Table 2.
Topics listed in guidance materials on nutritional care for Ebola patients in Ebola treatment units and the frequency of topic inclusion(3,5–14,16–21)
| Nutritional Care Guidance Materials for Ebola Patients in Ebola Treatment Units | No. mentioning this topic (n 17) | % |
|---|---|---|
| Validity of guidance document | ||
| Date/year of publication | 14 | 82 |
| Contains a statement of validity of document and its recommendations | 1 | 6 |
| Purpose of guidance document | ||
| Clarification on the principles of treatment of EVD in relation to nutritional care and needs | 10 | 59 |
| EVD and feeding phases/groups | ||
| Description of disease and feeding phases | ||
| a) Affecting nutritional intake | 11 | 65 |
| b) Causing specific nutritional needs | 10 | 59 |
| c) Different feeding phases (maintenance, boost, transitions) | 12 | 71 |
| Description of different feeding groups (consistency: solid, semi-solid and liquid) | 11 | 65 |
| Assessment of patients with Ebola virus disease | ||
| Instructions on whether and how to assess a patient’s dietary needs | ||
| a) Pregnant and lactating women | 2 | 12 |
| b) Consistency adjustments | 12 | 71 |
| c) Appetite | 12 | 71 |
| d) Assistance with feeding (feeding support) | 4 | 24 |
| Instructions on how to assess a patient’s nutritional status | 6 | 35 |
| Algorithm guiding nutritional care options (assessment tool) | 9 | 53 |
| General management, diet and feeding of children and adults with Ebola virus disease | ||
| Advice on energetic needs | 10 | 59 |
| Food products | ||
| a) Recommending use of specialised products* | 17 | 100 |
| b) Rationale on use of specialised products* | 14 | 82 |
| c) Instructions on what food products to avoid and why | 8 | 47 |
| d) Instructions on how to improve palatability of ORS, CSB etc. | 3 | 18 |
| Specific guidance on how to and what to feed | ||
| a) Infants <6 months | 13 | 76 |
| b) Children 6–23 months | 13 | 76 |
| Instructions on whether or how to use NGT feeding | 12 | 71 |
| Instructions on quantities of food/drinks needed per patient for different age groups | ||
| a) <6 months | 9 | 53 |
| b) 6–23 months | 11 | 65 |
| c) 24–59 months | 8 | 47 |
| d) Older children | 8 | 47 |
| e) Adults | 9 | 53 |
| Instructions on meal and snacks frequency for different age groups | 13 | 76 |
| Information on interactions of certain drugs used on EVD treatment and food/drinks | 2 | 12 |
| Instructions on night-time feeding | 5 | 29 |
| Instructions on whether and how to monitor patient’s food/drink intake | 5 | 29 |
| Intake of specific nutrients | ||
| Advice on need for provision of specific nutrients | ||
| a) Protein | 6 | 35 |
| b) Vitamin A | 3 | 18 |
| c) Vitamin C | 1 | 6 |
| d) Na | 1 | 6 |
| e) K | 9 | 53 |
| f) Ca | 2 | 12 |
| g) Mg | 3 | 18 |
| h) P | 2 | 12 |
| i) Zn | 7 | 41 |
| j) Others (e.g. multivitamins, vitamin K, Fe) | 8 | 47 |
| Symptoms of Ebola virus disease that affect nutritional care and status | ||
| Instructions on how to deal with specific symptoms and dietary intake/needs | ||
| a) Nausea | 3 | 18 |
| b) Vomiting | 3 | 18 |
| c) Diarrhoea | 6 | 35 |
| d) Severe dehydration | 7 | 41 |
| e) Hypoglycaemia | 3 | 18 |
| f) Hypokalaemia | 3 | 18 |
| Food preparation and distribution | ||
| Food preparation | ||
| a) Instructions on preparation of specific food/drinks | 11 | 65 |
| b) Instructions on how to organise food preparation | 9 | 53 |
| c) Instructions on how to organise quality control measures if food preparation is outsourced | 1 | 6 |
| Instructions on how to provide food to individual patients | ||
| a) Packaging | 3 | 18 |
| b) Allocation system | 2 | 12 |
| c) Which utensils | 11 | 65 |
| d) Advice on temperature | 4 | 24 |
| Instructions on specific advice for families if they want to bring meals for a patient | 4 | 24 |
| Instructions on how to organise feeding support | ||
| a) Who gives the feeding support | 9 | 53 |
| b) How to provide feeding support | 10 | 59 |
| c) Physical feeding support aids | 5 | 29 |
| Instructions on how to calculate | ||
| a) Number of meals needed in an ETU | 3 | 18 |
| b) Food/drink supplies for an ETU | 3 | 18 |
| c) Feeding support needs for patients (hardware and human resources) | 0 | 0 |
| Instructions on how to safely transport food from outside and within ETU to patients | 2 | 12 |
| Instructions on how to set up the food system to provide nutritional care for EVD patients | 5 | 29 |
| Instructions on how to handle leftover food and utensils from bed site | 11 | 65 |
| Patient’s preferences | ||
| Instructions on how to assess/accommodate for patient’s dietary preferences | 7 | 41 |
| Instructions on how to obtain patient’s feedback on nutritional care during stay in ETU | 3 | 18 |
| Malnutrition and/or anthropometry | ||
| Instructions on if, when and how to conduct anthropometric measurements | 12 | 71 |
| Instructions on whether or how to adjust treatment for malnourished patient with EVD | 4 | 24 |
| Discharge | ||
| Instructions on discharge procedures and food provision for recovery | 11 | 65 |
| Job instructions | ||
| Job descriptions of various roles in the nutritional care for EVD patients | 5 | 29 |
| Forms | ||
| Patient forms related to nutrition | ||
| a) Assessment | 5 | 29 |
| b) Monitoring | 7 | 41 |
| c) Meal calculations | 4 | 24 |
EVD, Ebola Virus Disease; ETU, Ebola Treatment Unit; ORS, oral rehydration salt; NGT, naso-gastric tube.
*
Ready-to-use therapeutic foods, high-energy biscuits, therapeutic milk, ready-to-use supplementary foods and/or corn soy blend (CSB).