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. 2018 Jan 11:7:45.
doi: 10.12688/f1000research.12922.2. eCollection 2018.

Incorporating health workers' perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak

Saskia Den Boon  1 , Constanza Vallenas  1 , Mauricio Ferri  1 , Susan L Norris  1
Affiliations

Incorporating health workers' perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak

Saskia Den Boon et al. F1000Res. .

Abstract

Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. The objective of this study was to understand frontline physicians' and nurses' perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. Methods : We surveyed frontline physicians and nurses deployed to West Africa between March and September of 2014. Results: We developed the protocol, obtained ethics approval, delivered the survey, analysed the data and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated within eight weeks. Forty-four physicians and nurses responded to the survey. They generally felt at low or extremely low risk of virus transmission with all types of PPE used. Eye protection reduced the ability to provide care, mainly due to impaired visibility because of fogging. Heat and dehydration were a major issue for 76% of the participants using goggles and for 64% using a hood. Both gowns and coveralls were associated with significant heat stress and dehydration. Most participants (59%) were very confident that they were using PPE correctly. Conclusion : Our study demonstrated that it was possible to incorporate primary data on end-users' preferences into a rapid advice guideline for a public health emergency in difficult field conditions. Health workers perceived a balance between transmission protection and ability to care for patients effectively while wearing PPE. These findings were used by the guideline development expert panel to formulate WHO recommendations on PPE for frontline providers caring for EVD patients in outbreak conditions.

Keywords: Ebolavirus; Guidelines; Hemorrhagic Fever; Personal Protective Equipment; Preferences; Values; World Health Organization.

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Conflict of interest statement

Competing interests: SDB and CV declare no competing interests. MF declares that his spouse is an employee at Bristol Myers Squibb and owns company stock as part of her remuneration plan. SLN declares that she is a member of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group, has published numerous papers related to GRADE, and that her career has benefited from this relationship. GRADE is the guideline process used by her employer, the World Health Organization, to develop guidelines.

References

    1. Ebola haemorrhagic fever in Zaire, 1976. Report of a WHO/International Study Team. Bull World Health Organ. 1978;56(2):271–293. - PMC - PubMed
    1. Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team. Bull World Health Organ. 1978;56(2):247–270. - PMC - PubMed
    1. WHO: Outbreak of Ebola haemorrhagic fever, Uganda, August 2000–January 2001. Wkly Epidemiol Rec. 2001;76(6):41–46. - PubMed
    1. WHO: Ebola Situation Report - 18 November 2015. Accessed 7 Nov 2016. Reference Source
    1. WHO: Health worker Ebola infections in Guinea, Liberia and Sierra Leone: Preliminary report. Geneva: World Health Organization;2015; Accessed 7 Nov 2016. Reference Source

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