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Real Time Evaluation of the Ebola Control Programs in Guinea, Sierra Leone and Liberia. Final Report
The scope includes the assessment of activities to improve the response to affected populations, stakeholders, partners and donors, building on lessons learnt so far in this outbreak.
Situation analysis
Description of the disaster
An Ebola epidemic that started in March 2014 in Guinea has relentlessly continued to claim lives and to spread to other countries in West Africa. The current Ebola outbreak is the largest in hist
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ory and the first to affect multiple countries simultaneously. There have been over 24 000 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (table 1), with almost 10 000 reported deaths (outcomes for many cases are unknown). A total of 58 new confirmed cases were reported in Guinea, 0 in Liberia, and 58 in Sierra Leone in the 7 days to 8 March (4 days to 5 March for Liberia). Many experts believe that the official numbers substantially understate the size of the outbreak because of families' widespread reluctance to report cases. Because of the fluidity of movement of people between West Africa and several countries in the East African countries, especially Kenya and Ethiopia (who in turn have extensive interaction with other countries in the region in terms of human movement), the risk of an outbreak of Ebola in East Africa is as eminent as in any of the countries bordering the affected countries. The IFRC regional office intends to support National Societies to raise their Ebola preparedness and response capacity through training, technical support in planning and implementation of Ebola related activities, and coordination both within and outside the movement.
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Learn more about the Ebola virus and how to avoid it. Free online course.
Having completed this course the learner will be able to: - Describe what the Ebola virus is; - List the countries where the outbreak has occurred; - Explain what the signs a
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nd symptoms of an infection are; - Explain how an infection is treated; - Explain how to avoid becoming infected
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The GO training package was developed by the World Health Organization for use by staff, consultants and partners who are part of the emergency response, so that they can work safely as part of the teams working to bring the outbreak under control.
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Training outline:
Module 1: Pre-deployment training
Module 2: Introduction to Ebola
Module 3: Global Ebola response
Module 4: Pillars of the global Ebola response
Module 5: Working with WHO
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Interim Guidance. This document provides guidance for: screening and triage of pregnant women in the context of an Ebola outbreak; infection prevention and control (IPC) precautions for pregnant women at risk of EVD transmission during childbirth
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and complication management; management of pregnant EVD cases, contacts and survivors; lactation and Ebola virus disease.
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The Toolkit is a library of technical tools and resources that have been constructed to support the implementation of national health plans during the recovery phase in the context of the Ebola outbreak. It brings together technical expertise and re
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sources on safe essential services into a single source
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PLoS Negl Trop Dis 10(3): e0004530 -Published: March 2, 2016
This paper reviews the status of the Zika virus outbreak, including medical countermeasureoptions, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immun
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ology inform options and strategies available for medical countermeasure development and deployment.
Please download directly from the website Open Access: http://journals.plos.org/plosntds/article/asset?id=10.1371%2Fjournal.pntd.0004530.PDF
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The paper sets out the specific communication challenge posed by Ebola and why it was so difficult to get to grips with this in the early months of the outbreak. It thendocuments when the health communication response became more useful and explores
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what that tells us about effective media and communication. Finally, it offers recommendations to ensure that media and communication are used to their full potential during other disease outbreaks and humanitarian crisis
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This document summarizes Haiti's cholera situation as of November 16, 2016. Between January and October 2016, Haiti reported 35,203 new suspected cholera cases (32% increase from 2015) and 369 deaths (56% increase). After Hurricane Matthew, cases rose dramatically, with 52% of new cases concentrated
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in Grand'Anse and South departments. Since the 2010 outbreak began, Haiti had experienced 797,000 total cases and 9,353 deaths. The report identifies key factors contributing to cholera persistence: weak water and sanitation infrastructure, limited healthcare access, underfunding, population density, and mobility. Despite concerning trends, humanitarian partners were cautiously optimistic as a feared nationwide outbreak following Hurricane Matthew had not materialized, and a vaccination campaign was underway. However, the cholera response was significantly underfunded, with only 42% of requested funds received.
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Integrating Clinical Research into Epidemic Response: The Ebola Experience
Gerald Keusch, Keith McAdam, Patricia Cuff, Michelle Mancher, and Emily R. Busta
National Academies of Sciences, Engineering, and Medicine
(2017)
C1
The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Repub
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lic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014–2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak.
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Emerg Infect Dis. 2017 Aug (Accessed July 18,2017)
Abstract: We report 77 cases of occupational exposures for 57 healthcare workers at the Ebola Treatment Center in Conakry, Guinea, during the Ebola virus disease outbreak in 2014-2015. Despite the
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high incidence of 3.5 occupational exposures/healthcare worker/year, only 18 percent of workers were at high risk for transmission, and no infections occurred.
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The GTFCC Laboratory Support for Public Health Surveillance document provides guidelines on using DNA-based molecular techniques for identifying and monitoring Vibrio cholerae strains in cholera outbreaks. It highlights the importance of genetic sequencing for tracking transmission, detecting new va
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riants, and improving outbreak response. The report explains methods like PCR testing, whole genome sequencing (WGS), and multiple loci VNTR analysis (MLVA), detailing their advantages and applications. It also outlines best practices for sample collection, storage, and transportation, emphasizing collaboration between national and international laboratories to enhance cholera surveillance and control efforts.
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The WHO Cholera Rapid Diagnostic Test (RDT) Target Product Profile outlines the key requirements for developing improved cholera RDTs. It highlights the need for fast, accurate, and easy-to-use tests for early outbreak detection in resource-limited
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settings. The document sets desired and acceptable performance criteria, including high sensitivity and specificity, rapid results (under 15 minutes), and usability by non-laboratory personnel. The tests should be affordable, stable in extreme conditions, and require minimal training. The goal is to enhance cholera surveillance and outbreak response, ensuring quick containment and improved public health outcomes.
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In January 2018, over 10,000 people fled their homes following clashes reported in multiple locations in Jonglei, including Yuai, Pultruk, Payai, Kuer-nyuon, Pieri, Waat and Walgak. Some crossed to
Ethiopia, where 2,300 people registered as refugees in the Gambela region. There were several report
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s of people returning from displacement camps and refugee settlements in Uganda to locations in
Central Equatoria, including Lainya, Kajo-keji, Morobo and Yei, as well as reports of movement from Sudan to Bentiu, Unity. However, partners are working to verify these reports; population movements
remain difficult to track and patterns hard to discern. About 5.1 million people were estimated to be severely food insecure between January and March 2018, including 20,000 who are facing catastrophic conditions. According to assessments conducted in January in the Baggari area, Wau County, malnutrition has improved compared to the same period last year, with surveys showing GAM rates of
about 2.8 per cent in Mboro and 3.6 per cent in Farajallah. Last year, Baggari was among locations which surpassed the WHO emergency threshold of 15 percent of the population malnourished. In
January, there were no new reports of cholera cases in South Sudan, marking a continued decline in the outbreak that was declared in June 2016.
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Lassa fever, a viral haemorrhagic fever with symptoms similar to those of Ebola virus disease, is endemic in much of West Africa and usually sparks a seasonal outbreak from December to March. Humans usually become infected with Lassa virus from expo
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sure to urine and faeces of infected Mastomys rats. Lassa virus may also be spread between humans through direct contact with the blood, urine, faeces or other bodily secretions of a person infected with Lassa fever.
These materials provide a general introduction to Lassa fever and are intended for personnel responding to outbreaks in complex emergencies or in settings where the basic environmental infrastructures have been damaged or destroyed.
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Adaptation and roll-out of Epidemic Control for Volunteers’ (ECV) Toolkit and Training Manual in Myanmar
The ECV Toolkit ensures that volunteers have the proper training and essential communication tools (among other materials) before they are engaged in ... outbreak and epidemic response in their communities. It is known that in the middle of an outbreak or epidemic, volunteers have limited time to remember everything they have learned during trainings, or to develop effective response – the ECV Toolkit is therefore designed as a set of practical, easy-to-follow tools to be easily picked up and followed. more
The ECV Toolkit ensures that volunteers have the proper training and essential communication tools (among other materials) before they are engaged in ... outbreak and epidemic response in their communities. It is known that in the middle of an outbreak or epidemic, volunteers have limited time to remember everything they have learned during trainings, or to develop effective response – the ECV Toolkit is therefore designed as a set of practical, easy-to-follow tools to be easily picked up and followed. more
The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera
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outbreak followed, leading to 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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The official death toll had risen to 493 people as of 29 March, according to the Government.
A new cholera outbreak was reported in Nhamatande; nine Cholera Treatment Centres have been established in Beira and other locations.
More than 140,000 pe
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ople were displaced in 161 sites across Sofala (116 sites), Manica (27 sites), Zambezia (13 sites) Tete (5 sites); of whom more than 7,400 were identified as vulnerable, according to the Government.
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Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201
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6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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PLoSONE 14(9):e0223104.https://doi.org/10.1371/journal.pone.0223104.
The survey centering on reasons behind community resistance was conducted in Butembo in November during a time of Ebola transmission. A researcher from Catholic University of Graben in Butembo and collaborators at the University o
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f Alberta in Edmonton published their findings on Sep 26 in PLOS One.
To spark focus group discussions, the researchers used an 18-item questionnaire based on similar ones used during West Africa's outbreak in Guinea, where community resistance and episodes of violence also complicated the outbreak response.
Participants were a convenience sample of 670 adults from the region who were recruited by medical students at Catholic University of Graben. Those surveyed included clinicians, community members, and displaced persons.
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