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Question to those working on Ebola in charge of feeding patients

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Mija Ververs

JHU and CDC

Normal user

3 Dec 2018, 22:47

Dear colleagues.
In 2014, WHO launched interim guidelines on Nutritional care of children and adults with Ebola Virus Disease. I would like to know whether these guidelines have been useful in your work in Ebola Treatment Centers.

1. Did you use these guidelines then or are you currently using them in DRC? (I know that the 2014 WHO guidelines are also now established for DRC in a more or less similar form).

2. If you have not been using them then or now in DRC, is there a specific reason for that?

3. Do you think these guidelines are useful? Are they practical? Feasible? Clear? If not, why? How should they be adjusted?

4. Have you developed other guidance that you are using to feed the EVD infected patients?

5. Lastly, does anyone know whether these 2014 WHO guidelines ever have been evaluated? (how they were used, etc)


I very much appreciate your thoughts on this. Thanks so much!
Mija

Indi Trehan

Normal user

6 Dec 2018, 00:48

Dear Mija,

I worked in an ETC in Sierra Leone in 2015.

We did not find the WHO Guideline particularly useful or practical in a real ETC setting. They are a good idea but simply didn't work for us and so we wrote our own guidelines. Our version was certainly not perfect but given the resources and time constraints we had, we felt this was the best we could do at the moment. The general principle was to go to push heavily on RUTF or BP-100 feedings given that local foods were actually not being eaten and would sit there and rot in the heat. You can see our guidelines at: https://drive.google.com/file/d/0B2VaL2OcPk-4X25sYnpMdGkxLVE/view?usp=sharing

I don't think anyone has evaluated the guidelines or nutritional recommendations for Ebola patients, but if there is an opportunity to evaluate the nutritional recommendations further, I would be happy to collaborate and help out.

indi

Mija Ververs

JHU and CDC

Normal user

12 Dec 2018, 21:39

Hi Indi
Thanks so much for your response. I am not surprised about your comments on the 2014 WHO GL.Are you again involved in the EVD outbreak, now in DRC?
A question now to you (and anyone else):

- what has worked best so far in terms of feeding protocols? The one Indi sent (Partners in Health); has anyone else used these?

- Indi, do you consider, after having used these in 2015, to adjust them? I assume you made these in 2015, worked with these GL and perhaps have now suggestions for improvement?

Anyone else - please relook at my questions and am very interested to hear about other people's experiences/answers.

Thanks so much in advance, Mija

Indi Trehan

Normal user

13 Dec 2018, 00:28

Hi Mija,

No, I am not involved in the DRC outbreak response.

The guidelines worked well for us in Sierra Leone in 2015 and were used until the ETC closed and there hasn't been any thought given to changing them in any particularly significant way. I think they are a reasonable set of guidelines to start from, but would of course need to be adjusted to local context -- taste preferences of patients, supply chain, temperature control for patient care, availability of local foods, etc.

indi

Mija Ververs

JHU and CDC

Normal user

13 Dec 2018, 14:34

Hi Indi, can we continue our dialogue through email? I have further some questions to you if you don't mind. Please write to mververs@jhu.edu

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