Institution
Donka Hospital
Healthcare•Conakry, Guinea•
About: Donka Hospital is a healthcare organization based out in Conakry, Guinea. It is known for research contribution in the topics: Ebola virus & Population. The organization has 18 authors who have published 13 publications receiving 869 citations.
Papers
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Donka Hospital1, University of Liverpool2, University of Washington3, Pasteur Institute4, University of North Carolina at Chapel Hill5, Université de Sherbrooke6, Tulane University7, Naval Medical Research Unit Six8, Médecins Sans Frontières9, University of Nebraska Medical Center10, World Health Organization11, Central Manchester University Hospitals NHS Foundation Trust12, University of Toronto13
TL;DR: Patients with EVD presented with evidence of dehydration associated with vomiting and severe diarrhea, and despite attempts at volume repletion, antimicrobial therapy, and limited laboratory services, the rate of death was 43%.
Abstract: BackgroundIn March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date. MethodsFrom March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors. ResultsOf 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed cases, the median age was 38 years (interquartile range, 28 to 46), 24 patients (65%) were men, and 14 (38%) were health care workers; among the health care workers, nosocomial transmission was implicated in 12 patients (32%). Patients with confirmed EVD presented to the hospital a median of 5 days (interquartile range, 3 to 7) after t...
335 citations
University of Toronto1, Liverpool School of Tropical Medicine2, University of North Carolina at Chapel Hill3, Université de Sherbrooke4, University of Washington5, World Health Organization6, Naval Medical Research Center7, Tulane University8, University of London9, University of Calgary10, Donka Hospital11, Nihon University12, University of Manchester13
TL;DR: Ebola virus disease represents an illness ready for a paradigm shift in care delivery and outcomes, and the profession of critical care medicine can and should be instrumental in helping this happen.
Abstract: The largest ever Ebola virus disease outbreak is ravaging West Africa. The constellation of little public health infrastructure, low levels of health literacy, limited acute care and infection prevention and control resources, densely populated areas, and a highly transmissible and lethal viral infection have led to thousands of confirmed, probable, or suspected cases thus far. Ebola virus disease is characterized by a febrile severe illness with profound gastrointestinal manifestations and is complicated by intravascular volume depletion, shock, profound electrolyte abnormalities, and organ dysfunction. Despite no proven Ebola virus-specific medical therapies, the potential effect of supportive care is great for a condition with high baseline mortality and one usually occurring in resource-constrained settings. With more personnel, basic monitoring, and supportive treatment, many of the sickest patients with Ebola virus disease do not need to die. Ebola virus disease represents an illness ready for a paradigm shift in care delivery and outcomes, and the profession of critical care medicine can and should be instrumental in helping this happen.
195 citations
French Institute of Health and Medical Research1, Bernhard Nocht Institute for Tropical Medicine2, Donka Hospital3, Paris Diderot University4, University of London5, University College London6, Katholieke Universiteit Leuven7, Public Health England8, Robert Koch Institute9, University of Liverpool10, Technische Universität München11, Heinrich Pette Institute12, University of Southampton13
TL;DR: Using the biostatistical model, it is predicted that 50% and 90% of male survivors clear Ebola virus RNA from seminal fluid at 115 days (90% prediction interval 72-160) and 294 days (212-399) after disease onset, respectively, and the number of men positive for Ebola virusRNA in affected countries would decrease from about 50 in January 2016, to fewer than 1 person by July, 2016.
99 citations
University of Toronto1, University of North Carolina at Chapel Hill2, Centers for Disease Control and Prevention3, Liverpool School of Tropical Medicine4, Defence Medical Services5, Sunnybrook Health Sciences Centre6, Université de Sherbrooke7, University of Washington8, University of Maryland, Baltimore9, University of British Columbia10, College of Health Sciences, Bahrain11, Donka Hospital12, Tulane University13, Uniformed Services University of the Health Sciences14, World Health Organization15, Royal Free London NHS Foundation Trust16, Derriford Hospital17, Emory University Hospital18
TL;DR: This experience emphasizes that, in addition to evaluating specific medical treatments, improving the global capacity to provide supportive critical care to patients with EVD may be the greatest opportunity to improve patient outcomes.
Abstract: As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa. EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury. Hypoxia and ventilation failure occurs most often with severe illness and may be exacerbated by substantial fluid requirements for intravascular volume repletion and some degree of systemic capillary leak. Although minor bleeding manifestations are common, hypovolemic and septic shock complicated by multisystem organ dysfunction appear the most frequent causes of death. Males and females have been equally affected, with children (0–14 years of age) accounting for 19 %, young adults (15–44 years) 58 %, and older adults (≥45 years) 23 % of reported cases. While the current case fatality proportion in West Africa is approximately 40 %, it has varied substantially over time (highest near the outbreak onset) according to available resources (40–90 % mortality in West Africa compared to under 20 % in Western Europe and the USA), by age (near universal among neonates and high among older adults), and by Ebola viral load at admission. While there is no Ebola virus-specific therapy proven to be effective in clinical trials, mortality has been dramatically lower among EVD patients managed with supportive intensive care in highly resourced settings, allowing for the avoidance of hypovolemia, correction of electrolyte and metabolic abnormalities, and the provision of oxygen, ventilation, vasopressors, and dialysis when indicated. This experience emphasizes that, in addition to evaluating specific medical treatments, improving the global capacity to provide supportive critical care to patients with EVD may be the greatest opportunity to improve patient outcomes.
91 citations
National Institutes of Health1, University of Toronto2, Carlos III Health Institute3, Donka Hospital4, Boston University5, Robert Koch Institute6, University of Oslo7, Uniformed Services University of the Health Sciences8, Johns Hopkins University9, University of Nebraska Medical Center10, University of Antwerp11, Leidos12, Médecins Sans Frontières13, Complutense University of Madrid14, New York University15, National Institute for Health Research16, Klinikum St. Georg17, King's College London18, Utrecht University19, University College London20, Liverpool School of Tropical Medicine21, Royal Free London NHS Foundation Trust22, World Health Organization23, University of Geneva24, University of Marburg25, Laval University26, Emory University27, Makerere University28, Partners In Health29, Université de Sherbrooke30, Ben-Gurion University of the Negev31, Uganda Virus Research Institute32, Military Hospital33, University of British Columbia34, University of Kinshasa35, University of London36, University of Texas Medical Branch37, University of Paris38, Massachusetts Institute of Technology39, Tulane University40, Public Health Agency of Canada41, University of Pretoria42, Centers for Disease Control and Prevention43, University of North Carolina at Chapel Hill44, Goethe University Frankfurt45
TL;DR: The recent large outbreak of Ebola virus disease in Western Africa resulted in greatly increased accumulation of human genotypic, phenotypic and clinical data, and improved the understanding of the spectrum of clinical manifestations, so that the WHO disease classification of EVD underwent major revision.
Abstract: The recent large outbreak of Ebola virus disease (EVD) in Western Africa resulted in greatly increased accumulation of human genotypic, phenotypic and clinical data, and improved our understanding of the spectrum of clinical manifestations. As a result, the WHO disease classification of EVD underwent major revision.
69 citations
Authors
Showing all 19 results
| Name | H-index | Papers | Citations |
|---|---|---|---|
| Mamadou Saliou Sow | 12 | 36 | 1651 |
| Elhadj Ibrahima Bah | 11 | 14 | 1136 |
| Fodé Amara Traoré | 5 | 20 | 163 |
| T.M. Barry | 3 | 3 | 66 |
| Alseny Modet Camara | 3 | 3 | 134 |
| B. Toure | 3 | 4 | 70 |
| Ibrahima Kaba | 3 | 4 | 42 |
| Namory Keita | 2 | 2 | 122 |
| Tamba S. Millimono | 2 | 2 | 26 |
| Marie Claire Lamah | 2 | 2 | 505 |
| Marie-Claire Lamah | 2 | 2 | 88 |
| Boubacar Toure | 1 | 1 | 7 |
| Ibrahima Elhadj Bah | 1 | 1 | 34 |
| Barry Moumié | 1 | 1 | 317 |
| Elhadj Ibrahima | 1 | 1 | 68 |