Experience of Rwanda on COVID-19 Case Management: From Uncertainties to the Era of Neutralizing Monoclonal Antibodies

Experience of Rwanda on COVID-19 Case Management: From Uncertainties to the Era of Neutralizing Monoclonal Antibodies

The management of COVID-19 in Rwanda has been dynamic, and the use of COVID-19 therapeutics has gradually been updated based on scientific discoveries. The treatment for COVID-19 remained patient-centered and entirely state-sponsored during the first and second waves. From the time of identification...

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Published in:International journal of environmental research and public health Vol. 19; no. 3; p. 1023
Main Authors: Nkeshimana, Menelas, Igiraneza, Deborah, Turatsinze, David, Niyonsenga, Otto, Abimana, Deborah, Iradukunda, Cyprien, Bizimana, Emmanuel, Muragizi, Jean, Mumporeze, Lise, Lussungu, Laurent, Mugisha, Hackim, Mgamb, Elizabeth, Bigirimana, Noella, Rwagasore, Edison, Gatare, Swaibu, Mugabo, Hassan, Nsekuye, Olivier, Semakula, Muhammed, Sendegeya, Augustin, Rurangwa, Ephraim, Kalimba, Edgar, Musafiri, Sanctus, Ntihabose, Corneille, Seruyange, Eric, Bavuma, Charlotte, Twagirumugabe, Theogene, Nyamwasa, Daniel, Nsanzimana, Sabin
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 18-01-2022
MDPI
Subjects:
Anti-inflammatory agents
Antibiotics
Antibodies, Monoclonal, Humanized - therapeutic use
Antibodies, Neutralizing - therapeutic use
Anticoagulants
Antiviral agents
Case management
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - therapy
COVID-19 vaccines
Disease transmission
Ebola virus
Epidemics
Health facilities
Hospitals
Humans
Hyperglycemia
Infections
Inflammation
Medical records
Monoclonal antibodies
Neutralizing
Pandemics
Patients
Public health
Quarantine
Rwanda - epidemiology
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Task forces
Vaccines
Rwanda
COVID-19
guidelines
interventions
outcomes
Rwanda
monoclonal antibodies
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Summary:The management of COVID-19 in Rwanda has been dynamic, and the use of COVID-19 therapeutics has gradually been updated based on scientific discoveries. The treatment for COVID-19 remained patient-centered and entirely state-sponsored during the first and second waves. From the time of identification of the index case in March 2020 up to August 2021, three versions of the clinical management guidelines were developed, with the aim of ensuring that the COVID-19 patients treated in Rwanda were receiving care based on the most recent therapeutic discoveries. As the case load increased and imposed imminent heavy burdens on the healthcare system, a smooth transition was made to enable that the asymptomatic and mild COVID-19 cases could continue to be closely observed and managed while they remained in their homes. The care provided to patients requiring facility-based interventions mainly focused on the provision of anti-inflammatory drugs, anticoagulation, broad-spectrum antibiotic therapy, management of hyperglycemia and the provision of therapeutics with a direct antiviral effect such as favipiravir and neutralizing monoclonal antibodies. The time to viral clearance was observed to be shortest among eligible patients treated with neutralizing monoclonal antibodies (bamlanivimab). Moving forward, as we strive to continue detecting COVID-19 cases as early as possible, and promptly initiate supportive interventions, the use of neutralizing monoclonal antibodies constitutes an attractive and cost-effective therapeutic approach. If this approach is used strategically along with other measures in place (i.e., COVID-19 vaccine roll out, etc.), it will enable us to bring this global battle against the COVID-19 pandemic under full control and with a low case fatality rate.
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ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph19031023