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Building Local Capacity in Hand-Rub Solution Production during the 2014-2016 Ebola Outbreak Disaster: The Case of Liberia and Guinea

Published online by Cambridge University Press:  05 November 2018

Frederique A Jacquerioz Bausch ,
Olivia Heller ,
Loséni Bengaly ,
Béatrice Matthey-Khouity ,
Pascal Bonnabry ,
Yakaria Touré ,
Garrison J Kervillain ,
Elhadj Ibrahima Bah ,
François Chappuis  and
Olivier Hagon
Frederique A Jacquerioz Bausch*
Affiliation:
Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
Olivia Heller
Affiliation:
Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
Loséni Bengaly
Affiliation:
Pharmacy, Gabriel Touré Hospital, Bamako, Mali
Béatrice Matthey-Khouity
Affiliation:
Pharmacy, Geneva University Hospitals, Geneva, Switzerland
Pascal Bonnabry
Affiliation:
Pharmacy, Geneva University Hospitals, Geneva, Switzerland School of Pharmaceutical Sciences, University of Geneva and Lausanne, Geneva, Switzerland
Yakaria Touré
Affiliation:
Ministry of Health, Conakry, Guinea
Garrison J Kervillain
Affiliation:
Ministry of Health, Congo Town, Monrovia, Liberia
Elhadj Ibrahima Bah
Affiliation:
Division of Infectious Disease, Geneva University Hospital, Geneva, Switzerland
François Chappuis
Affiliation:
Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
Olivier Hagon
Affiliation:
Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
*
Correspondence: Frederique A Jacquerioz Bausch, MD, MPH Rue Gabrielle-Perret-Gentil 4, 1211 Geneva E-mail: [email protected]
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Abstract

Background

During the 2014-2015 Ebola outbreak in West Africa, the lack of infection prevention and control (IPC) measures in health care facilities amplified human-to-human transmission and contributed to the magnitude of this humanitarian disaster.

Case Report

In the summer of 2014, the Geneva University Hospitals (HUG; Geneva, Switzerland) conducted an IPC assessment and developed a project based on the local needs and their expertise with the support of the Swiss Agency for Development and Cooperation and the Humanitarian Aid Unit (SDC/HA; Bern, Switzerland). The project consisted of building local capacity in the production of alcohol-based hand-rub solution (ABHRS) based on the World Health Organization (WHO; Geneva, Switzerland) formula in non-Ebola health facilities at the peak of the outbreak in Liberia (Fall 2014) and during recovery in Guinea (September 2015) to promote safer care. Twenty-one pharmacists in Liberia and 22 in Guinea were trained and one years’ worth of laboratory equipment, chemical products, containers for personal use, and bioethanol were delivered to 10 hospitals per country with more than 8,000 100 ml bottles of solution produced at the end of the project.

Discussion

Hand hygiene using hand-rub solution is a critical component of safer care, especially in health care settings lacking runnable water. Throughout the Ebola outbreak, it was a timely moment to promote hand-rub solution and to reinforce IPC measures in non-Ebola health facilities. During the project implementation, a substantial challenge was the unavailability of bioethanol in Liberia and Guinea. In the long run, sustainability of the production can become an issue as it depends heavily on the local government’s financial and political commitment, the capacity to create an on-going demand for hand-rub solution in health facilities, the local purchase and replacement of the materials and chemical products, as well as the availability of continuous local partners’ support.

Conclusion:

The project demonstrated that it was feasible to build local capacity in ABHRS production during an emergency and in limited-resource settings when materials and training are provided. Future programs in similar contexts should identify and address the factors of sustainability during the implementation phase and provide regular, long-term technical support.

Jacquerioz BauschFA, HellerO, BengalyL, Matthey-KhouityB, BonnabryP, TouréY, KervillainGJ, BahEI, ChappuisF, HagonO. Building Local Capacity in Hand-Rub Solution Production during the 2014-2016 Ebola Outbreak Disaster: The Case of Liberia and Guinea.. Prehosp Disaster Med. 2018;33(6):660–667.

Keywords

capacity buildingdisastersdisease outbreaksEbola virus diseasehand hygiene
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 6 , December 2018 , pp. 660 - 667
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest: none

References

1. World Health Organization. Health worker Ebola infections in Guinea, Liberia, and Sierra Leone. Preliminary report (May 2015). http://www.who.int/csr/resources/publications/ebola/health-worker-infections/en/). Accessed February 14, 2018.Google Scholar
2. Cooper, C, Fisher, D, Gupta, N, MaCauley, R, Pessoa-Silva, C. Infection prevention and control of the Ebola outbreak in Liberia, 2014-2015: key challenges and successes. BMC Medicine. 2016;14:2.Google Scholar
3. World Health Organization. Guidelines on hand hygiene in health care (2009). http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf. Accessed February 15, 2018.Google Scholar
4. Allegranzi, B, Sax, H, Bengaly, L, Richet, H, et al. World Health Organization “Point G” Project Management Committee. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa. Infect Control Hosp Epidemiol. 2010;31(2):133-141.Google Scholar
5. Kama-Kieghe, S. Local Production of Alcohol Based Hand Rubs (ABHR) in Nigeria – The Way of the Future? https://infectioncontrol.tips/2016/03/05/abhr/. Accessed February 15, 2018.Google Scholar
6. Bauer-Savage, J, Pittet, D, Kim, E, Allegranzi, B. Local production of WHO-recommended alcohol-based hand rubs: feasibility, advantages, barriers and costs. Bull World Health Org. 2013;91(12):963-969.Google Scholar
7. Djientcheu, V. African Partnership for Patient Safety in Cameroon: The Story So Far. GFH 2010 (Poster presentation). http://ghf.g2hp.net/2012/11/12/african-partnership-for-patient-safety-in-cameroon-the-story-so-far/. Accessed February 15, 2018.Google Scholar
8. World Health Organization. WHO Guide to Local Production: WHO-recommended hand rub formulations (2009, revised April 2010). http://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf. Accessed February 15, 2018.Google Scholar
9. World Health Organization. African Partnerships for Patient Safety. Local Production of Alcohol Based Hand rub Training Workshop Report. Harare, Zimbabwe (March 2013). http://www.who.int/patientsafety/implementation/apps/events/ABHR-workshop-report.pdf. Accessed on February 15, 2018.Google Scholar
10. Geneva University Hospitals. Pharm-Ed web site: Détermination de la teneur en H2O2 des solutions de désinfection des mains. Analyze quantitative. http://pharmacie.g2hp.net/lessons/fabrication-de-la-solution-hydro-alcoolique-pour-lhygiene-des-mains/. Accessed February 15, 2018.Google Scholar
11. World Health Organization. Infection prevention and control recovery plans and implementation: Guinea, Liberia, and Sierra Leone inter-country meeting: Report of a meeting, Liberia (20-22 July 2015). http://www.who.int/csr/resources/publications/ebola/ipc-meeting-report/en/. Accessed February 15, 2018.Google Scholar
12. Geneva University Hospitals. Parm-Ed web site: Détermination de la teneur en H2O2 des solutions de désinfection des mains. Test enzymatique sur bandelettes pour le dosage semi-quantitatif de l’H2O2. http://pharmacie.g2hp.net/lessons/fabrication-de-la-solution-hydro-alcoolique-pour-lhygiene-des-mains/. Accessed February 15, 2018.Google Scholar
13. Matanock, A, Arwady, MA, Ayscue, P, et al. Ebola virus disease cases among health care workers not working in Ebola treatment units - Liberia, June–August, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(46):1077-1081.Google Scholar
14. Forrester, JD, Pillai, SK, Beer, KD, et al. Assessment of Ebola virus disease, health care infrastructure, and preparedness - four counties, Southeastern Liberia, August 2014. MMWR Morb Mortal Wkly Rep. 2014;63(40):891-893.Google Scholar
15. Koroma, H. WASH Ebola away strategy gets major boost. WASH Liberia; 2015. http://wash-liberia.org/wash-ebola-away-strategy-gets-major-boost/. Accessed December 30, 2015.Google Scholar
16. Salmon, S, McLaws, ML, Fisher, D. Community-based care of Ebola virus disease in West Africa. Lancet Infect Dis. 2015;15(2):151-152.Google Scholar
17. Nyenswah, T, Massaquoi, M, Gbanya, MZ, et al. Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities - Liberia, January–February 2015. MMWR Morb Mortal Wkly Rep. 2015;64(18):505-508.Google Scholar
18. World Health Organization. African partnership for patient safety. Alcohol based hand rub procurement: APPS approach. http://www.who.int/patientsafety/implementation/apps/resources/APPS_approach_ABHR_proc_full_2012-04_EN Accessed February 15, 2018.Google Scholar
19. Geneva University Hospitals. Pharm-Ed web site. www.Pharm-Ed.net. Accessed February 14, 2018.Google Scholar
20. Production locale de la solution hydro-alcoolique pour les mains [French]. https://youtu.be/SZX0Y8vHGYU. Local production of WHO hand rub during and after the Ebola crisis on West Africa [English]. https://youtu.be/ss_0TZJUuQU. Accessed February 14, 2018.Google Scholar
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