{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T09:28:39Z","timestamp":1780824519390,"version":"3.54.1"},"reference-count":60,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,26]]},"abstract":"<jats:title>Abstract:<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>During the West Africa Ebola virus disease (EVD) outbreak, a Belgian laboratory was deployed for supporting the Ebola treatment unit (ETU) of N\u2019Zerekore, Guinea. Besides diagnosis of EVD and malaria, biochemical parameters were tested and used to guide supportive treatment of EVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>To preserve analytes stability, lithium-heparin blood samples were analyzed using the i-STAT<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Providing the medical staff with real-time biochemical data modified their therapeutic attitude, shifting from empiric to a semi-intensive laboratory-guided treatment of hydro-electrolytic disturbances, metabolic acidosis and\/or impaired kidney function. As illustrated with representative EVD cases (n=8), optimized supportive treatment with intravenous fluid therapy and electrolyte replacement often helped correct these abnormalities. However, the harsh operating conditions, especially the use of bleach decontamination inside the glovebox, caused several technical failures and the final breakdown of the POCT device.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>POCT availability resulted in a paradigm shift in laboratory practice and care delivery at the N\u2019Zerekore ETU. We conclude that there is urgent need for novel well-designed and validated POCT devices usable by non-expert operators in high ambient temperature and limited space. These devices should withstand regular and thorough decontamination by the personnel working on-site with life-threatening pathogens and be compatible with high biosafety level procedures. Such specific users\u2019 requirements need a European validation and standardization process of proposed solutions led by the EU Standardization Committee (CEN).<\/jats:p><\/jats:sec>","DOI":"10.1515\/cclm-2016-0456","type":"journal-article","created":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T10:44:36Z","timestamp":1489747476000},"source":"Crossref","is-referenced-by-count":6,"title":["Biochemical testing in a laboratory tent and semi-intensive care of Ebola patients on-site in a remote part of Guinea: a paradigm shift based on a bleach-sensitive point-of-care device"],"prefix":"10.1515","volume":"55","author":[{"given":"Leonid M.","family":"Irenge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Dindart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Gala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref11","doi-asserted-by":"crossref","first-page":"2054","DOI":"10.1056\/NEJMp1413084","article-title":"Ebola virus disease in West Africa\u2013clinical manifestations and management","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/S1473-3099(15)00144-9","article-title":"Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study","volume":"15","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1056\/NEJMoa1409838","article-title":"Clinical care of two patients with Ebola virus disease in the United States","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1056\/NEJMoa1511812","article-title":"Evaluation of convalescent plasma for ebola virus disease in Guinea","volume":"374","year":"2016","journal-title":"N Engl J Med"},{"key":"ref541","first-page":"32","article-title":"Decision support in a fieldable laboratory management during an epidemic outbreak of disease","volume":"6","year":"2016","journal-title":"Journal of Humanitarian Logistics and Supply Chain Management"},{"key":"ref641","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1586\/14737159.2015.1079776","article-title":"Molecular detection and point-of-care testing in Ebola virus disease and other threats: a new global public health framework to stop outbreaks","volume":"15","year":"2015","journal-title":"Expert Rev Mol Diagn"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1056\/NEJMoa1511812","article-title":"Evaluation of convalescent plasma for ebola virus disease in Guinea","volume":"374","year":"2016","journal-title":"N Engl J Med"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"3148","DOI":"10.1128\/JCM.01449-15","article-title":"Buffer AVL alone does not inactivate ebola virus in a representative clinical sample type","volume":"53","year":"2015","journal-title":"J Clin Microbiol"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jviromet.2004.03.015","article-title":"Virus inactivation by nucleic acid extraction reagents","volume":"119","year":"2004","journal-title":"J Virol Methods"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1056\/NEJMoa1504874","article-title":"Clinical management of ebola virus disease in the United States and Europe","volume":"374","year":"2016","journal-title":"N Engl J Med"},{"key":"ref621","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1513\/AnnalsATS.201410-481PS","article-title":"Clinical presentation and management of severe Ebola virus disease","volume":"11","year":"2014","journal-title":"Ann Am Thorac Soc"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1513\/AnnalsATS.201410-481PS","article-title":"Clinical presentation and management of severe Ebola virus disease","volume":"11","year":"2014","journal-title":"Ann Am Thorac Soc"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1164\/rccm.201408-1514CP","article-title":"Caring for critically ill patients with ebola virus disease. Perspectives from West Africa","volume":"190","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1056\/NEJMoa1411249","article-title":"Clinical presentation of patients with Ebola virus disease in Conakry, Guinea","volume":"372","year":"2015","journal-title":"N Engl J Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/S1473-3099(15)00144-9","article-title":"Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study","volume":"15","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1056\/NEJMoa1411249","article-title":"Clinical presentation of patients with Ebola virus disease in Conakry, Guinea","volume":"372","year":"2015","journal-title":"N Engl J Med"},{"key":"ref191","first-page":"155","article-title":"Existing and emerging technologies for point-of-care testing","volume":"35","year":"2014","journal-title":"Clin Biochem Rev"},{"key":"ref551","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/cid\/civ779","article-title":"Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea","volume":"62","year":"2016","journal-title":"Clin Infect Dis"},{"key":"ref611","doi-asserted-by":"crossref","first-page":"S48","DOI":"10.1086\/514285","article-title":"Human infection due to Ebola virus, subtype Cote d\u2019Ivoire: clinical and biologic presentation","volume":"179","year":"1999","journal-title":"J Infect Dis"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0140-6736(15)61117-5","article-title":"Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial","volume":"386","year":"2015","journal-title":"Lancet"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1093\/cid\/civ435","article-title":"Targeted electrolyte replacement in patients with Ebola virus disease","volume":"61","year":"2015","journal-title":"Clin Infect Dis"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1186\/s13054-016-1325-2","article-title":"Ebola virus disease and critical illness","volume":"20","year":"2016","journal-title":"Crit Care"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"S364","DOI":"10.1086\/520613","article-title":"Blood chemistry measurements and D-Dimer levels associated with fatal and nonfatal outcomes in humans infected with Sudan Ebola virus","volume":"196","year":"2007","journal-title":"J Infect Dis"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0140-6736(10)60667-8","article-title":"Ebola haemorrhagic fever","volume":"377","year":"2011","journal-title":"Lancet"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1093\/cid\/civ420","article-title":"Supportive care of the first 2 ebola virus disease patients at the monrovia medical unit","volume":"61","year":"2015","journal-title":"Clin Infect Dis"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1056\/NEJMoa1504874","article-title":"Clinical management of ebola virus disease in the United States and Europe","volume":"374","year":"2016","journal-title":"N Engl J Med"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1186\/s13054-016-1325-2","article-title":"Ebola virus disease and critical illness","volume":"20","year":"2016","journal-title":"Crit Care"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"e1001967","DOI":"10.1371\/journal.pmed.1001967","article-title":"Experimental treatment with favipiravir for ebola virus disease (the JIKI trial): a historically controlled, single-arm proof-of-concept trial in Guinea","volume":"13","year":"2016","journal-title":"PLOS Med"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1515\/CCLM.2011.185","article-title":"Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers","volume":"49","year":"2011","journal-title":"Clin Chem Lab Med"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa1411680","article-title":"Clinical illness and outcomes in patients with Ebola in Sierra Leone","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"e1001967","DOI":"10.1371\/journal.pmed.1001967","article-title":"Experimental treatment with favipiravir for ebola virus disease (the JIKI trial): a historically controlled, single-arm proof-of-concept trial in Guinea","volume":"13","year":"2016","journal-title":"PLOS Med"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"S364","DOI":"10.1086\/520613","article-title":"Blood chemistry measurements and D-Dimer levels associated with fatal and nonfatal outcomes in humans infected with Sudan Ebola virus","volume":"196","year":"2007","journal-title":"J Infect Dis"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jviromet.2004.03.015","article-title":"Virus inactivation by nucleic acid extraction reagents","volume":"119","year":"2004","journal-title":"J Virol Methods"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1001\/jama.2015.0942","article-title":"As Ebola epidemic begins to slow, trials of drugs and vaccines speed up","volume":"313","year":"2015","journal-title":"J Am Med Assoc"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"e0004393","DOI":"10.1371\/journal.pntd.0004393","article-title":"A 6-year-old child with severe ebola virus disease: laboratory-guided clinical care in an ebola treatment center in Guinea","volume":"10","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1056\/NEJMoa1411677","article-title":"A case of severe Ebola virus infection complicated by gram-negative septicemia","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1016\/S0140-6736(14)62384-9","article-title":"Severe Ebola virus disease with vascular leakage and multiorgan failure: treatment of a patient in intensive care","volume":"385","year":"2015","journal-title":"Lancet"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0140-6736(10)60667-8","article-title":"Ebola haemorrhagic fever","volume":"377","year":"2011","journal-title":"Lancet"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1056\/NEJMoa1411677","article-title":"A case of severe Ebola virus infection complicated by gram-negative septicemia","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"3148","DOI":"10.1128\/JCM.01449-15","article-title":"Buffer AVL alone does not inactivate ebola virus in a representative clinical sample type","volume":"53","year":"2015","journal-title":"J Clin Microbiol"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1586\/14737159.2015.1079776","article-title":"Molecular detection and point-of-care testing in Ebola virus disease and other threats: a new global public health framework to stop outbreaks","volume":"15","year":"2015","journal-title":"Expert Rev Mol Diagn"},{"key":"ref531","first-page":"13","article-title":"Information management Supporting Deployment of a Light Fieldable Laboratory: a case for Ebola Crisis","volume":"4","year":"2016","journal-title":"Universal J Manage"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0140-6736(15)61117-5","article-title":"Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial","volume":"386","year":"2015","journal-title":"Lancet"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1515\/CCLM.2011.185","article-title":"Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers","volume":"49","year":"2011","journal-title":"Clin Chem Lab Med"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5055\/ajdm.2015.0196","article-title":"The Ebola spatial care path: accelerating point-of-care diagnosis, decision making, and community resilience in outbreaks","volume":"10","year":"2015","journal-title":"Am J Disaster Med"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1016\/S0140-6736(14)62384-9","article-title":"Severe Ebola virus disease with vascular leakage and multiorgan failure: treatment of a patient in intensive care","volume":"385","year":"2015","journal-title":"Lancet"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"S48","DOI":"10.1086\/514285","article-title":"Human infection due to Ebola virus, subtype Cote d\u2019Ivoire: clinical and biologic presentation","volume":"179","year":"1999","journal-title":"J Infect Dis"},{"key":"ref521","first-page":"155","article-title":"Existing and emerging technologies for point-of-care testing","volume":"35","year":"2014","journal-title":"Clin Biochem Rev"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1093\/cid\/civ420","article-title":"Supportive care of the first 2 ebola virus disease patients at the monrovia medical unit","volume":"61","year":"2015","journal-title":"Clin Infect Dis"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/cid\/civ779","article-title":"Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea","volume":"62","year":"2016","journal-title":"Clin Infect Dis"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1164\/rccm.201408-1514CP","article-title":"Caring for critically ill patients with ebola virus disease. Perspectives from West Africa","volume":"190","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"ref631","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5055\/ajdm.2015.0196","article-title":"The Ebola spatial care path: accelerating point-of-care diagnosis, decision making, and community resilience in outbreaks","volume":"10","year":"2015","journal-title":"Am J Disaster Med"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa1411680","article-title":"Clinical illness and outcomes in patients with Ebola in Sierra Leone","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1001\/jama.2015.0942","article-title":"As Ebola epidemic begins to slow, trials of drugs and vaccines speed up","volume":"313","year":"2015","journal-title":"J Am Med Assoc"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"e0004393","DOI":"10.1371\/journal.pntd.0004393","article-title":"A 6-year-old child with severe ebola virus disease: laboratory-guided clinical care in an ebola treatment center in Guinea","volume":"10","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"ref201","first-page":"13","article-title":"Information management Supporting Deployment of a Light Fieldable Laboratory: a case for Ebola Crisis","volume":"4","year":"2016","journal-title":"Universal J Manage"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1093\/cid\/civ435","article-title":"Targeted electrolyte replacement in patients with Ebola virus disease","volume":"61","year":"2015","journal-title":"Clin Infect Dis"},{"key":"ref211","first-page":"32","article-title":"Decision support in a fieldable laboratory management during an epidemic outbreak of disease","volume":"6","year":"2016","journal-title":"Journal of Humanitarian Logistics and Supply Chain Management"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1056\/NEJMoa1409838","article-title":"Clinical care of two patients with Ebola virus disease in the United States","volume":"371","year":"2014","journal-title":"N Engl J Med"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"2054","DOI":"10.1056\/NEJMp1413084","article-title":"Ebola virus disease in West Africa\u2013clinical manifestations and management","volume":"371","year":"2014","journal-title":"N Engl J Med"}],"container-title":["Clinical Chemistry and Laboratory Medicine (CCLM)"],"original-title":[],"link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/cclm.2017.55.issue-12\/cclm-2016-0456\/cclm-2016-0456.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2016-0456\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T17:53:38Z","timestamp":1692726818000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2016-0456\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,1]]},"references-count":60,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.1515\/cclm-2016-0456","relation":{},"ISSN":["1437-4331","1434-6621"],"issn-type":[{"value":"1437-4331","type":"electronic"},{"value":"1434-6621","type":"print"}],"subject":[],"published":{"date-parts":[[2017,1,1]]}}}