GUINEA

Maternal1 and infant2 mortality rates are very high in Guinea. This is the result of various factors, including limited access to and low quality of medical care, combined with a high prevalence of malaria and low immunization coverage throughout the country.

The scale of the Ebola epidemic in West Africa between 2014 and 2016, with 3,804 people infected in Guinea, including 2,536 deaths, highlighted the weaknesses of the epidemiological surveillance system and the lack of capacity of the national health system to respond to outbreaks.

The Ebola epidemic also caused the population to be suspicious of health facilities that received suspected or confirmed Ebola patients. Fear of infection has led to a drop in the number of people attending health facilities and thus exposed the population to even greater vulnerability, particularly to infectious diseases.

Declared in March 2014 by the Ministry of Public Health in Guinea, the Ebola epidemic then spread massively in Liberia and Sierra Leone. A few sporadic cases were also reported in Mali, Nigeria and Senegal.

It is in this context that ALIMA opened a transit center in October 2014 within the N’Zérékoré General Hospital and then an Ebola Treatment Centre in December 2014. Between December 2014 and April 2016, ALIMA teams provided medical care to 174 suspected patients, including 90 patients confirmed to be infected with the Ebola virus. In parallel with the treatment of Ebola patients, ALIMA has partnered with Inserm to set up a clinical trial (JIKI) to evaluate the safety of antiviral treatment.

At the same time, training and awareness-raising campaigns were conducted among Guinean health personnel and communities on measures to prevent the disease.

In 2015, ALIMA’s response was  recognized at the international level and the organization received the first prize from the European Union for its action in the fight against the Ebola virus.

Strengthening access to healthcare in Guinea and setting up a pediatric therapeutic nutritional unit at the N’Zérékoré General Hospital

Between 2015 and 2017, as part of the recovery of the health system after the Ebola epidemic, ALIMA supported the pediatrics, neonatology, laboratory and emergency services of the N’Zérékoré General Hospital. A therapeutic nutritional unit was also set up within the pediatric ward.

In 2017, in partnership with the Guinean health authorities, ALIMA strengthened the community-based epidemiological surveillance system in the N’Zérékoré region. This system made it possible to detect the occurrence of a measles outbreak, during which ALIMA supported national and regional authorities in the emergency response vaccination campaign and the medical management of cases.

Ebola virus patients care and monitoring

From December 2014 to March 2015, ALIMA provided free care and treatment to 174 patients suspected or affected by the Ebola virus.

A protocol for medical follow-up and psychological support was also implemented to accompany survivors and their families, in partnership with the health authorities and the IRD (the French Institute of Research for Development). At the same time, health workers from the prefectures of N’Zérékoré and Lola were trained in measures to prevent and control the spread of the infection.

Starting in 2016, following the lessons learned in Guinea during Ebola outbreak, ALIMA developed the CUBE, a biosecure emergency care unit for outbreaks,  for a safer and more humane care of patients suffering from highly contagious diseases, such as Ebola.

Operational implementation of the PREVAC Phase II vaccine trial

Since April 2015, ALIMA has been a partner in the operational implementation of the PREVAC (Partnership for Ebola Vaccine Research) Phase II vaccine trial.

Launched in Guinea, Liberia, Sierra Leone and Mali with nearly 4,800 volunteers recruited, the trial aims to identify the best vaccine strategy (among three candidate vaccines) to avoid or contain an Ebola epidemic.

In Guinea, ALIMA and its partners are working attwo research sites: Conakry and Maférinyah. The 2,330 volunteer research participants registered at the two sites between 2017 and 2018 will benefit from close follow-up visits during the first year following inoculation of one of the candidate vaccines, followed by annual medical check-ups for a period of 4 years.

Focus on 2019

In 2019, 2,330 people participated in the randomized clinical trial for the Ebola vaccine in 2019 (PREVAV), and 12,984 blood samples were collected. In parallel, 8,599 outpatient consultations were carried out for PREVAC trial participants and their beneficiaries.

COVID-19 Response

In order to support the Guinean Ministry of Health’s response to the COVID-19 outbreak, ALIMA has been supporting the Donka University Hospital Center in Conakry since early April 2020.

ALIMA and Ministry teams set up a 450-bed emergency care unit, including a triage area and a 40-bed resuscitation unit. At the peak of the epidemic, nearly 800 health care, logistics and administrative personnel worked in the treatment center.

Between March and September 2020, nearly 3,000 patients confirmed at COVID-19 were treated at Donka University Hospital, including approximately 360 severe and critical cases. 2,900 patients were cured.

ALIMA also trains the Ministry of Health’s staff in the care of patients who tested positive for COVID-19, both for physiological and psychological aspects, as well as in Infection Prevention and Control measures (IPC). Learning practices and procedures adapted to the outbreak context reduces the risk of transmission of the virus to caregivers, patients and families.

In total, more than 300 health workers have been trained by ALIMA.