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Pasados once meses del inicio de la pandemia de COVID-19, se han confirmado más de 103 millones de casos en 188 países y el número de muertes se acerca a los 2,5 millones. Uno de los efectos colaterales de la COVID-19 es el impacto en la salud no relacionada con el propio coronavirus y el aumento de las necesidades de salud. Este artículo aborda los principales vectores que están afectando a la provisión de servicios de salud y se centra en la explicación de la adaptación de la prevención y el tratamiento de la malaria en un entorno COVID-19 por Médicos Sin Fronteras, mediante un ejemplo de la estrategia realizada en la ciudad de Batangafo (República Centroafricana). El mantenimiento de la gestión de los casos de malaria en condiciones seguras ha sido esencial en un contexto de COVID-19, y hemos adaptado los procedimientos para mantener nuestras actividades en este ámbito; en especial, adaptando la estrategia de quimioprevención estacional de la malaria (SMC) y reforzando la gestión comunitaria, adaptada a las medidas de PCI contra la COVID-19. Se ha puesto especial atención a las medidas de prevención y control de infecciones (PCI) para identificar y aislar a las personas con síntomas compatibles con COVID-19, mantenido las acciones dirigidas al control y tratamiento de la malaria., After eleven months of the start of the COVID-19 pandemic, more than 103 million cases have been confirmed in 188 countries and the number of deaths is close to 2.5 million. One of the side effects of COVID-19 is the health impact unrelated to coronavirus itself and increased health needs. This article addresses the main vectors that are affecting the provision of health services and focuses on explaining the adaptation of malaria prevention and treatment in a COVID-19 environment by Doctors Without Borders, using an example of the strategy carried out in the city of Batangafo (Central African Republic). Maintaining the management of malaria cases in safe conditions has been essential in a coVID-19 context, and we have adapted procedures to maintain our activities in this area; in particular, adapting the strategy of seasonal chemoprevention of malaria (SMC) and strengthening community management, adapted to PCI measures against COVID-19. Particular attention has been paid to infection prevention and control (PCI) measures to identify and isolate people with COVID-19-compatible symptoms, with actions aimed at malaria control and treatment.

Introduction: The Ebola virus disease (EVD) outbreak in Nigeria began when an infected diplomat from Liberia arrived in Lagos, the most populous city in Africa, with subsequent transmission to another large city. Methods: First-, second-, and third-generation contacts were traced, monitored, and classified. Symptomatic contacts were managed at Ebola treatment centers as suspected, probable, and confirmed EVD cases using standard operating procedures adapted from the World Health Organization EVD guidelines. Reverse transcription PCR tests confirmed EVD. Socio-demographic, clinical, hospitalization, and outcome data of the July–September 2014 Nigeria EVD cohort were analyzed. Results: The median age of the 20 EVD cases was 33 years (interquartile range 26–62 years). More females (55%), health workers (65%), and persons

Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control., During July–November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.

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.

Despite the magnitude of the Ebola virus disease (EVD) outbreak in West Africa, there is still a fundamental lack of knowledge about the pathophysiology of EVD 1 . In particular, very little is known about human immune responses to Ebola virus (EBOV) 2,3 . Here, we have for the first time evaluated the physiology of the human T cell immune response in EVD patients at the time of admission at the Ebola Treatment Center (ETC) in Guinea, and longitudinally until discharge or death. Through the use of multiparametric flow cytometry established by the European Mobile Laboratory in the field, we have identified an immune signature that is unique in EVD fatalities. Fatal EVD was characterized by high percentage of CD4 and CD8 T cells expressing the inhibitory molecules cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death-1 (PD-1), which was correlated with elevated inflammatory markers and high virus load. Conversely, surviving individuals showed significantly lower expression of CTLA-4 and PD-1 as well as lower inflammation despite comparable overall T cell activation. Concommittant with virus clearance, survivors mounted a robust EBOV-specific T cell response. Our findings suggest that dysregulation of the T cell response is a key component of EVD pathophysiology.