Experts stress need for Ebola treatment guidelines

WITH Ebola Virus Diseases (EVD) cases still on the rise, infectious diseases experts underscore the pressing need for treatment guidelines. An editorial published in the International Journal of Infectious Diseases raises awareness about the lack of a specific approved treatment plan in the medical community for Ebola amid more than 16,000 total cases and over 500 new infections reported per week, and probable underreporting of both cases and fatalities.

Dr Margaret Chan, WHO director-general, during a visit to an Ebola treatment center in Bamako, Mali, in November (Photo WHO Mali/Yvette Bivigou)

In addition to the lack of treatment guidelines, the report points to conflicting reports of mortality rates  and limited descriptions of actual treatments being used as compounding the problem. 

Authors Eskild Petersen, MD, editor-in-chief of the International Journal of Infectious Diseases and professor of Tropical Medicine, Department of Infectious Diseases and Clinical Microbiology, Aarhus University Hospital, Aarhus Denmark, and Boubacar Maiga, MD, PhD, faculty of Medicine, University of Sciences, Techniques and Technology of Bamako, (USTTB), Bamako, Mali, said very little data exists. While one published study reported a mortality of 72%, it did not contain any information about any treatment, leaving the question on whether the patients included in the study received treatment or none at all.

The few data available indicate simple fluid replacement and electrolyte imbalance correction are critical in lowering mortality. Further, there is significant difference in the treatment adopted by industrialized nations with well-developed public health systems and by less-developed nations, in particular those with histories of civil wars and little health infrastructure. 

Infectious diseases experts propose twinning with hospitals in industrialized countries, with such hospitals adopting an EVD treatment facility, and ensuring staffing and training. This will guarantee the provision of an effective intravenous fluid replacement therapy, which can result in lower mortality. Such program will need the support of national health authorities. But if put in place, it will ensure confidence in treatment facilities among the local population and increase the use of these facilities with earlier admissions and higher proportion of cases treated, isolated, and recovered, experts said.