COPY OF Sustained Strengthening of Public Health Laboratory, Transfusion Services, and Health Care Worker Infection Control Practices for Ebola Virus Disease in Liberia

Description

Liberia is one of three West African nations most heavily affected by the Ebola virus disease (EVD). During the onset of EVD outbreak in Liberia, many hospitals and clinics were closed. As these facilities reopen it is imperative that Health Care Workers (HCW) remain vigilant to ensure that they are able to appropriately triage suspected EVD patients while protecting themselves from possible exposure. One of the highest risk groups for contracting EVD has been healthcare workers (HCW), with over 360 cases and 170 fatalities reported in this high-risk group in Liberia alone. This award will implement comprehensive Infection Prevention Control (IPC) training, as well as support and monitoring for Health Care Workers in Eastern Liberia. A second component of the award is to prioritize and strengthen clinical laboratory support that will provide more rapid diagnosis for EVD and other common illnesses in hospital laboratories and to support laboratory transport processes to reference laboratories. A major challenge is differentiating the diagnosis of Ebola which has non-specific initial symptoms such fever, vomiting, diarrhea from more common everyday diseases such as malaria, viral illnesses, or complicated pregnancy. Direct PCR testing or a rapid diagnostic within the hospital laboratory setting could play a crucial role in allowing patients with Ebola to be addressed appropriately. Another key component is to geographically align laboratories to maximize testing coverage, enhance transportation of specimens, and facilitate the development of more comprehensive testing, education, and training opportunities for Liberian laboratory technicians. In addition, this is an unparalleled opportunity to strengthen blood transfusion services for the country of Liberia. Convalescent plasma and whole blood have been used extensively for the treatment of Ebola on the basis that antibodies to Ebola virus within the plasma of survivors could confer immunity or partial immunity for the acutely ill EVD patient. While definitive studies have yet to prove the efficacy of convalescent plasma in controlled trials, for patients in the US during this epidemic, convalescent plasma has become an unofficial standard of treatment. Within Liberia, the Bill and Melinda Gates Foundation is currently funding an ongoing clinical trial at ELWA to test the efficacy of convalescent plasma. Improving donor collection and implementing component therapy allowing for the collection and storage of convalescent plasma could provide larger-scale life-saving therapy and potentially prophylaxis during this current outbreak in Liberia, as well as other affect West African nations, and if stored could help in the treatment of future outbreaks in the near-term or long-term.

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