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Health - West Africa MPHISE

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This working group is focused on discussions about health within the West Africa MPHISE.

The mission of this working group is to focus on discussions about health within the West Africa MPHISE.

Members

evakee John.R.Falco.VMD Kathy Gilbeaux mdmcdonald MDMcDonald_me_com

Email address for group

health_westafrica_mphise@m.resiliencesystem.org

Ebola Lying in Wait

NEW YORK TIMES by Pam Belluck and William J. Broad     April 20, 2015

A growing body of scientific clues — some ambiguous, others substantive — suggests that the Ebola virus may have lurked in the West African rain forest for years, perhaps decades, before igniting the deadly epidemic that swept the region in the past year, taking more than 10,000 lives.

Around 2004 at a government hospital in Kenema, Sierra Leone, a team of American scientists and West African medical personnel found what appeared to be Ebola antibodies in nearly 9 percent of blood samples. Credit Carl De Souza/Agence France-Presse — Getty Images

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Social Pathways for Ebola Virus Disease in Rural Sierra Leone, and Some Implications for Containment

PLOS     by Paul Richards and others                                                          April. 17,  2015                  
The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact.

 Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed.

 The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic—the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure.

 Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties.

http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003567

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Signs Ebola Spreads in Sex Prompt a C.D.C. Warning

NEW YORK TIMES  by SHeri Fink                                                                                  April 20, 2015
The Centers for Disease Control and Prevention revised its guidelines on Ebola transmission on Sunday night, urging survivors to abstain from all forms of sex or use condomsevery time “until more information becomes available,” rather than three months as previously recommended.

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Pesticides likely behind 'mysterious killer disease' in Nigeria

Deutsche Welle                                                                            April 19, 2015

 Eighteen people died under mysterious circumstances in southwest Nigeria this week, sparking fears of a new infectious disease outbreak. Weed killer was the likely cause, the World Health Organization has now said.

When over a dozen men in the village of Ode Irele in southwestern Ondo state who complained of similar symptoms all died within a day, alarm bells began to ring. However, according to the World Health Organization (WHO), there is no reason to suspect any outbreak of infectious disease, such as Ebola, which has claimed over 10,000 lives in Sierra Leone, Guinea and Liberia.

The "current hypothesis is herbicides," WHO spokesman Gregory Hartl said on Sunday, adding: "Tests done so far are negative for viral and bacterial infection."

The victims began showing symptoms between April 13 and 15, including blurred vision and loss of consciousness, and Ondo spokesman Kayode Akinmade said it was due to a "mysterious killer disease."

Read complete story

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Evaluating Clinical Trial Designs for Investigational Treatments of Ebola Virus Disease

PLOS MEDICINE   by Ben Cooper and others                                                             April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

Read complete study.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815

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Ebola: World Bank Group Provides New Financing to Help Guinea, Liberia and Sierra Leone Recover from Ebola Emergency

THE WORLD BANK                                                                           April 17, 2015

New GDP Estimates Show International Support Vital to Speed Recovery

WASHINGTON--The World Bank Group (WBG) announced today that it would provide at least US$650 million during the next 12 to 18 months to help Guinea, Liberia and Sierra Leone recover from the devastating social and economic impact of the Ebola crisis and advance their longer-term development needs. The new WBG pledge brings the organization’s total financing for Ebola response and recovery efforts to date to US$1.62 billion.

The additional funding announcement comes as the WBG releases new GDP estimates showing that the Ebola epidemic continues to cripple the economies of Guinea, Liberia and Sierra Leone. Estimated GDP losses for the three countries in 2015 rose to US$2.2 billion: US$240 million for Liberia, US$535 million for Guinea and US$1.4 billion for Sierra Leone. In addition to the severe effects of Ebola, the economic downturn in the three countries is aggravated by the sharp decline in global iron ore prices, as well as the collapse of the mining sector in Sierra Leone...

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"Exhausted" Liberia struggles with long Ebola 'to do' list -

REUTERS  by Astrid Zweynert                                                                 April 17, 2015

OXFORD, England-- Treating trauma and the mental health issues of Ebola survivors is one of the many challenges facing "exhausted" Liberia, a senior health ministry official said.

Liberia has weathered the worst ever outbreak of Ebola, which has killed more than 10,600 people and infected 25,791, more successfully than its neighbours Sierra Leone and Guinea....

"Our country is exhausted. We still have huge needs," said Miatta Gbanya, deputy incident manager of Ebola response at the Liberian healthy ministry.

"The mental health of survivors, of health care workers need addressing. That's just one thing - there is still a lot to be done," she told the Thomson Reuters Foundation....

 The Liberian government has been analysing its response to the Ebola epidemic and ways it could prevent similar outbreaks in the future, including investing some of the aid it has received into the healthcare system, Gbanya said.

Read complete story.

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Dramatic’ progress in fighting Ebola must be followed by long-term recovery efforts

UNITED NATIONS NEWS CENTRE                                                      April 16, 2015

WASHINGTON  --Intense efforts to control the Ebola outbreak in the three most-affected West African countries in will continue, the United Nations health chief said in Washington, DC today, adding that the international community is also looking for ways to build on dramatic recent progress by aiding with efforts aimed at recovery from the outbreak.

Tuesday 14 April 2015 was a happy day in Sierra Leone as children returned to school after many months             away, due to the Ebola outbreak. Photo: WHO/N. Alexander

“The goal is to help people and their communities to return to a normal life again,” said Margaret Chan, Director-General of the World Health Organization (WHO). “It means that children are going back to school, women can once again shop in their local markets, and livelihoods are restored.”

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Ebola Fighters Say Now Is Not the Time to Let Up

 Cases may be nearing zero in certain areas, but the threat of the disease lingers

 TIME MAGAZINE  by Maya Rhodan                                                   April 16, 2015

There were only 37 confirmed cases of Ebola last week, just a year after the deadly virus was spreading quickly across Western Africa. But key stakeholders in the effort to reduce the number of cases to zero said Thursday that success is not guaranteed.

President Barack Obama, flanked by Liberian President Ellen Johnson Sirleaf, left, and Guinean President Alpha Condé, speaks in the Cabinet Room of the White House in Washington, Wednesday, April 15, 2015, to discuss the progress made in the international Ebola response. Manuel Balce Ceneta—AP

“We are dealing now with the most difficult areas,” said Bruce Aylward, the assistant director-general of polio and emergencies at the World Health Organization. “We’re dealing with issues of fear, of trust with communities that have been marginalized. That have not been fully engaged.”

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Turning the Page on Ebola

Joint Statement by Presidents Alpha Condé  of Guinea, Ernest Bai Koroma  of Sierra Leone. and Ellen Johnson Sirleaf of Liberia 

 PROJECT SYNDICATE   COMMENTARY                                                                                       April 16, 2015

....The uncontrolled spread of the disease exposed the shortcomings of our national health care systems, as well as regional and global institutions’ weak capacity for coordination and effective response. Simply put, we were ill prepared to cope with, much less prevent, an outbreak on this scale.

We bear a collective responsibility for the thousands of lives lost to Ebola and the tens of thousands affected by the disease. And, today, thanks to institutional improvement and adaptation, we are closer to winning the fight against Ebola. Although the disease has not been contained and eradicated throughout the region, its spread has slowed; now we have to start planning our recovery, which must include strengthening the national, regional, and international systems that protect our people’s lives and futures....

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