Embedding treatment in stronger care systems.

Autor:	Rojek A; Pandemic Sciences Institute, Oxford, UK. Electronic address: amanda.rojek@ndm.ox.ac.uk., Fieggen J; Pandemic Sciences Institute, Oxford, UK., Paterson A; Pandemic Sciences Institute, Oxford, UK., Byakika-Kibwika P; Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Camara M; The Alliance for Medical Action, Route des Almadies, Dakar, Senegal., Comer K; Médecins Sans Frontières, Paris, France., Fletcher TE; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK., Günther S; Virology Department, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany., Jonckheere S; Médecins Sans Frontières, Operational Centre Belgium, Brussels, Belgium., Mwima G; Baylor College of Medicine, Children's Foundation Uganda, Kampala, Uganda., Dunning J; Pandemic Sciences Institute, Oxford, UK., Horby P; Pandemic Sciences Institute, Oxford, UK.
Jazyk:	angličtina
Zdroj:	The Lancet. Infectious diseases [Lancet Infect Dis] 2024 Dec 12. Date of Electronic Publication: 2024 Dec 12.
DOI:	10.1016/S1473-3099(24)00727-8
Abstrakt:	A key lesson from the west Africa (2014-16) Ebola disease epidemic was that outbreak responses fail when they respond to patients through a narrow clinical lens without considering the broader community and social context of care. Here, in the second of two Series papers on the modern landscape of Ebola disease, we review progress made in the last decade to improve patient-centred care. Although the biosafety imperatives of treating Ebola disease remain, recent advances show how to mitigate these so that patients are cared for in a safe and dignified manner that encourages early treatment-seeking behaviour and provides support after the return of patients to their communities. We review advances in diagnostics, including faster Ebola disease detection via real-time RT-PCR, and consider design improvements in Ebola disease treatment units that enhance patient safety and dignity. We also review advances in care provision, such as the integration of palliative care and mobile communication into routine care, and address how greater access to research is possible through harmonised clinical trials. Finally, we discuss how strengthened community engagement and psychosocial programmes are addressing stigma and providing holistic support for survivors. Competing Interests: Declaration of interests SG has received grants from the German Research Foundation, European Commission, German Government, Coalition for Epidemic Preparedness Innovations, and Kirmser Foundation; a speaker honorarium for continuing medical education on viral haemorrhagic fevers; support for attending the WHO Coalition for Epidemic Preparedness Innovations; and supplies for clinical trials from Toyama/Fujifilm. AR has received a pump-priming grant and AfOx catalyst grant from the University of Oxford and travel support from WHO (for travel to the workshop on building research readiness for a future filovirus outbreak and the WHO R&D pathogen shortlisting meeting). PH and AR are supported by the Moh Family Foundation, which provides institutional support to the Pandemic Sciences Institute. AR, PH, and PB-K are authors on the SOLIDARITY PARTNERS trial protocol. All other authors declare no competing interests. (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
Databáze:	MEDLINE
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