Open AccessImplementation 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
Author(s) -
Gibrilla F. Deen,
Suzanna L. R. McDonald,
Jaclyn E Marrinan,
Foday Sesay,
Elizabeth Ervin,
Anna Thorson,
Wenbo Xu,
Ute Ströher,
Patricia Ongpin,
Neetu Abad,
Archchun Ariyarajah,
Tasneem Malik,
Hongtu Liu,
Christine Ross,
Kara Durski,
Philippe Gaillard,
Oliver Morgan,
Pierre Formenty,
Barbara Knust,
Nathalie Broutet,
Foday Sahr
Publication year - 2017
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0005723
Subject(s) - ebola virus , sierra leone , medicine , ebola hemorrhagic fever , transmission (telecommunications) , sexual transmission , disease , virology , virus , microbicide , human immunodeficiency virus (hiv) , development economics , electrical engineering , economics , engineering
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.