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Current Ebola virus disease (EVD) diagnosis relies on reverse transcription-PCR (RT-PCR) technology, requiring skilled laboratory personnel and technical infrastructure. Lack of laboratory diagnostic capacity has led to diagnostic delays in the current West African EVD outbreak of 2014 and 2015, compromising outbreak control. We evaluated the diagnostic accuracy of the EVD bedside rapid diagnostic antigen test (RDT) developed by the United Kingdom's Defence Science and Technology Laboratory, compared with Ebola virus RT-PCR, in an operational setting for EVD diagnosis of suspected cases admitted to Ebola holding units in the Western Area of Sierra Leone. From 22 January to 16 February 2015, 138 participants were enrolled. EVD prevalence was 11.5%. All EVD cases were identified by a positive RDT with a test line score of 6 or more, giving a sensitivity of 100% (95% confidence interval (CI): 78.2-100). The corresponding specificity was high (96.6%, 95% CI: 91.3-99.1). The positive and negative predictive values for the population prevalence were 79.0% (95% CI: 54.4-93.8) and 100% (95% CI: 96.7-100), respectively. These results, if confirmed in a larger study, suggest that this RDT could be used as a 'rule-out' screening test for EVD to improve rapid case identification and resource allocation.

COVID-19, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly transmissible, with a high mortality in vulnerable individuals and no known disease-specific treatment or vaccine. [1] On 11 March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak to be a pandemic, making global recommendations to reduce transmission, prepare and be ready. [2] As anticipated, it continued to spread and is now prevalent in South Africa (SA) and other African countries, [1] putting healthcare systems under severe pressure.Healthcare workers (HCWs) are the most important resource in both the COVID-19 response and in maintaining essential services. [3] HCW motivation and empathy are critical to effective and compassionate healthcare. Mental health conditions may compromise work performance and increase risk of burnout, absenteeism and resignations. [4,5] Fatigue, emotional exhaustion or poor concentration are likely to increase clinical error, including breaches in infection control, impacting on patient care and staff infections. Protecting the mental health and wellbeing of HCWs is therefore of paramount importance during an infectious disease outbreak.Such outbreaks cause high levels of psychosocial stress, [6] related to uncertainty regarding risk of infection and prognosis, loss of loved ones, and the social impact of measures instituted to contain the spread of disease. Being at the frontline in disease detection and management, HCWs are vulnerable, exposed to infection, high workloads and difficult working conditions. Resource constraints, including shortages of personal protective equipment (PPE), limit individual capacity to provide appropriate patient care and heighten the mental health risk. Being quarantined appears to convey particular stress. [7] The Gauteng Province Department of Health's research and evaluation workstream therefore requested evidence-based recommendations regarding the potential impact of the COVID-19 pandemic on the mental health of HCWs and their protection. This article describes the process behind, and builds upon, a presentation made to the senior leadership of the Gauteng Department of Health's COVID-19 response team in April 2020, for which we sought to answer two questions: (i) what may be expected regarding the psychological impact of the COVID-19 outbreak on HCWs; and (ii) what interventions could be considered in order to protect and support the mental health and wellbeing of HCWs during the crisis. MethodsWe conducted a rapid scoping review of published literature on mental health of HCWs exposed to infectious disease outbreaks. Literature search and study selectionTo gain an understanding of the topic, we conducted a preliminary search and screen of the PubMed and Cochrane databases on 7 and 8 April 2020, respectively, using terms (healthcare workers OR medical doctors OR nurses OR community health workers) AND This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.