Added Value of an Anti-Ebola Serology for the Management of Clinically Suspected Ebola Virus Disease Patients Discharged as Negative in an Epidemic Context.

Background: Survivors from Ebola virus disease (EVD) may be at the origin of EVD resurgence.

Methods: Simultaneous reactivity to at least 2 Ebola virus or Zaire ebolavirus (EBOV) antigens was detected in 11 of 488 (2.3%; 95% confidence interval [CI], 1.

Knee injuries concomitant to posterior acetabular fractures: an association to look for.

Purpose: Acetabular fractures are frequently associated with other skeletal injuries, particularly knee injuries. This study aims to evaluate the relationship between posterior acetabular fractures and knee injury, analyzing its patterns and association with other injuries.

Methods: This is a retrospective monocentric study in a tertiary referral centre.

Bone cultures from war-wounded civilians in the Middle East: a surgical prospective.

Purpose: Hidden infections in a reconstructive surgery program are frequently underestimated.

Methods: A retrospective study was undertaken of 1,891 civilian war-wounded patients from Iraq, Syria, Yemen and Gaza treated in Amman from August 2006 to January 2016. One thousand three hundred and fifty-three underwent surgical interventions for previous bone injury and had systematic bone cultures.

Quality orthopaedic care in sudden-onset disasters: suggestions from Médecins Sans Frontières-France.

A huge change is needed in the conception and implementation of surgical care during sudden-onset disasters (SOD). The inadequate surgical response mounted by the majority of foreign medical teams (FMT) after Haiti's earthquake is a striking example of the need for a structured professional approach. Logistical capacity already exists to provide safe, timely, effective, efficient, equitable and ethical patient-centred care with minimum standards.

Implementation and Operational Research: Programmatic Feasibility of Dried Blood Spots for the Virological Follow-up of Patients on Antiretroviral Treatment in Nord Kivu, Democratic Republic of the Congo.

Background: As part of its policy to shift monitoring of antiretroviral therapy (ART) to primary health care (PHC) workers, the Ministry of Health of the Democratic Republic of Congo (DRC) tested the feasibility of using dried blood spots (DBS) for viral load (VL) quantification and genotypic drug resistance testing in off-site high-throughput laboratories.

Methods: DBS samples from adults on ART were collected in 13 decentralized PHC facilities in the Nord-Kivu province and shipped during program quarterly supervision to a reference laboratory 2000 km away, where VL was quantified with a commercial assay (m2000rt, Abbott). A second DBS was sent to a World Health Organization (WHO)-accredited laboratory for repeat VL quantification on a subset of samples with a generic assay (Biocentric) and genotypic drug resistance testing when VL >1000 copies per milliliter.

External fixators and sudden-onset disasters: Médecins Sans Frontières experience.

Purpose: Carrying out osteosynthesis is challenging, and controlling for results and complications is necessary to define the limits of acceptable complications. Within the context of sudden-onset disasters, comparing internal with external osteosynthesis remains controversial.

Methods: The most recent and significant Médecins Sans Frontières (MSF) experience with osteosynthesis was following the earthquake in Haiti in 2010: 353 external fixators were used in the 12 months following the catastrophe, 62 of which were used in the first month.

Triage in surgery: from theory to practice, the Medecins Sans Frontières experience.

Establishing triage is necessary in mass casualty events. If the concept of triage itself is easy, its application in the field encounters many difficulties at times unforseen. MSF offers a list of the main obstacles encountered when establishing an efficient triage system.

Amputation in emergency situations: indications, techniques and Médecins Sans Frontières France's experience in Haiti.

Purpose: The decision to amputate is always difficult but becomes even harder in emergency situations, which usually present extra complicating factors.

Msf Experience: These include human factors (related to both the surgeon and the patient); poor or nonexistent medical facilities, especially in war conditions or resource-poor countries; and cultural and religious considerations. Médecins Sans Frontières (MSF) has developed a quick medical and logistical response that relies on surgical protocols adapted to emergency situations, together with complete "kits" of medical equipment, supplies and inflatable facilities.

Resistance to antiretroviral drugs in treated and drug-naive patients in the Democratic Republic of Congo.

Background: We studied virological outcome and drug resistance in patients on antiretroviral therapy (ART) in health care centers in the Democratic Republic of Congo and looked for the presence of drug resistance in antiretroviral-naive patients attending the same clinics.

Methods: In 2008, we conducted a cross-sectional survey among patients on ART for ≥ 12 months in 4 major cities [Kinshasa (n = 289), Matadi (n = 198), Lubumbashi (n = 77), and Mbuji-Mayi (n = 103)]. Genotypic drug resistance tests were done with an in-house assay on samples with viral load >1000 copies/mL.

[Perception of pain by patients receiving antiretroviral treatment in North Kivu, DR Congo].

This operational research conducted among TB patients co-infected with HIV in North Kivu had three objectives: (i) to clarify the local perception of a certain type of pain (michi in the local language) in patients on antiretroviral treatment (ART); (ii) to identify the attitudes of health care personnel regarding the management of ART side effects; and (iii) to explore ways to improve the quality of life of patients on ART and provide them with pain relief. Twenty in-depth interviews were conducted with patients on ART and their medical care providers in district health centers of North-Kivu and at patients' homes. A semantic analysis of the term michi revealed a nosologic folk entity based on a naturalistic view of the body; the term michi is used to name: (i) the "roots" of plants or trees; (ii) channels (veins, arteries, but also nerves and tendons) in the body through which fluids (blood, water) and energy are conveyed; (iii) different types of acute pain, possibly located along these channels.

Effect of storage conditions of dried plasma and blood spots on HIV-1 RNA quantification and PCR amplification for drug resistance genotyping.

Objectives: Dried blood spots (DBS) and dried plasma spots (DPS) are easy to collect and store, and have been successfully tested as an alternative to plasma for performing virological analyses. Adequate storage conditions still need to be established and cell-associated proviral DNA in DBS can contribute to the amplified products. We evaluated these two parameters.

Structure and management of tuberculosis control programs in fragile states--Afghanistan, DR Congo, Haiti, Somalia.

Objectives: Health care delivery is particularly problematic in fragile states often connected with increased incidence of communicable diseases, among them tuberculosis. This article draws upon experiences in tuberculosis control in four fragile states from which four lessons learned were derived.

Methods: A structured inventory to extract common themes specific for TB control in fragile states was conducted among twelve providers of technical assistance who have worked in fragile states.

Evaluation of different RNA extraction methods and storage conditions of dried plasma or blood spots for human immunodeficiency virus type 1 RNA quantification and PCR amplification for drug resistance testing.

The development and validation of dried sample spots as a method of specimen collection are urgently needed in developing countries for monitoring of human immunodeficiency virus (HIV) infection. Our aim was to test some crucial steps in the use of dried spots, i.e.