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3 result(s)
Journal Article > Pre-PrintFull Text

The first line. Study on population of caregivers in contact with epidemic patients in the Sahel, the case of SARS-CoV-2

Research Square. 26 July 2024; DOI:10.21203/rs.3.rs-4675025/v1
Ramatoulaye HL, Ibrahim KD, Maiga MA, Alhassane Z, Aliane FA,  et al.
Research Square. 26 July 2024; DOI:10.21203/rs.3.rs-4675025/v1

INTRODUCTION

The health systems of countries in the South and the North have been directly affected by the COVID-19 pandemic. Healthcare workers have paid a high price. The aim of this study was to better describe the personnel who are on the front line when patients visit health care facilities and to analyze their risk factors for exposure, their perception of infection and the prevention practices implemented by these health care workers.


METHODS

A cross-sectional study was conducted over a 6-month period from October 2021 to March 2022 (i.e., at a distance from the index cases) among health care workers in 62 integrated health centers and five public urban hospitals in Niamey and Dosso. Information on socio-demographic characteristics, clinical symptoms, co-morbidities, knowledge and attitudes, and vaccination status was collected by means of a questionnaire. Blood samples were taken for serological analysis for each agent included.


RESULTS

A total of 733 agents were included, mostly women (628, 85.67%) with a mean age of 40.5 years. Only 5.5% (40/733) of the workers reported having been in contact with a positive case of Covid-19. The most common method of protection was the use of alcohol and soap for hand hygiene. 76% of them reported having been vaccinated against the SARS-CoV2 virus. However, only 7.7% reported having used a Covid-19 diagnostic test in the last few months. IgM and IgG COVID-19 serologies were positive in 1.2% and 92.2% of the health care workers, respectively, during the survey period.


CONCLUSION

In Niger, frontline health workers have been widely exposed to SARS CoV-2, but most of them don't think so. As a result, in their daily practice, they make poor use of means to prevent and control COVID-19 infection and rarely use diagnostic tests in case of illness. Vaccination was widely accepted by these staff, according to their statements.

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Journal Article > ResearchFull Text

Clinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea

N Engl J Med. 5 November 2014; Volume 372 (Issue 1); DOI:10.1056/NEJMoa1411249
Brah E, Lamah MC, Fletcher TE, Jacob S, Brett-Major D,  et al.
N Engl J Med. 5 November 2014; Volume 372 (Issue 1); DOI:10.1056/NEJMoa1411249
Background In March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date. Methods From March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors. Results Of 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed cases, the median age was 38 years (interquartile range, 28 to 46), 24 patients (65%) were men, and 14 (38%) were health care workers; among the health care workers, nosocomial transmission was implicated in 12 patients (32%). Patients with confirmed EVD presented to the hospital a median of 5 days (interquartile range, 3 to 7) after the onset of symptoms, most commonly with fever (in 84% of the patients; mean temperature, 38.6°C), fatigue (in 65%), diarrhea (in 62%), and tachycardia (mean heart rate, >93 beats per minute). Of these patients, 28 (76%) were treated with intravenous fluids and 37 (100%) with antibiotics. Sixteen patients (43%) died, with a median time from symptom onset to death of 8 days (interquartile range, 7 to 11). Patients who were 40 years of age or older, as compared with those under the age of 40 years, had a relative risk of death of 3.49 (95% confidence interval, 1.42 to 8.59; P=0.007). Conclusions Patients with EVD presented with evidence of dehydration associated with vomiting and severe diarrhea. Despite attempts at volume repletion, antimicrobial therapy, and limited laboratory services, the rate of death was 43%.More
Journal Article > LetterFull Text

Evidence-based guidelines for supportive care of patients with Ebola virus disease

Lancet. 17 October 2017; Volume 391 (Issue 10121); 700-708.; DOI:10.1016/S0140-6736(17)31795-6
Lamontagne F, Fowler RA, Adhikari NK, Murthy S, Brett-Major D,  et al.
Lancet. 17 October 2017; Volume 391 (Issue 10121); 700-708.; DOI:10.1016/S0140-6736(17)31795-6
The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units. Key recommendations include administration of oral and, as necessary, intravenous hydration; systematic monitoring of vital signs and volume status; availability of key biochemical testing; adequate staffing ratios; and availability of analgesics, including opioids, for pain relief.More