WHO AFRO TRANSFORMATION AGENDA AT WORK: A TEST CASE IN THE INVESTIGATION OF A SUSPECTED CASE OF EBOLA VIRUS DISEASE THAT TURNED OUT NEGATIVE.

Murebwa Chirambo Rufaro*, Muzala Kapina, Elizabeth Chizema, Mazaba-Liwewe Mazyanga; Ndumba Idah, Musumali Mbaulo, Mweemba Nora, Asaph Choonga, Harison Ng’uni, Herbert Mbewe, Ngonda Saasa, Katendi Changula, Qiu Yongjin, Kajihara Masahiro, Akina Mori, Yasuko Orba, Edgar Simulundu, Ladslav Moonga, Kashihara Sakae, Ayato Takada, Aaron S. Mweene and Mufunda Jacob

ABSTRACT

Background: Ebola virus disease (EVD) was first reported in the African region in DRC and Sudan in 1976. In the recent past (2014), an outbreak was reported in Guinea, which mostly affected West African countries, but with the greatest impact on Liberia and Sierra Leonne, where many cases and deaths have been recorded. The lessons learnt from this outbreak in terms of the rate at which cases were confirmed and the response among other issues led the incoming World Health Organization (WHO) Regional Director for Africa to come up with the concept of Transformation Agenda, which basically focusses on the need to change the way WHO does its business. Objective: To document the investigation of a suspected EVD case within the principles of the Transformation Agenda. Methodology: A recently EVD trained health worker suspected a 30 year old man of Ebola, who presented at the health center with epistaxis, hematemesis and fever. There was no history of having traveled to DRC or any EVD affected countries and no contact with suspected or confirmed EVD case. The patient was immediately quarantined, together with immediate family members and the district, province and national levels notified accordingly. Meetings were convened for a rapid and transparent response and a Rapid Response team was dispatched to the health center which is 154km from Solwezi and 2km from the DRC border. He was commenced on IV fluids and magnesium triscillicate. A blood sample was collected and taken to the University of Zambia Veterinary laboratory in Lusaka. Daily feedbacks were sent to WCO and MoH headquarters. Results: The patient’s plasma was tested for Ebola, Marburg and Filovirus genes using Polymerase Chain Reaction (PCR) techniques (Protocol for Ebola Diagnosis at UNZA-VET, YEAR). The samples were handled in a BSL-3 containment laboratory. The results were Negative - No amplification of Ebola, Marburg or Filovirus genes. Conclusion: It took less than 3 days to isolate the case, collect the sample and confirm the diagnosis from the initial notification of the case. This was possible because of the implementation of the tenets of the transformation agenda (accountability, responsiveness, transparency, tolerance to non-compliance), including the team work between WHO, MoH and the Veterinary Laboratory and readily available resources to respond.

Keywords: magnesium triscillicate, Filovirus genes, Solwezi.