{"id":3435,"date":"2022-09-27T09:34:47","date_gmt":"2022-09-27T09:34:47","guid":{"rendered":"https:\/\/afiyafrica.com\/?p=3435"},"modified":"2022-09-27T09:35:06","modified_gmt":"2022-09-27T09:35:06","slug":"rdc-le-suivi-des-patients-gueris-debola-reduit-le-risque-de-resurgences-dr-raymond-pallawo","status":"publish","type":"post","link":"https:\/\/afiyafrica.com\/index.php\/actualite\/rdc-le-suivi-des-patients-gueris-debola-reduit-le-risque-de-resurgences-dr-raymond-pallawo\/","title":{"rendered":"RDC \u00ab le suivi des patients gu\u00e9ris d\u2019Ebola r\u00e9duit le risque de r\u00e9surgences \u00bb Dr Raymond Pallawo"},"content":{"rendered":"
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\n \t<\/i> Read Time:<\/span>5 Minute, 2 Second <\/div>\n\n <\/div>
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Le Dr Raymond Pallawo, m\u00e9decin \u00e9pid\u00e9miologiste et coordinateur du programme de soins et de suivi des personnes gu\u00e9ries de la maladie \u00e0 virus Ebola, mis en place en 2018 par\u00a0 l\u2019Organisation mondiale de la Sant\u00e9 (OMS), explique comment ce soutien permet aux anciens malades de faire face \u00e0 des difficult\u00e9s m\u00e9dicales et socio-\u00e9conomiques et de mieux comprendre et pr\u00e9venir d\u2019\u00e9ventuelles r\u00e9surgences du virus chez les personnes gu\u00e9ries.\u00c0 quelles difficult\u00e9s font face les personnes gu\u00e9ries de la maladie \u00e0 virus Ebola\u00a0?<\/strong><\/p>\n

Nous avons recens\u00e9 1269 personnes gu\u00e9ries de la maladie \u00e0 virus Ebola au cours des sept derni\u00e8res \u00e9pid\u00e9mies dans le pays. Les gu\u00e9ris ont fait part de stigmatisations socio\u00e9conomiques\u00a0: certains ont perdu leur emploi, d\u2019autres ont des difficult\u00e9s \u00e0 en trouver\u2026 Il arrive aussi qu\u2019un gu\u00e9ri qui se pr\u00e9sente dans un centre de sant\u00e9 soit rejet\u00e9 quand son statut est connu. Il y a aussi des probl\u00e8mes m\u00e9dicaux, qui ont d\u00e9j\u00e0 \u00e9t\u00e9 document\u00e9s. En juillet 2022, nous avons r\u00e9alis\u00e9 une \u00e9valuation de gu\u00e9ris qui se plaignaient de troubles persistants et il a \u00e9t\u00e9 confirm\u00e9 qu\u2019ils connaissent des troubles neuropsychiatriques, des probl\u00e8mes oculaires ou ost\u00e9o-articulaires.<\/p>\n

Afin de mieux recenser leurs difficult\u00e9s, nous avons propos\u00e9 au Minist\u00e8re de la sant\u00e9 de mener une enqu\u00eate aupr\u00e8s des gu\u00e9ris, en collaboration avec l\u2019UNICEF et des associations de personnes gu\u00e9ries. Cette enqu\u00eate, qui recueillera aussi les appr\u00e9ciations des personnes gu\u00e9ries par rapport au suivi qui leur a \u00e9t\u00e9 accord\u00e9, devrait commencer prochainement.<\/p>\n

Comment les personnes gu\u00e9ries sont-elles soutenues\u00a0?<\/strong><\/p>\n

Le programme de soins et de suivi des personnes gu\u00e9ries de la maladie \u00e0 virus Ebola est d\u2019abord un programme de sant\u00e9 publique. Il vise \u00e0 apporter des soins cliniques et psychologiques pendant 18 mois apr\u00e8s la sortie du centre de traitement ainsi que de surveiller une \u00e9ventuelle persistance du virus dans les fluides biologiques.\u00a0 Ce suivi consiste \u00e0 identifier les signes \u00e9vocateurs de rechute afin d\u2019att\u00e9nuer le risque de r\u00e9surgences \u00e0 travers une d\u00e9tection et une prise en charge pr\u00e9coces.<\/p>\n

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Si on d\u00e9tecte des signes qui peuvent faire penser \u00e0 une \u00e9ventuelle rechute, on approfondit les investigations et on prend en charge le patient<\/p><\/blockquote>\n<\/div>\n

En pratique, les gu\u00e9ris sont vus chaque mois. On les examine sur les plans clinique, psychologique et m\u00e9dical. Si on d\u00e9tecte des signes qui peuvent faire penser \u00e0 une \u00e9ventuelle rechute, on approfondit les investigations et on prend en charge le patient.<\/p>\n

Des cas de rechutes ont ainsi \u00e9t\u00e9 g\u00e9r\u00e9s par le programme sans provoquer de r\u00e9surgence\u00a0: des gu\u00e9ris ont fait des m\u00e9ningites enc\u00e9phalites, mais n\u2019ont contamin\u00e9 personne parce qu\u2019on les a isol\u00e9s et pris en charge tout de suite. Le personnel qui travaille dans les cliniques de suivi des gu\u00e9ris a \u00e9t\u00e9 form\u00e9 \u00e0 la prise en charge des personnes gu\u00e9ries de la maladie \u00e0 virus Ebola, ainsi qu\u2019au respect des mesures et pratiques de pr\u00e9vention et de contr\u00f4le des infections. Donc, un gu\u00e9ri chez qui on suspecte des signes de rechute est suivi de telle sorte qu\u2019il ne puisse pas contaminer. On r\u00e9duit ainsi le risque de propagation de l\u2019infection.<\/p>\n

De plus, un gu\u00e9ri qui pr\u00e9sente une autre maladie, comme le paludisme, ou des troubles psychologiques est pris en charge dans nos cliniques de suivi, en prenant tous les frais en charge. Les cas graves de maladie, qui ne peuvent pas \u00eatre trait\u00e9s \u00e0 la clinique, sont r\u00e9f\u00e9r\u00e9s dans les centres sp\u00e9cialis\u00e9s, toujours avec le soutien du programme. De m\u00eame, les femmes enceintes qui ont \u00e9t\u00e9 gu\u00e9ries d\u2019Ebola sont suivies pendant les consultations pr\u00e9natales et m\u00eame l\u2019accouchement. La plupart de ces femmes ont men\u00e9 leur grossesse \u00e0 terme et les enfants se portent tr\u00e8s bien. Nous faisons des pr\u00e9l\u00e8vements \u00e0 chaque accouchement sur les b\u00e9b\u00e9s et leur m\u00e8re et jusqu\u2019\u00e0 pr\u00e9sent, nous n\u2019avons pas constat\u00e9 de transmission du virus de la m\u00e8re \u00e0 l\u2019enfant.<\/p>\n

Quelles difficult\u00e9s rencontrez-vous dans le suivi des gu\u00e9ris et comment y faites-vous face\u00a0?<\/strong><\/p>\n

Au-del\u00e0 de 18 mois, un gu\u00e9ri n\u2019est plus suivi dans le cadre du programme, ce qui pose certaines difficult\u00e9s car on se rend compte que, m\u00eame des ann\u00e9es apr\u00e8s, le virus peut se remettre \u00e0 circuler dans l\u2019organisme des gu\u00e9ris. Il s\u2019agit de personnes pr\u00e9sentant des sympt\u00f4mes souvent m\u00e9ning\u00e9s dont les tests sanguins ou du liquide c\u00e9phalo-rachidien sont positifs \u00e0 Ebola, alors qu\u2019ils \u00e9taient pr\u00e9c\u00e9demment gu\u00e9ris de la maladie \u00e0 virus Ebola. Ce ph\u00e9nom\u00e8ne peut se produire des mois ou des ann\u00e9es plus tard. C\u2019est pourquoi nous voulons intensifier la recherche pour comprendre ce ph\u00e9nom\u00e8ne, quels sont les facteurs de rechute et comment les anticiper pour r\u00e9duire les risques en proposant des actions ad\u00e9quates de sant\u00e9 publique.<\/p>\n

Les \u00e9tudes ont en effet montr\u00e9 que les survivants peuvent converser le virus dans leur organisme pendant de longues p\u00e9riodes. Dans ce contexte, quelle est l\u2019importance de la surveillance pour d\u00e9tecter une \u00e9ventuelle r\u00e9surgence\u00a0?<\/strong><\/p>\n

D\u2019abord, il est important de ne pas alimenter de stigmatisation \u00e0 l\u2019\u00e9gard des gu\u00e9ris. La proportion des gu\u00e9ris chez qui le virus persiste est infime et toutes les persistances du virus ne sont pas \u00e0 l\u2019origine de r\u00e9surgences. Par exemple, sur les 1269 gu\u00e9ris suivis, seulement deux continuent \u00e0 \u00eatre test\u00e9s positif au virus.<\/p>\n

Donc, suivre les gu\u00e9ris permet de d\u00e9tecter les signes avant-coureur d\u2019une rechute et d\u2019adopter les bonnes attitudes. Par ailleurs, gr\u00e2ce au suivi biologique et \u00e0 la promotion de pratiques sexuelles \u00e0 moindre risque, comme l\u2019abstinence ou l\u2019utilisation des pr\u00e9servatifs, nous n\u2019avons pas observ\u00e9 de transmission par voie sexuelle.<\/p>\n

Nous sugg\u00e9rons donc de renforcer les syst\u00e8mes de surveillance et le respect des mesures et pratiques de pr\u00e9vention et de contr\u00f4le des infections. Depuis 2020, nous avons form\u00e9 les acteurs de la surveillance \u00e0 tous les niveaux\u00a0\u2013 provincial, zones de sant\u00e9, aires de sant\u00e9 \u2013, et plus de 18000 relais communautaires. Nous avons aussi mis en place des \u00e9quipes d\u2019intervention rapides dans les provinces du Nord-Kivu, du Sud-Kivu et de l\u2019Ituri.<\/p>\n<\/div>\n<\/div>\n

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Goldsmith This colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion. See PHIL 1832 for a black and white version of this image. Where is Ebola virus found in nature?The exact origin, locations, and natural habitat (known as the \"natural reservoir\") of Ebola virus remain unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is zoonotic (animal-borne) and is normally maintained in an animal host that is native to the African continent. A similar host is probably associated with Ebola-Reston which was isolated from infected cynomolgous monkeys that were imported to the United States and Italy from the Philippines. The virus is not known to be native to other continents, such as North America."},{"@type":"BreadcrumbList","@id":"https:\/\/afiyafrica.com\/index.php\/actualite\/rdc-le-suivi-des-patients-gueris-debola-reduit-le-risque-de-resurgences-dr-raymond-pallawo\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/afiyafrica.com\/"},{"@type":"ListItem","position":2,"name":"RDC \u00ab le suivi des patients gu\u00e9ris d\u2019Ebola r\u00e9duit le risque de r\u00e9surgences \u00bb Dr Raymond Pallawo"}]},{"@type":"WebSite","@id":"https:\/\/afiyafrica.com\/#website","url":"https:\/\/afiyafrica.com\/","name":"","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/afiyafrica.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"fr-FR"},{"@type":"Person","@id":"https:\/\/afiyafrica.com\/#\/schema\/person\/c5f0b28c02b60581c2b7be7d70585963","name":"Afiyafrica","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/afiyafrica.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/7ba29d2ab89d2021069ac4491d7c1c6a24324aa7fc90826fd0f9535402ef6a62?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/7ba29d2ab89d2021069ac4491d7c1c6a24324aa7fc90826fd0f9535402ef6a62?s=96&d=mm&r=g","caption":"Afiyafrica"},"sameAs":["https:\/\/afiyafrica.com"],"url":"https:\/\/afiyafrica.com\/index.php\/author\/admin3846\/"}]}},"featured_image_urls":{"full":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"thumbnail":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa-150x150.jpg",150,150,true],"medium":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa-300x141.jpg",300,141,true],"medium_large":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa-768x361.jpg",640,301,true],"large":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",640,301,false],"rpg_image_slider":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"rpg_image_thumbnail":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"1536x1536":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"2048x2048":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"enternews-slider-full":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"enternews-featured":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",775,364,false],"enternews-medium":["https:\/\/afiyafrica.com\/wp-content\/uploads\/2022\/09\/01aa.jpg",720,338,false]},"author_info":{"display_name":"Afiyafrica","author_link":"https:\/\/afiyafrica.com\/index.php\/author\/admin3846\/"},"category_info":"<a href=\"https:\/\/afiyafrica.com\/index.php\/category\/actualite\/\" rel=\"category tag\">Actualit\u00e9<\/a> <a href=\"https:\/\/afiyafrica.com\/index.php\/category\/epidemie\/\" rel=\"category tag\">Epid\u00e9mie<\/a> <a href=\"https:\/\/afiyafrica.com\/index.php\/category\/rd-congo\/\" rel=\"category tag\">RD Congo<\/a>","tag_info":"RD Congo","comment_count":"0","_links":{"self":[{"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/posts\/3435","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/comments?post=3435"}],"version-history":[{"count":3,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/posts\/3435\/revisions"}],"predecessor-version":[{"id":3441,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/posts\/3435\/revisions\/3441"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/media\/3438"}],"wp:attachment":[{"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/media?parent=3435"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/categories?post=3435"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/afiyafrica.com\/index.php\/wp-json\/wp\/v2\/tags?post=3435"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}