[Input of a laboratory in the management of patients with Ebola virus disease and in the training of health personnel: experience of the Forecariah Ebola treatment centre (Guinea) in 2015]

Ebola virus disease (EVD) is associated with a high lethality rate even when the afflicted are provided with good support in an Ebola treatment center (ETC). Basic laboratory tests can help to better understand the pathophysiology of the disease, to guide treatment and to establish simple protocols and procedures tailored to the practice of medicine in the context of such precarious environment for caregivers. Based on a few clinical cases of patients treated in the ETC of Forecariah, Guinea, run by the French Red Cross, this article describes the difficult conditions associated with the provision of medical practice in this challenging environment, aiming to minimize the casualties in the EVD patient and to train the health staff.

[Drug supply for HIV patients in day care centre in Republic of Congo: the French Red Cross experience]

The commitment of the French Red Cross Society to fight against HIV-AIDS in Africa is based on day care centres (DCC) set up and operated within public hospitals, for instance in Brazzaville and Pointe-Noire in Republic of Congo. These outpatient facilities offer global care including supply of medicines and antiretroviral therapies. The regular supply of medicines, laboratory and medicals materials necessary for the follow-up of the patient is the key of the quality of these structures and their durability. The French Red Cross guarantees this supply chain in countries where no secure pharmaceutical purchasing centre exists, as for exemple in Republic of Congo.

[The French Red Cross: a network of care centers dedicated to HIV-AIDS]

The commitment of the French Red Cross Society to the fight against HIV/AIDS in Africa and Asia is based on day care centers (DCC) set up and operated within public hospitals. These outpatient facilities offer global care including clinical and biologic follow-up for patients undergoing anti-retroviral treatment. In most countries these DCC have become reference centers providing support for national decentralization policies. To reinforce the impact of their activities, centers offer regular educational programs and provide extensive training for medical personnel.

Long-term central venous catheter infection in HIV-infected and cancer patients: a multicenter cohort study

OBJECTIVES

To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.

DESIGN

Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.

SETTING

Services of infectious diseases and oncology of 12 university hospitals in Paris, France.

PARTICIPANTS

In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.

RESULTS

Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.

CONCLUSIONS

Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.