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Matthias Borchert

Publications and source records attributed to Matthias Borchert.

8 recordsLinked to original sources
PubMed2006

Marburg hemorrhagic fever associated with multiple genetic lineages of virus.

BACKGROUND: An outbreak of Marburg hemorrhagic fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. METHODS: We investigated the outbreak of Marburg hemorrhagic fever most intensively in May and October 1999. Sporadic cases and short chains of human-to-human transmission continued to occur until September 2000. Suspected cases were identified on the basis of a case definition; cases were confirmed by the detection of virus antigen and nucleic acid in blood, cell culture, antibody responses, and immunohistochemical analysis. RESULTS: A total of 154 cases (48 laboratory-confirmed and 106 suspected) were identified (case fatality rate, 83 percent); 52 percent of cases were in young male miners. Only 27 percent of these men reported having had contact with other affected persons, whereas 67 percent of patients who were not miners reported such contact (P<0.001). Most of the affected miners (94 percent) worked in an underground mine. Cessation of the outbreak coincided with flooding of the mine. Epidemiologic evidence of multiple introductions of infection into the population was substantiated by the detection of at least nine genetically distinct lineages of virus in circulation during the outbreak. CONCLUSIONS: Marburg hemorrhagic fever can have a very high case fatality rate. Since multiple genetic variants of virus were identified, ongoing introduction of virus into the population helped perpetuate this outbreak. The findings imply that reservoir hosts of Marburg virus inhabit caves, mines, or similar habitats.

Adolescent↗
PubMed2006

Serosurvey on household contacts of Marburg hemorrhagic fever patients.

The first major outbreak of Marburg hemorrhagic fever (MHF) outside a laboratory environment occurred in the subdistrict of Watsa, Democratic Republic of Congo, from October 1998 to August 2000. We performed a serosurvey of household contacts of MHF patients to identify undetected cases, ascertain the frequency of asymptomatic Marburg infection, and estimate secondary attack risk and postintervention reproduction number. Contacts were interviewed about their exposure and symptoms consistent with MHF. Blood samples were tested for anti-Marburg immunoglobulin G (IgG). One hundred twenty-one (51%) of 237 identified contacts participated; 72 (60%) were not known to the health authorities. Two participating contacts were seropositive and reported becoming ill after the contact; no serologic evidence for asymptomatic or mild Marburg infection was found. The secondary attack risk was 21%; the postintervention reproduction number was 0.9, consistent with an outbreak sustained by repeated primary transmission, rather than large-scale secondary transmission.

Adolescent↗
PubMed2004

Organisation of health care during an outbreak of Marburg haemorrhagic fever in the Democratic Republic of Congo, 1999.

Organising health care was one of the tasks of the International Scientific and Technical Committee during the 1998-1999 outbreak in Durba/Watsa, in the north-eastern province (Province Orientale), Democratic Republic of Congo. With the logistical support of Médecins sans Frontières (MSF), two isolation units were created: one at the Durba Reference Health Centre and the other at the Okimo Hospital in Watsa. Between May 6th, the day the isolation unit was installed and May 19th, 15 patients were admitted to the Durba Health Centre. In only four of them were the diagnosis of Marburg haemorrhagic fever (MHF) confirmed by laboratory examination. Protective equipment was distributed to health care workers and family members caring for patients. Information about MHF, modes of transmission and the use of barrier nursing techniques was provided to health care workers and sterilisation procedures were reviewed. In contrast to Ebola outbreaks, there was little panic among health care workers and the general public in Durba and all health services remained operational.

Delivery of Health Care↗
PubMed2004

Bridging the implementation gap between knowledge and action for health.

There is widespread evidence of failure to implement health interventions that have been demonstrated to be cost-effective by high-quality research; this failure affects both high-income and low-income countries. Low-income countries face additional challenges to using research evidence including: the weakness of their health systems, the lack of professional regulation and a lack of access to evidence. There is a need to strengthen institutions and mechanisms that can more systematically promote interactions between researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The concept of public engagement with health research requires a public that is both informed and active. Even when systematic reviews are available further work is needed to translate their findings into guidelines or messages that are understandable to patients and health professionals. Many of the commonly used approaches for keeping health professionals' knowledge up-to-date appear to have small or inconsistent effects. The evidence-base is more extensive for interventions directed towards professionals, such as education, reminders or feedback, than for those directed at organizations or patients. The effect of interventions varies according to the setting and the behaviour that is targeted. Case studies in low-income settings suggest that some strategies can result in increased coverage of evidence-based interventions, but there is a lack of evidence from systematic reviews of rigorous research. Given the potential for near-term improvements in health, finding more effective ways of promoting the uptake of evidence-based interventions should be a priority for researchers, practitioners and policy-makers.

Diffusion of Innovation↗
PubMed2003

Risk factors for Marburg hemorrhagic fever, Democratic Republic of the Congo.

We conducted two antibody surveys to assess risk factors for Marburg hemorrhagic fever in an area of confirmed Marburg virus transmission in the Democratic Republic of the Congo. Questionnaires were administered and serum samples tested for Marburg-specific antibodies by enzyme-linked immunosorbent assay. Fifteen (2%) of 912 participants in a general village cross-sectional antibody survey were positive for Marburg immunoglobulin G antibody. Thirteen (87%) of these 15 were men who worked in the local gold mines. Working as a miner (odds ratio [OR] 13.9, 95% confidence interval [CI] 3.1 to 62.1) and receiving injections (OR 7.4, 95% CI 1.6 to 33.2) were associated with a positive antibody result. All 103 participants in a targeted antibody survey of healthcare workers were antibody negative. Primary transmission of Marburg virus to humans likely occurred via exposure to a still unidentified reservoir in the local mines. Secondary transmission appears to be less common with Marburg virus than with Ebola virus, the other known filovirus.

Adolescent↗
PubMed2002

Short communication: a cluster of Marburg virus disease involving an infant.

A noteworthy cluster of six cases of Marburg haemorrhagic fever (MHF) was identified in the Democratic Republic of Congo. One of the cases is the first infant Marburg fever patient ever documented. Three of six cases presented surprisingly mild symptoms. The results of epidemiological and virological investigations are compatible with person-to-person transmission through body fluids and with mother-to-child transmission while nurturing. The findings show that mild cases of MHF have to be expected during an outbreak and point out the difficulty to base patient management decisions on clinical case definitions alone.

Adult↗