the eastern Democratic Republic of the Congo (2018–2020) demonstrates that early initiation of essential critical care and administration of Zaire Ebolavirus specific monoclonal antibodies may be associated with improved outcomes among patients with Ebola virus disease (EVD).Objectives: This series describes 13 EVD patients and 276 patients with suspected EVD treated during a Zaire Ebolavirus outbreak in Guinea in 2021.Method: Patients with confirmed or suspected EVD were treated in two Ebola treatment centres (ETC) in the region of N’zérékoré. Data were reviewed from all patients with suspected or confirmed EVD hospitalised in these two ETCs during the outbreak (14 February 2021 – 19 June 2021). Ebola-specific monoclonal antibodies, were available 2 weeks after onset of the outbreak.Results: Nine of the 13 EVD patients (age range: 22–70 years) survived. The four EVD patients who died, including one pregnant woman, presented with multi-organ dysfunction and died within 48 h of admission. All eight patients who received Ebola-specific monoclonal antibodies survived. Four of the 13 EVD patients were health workers. Improvement of ETC design facilitated implementation of WHO-recommended ‘optimized supportive care for EVD’. In this context, pragmatic clinical training was integrated in routine ETC activities. Initial clinical manifestations of 13 confirmed EVD patients were similar to those of 276 patients with suspected, but subsequently non confirmed EVD. These patients suffered from other acute infections (e.g. malaria in 183 of 276 patients; 66%). Five of the 276 patients with suspected EVD died. One of these five patients had Lassa virus disease and a coronavirus disease 2019 (COVID-19) co-infection.Conclusion: Multidisciplinary outbreak response teams can rapidly optimise ETC design. Trained clinical teams can provide WHO-recommended optimised supportive care, including safe administration of Ebola-specific monoclonal antibodies. Pragmatic training in essential critical care can be integrated in routine ETC activities.Contribution: This article describes clinical realities associated with implementation of WHO-recommended standards of ‘optimized supportive care’ and administration of Ebola virus specific treatments. In this context, the importance of essential design principles of ETCs is underlined, which allow continuous visual contact and verbal interaction of health workers and families with their patients. Elements that may contribute to further quality of care improvements for patients with confirmed or suspected EVD are discussed.

show abstract

Section: Resultsmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease

Paré

Camara

et al. 2023

Southern African Journal of Infectious Diseases

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Was Guinea Better Prepared For the 2021 Evd Outbreak?mentioning

confidence: 99%

“…An alert was raised regarding the individual whose signs and symptoms of illness were commensurate with EVD infection followed prompt declaration of a Lassa fever epidemic and the rapid implementation of control measures to limit the virus' spread in Guinea. 44 In addition, a Marburg virus disease (MVD) outbreak was confirmed in Gueckedou on 9 August 2021. This is the first time it has been detected in Guinea and West Africa.…”

Section: Early Detection Of Other Epidemicsmentioning

confidence: 99%

Investing in preparedness for rapid detection and control of epidemics: analysis of health system reforms and their effect on 2021 Ebola virus disease epidemic response in Guinea

et al. 2023

Self Cite

View full text Add to dashboard Cite

The 2014–2016 West Africa Ebola Virus Disease (EVD) Epidemic devastated Guinea’s health system and constituted a public health emergency of international concern. Following the crisis, Guinea invested in the establishment of basic health system reforms and crucial legal instruments for strengthening national health security in line with the WHO’s recommendations for ensuring better preparedness for (and, therefore, a response to) health emergencies. The investments included the scaling up of Integrated Disease Surveillance and Response; Joint External Evaluation of International Health Regulation capacities; National Action Plan for Health Security; Simulation Exercises; One Health platforms; creation of decentralised structures such as regional and prefectural Emergency Operation Centres; Risk assessment and hazard identification; Expanding human resources capacity; Early Warning Alert System and community preparedness. These investments were tested in the subsequent 2021 EVD outbreak and other epidemics. In this case, there was a timely declaration and response to the 2021 EVD epidemic, a lower-case burden and mortality rate, a shorter duration of the epidemic and a significant reduction in the cost of the response. Similarly, there was timely detection, response and containment of other epidemics including Lassa fever and Marburg virus disease. Findings suggest the utility of the preparedness activities for the early detection and efficient containment of outbreaks, which, therefore, underlines the need for all countries at risk of infectious disease epidemics to invest in similar reforms. Doing so promises to be not only cost-effective but also lifesaving.

show abstract

How has Guinea learnt from the response to outbreaks? A learning health system analysis

et al. 2023

Self Cite

View full text Add to dashboard Cite

IntroductionLearning is a key attribute of a resilient health system and, therefore, is central to health system strengthening. The main objective of this study was to analyse how Guinea’s health system has learnt from the response to outbreaks between 2014 and 2021.MethodsWe used a retrospective longitudinal single embedded case study design, applying the framework conceptualised by Sheikh and Abimbola for analysing learning health systems. Data were collected employing a mixed methods systematic review carried out in March 2022 and an online survey conducted in April 2022.ResultsThe 70 reports included in the evidence synthesis were about the 2014–2016 Ebola virus disease (EVD), Measles, Lassa Fever, COVID-19, 2021 EVD and Marburg virus disease. The main lessons were from 2014 to 2016 EVD and included: early community engagement in the response, social mobilisation, prioritising investment in health personnel, early involvement of anthropologists, developing health infrastructure and equipment and ensuring crisis communication. They were learnt through information (research and experts’ opinions), action/practice and double-loop and were progressively incorporated in the response to future outbreaks through deliberation, single-loop, double-loop and triple-loop learning. However, advanced learning aspects (learning through action, double-loop and triple-loop) were limited within the health system. Nevertheless, the health system successfully controlled COVID-19, the 2021 EVD and Marburg virus disease. Survey respondents’ commonly reported that enablers were the creation of the national agency for health security and support from development partners. Barriers included cultural and political issues and lack of funding. Common recommendations included establishing a knowledge management unit within the Ministry of Health with representatives at regional and district levels, investing in human capacities and improving the governance and management system.ConclusionOur study highlights the importance of learning. The health system performed well and achieved encouraging and better outbreak response outcomes over time with learning that occurred.

show abstract

Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea

Cited by 3 publications

References 21 publications

Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease

Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease

Investing in preparedness for rapid detection and control of epidemics: analysis of health system reforms and their effect on 2021 Ebola virus disease epidemic response in Guinea

How has Guinea learnt from the response to outbreaks? A learning health system analysis

Contact Info

Product

Resources

About