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Challenges in preparing and implementing a clinical trial at field level in an Ebola emergency: A case study in Guinea, West Africa

PLoS Negl Trop Dis. 2017 Jun 22;11(6):e0005545. doi: 10.1371/journal.pntd.0005545. eCollection 2017 Jun.

Abstract

During the large Ebola outbreak that affected West Africa in 2014 and 2015, studies were launched to evaluate potential treatments for the disease. A clinical trial to evaluate the effectiveness of the antiviral drug favipiravir was conducted in Guinea. This paper describes the main challenges of the implementation of the trial in the Ebola treatment center of Guéckédou. Following the principles of the Good Clinical Research Practices, we explored the aspects of the community's communication and engagement, ethical conduct, trial protocol compliance, informed consent of participants, ongoing benefit/risk assessment, record keeping, confidentiality of patients and study data, and roles and responsibilities of the actors involved. We concluded that several challenges have to be addressed to successfully implement a clinical trial during an international medical emergency but that the potential for collaboration between research teams and humanitarian organizations needs to be highlighted.

MeSH terms

  • Amides / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Clinical Trials as Topic / organization & administration*
  • Clinical Trials as Topic / standards
  • Confidentiality
  • Disease Outbreaks
  • Guinea / epidemiology
  • Hemorrhagic Fever, Ebola / drug therapy*
  • Hemorrhagic Fever, Ebola / epidemiology*
  • Humans
  • Informed Consent
  • Medical Records / standards
  • Pyrazines / therapeutic use*
  • Research Design

Substances

  • Amides
  • Antiviral Agents
  • Pyrazines
  • favipiravir

Grants and funding

The authors received no specific funding for this work.