In early August, on the eve of the arrival of a medical team with free services, villagers gathered in groups of twos and threes, buzzing with tales of the wondrous Chinese doctors.

“Without them, I would have been dead” said Christophe Ndi Owona, the 76-year-old chief of the southern Cameroonian village of Ngat-Bane.

Before Chinese doctors came to his village, Owona had been suffering from severe headache for years. “Everybody thought I would die.”

The team gave him medicine and advised him to stop drinking alcohol, Owona told his folks. “Thanks to the Chinese, I am now as healthy as a baby.”

Ngat-Bane, like many other Cameroonian villages, has abundant wildlife and dispersed thatched huts, but zero hospitals. Villagers are often troubled by such health problems as rheumatism, typhoid, malaria, but most of them cannot afford medical services in Mbalmayo, the nearest town.

The next day, in the heartland of Ngat-Bane, a good number of patients from nearby villages gathered in a makeshift, but free and comprehensive clinic, lining up to see doctors from various departments, who are here as members of the 19th Chinese medical team to Cameroon.

For the first time in almost a year, 69-year-old Liliane Mfoumou felt relieved from her back injury after an acupuncture treatment. Before this, the mother of six had visited doctors several times in Mbalmayo, a major city in Cameroon’s Central Province.

“Medical checkups and treatments in hospitals are quite expensive, and I can’t afford them again,” Mfoumou said, expressing gratitude to the free clinic.

A Chinese acupuncturist inserted fine needles in Mfoumou’s skin at specific points. Thanks to this traditional Chinese method, which is applicable to many health conditions, Mfoumou said she “now can feel my back and legs.”

Michel Ndi has insomnia and heart problems, making it difficult for the 59-year-old to trek to his farm. He consulted almost all the specialists and was offered free treatments, including medicine, for his multiple conditions.

“Their kind and friendly manner heals you even before you start treatment,” said the father of 10 children, “I am sure that in the next two or three days, I will be able to go (to) the farm without difficulties.”

A total of 100 patients, aged from 20 months to 98 years, received diagnosis and treatments worth 1,500 U. S. dollars.

The free clinic ran for more than five consecutive hours, after which the folks offered the Chinese medical team a local dish called Kpem, a traditional meal made from cassava leaves.

China started to dispatch medical teams to Cameroon in 1975 and hundreds of medical professionals have worked in Cameroon since then.

Source: Xinhuanet

Two experimental Ebola drugs being tested in the Democratic Republic of Congo, where a yearlong outbreak has killed more than 1,800 people, have succeeded in raising the survival rate to around 90%, health authorities said Monday.

Scientists are a step closer to finding the first effective treatments for the deadly Ebola haemorrhagic fever after two potential drugs showed survival rate of as much as 90% in a clinical trial in Congo.

Two experimental drugs – Regeneron’s REGN-EB3 and a monoclonal antibody called mAb114 – were both developed using antibodies harvested from survivors of Ebola infection.

The treatments are now going to be offered to all patients in the Democratic Republic of Congo (DRC), according to U.S. National Institute of Allergy and Infectious Diseases.

They showed “clearly better” results in patients in a trial of four potential treatments being conducted during the world’s second largest Ebola outbreak in history, now entering its second year in DRC.

The drugs improved survival rates from the disease more than two other treatments being tested – ZMapp, made by Mapp Biopharmaceutical, and Remdesivir, made by Gilead Sciences – and those products will be now dropped, said Anthony Fauci, one of the researchers co-leading the trial.

The agency said 49% of the patients on ZMapp and 53% on remdesivir died in the study. In comparison, 29% of the patients on REGN-EB3 and 34% on mAb-114 died.

Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told reporters in a telebriefing the results were “very good news” for the fight against Ebola.

“What this means is that we do now have what look like (two) treatments for a disease for which not long ago we really had no approach at all,” he said.

The agency said of the patients who were brought into treatment centres with low levels of virus detected in their blood, 94% who got REGN-EB3 and 89% on mAb114 survived.

In comparison, two-third of the patients who got remdesivir and nearly three-fourth on ZMapp survived.

Ebola has been spreading in eastern Congo since August 2018 in an outbreak that has now become the second largest, killing at least 1,800 people. Efforts to control it have been hampered by militia violence and some local resistance to outside help.

A vast Ebola outbreak in West Africa become the world’s largest ever when it spread through Guinea, Liberia and Sierra Leone from 2013 to 2016 and killed more than 11,300 people.

The Congo treatment trial, which began in November last year, is being carried out by an international research group coordinated by the World Health Organization (WHO).

Mike Ryan, head of the WHO’s emergencies program, said the trial’s positive findings were encouraging but would not be enough on their own to bring the epidemic to an end.

“The news today is fantastic. It gives us a new tool in our toolbox against Ebola, but it will not in itself stop Ebola,” he told reporters.

Jeremy Farrar, director of the Wellcome Trust global health charity, also hailed the success of the trial’s findings, saying they would “undoubtedly save lives”.

“The more we learn about these two treatments, …the closer we can get to turning Ebola from a terrifying disease to one that is preventable and treatable,” he said in a statement.

“We won’t ever get rid of Ebola but we should be able to stop these outbreaks from turning into major national and regional epidemics.”

Some 681 patients at four separate treatment centres in Congo have already been enrolled in the Congo treatment clinical trial, Fauci said. The study aims to enrol a total of 725.

The decision to drop two of the trial drugs was based on data from almost 500 patients, he said, which showed that those who got REGN-EB3 or mAb114 “had a greater chance of survival compared to those participants in the other two arms”.

(REUTERS)

Health care providers have a legal and ethical duty for the care of their patients and are required, therefore, to provide care in a safe way and a harm-free environment. Routine clinical practice is expected to be based on knowledge, skills, judgment, and attitudes needed for safe patient care.The field of infection prevention and control for, example, isan area where the expectations are high as the field is characterized by guidelines and standards, and failure to comply with recommended guidelines will mean a failure to meet the appropriate standard of care.

Infection prevention and control practice has evolved significantly over the years and health care professionals need to stay abreast with the new scientific literature to adapt to changing guidelines. This is particularly important as the threat of emerging infectious diseases like Ebola, SARS, avian influenza and multidrug-resistance are on the rise.

The skill sets required for the effective application of infection prevention and control is therefore indispensable for safe and quality patient care amidst enormous clinical challenges. For example, environmental surfaces and equipment frequently become contaminated with germs and can serve as an indirect source of transmission to patients and staff. Surgical procedures may result in secondary infections from contaminated devices with either endogenous or exogenous microorganisms. Needle stick injuries may result in blood borne infections such as HIV, hepatitis B, and Hepatitis C. Gaps in vaccination coverage for vaccine-preventable diseases may result in an outbreak. Natural or man-made disasters may also increase the burden of communicable diseases. Also, catheter-associated urinary tract infections, central line-associated bloodstream infection, ventilator-associated pneumonia, and surgical site infections together referred to as healthcare-associated infections (HAIs)are increasingly prevalent inpatient care environments. These HAIs often result from gaps in the application of aseptic techniques and standard precautions.

Besides the problem of HAIs, the prevalence of infections caused by multidrug-resistant organisms is also on the rise. The problem of antimicrobial-resistant infection is further compounded by the following: the continuous reluctance of pharmaceutical companies to invest in the search for new antimicrobials because of fear of the potential development of resistance; regulatory difficulties faced by public health bodies to effectively control access and proper use of antimicrobials and fundamental challenges in antimicrobial stewardship programs. Consequently, considering that every infection prevented is one that needs no treatment, infection prevention and control is undoubtedly an attractive way to mitigate the spread of infections and reduce the global burden of infectious diseases.

Despite the need and relevance of infection prevention and control in quality patient care, the day-to-day application is sometime overlooked or missed by health care professionals,partly because of knowledge gaps, negligence, or busy shifts. Continuous education and training is necessary to reawaken awareness and improve compliance.

The purpose of this guide is to provide health care professionals and their organizations with a practical resource for infection prevention and control.Contained within the guide is an introduction to infections including HAIs and infections caused by multi drug-resistant organisms, how they are transmitted, methods to control the spread, antimicrobial stewardship, standard precautions, transmission precautions, emergency response, the environment of care, and equipment reprocessing.

Without proper training on how infections are transmitted, including infection prevention and control standards, health care professionals may unconsciously fail to adhere to standard precautions and guidelines and this may enhance the transmission of pathogens.  Therefore, health care workers need adequate knowledge of the infectious process and the application of both standard and transmission-based precautions along with an optimum environment of care. To maintain quality in practice, health care professionals must seek to continuously improve their knowledge in infection prevention and control, as well as remain constantly vigilant to emerging microbial threats.

I encourage all health care professionals to take advantage of this professional development opportunity to enhance their competency and improve patient care.

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About the author

Dr. Ayukekbong holds a Ph.D in medical science and is a board-certified infection preventionist (CIC). He is the founder and chief infection preventionist at EpiTech Public Health, Canada and also an instructor at Algonquin College, University of Ottawa. Through his organization, he has led the training of hundreds of health care professionals on infection prevention and control. His primary research interest is infectious disease surveillance and has published several papers within this field. He is a member of Infection prevention and control (IPAC) Canada and the Infection Control Africa Network (ICAN). He is a guest editor to the Canadian Journal of Infectious Diseases and Medical Microbiology, a member of the Editorial Board of the International Journal of Virology and AIDS, and also serves as an expert reviewer to several international scientific and public health journals.

Three Congolese medics have been detained over the murder of a World Health Organization (WHO) doctor who was fighting an Ebola outbreak in Democratic Republic of Congo, a military prosecutor said on Wednesday.

Cameroonian doctor Richard Valery Mouzoko Kiboung was shot dead on April 19 in an attack on a hospital in the eastern city of Butembo.

The arrested doctors will be prosecuted for “terrorism” and “criminal conspiracy,” Lieutenant-Colonel Jean-Baptiste Kumbu Ngoma, military prosecutor for Butembo in North Kivu province, told AFP.

The three are accused of holding meetings on April 14 to plot the assassination of Mouzoko, he added.

The WHO said Mouzoko had been deployed as part of a medical team to help rein in the Ebola outbreak which started last August in North Kivu.

The prosecutor said the doctors were “among the moral authors” of the attack on Mouzoko. He said one more doctor was being sought in the case.

In a letter to the mayor of Butembo, the local doctors’ association expressed indignation at the arrests and said they would go on strike if their colleagues were not released within 48 hours.

But the military prosecutor dismissed their demands as “out of the question”.

“It’s a delicate situation. As a man has died, we absolutely have know the truth about what happened,” the coordinator of the fight against Ebola in the DR Congo, Jean-Jacques Muyembe, told AFP.

More than 1,800 people have died from the virus in the past year.

The outbreak is the second deadliest on record, after the epidemic that struck West Africa in 2014-2016, which killed more than 11,300 people.

Efforts to roll back the highly contagious haemorrhagic fever have been hampered not only by fighting but also by resistance within communities to preventative measures, care facilities and safe burials.

Attacks on health workers have had a devastating effect, with seven murdered and more than 50 seriously hurt, according to an unofficial tally.

After the killing of Mouzoko in April, WHO chief Tedros Adhanom Ghebreyesus said: “We will not be intimidated… we will finish our work.”

Source: AFP

Malaria has killed more than 1,800 people in Burundi this year, the United Nations (UN)’s humanitarian agency says, a death toll rivaling a deadly Ebola outbreak in the neighboring Democratic Republic of the Congo.

In its latest situation report, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) said 5.7 million cases of malaria had been recorded in Burundi in 2019 — a figure roughly equal to half its entire population.

Of those cases, a total of 1,801 died from the mosquito-borne disease in Burundi between January 1 and July 21, OCHA said.

The tiny country of 11 million people in the African Great Lakes region has still not declared a national emergency, despite OCHA saying the outbreak crossed “epidemic proportions” in May.

“The national malaria outbreak response plan, which is currently being validated, has highlighted a lack of human, logistical and financial resources for effective response,” OCHA said in its latest weekly bulletin on humanitarian emergencies.

“All stakeholders, including the national authorities and partners are called upon to provide the requisite resources to mount a robust response to this event before it escalates.”

A lack of preventative measures like mosquito nets, climatic changes, and increased movements of people from mountain areas with low immunity to malaria were driving the crisis, OCHA said.

‘Many crises’

An OCHA official told AFP that “the decision to declare an epidemic is the sovereignty of the Burundian state.”

The country declared a malaria epidemic in March 2017, when it recorded 1.8 million cases and 700 deaths, but is resisting doing the same now.

A senior government official, who declined to be named, said the government did not want to admit weaknesses ahead of elections set for 2020.

“We are less than a year away from the presidential election. [President Pierre] Nkurunziza, who is facing many crises, does not want to recognize what could be considered a failure of his health policy,” the official told AFP.

Burundi has been in crisis since 2015, when Nkurunziza ran for a third term and was re-elected in elections boycotted by most of the opposition.

At least 1,200 people were killed and more than 400,000 displaced in violence the UN says was mostly carried out by state security forces.

Nkurunziza announced in 2018 that he would not stand again, confounding critics who accused him of working to extend his grip on power.

UN investigators said in July that “drastic” steps were needed to boost democratic freedoms in Burundi if the government wanted the elections to be considered credible.

Burundi, one of the poorest countries in the region, abuts the Democratic Republic of the Congo, where the second-worst Ebola outbreak in history has killed more than 1,800 people amid fears the infectious fever could spread beyond its borders.

But malaria is a much bigger killer on the continent.

The World Health Organization recorded nearly 220 million cases of the parasitic illness in 2017, with an estimated 435,000 deaths. More than 90 percent of malaria cases and deaths have been in Africa.

(Source: Agencies)