In this series in The Lancet Infectious Diseases on the modern landscape of Ebola disease, we reflect on the 10-year anniversary of the west Africa (2014–16) epidemic and provide an overview of the progress made since then in improving clinical care for patients with Ebola disease. The first series paper focuses on advances in the understanding of the epidemiology and clinical manifestations of Ebola disease, along with developments in treatment and vaccines, care in special populations, and the evolving challenges of Ebola disease sequelae and viral persistence. However, one of the most crucial lessons of the west Africa epidemic was that responding through a restricted clinical focus—without considering the broader context of care—fails patients and communities. In the second series paper we review progress made in the last decade to improve patient-centred care. Although the biosafety imperatives of treating Ebola disease remain, recent advances show how to mitigate these so that patients are cared for in a safe and dignified manner that encourages early treatment-seeking behaviour and provides support after the return of patients to their communities. We review advances in diagnostics, including faster Ebola disease detection via real-time RT-PCR, and consider design improvements in Ebola disease treatment units that enhance patient safety and dignity. We also review advances in care provision, such as the integration of palliative care and mobile communication into routine care, and address how greater access to research is possible through harmonised clinical trials. Finally, we discuss how strengthened community engagement and psychosocial programmes are addressing stigma and providing holistic support for survivors.
Ebola disease: bridging scientific discoveries and clinical application
