Care of Ebola Survivors and Factors Associated With Clinical Sequelae—Monrovia, Liberia

BackgroundThe Eternal Love Winning Africa (ELWA) Clinic was the first clinic to provide free, comprehensive care to Ebola virus disease (EVD) survivors in Liberia. The objectives of this analysis were to describe the demographics and symptoms of EVD survivors at ELWA from January 2015 through March 2017 and to identify risk factors for development of sequelae.MethodsPatients' demographic and clinical information was collected by chart review in June 2016 and March 2017. Associations with clinical sequelae were analyzed using the chi-square test, t test, and multivariate logistic regression.ResultsFrom January 2015 to March 2017, 329 EVD survivors were evaluated at ELWA. Most survivors experienced myalgia/arthralgia (73%; n = 239) and headache (53%; n = 173). The length of time from Ebola Treatment Unit (ETU) discharge to first clinic visit ranged from 0 to 30 months. Many visits (30%) occurred 24 or more months after ETU discharge. The proportion of visits for headache, weight loss, joint pain, visual problems, insomnia, fatigue, memory loss, decreased libido, depression, and uveitis decreased over time. More men than women had visits for depression; however, these differences were not significant. Symptom prevalence differed in adults and children; significantly more adults experienced myalgia/arthralgia (77% vs 44%), visual problems (41% vs 12%), post-EVD-related musculoskeletal pain (42% vs 15%), and insomnia (17% vs 2%).ConclusionsEVD survivors frequented ELWA for EVD-related symptoms many months after ETU discharge, indicating a long-term need for care. Reported symptoms changed over time, which may reflect eventual resolution of some sequelae

A breeding scheme for local adoption of cassava (Manihot esculenta Crantz)

In many rural communities, cassava mosaic disease (CMD) resistant varieties are being rejected by farmers owing to their inferior root qualities when compared to locally adapted varieties. In response to this challenge, we implemented a breeding scheme whose objective was to combine CMD resistance with farmer preferred root qualities, whose genes were respectively sourced for elite and local varieties. We targeted to achieve this goal within five years that comprised of: i) hybridization of complementary parental lines, ii) seedling evaluation trial (SET); iii) clonal evaluation trial (CET); iv) modified preliminary yield trial (MPYT) and v) modified uniform yield trial (MUYT). At SET and CET, emphasis was placed on traits of moderate to high heritability while for MPYT and MUYT emphasis was on traits of low heritability. Generated F 1 progeny (4080 half sibs) were established in SET of which 1014 seedlings were selected and advanced to the CET. At CET, only 143 clones were selected and advanced. Under MPYT, slightly less than 50% of the clones were selected, while under MUYT, (8 to 40 clones per site) were selected. Clones selected per site were characterized by: DMC (28 to 38%); ii) HI (0.26 to 0.62); iii) yield (14 to 59 t/ha), resistance to CMD and desirable farmer root qualities. Given this outcome, we have demonstrated the utility of this scheme in accelerating development of locally adapted cassava varieties and thus propose the scheme be referred to as "speed cassava breeding"