1. RESEARCH POSTER PRESENTATION DESIGN © 2015
www.PosterPresentations.com
• Infectious disease remains challenging to control
in austere environments with weak
infrastructure. Ebola, Anthrax, and the Plague
pose high levels of threat if left uncontained (1).
Personal Protective Equipment (PPE) utilized in
BSL-3 and BSL-4 type laboratories in the United
States can prove to be quite costly if employed
in austere environments such as East Africa (1).
• Essential knowledge, attitudes, and best
practices were taught to East African Clinicians
in an effort to combat the spread of infectious
disease without utilizing high level PPE. Through
the help of the United States Army Medical
Research Institute of Infectious Diseases
(USAMRIID), the Infectious Diseases Institute at
Makerere University (IDI) and the Ministries of
Health in Uganda and Kenya, a joint effort
helped to create the EDP training course. The
EDP course is founded on the MCBC training
course given at USAMRIID (2)
INTRODUCTION
• Primary focus is on improving clinician
preparedness in Austere environments through
the use of practical infection control knowledge.
• A survey was designed for quality control
purposes, but the data has now also been
analyzed to serve as a metric for clinician
preparedness.
• An ideal goal would be to have every clinician
prepared to deal with, and contain, an EDP
outbreak irrespective of environment.
• Inspiration comes from Dr. Innocent
Nkonwa, who managed to isolate an
Ebola outbreak without the use of PPE,
in an austere environment.
PRIMARY GOALS AND OBJECTIVES
• The program starts with
essential knowledge;
clinicians and hospital staff
were taught through
interactive lectures and
hands-on training with
donning/removing of PPE
METHODS
RESULTS AND DISCUSSION
SUMMARY AND CONCLUSIONS
REFERENCES
1. Diers J, Kouriba B, Ladan Fofana L, Fleischmann
E, Starke M, Diallo S, Babin FX, von Bonin J,
Wölfel R (2015) Mobile laboratories for rapid
deployment and their contribution to the
containment of emerging diseases in Sub-Saharan
Africa, illustrated by the example of Ebola virus
disease. Med. Sante. Trop. 25(3):229-233.
2. Medical Management of Chemical and Biological
Casualties Course -
http://www.usamriid.army.mil/education/
ACKNOWLEDGEMENTS
Danyas Sarathy is indebted to all the team members
who stimulated, encouraged, and supported him
throughout this study. Some notable individuals
include:
• Dr. Umaru Ssekabira, MD
• Ms. Barbara Kunihira
• Dr. Ian Njeru, MD
• Mr. Peter Lokomar
• Dr. Bernard Opar
• Dr. Shikanga O-tipo, MD
Danyas Sarathy2, MAJ Elena Kwon1, MAJ Michael D’Onofrio1, MAJ Matthew Chambers1, Dr. Solome Okware3
Dr. Joseph Walter Arinatwe3
Defense Against Especially Dangerous Pathogens (EDPs) in Low Infrastructure
Environments: Preparedness Among East African Clinicians
32.53%
48.07%
55.81%
28.29%
44.84%
29.80%
64.93%
22.05%
30.97%
0.00% 10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%100.00%
INFECTION CONTROL
MORTUARY DATA
INFECTION CONTROL TRAINING
RADIOLOGY DATA
TRAINING DATA
LAB ASSESSMENT
HAND HYGEINE
CHART REVIEW
AVERAGE PERCENTAGE 'CORRECT'
PERCENTAGE OF "CORRECT" ANSWERS BY SUBSECTION
• Posters were placed throughout
the facility to remind clinicians
of best practices and attitudes
• This served as practical
knowledge for the clinicians
and faculty.
• Following the EDP course,
participants took part in a
questionnaire to measure
knowledge retention; the
facility was also assessed
on biosafety and medical
records
USAMRIID1, The Pennsylvania State University2, Infectious Diseases Institute of Makerere University3
• Overall percentage of correct answers
(fig. 1) show that hand hygiene training
was comparatively successful (with
clinicians scoring ~30% higher than the
total average)
• Comparatively speaking, the “training”
sections (“Hand Hygiene, Infection
Control Training, and Training Data”)
scored higher than the “non training”
sections.
• “Correct” answers correspond to
responses that benefit personal
protection, and maximize overall safety.
Fig 1: Total percentages across each survey subsection
Fig 2: Total responses; blue are “correct responses”, red are “incorrect responses”
• Sustainable preventative measures need to be
employed, especially in low infrastructure
medical facilities, to combat the spread of
infectious disease
• The proliferation of EDPs can be prevented with
the correct training and mindset, and without
the need for advanced protective equipment.
• The use of a practical, self-contained, and
intensive training course may aid in teaching
clinicians proper containment techniques.
• This could potentially serve as a more
practical, sustainable method of
preventing the spread of EDPs in low
infrastructure environments
• This bypasses the need for cost-
inefficient methods, such as providing
costly PPE to austere medical locations.
• These data may suggest that EDP training can
impact overall clinician preparedness, and
infection control awareness.
• Low-scoring facility metrics (radiology data,
lab assessments, chart review) highlight
structural deficiencies; contrasting high
scoring personal safety metrics
• Free response post-course survey questions
indicate that clinicians feel “empowered to
identify and handle EDPs”
0 500 1000 1500 2000 2500 3000 3500
INFECTION CONTROL
MORTUARY DATA
INFECTION CONTROL TRAINING
RADIOLOGY DATA
TRAINING DATA
LAB ASSESSMENT
HAND HYGEINE
CHART REVIEW
NUMBER OF RESPONSES
CORRECT VS. INCORRECT TOTAL ANSWERS
Above are members of the USAMRIID and IDI team who developed the EDP course
The views expressed in this presentation are the opinions of the authors, and do not necessarily reflect the
official position of the Department of Defense or the US Army