TY - JOUR
T1 - Prevention of sexual transmission of Ebola in Liberia through a national semen testing and counselling programme for survivors
T2 - an analysis of Ebola virus RNA results and behavioural data
AU - Soka, Moses J.
AU - Choi, Mary J.
AU - Baller, April
AU - White, Stephen
AU - Rogers, Emerson
AU - Purpura, Lawrence J.
AU - Mahmoud, Nuha
AU - Wasunna, Christine
AU - Massaquoi, Moses
AU - Abad, Neetu
AU - Kollie, Jomah
AU - Dweh, Straker
AU - Bemah, Philip K.
AU - Christie, Athalia
AU - Ladele, Victor
AU - Subah, Oneychachi C.
AU - Pillai, Satish
AU - Mugisha, Margaret
AU - Kpaka, Jonathan
AU - Kowalewski, Stephen
AU - German, Emilio
AU - Stenger, Mark
AU - Nichol, Stuart
AU - Ströher, Ute
AU - Vanderende, Kristin E.
AU - Zarecki, Shauna Mettee
AU - Green, Hugh Henry W.
AU - Bailey, Jeffrey A.
AU - Rollin, Pierre
AU - Marston, Barbara
AU - Nyenswah, Tolbert G.
AU - Gasasira, Alex
AU - Knust, Barbara
AU - Williams, Desmond
N1 - Publisher Copyright:
© 2016 World Health Organization
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Ebola virus has been detected in semen of Ebola virus disease survivors after recovery. Liberia's Men's Health Screening Program (MHSP) offers Ebola virus disease survivors semen testing for Ebola virus. We present preliminary results and behavioural outcomes from the first national semen testing programme for Ebola virus. Methods The MHSP operates out of three locations in Liberia: Redemption Hospital in Montserrado County, Phebe Hospital in Bong County, and Tellewoyan Hospital in Lofa County. Men aged 15 years and older who had an Ebola treatment unit discharge certificate are eligible for inclusion. Participants' semen samples were tested for Ebola virus RNA by real-time RT-PCR and participants received counselling on safe sexual practices. Participants graduated after receiving two consecutive negative semen tests. Counsellors collected information on sociodemographics and sexual behaviours using questionnaires administered at enrolment, follow up, and graduation visits. Because the programme is ongoing, data analysis was restricted to data obtained from July 7, 2015, to May 6, 2016. Findings As of May 6, 2016, 466 Ebola virus disease survivors had enrolled in the programme; real-time RT-PCR results were available from 429 participants. 38 participants (9%) produced at least one semen specimen that tested positive for Ebola virus RNA. Of these, 24 (63%) provided semen specimens that tested positive 12 months or longer after Ebola virus disease recovery. The longest interval between discharge from an Ebola treatment unit and collection of a positive semen sample was 565 days. Among participants who enrolled and provided specimens more than 90 days since their Ebola treatment unit discharge, men older than 40 years were more likely to have a semen sample test positive than were men aged 40 years or younger (p=0·0004). 84 (74%) of 113 participants who reported not using a condom at enrolment reported using condoms at their first follow-up visit (p<0·0001). 176 (46%) of 385 participants who reported being sexually active at enrolment reported abstinence at their follow-up visit (p<0·0001). Interpretation Duration of detection of Ebola virus RNA by real-time RT-PCR varies by individual and might be associated with age. By combining behavioural counselling and laboratory testing, the Men's Health Screening Program helps male Ebola virus disease survivors understand their individual risk and take appropriate measures to protect their sexual partners. Funding World Health Organization and the US Centers for Disease Control and Prevention.
AB - Background Ebola virus has been detected in semen of Ebola virus disease survivors after recovery. Liberia's Men's Health Screening Program (MHSP) offers Ebola virus disease survivors semen testing for Ebola virus. We present preliminary results and behavioural outcomes from the first national semen testing programme for Ebola virus. Methods The MHSP operates out of three locations in Liberia: Redemption Hospital in Montserrado County, Phebe Hospital in Bong County, and Tellewoyan Hospital in Lofa County. Men aged 15 years and older who had an Ebola treatment unit discharge certificate are eligible for inclusion. Participants' semen samples were tested for Ebola virus RNA by real-time RT-PCR and participants received counselling on safe sexual practices. Participants graduated after receiving two consecutive negative semen tests. Counsellors collected information on sociodemographics and sexual behaviours using questionnaires administered at enrolment, follow up, and graduation visits. Because the programme is ongoing, data analysis was restricted to data obtained from July 7, 2015, to May 6, 2016. Findings As of May 6, 2016, 466 Ebola virus disease survivors had enrolled in the programme; real-time RT-PCR results were available from 429 participants. 38 participants (9%) produced at least one semen specimen that tested positive for Ebola virus RNA. Of these, 24 (63%) provided semen specimens that tested positive 12 months or longer after Ebola virus disease recovery. The longest interval between discharge from an Ebola treatment unit and collection of a positive semen sample was 565 days. Among participants who enrolled and provided specimens more than 90 days since their Ebola treatment unit discharge, men older than 40 years were more likely to have a semen sample test positive than were men aged 40 years or younger (p=0·0004). 84 (74%) of 113 participants who reported not using a condom at enrolment reported using condoms at their first follow-up visit (p<0·0001). 176 (46%) of 385 participants who reported being sexually active at enrolment reported abstinence at their follow-up visit (p<0·0001). Interpretation Duration of detection of Ebola virus RNA by real-time RT-PCR varies by individual and might be associated with age. By combining behavioural counselling and laboratory testing, the Men's Health Screening Program helps male Ebola virus disease survivors understand their individual risk and take appropriate measures to protect their sexual partners. Funding World Health Organization and the US Centers for Disease Control and Prevention.
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U2 - 10.1016/S2214-109X(16)30175-9
DO - 10.1016/S2214-109X(16)30175-9
M3 - Article
C2 - 27596037
AN - SCOPUS:84991571506
SN - 2214-109X
VL - 4
SP - e736-e743
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 10
ER -