Implementation of a study to examine the persistence of Ebola virus in the body fluids of Ebola virus disease survivors in Sierra Leone: Methodology and lessons learned,PLOS Neglected Tropical Diseases

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Implementation of a study to examine the persistence of Ebola virus in the body fluids of Ebola virus disease survivors in Sierra Leone: Methodology and lessons learned
PLOS Neglected Tropical Diseases ( IF 3.4 ) Pub Date : 2017-09-11 , DOI: 10.1371/journal.pntd.0005723
Gibrilla Fadlu Deen ₁ , Suzanna L R McDonald ₂ , Jaclyn E Marrinan ₂ , Foday R Sesay ₃ , Elizabeth Ervin ₄ , Anna E Thorson ₅ , Wenbo Xu _{6,

7} , Ute Ströher ₄ , Patricia Ongpin ₈ , Neetu Abad ₉ , Archchun Ariyarajah ₂ , Tasneem Malik ₁₀ , Hongtu Liu _{6,

7} , Christine Ross ₁₁ , Kara N Durski ₁₂ , Philippe Gaillard ₂ , Oliver Morgan ₁₃ , Pierre Formenty ₁₂ , Barbara Knust ₄ , Nathalie Broutet ₅ , Foday Sahr ₃ ,

Affiliation

Clinical Studies, Internal Medicine, Connaught Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone.
Comprehensive Care & Support for EVD Survivors, EVD Research, World Health Organization, Freetown, Sierra Leone.
34 Military Hospital, Sierra Leone Ministry of Defence, Freetown, Sierra Leone.
Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Department of Reproductive Health and Research, Family, Women's and Children's Health, World Health Organization, Geneva, Switzerland.
National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
Sierra Leone-China Friendship Biological Safety Laboratory, Chinese Center for Disease Control and Prevention, Freetown, Sierra Leone.
Strategic information, Joint United Nations Programme on HIV/AIDS, Freetown, Sierra Leone.
Social & Behavioral Research and Evaluation Branch, Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Office of Global Activities, Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
HIV Care and Treatment Branch, Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Pandemic and Epidemic Disease Department, Outbreaks and Health Emergencies, World Health Organization, Geneva, Switzerland.
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Background

The 2013–2016 West African Ebola virus disease epidemic was unprecedented in terms of the number of cases and survivors. Prior to this epidemic there was limited data available on the persistence of Ebola virus in survivors’ body fluids and the potential risk of transmission, including sexual transmission.

Methodology/Principal findings

Given the urgent need to determine the persistence of Ebola virus in survivors’ body fluids, an observational cohort study was designed and implemented during the epidemic response operation in Sierra Leone. This publication describes study implementation methodology and the key lessons learned. Challenges encountered during implementation included unforeseen duration of follow-up, complexity of interpreting and communicating laboratory results to survivors, and the urgency of translating research findings into public health practice. Strong community engagement helped rapidly implement the study during the epidemic. The study was conducted in two phases. The first phase was initiated within five months of initial protocol discussions and assessed persistence of Ebola virus in semen of 100 adult men. The second phase assessed the persistence of virus in multiple body fluids (semen or vaginal fluid, menstrual blood, breast milk, and urine, rectal fluid, sweat, saliva, tears), of 120 men and 120 women.

Conclusion/Significance

Data from this study informed national and global guidelines in real time and demonstrated the need to implement semen testing programs among Ebola virus disease survivors. The lessons learned and study tools developed accelerated the implementation of such programs in Ebola virus disease affected countries, and also informed studies examining persistence of Zika virus. Research is a vital component of the public health response to an epidemic of a poorly characterized disease. Adequate resources should be rapidly made available to answer critical research questions, in order to better inform response efforts.

中文翻译：

实施一项研究以检查埃博拉病毒在塞拉利昂埃博拉病毒病幸存者体液中的持久性：方法和经验教训

背景

就病例数和幸存者而言，2013-2016 年西非埃博拉病毒病流行是史无前例的。在这次流行病之前，关于埃博拉病毒在幸存者体液中的持续存在以及包括性传播在内的潜在传播风险的数据有限。

方法论/主要发现

鉴于迫切需要确定埃博拉病毒在幸存者体液中的持久性，在塞拉利昂的流行病应对行动中设计并实施了一项观察性队列研究。本出版物描述了研究实施方法和主要经验教训。实施过程中遇到的挑战包括无法预料的随访时间、向幸存者解释和传达实验室结果的复杂性以及将研究结果转化为公共卫生实践的紧迫性。强大的社区参与有助于在疫情期间迅速实施这项研究。该研究分两个阶段进行。第一阶段在最初的方案讨论后的五个月内启动，并评估了 100 名成年男性精液中埃博拉病毒的持久性。

结论/意义

该研究的数据实时为国家和全球指南提供信息，并证明有必要在埃博拉病毒病幸存者中实施精液检测计划。吸取的经验教训和开发的研究工具加速了此类计划在埃博拉病毒病影响国家的实施，并为检查寨卡病毒持续性的研究提供了信息。研究是公共卫生应对缺乏特征的疾病流行的重要组成部分。应迅速提供足够的资源来回答关键的研究问题，以便更好地为响应工作提供信息。

更新日期：2017-09-14

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