Abstract

BackgroundA rapid review, guided by a protocol, was conducted to inform development of the World Health Organization’s guideline on personal protective equipment in the context of the ongoing (2013–present) Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases.MethodsElectronic databases and grey literature sources were searched. Eligibility criteria initially included comparative studies on Ebola and Marburg virus diseases reported in English or French, but criteria were expanded to studies on other viral hemorrhagic fevers and non-comparative designs due to the paucity of studies. After title and abstract screening (two people to exclude), full-text reports of potentially relevant articles were assessed in duplicate. Fifty-seven percent of extraction information was verified. The Grading of Recommendations Assessment, Development and Evaluation framework was used to inform the quality of evidence assessments.ResultsThirty non-comparative studies (8 related to Ebola virus disease) were located, and 27 provided data on viral transmission. Reporting of personal protective equipment components and infection prevention and control protocols was generally poor.ConclusionsInsufficient evidence exists to draw conclusions regarding the comparative effectiveness of various types of personal protective equipment. Additional research is urgently needed to determine optimal PPE for health care workers caring for patients with filovirus.

Highlights

  • The family Filoviridae includes three genera, Cuevavirus, Ebolavirus, and Marburgvirus

  • A rapid review, guided by a protocol, was conducted to inform development of the World Health Organization’s guideline on personal protective equipment in the context of the ongoing (2013–present) Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases

  • Insufficient evidence exists to draw conclusions regarding the comparative effectiveness of various types of personal protective equipment

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Summary

Introduction

The family Filoviridae includes three genera, Cuevavirus, Ebolavirus, and Marburgvirus. EVD and MVD are severe illnesses in humans, with a combined mean case fatality rate of 55.4% [2]. The natural hosts of the filoviruses are unknown but fruit bats have been implicated in the transmission of Marburg virus and Ravn virus [3,4]. EVD and Marburg virus disease (MVD) have similar presentations, case fatality rate, and transmission mechanism. Both have no specific treatment to date. A rapid review, guided by a protocol, was conducted to inform development of the World Health Organization’s guideline on personal protective equipment in the context of the ongoing (2013–present) Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases

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