According to the Head of World Health Organization (WHO) Margaret
Chan “the Ebola outbreak in West Africa is spreading faster than efforts to
control it”. She told a summit of regional leaders that failure to contain
Ebola could be “catastrophic” in terms of lives lost. She noted that the virus,
which has claimed 728 lives in Guinea, Liberia, and Sierra Leone since
February, could be stopped if well managed.
As a result of the sudden outbreak in West Africa what is the way
forward?
The Ebola Virus disease (EVD), formerly known as Ebola
hemorrhagic fever is a severe condition caused by a virus from the Filoviridae family. It is zoonotic in nature,
that is, it is a condition that can be transmitted from animals to man, this
virus spreads through direct contact with bodily fluids of an infected person
or animal.
According to WHO, Ebola is
introduced into the human population through close contact with blood, secretions,
organs or bodily fluids of infected animals. In Africa infection has been documented
through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest
antelope and porcupines found ill or dead or in the rain forest.
Ebola then spreads in
the Community through human-to-human transmission, with infection resulting
from direct contact (through broken skin or mucous membranes) with the blood,
secretions, organs, or other bodily fluids of infected people, and indirect
contact with environments contaminated with such fluids. Burial ceremonies in
which mourners have direct contact with the body of the deceased person can
also play a role in the transmission of Ebola. Men who have recovered from the
disease can still transmit the virus through their semen for up to 7 weeks
after recovery from illness.
WHO informs us that before we
diagnose EVD we must rule out other diseases like malaria, typhoid,
shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis,
hepatitis and other haemorrhagic fevers.
Ebola virus infection can be
diagnosed definitively in the Medical Laboratory through several types of test
namely:
(a) Antibody-Capture
Enzyme-Linked Immunosorbent Assay(ELISA)
(b)Antigen Detection Tests
(c) Serum Neutralization Test
(d) Reverse Transcriptase
Polymerase Chain Reaction (RT-PCR)
(e) Electron Microscopy
(f) Virus Isolation by Cell
Culture
Samples from patients should be
seriously handled with care as they are extreme biohazards, and testing should
be conducted under maximum biological containment conditions.
The fruit bat particularly species
of the genera- Hypsignathus monstrosus, Epomops franqueti and Myonycteris
torquata, in Africa are considered possible natural hosts for Ebola Virus
WHO still informs us that as at
today there is no licensed vaccine for EVD. Many vaccines are being tested, but
none are available for clinical use. Ill patients require intensive supportive
care. Patients are frequently dehydrated and require oral rehydration with
solutions containing electrolytes or intravenous fluids. No specific
conventional treatment is available and new drug therapies are being evaluated.
According to a research, led by
Professor Maurice Iwu, head, the Bioresource Development and Conservative
Program, a Nigerian Professor of Pharmacognosy and former Independent Electoral
Committee Chairman( INEC Chairman) a plant commonly eaten in West Africa,
Garcinia kola has been found to halt the deadly
Ebola virus in its tracks in tests.
This discovery was announced at the
16th International Botanical Congress in St Louis in the United
States of America in 1999.This inhibitory action is yet to be duplicated in
animals and in humans. IF this can be achieved in human, then it means that we
are at the verge of another breakthrough. Prof Iwu had this to say “This is a
very exciting discovery, the same forest that yields the dreaded Ebola virus
could be a source of the cure”
The active compound in the Garcina kola is a
dimeric flavonoids, which is two flavonoid molecules fused together. More work
needs to be done to see if a phytomedicine can be developed from Garcinia kola
commonly called bitter kola. Phytomedicine has always been useful to man, that
some modern drugs are of plant origin eg Digitalis from the plant floxglove for
management of cardiac abnormality, the Pacific Yew –Taxus brevifolia which gave
the anticancer drug Taxol, aspirin from the Willow tree which is used as a pain
killer, quinine from the cinchona plant which is used as an anitmalaria etc.
Embracing Integrative Medicine in
Nigeria
As a result of reemerging and
emerging outbreaks that have defied conventional therapies, antibiotic
resistance, cases of multiple drug resistance, frequent closure of hospitals as
a result of unwarranted/unnecessary strike action, there is an urgent need to
embrace medical pluralism in Nigeria. Medical pluralism is all about
Integrative Medicine.
Integrative Medicine is the application/use of
conventional therapies and ethnomedical therapies like in Alternative Medicine,
Traditional Medicine(TM), and Complementary Medicine in the prevention, diagnosis,
treatment and management of diseases in a community. The new paradigm is
Integrative Medicine in order to achieve healthcare for all through a
functional and holistic approach.
WHO informs that an integrated system
integrates conventional and TM systems at level of medical education and
practice. Integrative measures include government regulation and registration
to control the safety, efficacy, and quality of herbal medicine products;
registration of healers and herbalist; and establishment of specialized
hospitals, colleges, and universities.
China, the Democratic People’s Republic
of Korea, the Republic of Korea, and Vietnam are countries considered to have
fully integrated system (WHO 2002). Philippines has a national policy on TM,
while India has one of the best digital library/data base on knowledge and
formulations used in Ayurveda .Countries like, United Kingdom, United States,
Germany, Canada, Australia etc are said to practice a mixed medical system.
In
Africa, Uganda has added traditional healing studies to its university
curriculum to show that TM has a role in the healthcare system. Ghana has
already established universities running bachelors in herbal medicine, while
South Africa recognizes traditional healthcare providers as full-fledged
healthcare professionals.
In other to tackle the
reemergence and emerging infections, sporadic outbreaks and to provide
effective healthcare services in Nigeria, Government as a matter of urgency
should adopt the Total Integrative Medical System Initiative (TIMS Initiative) which
tends to utilize Conventional therapies, Ethnomedical therapies like
Traditional Medicine, Alternative Medicine, and Complementary Medicine in the
prevention, diagnosis, treatment and management of diseases.
Government should equip our
medical laboratories to handle the identification, isolation and
characterization of emerging microorganisms and make sure that medical
laboratories in Nigeria are strategically placed in monitoring disease
outbreaks and control.
Government should introduce the
practice of ethnomedicine in our hospitals and create an Ethnomedical Council
of Nigeria to regulate its practice and practitioners.
Government should really empower
the National Natural Medicine Development Agency Koffo Abayomi Victoria Island
to develop a curriculum for the training of Ethnomedical practitioners in
Nigeria for the onward integration into the Nigerian Healthcare System.
Government at all levels (Local,
State, and Federal) should encourage research and documentation of our
indigenous medicinal fauna and flora for drug development and utilization.
Dr. Benjamin Chukwunonso Ajufo wrote from Kolkata India, he is a Medical
Laboratory Scientist/Doctor of Holistic Medicine.
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