Congo has begun the first-ever trial to test the effectiveness and safety of four experimental Ebola drugs, the first time scientists have directly compared such treatments, the World Health Organization said Monday.
The U.N. health agency described the multi-drug trial as “a giant step” that would “bring clarity about what works best.”
“While our focus remains on bringing this outbreak to an end, the launch of the randomized control trial in DRC [Congo] is an important step toward finally finding an Ebola treatment that will save lives,” said WHO Director-General Tedros Adhanom Ghebreyesus.
Since the beginning of the Ebola outbreak in the North Kivu province in August, four therapeutic drugs have been used to treat patients, namely mAb 114, ZMapp, Remdesivir and Regeneron, according to Congo’s Health Ministry.
To date, more than 160 people have been treated with these experimental drugs. Patients won’t be treated much differently than before, but scientists will now have a clinical trial framework to collect data on the three antibody treatments and the antiviral.
Congo’s Health Ministry said the clinical trial began last week in Beni with Zmapp, mAb 114 and Remdesivir. The test could be extended to other sites and include the fourth medicine, it said. The number of patients who participate “will depend on the evolution of the epidemic and the willingness of patients to participate.”
Congo, with poor infrastructure, presents a difficult environment for administering these treatments. ZMapp is difficult to use; it takes three infusions, given over hours. If patients are treated with Remdesivir, their liver function must be analyzed regularly.
Because the data collected in the North Kivu epidemic is unlikely to be sufficient for a complete study, the ministry said that the clinical trial may extend over a five-year period to cover several Ebola outbreaks in several countries.
So far in the current outbreak in Congo, there have been 365 confirmed Ebola cases with 189 deaths, according to figures provided by the health ministry Sunday.
“Our country is struck with Ebola outbreaks too often, which also means we have unique expertise in combatting it,” said Congo’s Minister of Health Dr. Oly Ilunga Kalenga. “These trials will contribute to building that knowledge, while we continue to respond on every front to bring the current outbreak to an end.”
This is Congo’s tenth outbreak since the virus was identified there in 1976. The outbreak has been plagued by security problems, with health workers attacked by rebels in districts where the virus has been spreading. (VOA)
The Democratic Republic of Congo is in the throes of its worst-ever Ebola outbreak, with more than 420 cases in the country’s volatile east, and a mortality rate of just under 60 percent. But this outbreak — the nation’s tenth known Ebola epidemic — is unusual because more than 60 percent of patients are women.
Among them is Baby Benedicte. Her short life has already been unimaginably difficult.
At one month old, she is underweight, at 2.9 kilograms. And she is alone. Her mother had Ebola, and died giving birth to her. She’s spent the last three weeks of her life in a plastic isolation cube, cut off from most human contact. She developed a fever at eight days old and was transferred to this hospital in Beni, a town of some half-million people in the east of the Democratic Republic of Congo.
More than 400 people have been diagnosed with Ebola here since the beginning of August, and more than half of them have died in a nation the size of Western Europe that struggles with insecurity and a lack of the most basic infrastructure and services. That makes this the second-worst Ebola outbreak in history, after the hemorrhagic fever killed more than 11,000 people in West Africa between 2013 and 2016.
This is 10th outbreak to strike the vast country since 1976, when Ebola was first identified in Congo. And this particular outbreak is further complicated by a simmering civil conflict that has plagued this region for more than two decades.
Guido Cornale, UNICEF’s coordinator in the region, says the scope of this outbreak is clear.
“It has become the worst outbreak in Congo, this is not a mystery,” he said.
What is mysterious, however, is the demographics of this outbreak. This time, more than 60 percent of cases are women, says the government’s regional health coordinator, Ndjoloko Tambwe Bathe.
“All the analyses show that this epidemic is feminized. Figures like this are alarming. It’s true that the female cases are more numerous than the male cases,” he said.
Bathe declined to predict when the outbreak might end, though international officials have said it may last another six months. Epidemiologists are still studying why this epidemic is so skewed toward women and children, Cornale said.
“So now we can only guess. And one of the guesses is that woman are the caretakers of sick people at home. So if a family member got sick, who is taking care of him or her? Normally, a woman,” he said.
Or a nurse. Many of those affected are health workers, who are on the front line of battling this epidemic. Nurse Guilaine Mulindwa Masika, spent 16 days in care after a patient transmitted the virus to her. She says it was the fight of her life.
“The pain was enormous, the pain was constant,” she said. “The headache, the diarrhea, the vomiting, and the weakness — it was very, very bad.”
For the afflicted, the road to recovery is long and lonely. Masika and her cured colleagues face weeks of leave from work to ensure the risk of infection is gone. In the main hospital in the city of Beni, families who have recovered live together in a large white tent, kept four meters from human contact by a bright orange plastic cordon. They yell hello at their caretakers, who must don protective gear if they want to get any closer.
And for Baby Benedicte, who is tended to constantly by a nurse covered head to toe in protective gear, the future is uncertain. Medical workers aren’t entirely sure where her father is, or if he is going to come for her.