Abstract
To evaluate the inclusion and exclusion of nutritional content in guidance materials related to nutritional care for hospitalised Ebola Virus Disease (EVD) patients of any age with the aim to provide recommendations for future revised nutritional care guidelines in Ebola Treatment Units (ETU). Qualitative and quantitative analyses of ETU protocols and other guidance materials were conducted. Materials were obtained from practitioners, their organisations and governments active in EVD outbreaks since 2014. Guinea, Liberia, Sierra Leone and Democratic Republic of Congo. Guidance materials showed a wide variety of topics. Most contained information on different feeding phases during illness, the use of specialised products, what and how to feed children aged 0-23 months, and meal and snack frequency for different age groups. Most materials lacked guidance on how to assess or accommodate patients' dietary preferences, how to obtain feedback on nutritional care from patients or how to assess whether patients need feeding support. These aspects are particularly relevant to prevent deterioration of the patients' nutritional status. There was limited guidance on operational aspects of food preparation and provision. Since 2014, numerous materials have been developed by organisations and governments on nutritional support in ETU. Although every EVD outbreak response must be contextualised because of the complexity of EVD and its case management, it is important to resolve technical differences and to provide comprehensive and more practical guidance. The findings of this study may inform future revised guidelines from normative UN organisations and governments of countries affected by EVD.
Highlights
MethodsThis study took place in June and July 2019 and examined guidance materials retrieved from practitioners, their organisations and governments that are or have been active in the Ebola Virus Disease (EVD) outbreaks.Practitioners engaged in the nutritional care in the Ebola Treatment Units (ETU) and who participated in a previous investigation[2] were approached to share their materials they used, which were developed to guide nutritional care in ETU by their respective organisations or by others (see Ref. [2] how practitioners were selected)
Centers for Disease Control and Prevention, 2500 Century Boulevard NE, Mailstop E-22, Atlanta 30345, GA, USA: Medicine, Science and Humanities, Johns Hopkins University, Baltimore, MD, USA
Republic of Congo reported a new outbreak of Ebola virus disease (EVD)
Summary
This study took place in June and July 2019 and examined guidance materials retrieved from practitioners, their organisations and governments that are or have been active in the EVD outbreaks.Practitioners engaged in the nutritional care in the ETU and who participated in a previous investigation[2] were approached to share their materials they used, which were developed to guide nutritional care in ETU by their respective organisations or by others (see Ref. [2] how practitioners were selected). This study took place in June and July 2019 and examined guidance materials retrieved from practitioners, their organisations and governments that are or have been active in the EVD outbreaks. An initial screening of all materials by the authors resulted in a list of most common themes and sub-themes of all instructions found in the guidance materials. A second, more detailed analysis scored each document to indicate whether any instruction on a given theme was present or absent. Mentioning the sub-theme was sufficient to get a ‘present’ score, even if instructions lacked details. As scientific evidence on the best nutritional care in EVD patients is limited and lacks consensus[4], no analysis was conducted to evaluate the accuracy of the instructions
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