Journal Article > ResearchFull Text
PLoS Negl Trop Dis. 2018 December 7
Ingelbeen B, Weregemere NA, Noel H, Tshapenda G, Mossoko M, et al.
PLoS Negl Trop Dis. 2018 December 7
Background
Between December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas
of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in
DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of
cases in future urban outbreaks.
Methodology/Principal findings
In DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever
onset and was confirmed by either IgM serology or PCR for YF viral RNA. We used case
investigation and hospital admission forms. Comparing clinical signs between confirmed
and discarded suspected YF cases, we calculated the predictive values of each sign for confirmed YF and the diagnostic accuracy of several suspected YF case definitions. Fifty seven
of 78 (73%) confirmed cases had travelled from Angola: 88% (50/57) men; median age 31
years (IQR 25–37). 15 (19%) confirmed cases were infected locally in urban settings in
DRC. Median time from symptom onset to healthcare consultation was 7 days (IQR 6–9), to
appearance of jaundice 8 days (IQR 7–11), to sample collection 9 days (IQR 7–14), and to
hospitalization 17 days (IQR 11–26). A case definition including fever or jaundice, combined
with myalgia or a negative malaria test, yielded an improved sensitivity (100%) and specificity (57%).
Conclusions/Significance
As jaundice appeared late, the majority of cases were diagnosed too late for supportive care
and prompt vector control. In areas with known local YF transmission, a suspected case definition without jaundice as essential criterion could facilitate earlier YF diagnosis, care and control.
Between December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas
of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in
DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of
cases in future urban outbreaks.
Methodology/Principal findings
In DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever
onset and was confirmed by either IgM serology or PCR for YF viral RNA. We used case
investigation and hospital admission forms. Comparing clinical signs between confirmed
and discarded suspected YF cases, we calculated the predictive values of each sign for confirmed YF and the diagnostic accuracy of several suspected YF case definitions. Fifty seven
of 78 (73%) confirmed cases had travelled from Angola: 88% (50/57) men; median age 31
years (IQR 25–37). 15 (19%) confirmed cases were infected locally in urban settings in
DRC. Median time from symptom onset to healthcare consultation was 7 days (IQR 6–9), to
appearance of jaundice 8 days (IQR 7–11), to sample collection 9 days (IQR 7–14), and to
hospitalization 17 days (IQR 11–26). A case definition including fever or jaundice, combined
with myalgia or a negative malaria test, yielded an improved sensitivity (100%) and specificity (57%).
Conclusions/Significance
As jaundice appeared late, the majority of cases were diagnosed too late for supportive care
and prompt vector control. In areas with known local YF transmission, a suspected case definition without jaundice as essential criterion could facilitate earlier YF diagnosis, care and control.
Journal Article > Short ReportFull Text
Confl Health. 2014 July 3; Volume 8 (Issue 1); DOI:10.1186/1752-1505-8-9
Mancini S, Coldiron ME, Ronsse A, Ilunga BK, Porten K, et al.
Confl Health. 2014 July 3; Volume 8 (Issue 1); DOI:10.1186/1752-1505-8-9
Although measles mortality has declined dramatically in Sub-Saharan Africa, measles remains a major public health problem in countries like the Democratic Republic of Congo (DRC). Here, we describe the large measles epidemic that occurred in the Democratic Republic of Congo between 2010 and 2013 using data from the national surveillance system as well as vaccine coverage surveys to provide a snapshot of the epidemiology of measles in DRC.
Journal Article > ResearchFull Text
Confl Health. 2013 January 22; Volume 7 (Issue 1); DOI:10.1186/1752-1505-7-1
Polonsky JA, Ronsse A, Ciglenecki I, Rull M, Porten K
Confl Health. 2013 January 22; Volume 7 (Issue 1); DOI:10.1186/1752-1505-7-1
Following a rapid influx of over 200,000 displaced Somalis into the Dadaab refugee camp complex in Kenya, Médecins Sans Frontières conducted a mortality and nutrition survey of the population living in Bulo Bacte, a self-settled area surrounding Dagahaley camp (part of this complex).
Journal Article > Short ReportFull Text
J Infect Dis. 2017 January 15; DOI:10.1093/infdis/jiw493
Dornemann J, Burzio C, Ronsse A, Sprecher A, De Clerck H, et al.
J Infect Dis. 2017 January 15; DOI:10.1093/infdis/jiw493
A neonate born to an Ebola virus-positive woman was diagnosed with Ebola virus infection on her first day of life. The patient was treated with monoclonal antibodies (ZMapp), a buffy coat transfusion from an Ebola survivor, and the broad-spectrum antiviral GS-5734. On day 20, a venous blood specimen tested negative for Ebola virus by quantitative reverse-transcription polymerase chain reaction. The patient was discharged in good health on day 33 of life. Further follow-up consultations showed age-appropriate weight gain and neurodevelopment at the age of 12 months. This patient is the first neonate documented to have survived congenital infection with Ebola virus.
Journal Article > CommentaryFull Text
Emerg Infect Dis. 2017 July 1; Volume 23 (Issue 7); 1057-62.; DOI:10.3201/eid2307.161389
Fitzpatrick G, Decroo T, Draguez B, Crestani R, Ronsse A, et al.
Emerg Infect Dis. 2017 July 1; Volume 23 (Issue 7); 1057-62.; DOI:10.3201/eid2307.161389
Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare. Importantly, operational research questions were decided to a large extent by returning volunteers who had first-hand knowledge of the immediate issues facing teams in the field. Such a method is appropriate for an emergency medical organization. Many challenges were also identified while carrying out operational research across 3 different countries, including the basic need for collecting data in standardized format to enable comparison of findings among treatment centers.