Testing trouble adds to disorder in Uganda’s Ebola response

The nurse wanted the toddler with a high fever transferred at once from a private clinic in Uganda to a public hospital even though the child tested positive for malaria amid an Ebola outbreak that has rattled health workers.But the clinic’s owner wasn’t convinced as he examined the boy in his lap. The boy didn’t have Ebola, he concluded after looking for the tell-tale bloody signs of the virus, and then sent the patient and his thankful mother home after administering intravenous medication.The incident underscores the pitfalls health workers face in their response to a new Ebola outbreak in central Uganda. Because some malaria symptoms are similar to those of the Sudan strain of Ebola now circulating in three districts, community-based clinics that are usually the first port of call for those seeking care can be ill-equipped to make the right decisions at the right time.“You can’t say that everyone who is dying is dying of Ebola,” said nurse Edgar Muhindo of Mubende’s St. Florence Clinic, which unknowingly treated two Ebola patients for malaria before they sought care elsewhere. “But if it’s Ebola, it’s important to confirm that it’s Ebola. That’s why it’s important for more health units to have the machines that can detect this Ebola virus.” Simple microscopes at such remote clinics can quickly confirm malaria or typhoid, possibly obscuring the possibility that the same patient could simultaneously have Ebola.This was the case with a 24-year-old man who became sick in mid-September, was treated for malaria and pneumonia, and died the day before a sample from him confirmed the Ebola outbreak.