Repository logo
 

Ebola outbreak response; experience and development of screening tools for viral haemorrhagic fever (VHF) in a HIV center of excellence near to VHF epicentres.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Parkes-Ratanshi, Rosalind  ORCID logo  https://orcid.org/0000-0001-9297-1311
Elbireer, Ali 
Mbambu, Betty 
Mayanja, Faridah 
Coutinho, Alex 

Abstract

INTRODUCTION: There have been 3 outbreaks of viral hemorrhagic fever (VHF) in Uganda in the last 2 years. VHF often starts with non-specific symptoms prior to the onset of haemorrhagic signs. HIV clinics in VHF outbreak countries such as Uganda see large numbers of patients with HIV 1/2 infection presenting with non-specific symptoms every day. Whilst there are good screening tools for general health care facilities expecting VHF suspects, we were unable to find tools for use in HIV or other non-acute clinics. METHODS: We designed tools to help with communication to staff, infection control and screening of HIV patients with non-specific symptoms in a large HIV clinic during the outbreaks in Uganda. We describe our experiences in using these tools in 2 Ebola Virus Disease outbreaks in Uganda. RESULTS: During the Ebola Virus Disease (EVD) outbreaks, enhanced infection control and communication procedures were implemented within 24 hours of the WHO/Ministry of Health announcement of the outbreaks. During course of these outbreaks the clinic saw 12,544 patients with HIV 1/2 infection, of whom 3,713 attended without an appointment, suggesting new symptoms. Of these 4 were considered at risk of EVD and seen with full infection procedures; 3 were sent home after further investigation. One patient was referred to the National Referral Hospital VHF unit, but discharged on the same day. One additional VHF suspect was identified outside of a VHF outbreak; he was transferred to the National Referral Hospital and placed in isolation within 2 hours of arriving at the HIV clinic. DISCUSSION: Use of simple screening tools can be helpful in managing large numbers of symptomatic patients attending for routine and non-routine medical care (including HIV care) within a country experiencing a VHF outbreak, and can raise medical staff awareness of VHF outside of the epidemics.

Description

Keywords

Adult, Coinfection, Disease Outbreaks, Female, HIV Infections, Health Plan Implementation, Hemorrhagic Fever, Ebola, Humans, Male, Middle Aged, Outpatient Clinics, Hospital, Uganda

Journal Title

PLoS One

Conference Name

Journal ISSN

1932-6203
1932-6203

Volume Title

9

Publisher

Public Library of Science (PLoS)