Publications by authors named "Daniel G Bausch"

Background: Nucleic acid-based assays are the diagnostic gold standard for filoviruses, including Ebola (EBOV) and Sudan (SUDV) viruses. However, outbreaks in areas with limited laboratory infrastructure highlight the need for simpler diagnostic tests that can be rapidly and safely used in the field.

Methods: We evaluated eight antigen rapid diagnostic tests (Ag-RDTs) for their ability to detect EBOV and SUDV.

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Despite being a dangerous disease found across West Africa, with occasional cases imported elsewhere, few medical countermeasures for Lassa fever are available, with no vaccine or validated treatment, and limited regulatory-approved diagnostics. Scientific research on the Lassa virus (LASV) is needed to accelerate the development of such tools but is dependent on access to high-quality biological samples. To meet this need, we have established a well-curated biobank to prospectively collect, process, and store high-quality, well-characterized clinical specimens from patients with Lassa fever at the Federal Medical Center Owo (FMCO) in Nigeria.

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Clinical trials in settings with intermittent or non-existent internet and power connectivity, for example during humanitarian emergencies, present challenges in the synchronisation of data across different sites, in addition to accessing a centralised database in real-time. To overcome these, we designed a novel hybrid analogue/digital data management system which was deployed during the rapid implementation of a Phase III evaluation of a two-dose preventative vaccine for Ebola virus disease in Goma, Democratic Republic of the Congo, from 2019 to 2022. We provided study participants with an Enhanced Participant Record Card (EPRC) that served as eligibility for, and confirmation of, vaccination and was used in combination with Open Data Kit (ODK) electronic case report forms to create an off-grid study participant management system.

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Lassa fever is a zoonotic disease found in several countries across West Africa, with estimates of up to 300,000 infections and 10,000 deaths yearly. The highest incidence is in Nigeria. Suspected cases are often seen in areas with limited infrastructure and diagnostics capacity, hence the availability of an accurate rapid diagnostic test (RDT) that could be used in the community would be an important public health tool.

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Background: Conflict is known to impact maternal and neonatal health in Eastern Democratic Republic of the Congo (DRC), an area of longstanding insecurity. We conducted a systematic review on pregnancy and neonatal outcomes in this region to provide a comprehensive overview of maternal and neonatal outcomes over a 20-year period.

Methods: We systematically searched databases, such as Medline, EMBASE, Global Health, ClinicalTrials.

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Article Synopsis
  • * The analysis showed that Ag RDTs had a pooled sensitivity of 82.1% and a specificity of 97.0%, indicating that they are quite effective in identifying patients with EVD.
  • * While Ag RDTs can reliably confirm EVD, there is a need for high-sensitivity tests that work well in field conditions and can detect various ebolavirus species.
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During the COVID-19 pandemic, the need for making testing readily available was recognized as an important factor for individuals to help make informed decisions, including to isolate or seek care, and for policymakers to control transmission. Toward this end, FIND and the Access to COVID-19 Tools Accelerator funded 16 rapid operational research studies and one implementation project in Africa, the Caribbean, and Asia evaluating the utility, acceptability, and feasibility of different community-based SARS-CoV-2 testing approaches. Here, we discuss common factors and challenges encountered during study implementation.

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During the 2018-2020 Ebola virus disease outbreak in Democratic Republic of the Congo, a phase 3 trial of the Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine (DRC-EB-001) commenced in Goma, with participants being offered the two-dose regimen given 56 days apart. Suspension of trial activities in 2020 due to the COVID-19 pandemic led to some participants receiving a late dose 2 outside the planned interval.

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Article Synopsis
  • * While fewer than 1% of non-pregnant participants faced serious adverse events (SAEs), 30.4% of pregnant women experienced SAEs, primarily due to caesarean sections, but none were linked to the vaccine.
  • * Among 1169 tracked pregnancies, there were some miscarriages, stillbirths, and low birth weights, yet the vaccine was generally well-tolerated, with a high uptake rate of 75.1%, prompting calls for more controlled trials for further insights.
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Article Synopsis
  • In 2016, WHO prioritized Lassa fever for epidemic preparedness, highlighting the need for improved diagnostics, treatments, and vaccines.
  • Diagnostic methods for Lassa fever currently have significant limitations, and treatment options are limited to the controversial drug ribavirin.
  • Ongoing research and collaboration among experts are essential to develop effective medical countermeasures by the end of the decade to combat Lassa fever in affected regions.
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Background: Marburg virus disease is an acute haemorrhagic fever caused by Marburg virus. Marburg virus is zoonotic, maintained in nature in Egyptian fruit bats, with occasional spillover infections into humans and nonhuman primates. Although rare, sporadic cases and outbreaks occur in Africa, usually associated with exposure to bats in mines or caves, and sometimes with secondary human-to-human transmission.

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Mpox (formerly known as monkeypox) is a zoonotic viral disease endemic in parts of Africa. In May, 2022, the world was alerted to circulation of monkeypox virus in many high-income countries outside of Africa. Continued spread resulted in a WHO declaration of a Public Health Emergency of International Concern.

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The Joint External Evaluation (JEE) assesses national capacities to implement the International Health Regulations (IHR). Previous studies have found that higher JEE scores are associated with fewer communicable disease deaths. But given the impact of COVID-19 in many countries, including those believed to have developed IHR capacities, the validity of the JEE for pandemic preparedness has been questioned.

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During the 10th Ebola virus disease (EVD) epidemic in the eastern Democratic Republic of the Congo (DRC) (2018-2020), two experimental EVD vaccines were deployed in North Kivu. This province has been at the centre of conflict in the region for the last 25 years. Amidst ambivalence towards protracted foreign intervention and controversy about introducing two experimental vaccines, the existing literature has focused on mistrust and 'resistance' towards the Ebola response and vaccines.

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