Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.009
Filtrar
2.
Artículo en Inglés | MEDLINE | ID: mdl-33167397

RESUMEN

Improving maternal outcomes and reducing pregnancy morbidity and mortality are critical public health goals. The provision of quality antenatal care (ANC) is one method of doing so. Increasing women's empowerment is associated with positive women's health outcomes, including the adequate timing and amount of ANC use. However, little is known about the relationship between women's empowerment and quality ANC care. Despite a history of political instability, low women's equality and poor maternal health, the Republic of Guinea has committed to improving the status of women and access to health. However, the 2014 Ebola outbreak may have had a negative impact on achieving these goals. This study sought to examine factors in the relationship between women's empowerment and the receipt of quality ANC (indicated by the number of health components) within the context of the Ebola outbreak. This study conducted multiple logistic regressions examining associations between covariates and the number of ANC components received using data from the 2012 and 2018 Guinea Demographic Health Surveys. Several aspects of women's empowerment (healthcare decision-making, literacy/access to magazines, monogamous relationship status, contraceptive use, socio-economic status/employment) were significantly linked with the receipt of a greater number of ANC components, highlighting the importance of women's empowerment in accessing quality maternity care.


Asunto(s)
Fiebre Hemorrágica Ebola/epidemiología , Servicios de Salud Materna , Brotes de Enfermedades , Femenino , Guinea/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Embarazo , Atención Prenatal , Factores Socioeconómicos
9.
Yale J Biol Med ; 93(4): 579-585, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33005122

RESUMEN

Not only do epidemics such as HIV/AIDS, Ebola Virus Disease (EVD), and the current Coronavirus Disease (COVID-19) cause the loss of millions of lives, but they also cost the global economy billions of dollars. Consequently, there is an urgent need to formulate interventions that will help control their spread and impact when they emerge. The education of young girls and women is one such historical approach. They are usually the vulnerable targets of disease outbreaks - they are most likely to be vehicles for the spread of epidemics due to their assigned traditional roles in resource-limited countries. Based on our work and the work of others on educational interventions, we propose six critical components of a cost-effective and sustainable response to promote girl-child education in resource-limited settings.


Asunto(s)
Enfermedades Transmisibles Emergentes , Infecciones por Coronavirus , Identidad de Género , Salud Global , Educación en Salud , Pandemias , Neumonía Viral , Betacoronavirus , Niño , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Países en Desarrollo , Femenino , Salud Global/economía , Salud Global/educación , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Educación en Salud/métodos , Educación en Salud/organización & administración , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Evaluación de Necesidades , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
10.
PLoS Negl Trop Dis ; 14(9): e0008556, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32925964

RESUMEN

Sexual transmission of Ebola virus (EBOV) is well established and has been implicated in multiple resurgences during the West African Ebola epidemic. Given the persistence of viral RNA in semen, guidelines from the World Health Organization (WHO) recommend abstinence or condom use for at least 1 year or until two semen PCR tests are negative. To better understand the impact of semen testing on sexual behavior, male EVD survivors were surveyed regarding their sexual behavior before and after semen testing. Of the 171 men who enrolled, 148 reported being sexually active following discharge from an ETU with 59% reporting episodes of condomless sex. At least one semen sample for testing was provided by 149 men and 13 of these men had EBOV RNA detected in their semen. When comparing sexual behaviors before and after semen testing, a positive semen test result had limited impact on behavior. Of those with seminal EBOV RNA detected, 61% reported no change in behavior pre- and post-semen testing with 46% engaging in condomless sex before and after testing and only 1 adopted safer sex behaviors following receipt of a positive result. Similarly, among men with undetectable EBOV in their semen, 66% reported no change in sexual behaviors with semen testing, with 55% forgoing condoms during sex. In only 11% was a negative semen result followed by abandoning condoms. There were no known sexual transmission events of Ebola virus in this cohort despite viral presence in semen during periods of condomless sex. This highlights the need to better understand the infectious potential of viral RNA persistence and determine what constitutes effective counseling for survivors and their partners.


Asunto(s)
Consejo , ARN Viral/análisis , Semen/virología , Conducta Sexual/psicología , Adolescente , Adulto , Portador Sano , Niño , Condones/estadística & datos numéricos , Ebolavirus , Fiebre Hemorrágica Ebola/prevención & control , Fiebre Hemorrágica Ebola/transmisión , Humanos , Liberia/epidemiología , Masculino , Persona de Mediana Edad , Conducta Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Sobrevivientes
11.
PLoS Negl Trop Dis ; 14(9): e0008539, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32956374

RESUMEN

During the initial phase of the 2014-2016 Ebola virus disease (EVD) outbreak in Monrovia, Liberia, all hospitals' isolation capacities were overwhelmed by the sheer caseload. As a stop-gap measure to halt transmission, Medecins sans Frontieres (MSF) distributed household disinfection kits to those who were at high risk of EVD contamination. The kit contained chlorine and personal protective materials to be used for the care of a sick person or the handling of a dead body. This intervention was novel and controversial for MSF. This paper shed the light on this experience of distribution in Monrovia and assess if kits were properly used by recipients. Targeted distribution was conducted to those at high risk of EVD (relatives of confirmed EVD cases) and health staff. Mass distributions were also conducted to households in the most EVD affected urban districts. A health promotion strategy focused on the purpose and use of the kit was integrated into the distribution. Follow-up phone calls to recipients were conducted to enquire about the use of the kit. Overall, 65,609 kits were distributed between September and November 2014. A total of 1,386 recipients were reached by phone. A total of 60 cases of sickness and/or death occurred in households who received a kit. The majority of these (46, 10%) were in households of relatives of confirmed EVD cases. Overall, usage of the kits was documented in 56 out of 60 affected households. Out of the 1322 households that did not experience sickness and/or death after the distribution, 583 (44%) made use of elements of the kit, mainly (94%) chlorine for hand-washing. At the peak of an EVD outbreak, the distribution of household disinfection kits was feasible and kits were appropriately used by the majority of recipients. In similar circumstances in the future, the intervention should be considered.


Asunto(s)
Desinfectantes , Promoción de la Salud/métodos , Fiebre Hemorrágica Ebola/prevención & control , Equipo de Protección Personal , Compuestos de Cloro , Brotes de Enfermedades/prevención & control , Ebolavirus , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Liberia
12.
Sci Rep ; 10(1): 15247, 2020 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-32943689

RESUMEN

Microbicides play critical roles in infection prevention and control of Ebola virus by decontaminating high-touch environmental surfaces (HITES), interrupting the virus-HITES-hands nexus. We evaluated the efficacy of formulations containing different microbicidal actives for inactivating Ebola virus-Makona strain (EBOV/Mak) on stainless-steel carriers per ASTM E2197-11. Formulations of sodium hypochlorite (NaOCl) (0.05-1%), ethanol (70%), chloroxylenol (PCMX) (0.12-0.48% by weight) in hard water, and a ready-to-use disinfectant spray with 58% ethanol (EDS), were tested at contact times of 0, or 0.5 to 10 min at ambient temperature. EBOV/Mak was inactivated (> 6 log10) by 70% ethanol after contact times ≥ 2.5 min, by 0.5% and 1% NaOCl or EDS (> 4 log10) at contact times ≥ 5 min, and by 0.12-0.48% PCMX (> 4.2 log10) at contact times ≥ 5 min. Residual infectious virus in neutralized samples was assessed by passage on cells and evaluation for viral cytopathic effect. No infectious virus was detected in cells inoculated with EBOV/Mak exposed to NaOCl (0.5% or 1%), PCMX (0.12% to 0.48%), or EDS for ≥ 5 min. These results demonstrate ≥ 6 log10 inactivation of EBOV/Mak dried on prototypic surfaces by EDS or formulations of NaOCl (≥ 0.5%), PCMX (≥ 0.12%), or 70% ethanol at contact times ≥ 5 min.


Asunto(s)
Antiinfecciosos/farmacología , Ebolavirus/efectos de los fármacos , Fiebre Hemorrágica Ebola/prevención & control , Inactivación de Virus/efectos de los fármacos , Animales , Chlorocebus aethiops , Efecto Citopatogénico Viral/efectos de los fármacos , Desinfectantes/farmacología , Ebolavirus/patogenicidad , Microbiología Ambiental , Etanol/farmacología , Fiebre Hemorrágica Ebola/transmisión , Fiebre Hemorrágica Ebola/virología , Humanos , Técnicas In Vitro , Porosidad , Hipoclorito de Sodio/farmacología , Propiedades de Superficie , Células Vero , Xilenos/farmacología
15.
PLoS One ; 15(8): e0238196, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32841291

RESUMEN

The need for an efficacious vaccine against highly pathogenic filoviruses was reinforced by the devastating 2014-2016 outbreak of Ebola virus (EBOV) disease (EVD) in Guinea, Sierra Leone, and Liberia that resulted in over 28,000 cases and over 11,300 deaths. In addition, the 2018-2020 outbreak in the Democratic Republic of the Congo currently has over 3,400 cases and over 2,200 deaths. A fully licensed vaccine and at least one other investigational vaccine are being deployed to combat this EVD outbreak. To support vaccine development and pre-clinical/clinical testing a Filovirus Animal Nonclinical Group (FANG) human anti-EBOV GP IgG ELISA was developed to measure anti-EBOV GP IgG antibodies. This ELISA is currently being used in multiple laboratories. Reported here is a characterization of an interlaboratory statistical analysis of the human anti-EBOV GP IgG ELISA as part of a collaborative study between five participating laboratories. Each laboratory used similar method protocols and reagents to measure anti-EBOV GP IgG levels in human serum samples from a proficiency panel consisting of ten serum samples created by the differential dilution of a serum sample positive for anti-GP IgG antibodies (BMIZAIRE105) with negative serum (BMI529). The total assay variability (inter- and intra-assay variability) %CVs observed at each laboratory ranged from 12.2 to 30.6. Intermediate precision (inter-assay variability) for the laboratory runs ranged from 8.9 to 21.7%CV and repeatability (intra-assay variability) %CVs ranged from 7.2 to 23.7. The estimated slope for the relationship between log10(Target Concentration) and the log10(Observed Concentration) across all five laboratories was 0.95 with a 90% confidence interval of (0.93, 0.97). Equivalence test results showed that the 90% confidence interval for the ratios for the sample-specific mean concentrations at the five individual labs to the overall laboratory consensus value were within the equivalence bounds of 0.80 to 1.25 for each laboratory and test sample, except for six test samples from Lab D, two samples from Lab B1, and one sample from Lab B2. The mean laboratory concentrations for Lab D were less than those from the other laboratories by 20% on average across the serum samples. The evaluation of the proficiency panel at these laboratories provides a limited assessment of assay precision (intermediate precision, repeatability, and total assay variability), dilutional linearity, and accuracy. This evaluation suggests that the within-laboratory performance of the anti-EBOV GP IgG ELISA as implemented at the five laboratories is consistent with the intended use of the assay based on the acceptance criteria used by laboratories that have validated the assay. However, the assessment of between-laboratory performance revealed lower observed concentrations at Lab D and greater variability in assay results at Lab B1 relative to other laboratories.


Asunto(s)
Anticuerpos Antivirales/sangre , Ebolavirus/inmunología , Ensayo de Inmunoadsorción Enzimática/normas , Fiebre Hemorrágica Ebola/inmunología , Proteínas Virales/inmunología , África Occidental/epidemiología , Animales , República Democrática del Congo/epidemiología , Brotes de Enfermedades , Vacunas contra el Virus del Ébola/inmunología , Vacunas contra el Virus del Ébola/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática/estadística & datos numéricos , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Inmunoglobulina G/sangre , Laboratorios , Variaciones Dependientes del Observador
17.
Syst Rev ; 9(1): 173, 2020 08 08.
Artículo en Inglés | MEDLINE | ID: mdl-32771035

RESUMEN

BACKGROUND: Healthcare workers (HCWs) are at particular risk during pandemics and epidemics of highly virulent diseases with significant morbidity and case fatality rate. These diseases include severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, Middle Eastern Respiratory Syndrome (MERS), and Ebola. With the current (SARS-CoV-2) global pandemic, it is critical to delineate appropriate contextual respiratory protection for HCWs. The aim of this systematic review was to evaluate the effect of powered air-purifying respirators (PAPRs) as part of respiratory protection versus another device (egN95/FFP2) on HCW infection rates and contamination. METHODS: Our primary outcomes included HCW infection rates with SARS-CoV-2, SARS-CoV-1, Ebola, or MERS when utilizing PAPR. We included randomized controlled trials, non-randomized controlled trials, and observational studies. We searched the following databases: MEDLINE, EMBASE, and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two reviewers independently screened all citations, full-text articles, and abstracted data. Due to clinical and methodological heterogeneity, we did not conduct a meta-analysis. Where applicable, we constructed evidence profile (EP) tables for each individual outcome. Confidence in cumulative evidence for each outcome was classified according to the GRADE system. RESULTS: We identified 689 studies during literature searches. We included 10 full-text studies. A narrative synthesis was provided. Two on-field studies reported no difference in the rates of healthcare workers performing airway procedures during the care of critical patients with SARS-CoV-2. A single simulation trial reported a lower level of cross-contamination of participants using PAPR compared to alternative respiratory protection. There is moderate quality evidence that PAPR use is associated with greater heat tolerance but lower scores for mobility and communication ability. We identified a trend towards greater self-reported wearer comfort with PAPR technology in low-quality observational simulation studies. CONCLUSION: Field observational studies do not indicate a difference in healthcare worker infection utilizing PAPR devices versus other compliant respiratory equipment. Greater heat tolerance accompanied by lower scores of mobility and audibility in PAPR was identified. Further pragmatic studies are needed in order to delineate actual effectiveness and provider satisfaction with PAPR technology. SYSTEMATIC REVIEW REGISTRATION: The protocol for this review was prospectively registered with the International Register of Systematic Reviews identification number CRD42020184724 .


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Personal de Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Dispositivos de Protección Respiratoria , Enfermedades Transmisibles , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Neumonía Viral/transmisión , Neumonía Viral/virología
18.
Trends Biotechnol ; 38(9): 943-947, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32600777

RESUMEN

Vaccine solutions rarely reach the public until after an outbreak abates; an Ebola vaccine was approved 5 years after peak outbreak and SARS, MERS, and Zika vaccines are still in clinical development. Despite massive leaps forward in rapid science, other regulatory bottlenecks are hamstringing the global effort for pandemic vaccines.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Aprobación de Drogas/organización & administración , Fiebre Hemorrágica Ebola/prevención & control , Gripe Humana/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Vacunas Virales/biosíntesis , Betacoronavirus/efectos de los fármacos , Betacoronavirus/inmunología , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Vacunas contra el Virus del Ébola/administración & dosificación , Vacunas contra el Virus del Ébola/biosíntesis , Ebolavirus/efectos de los fármacos , Ebolavirus/inmunología , Ebolavirus/patogenicidad , Europa (Continente)/epidemiología , Salud Global/tendencias , Regulación Gubernamental , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/inmunología , Fiebre Hemorrágica Ebola/virología , Humanos , Subtipo H1N1 del Virus de la Influenza A/genética , Subtipo H1N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/administración & dosificación , Vacunas contra la Influenza/biosíntesis , Gripe Humana/epidemiología , Gripe Humana/inmunología , Gripe Humana/virología , Coronavirus del Síndrome Respiratorio de Oriente Medio/efectos de los fármacos , Coronavirus del Síndrome Respiratorio de Oriente Medio/inmunología , Coronavirus del Síndrome Respiratorio de Oriente Medio/patogenicidad , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Neumonía Viral/virología , Virus del SRAS/efectos de los fármacos , Virus del SRAS/inmunología , Virus del SRAS/patogenicidad , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/inmunología , Síndrome Respiratorio Agudo Grave/prevención & control , Síndrome Respiratorio Agudo Grave/virología , Estados Unidos/epidemiología , Vacunas Virales/administración & dosificación , Virus Zika/efectos de los fármacos , Virus Zika/inmunología , Virus Zika/patogenicidad , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/inmunología , Infección por el Virus Zika/prevención & control , Infección por el Virus Zika/virología
20.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-32634005

RESUMEN

As the Coronavirus disease 2019 (COVID-19) pandemic has spread globally, with no effective treatment or vaccine yet available, governments in many countries have put in place social interventions to control the outbreak. The various lockdown measures may have devastating impacts on economies and livelihoods. This approach risks undermining public trust in government responses and therefore undermines efforts to promote behaviour change, which is key to the success of social interventions. Important lessons can be drawn from past Ebola outbreaks and the human immunodeficiency virus pandemic on how communities should be central to COVID-19 responses. Communities are complex and only their members can inform public health experts about their lived realities, the community's understanding of the outbreak and what will work locally to reduce transmission. The public should be encouraged to take positive actions to ensure their own health and well-being, rather than made to feel powerless. Communities should be supported to develop their own response plans, community leaders should be recognised as vital assets, community representatives should have equal inclusion in strategic meetings and greater empathy should be built into decision-making processes.


Asunto(s)
Betacoronavirus , Planificación en Salud Comunitaria/organización & administración , Participación de la Comunidad/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , África , Infecciones por VIH/prevención & control , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Salud Pública
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA