The 2013–2016 Western African outbreak of the Ebola virus disease (EVD), the largest recorded outbreak since the discovery of Ebola virus (EBOV) in 1976, destabilised local health systems and left thousands of survivors at risk for postacute sequelae, including vision-threatening uveitis. In an EVD survivor with severe panuveitis, the detection of persistent EBOV in the aqueous humour, long after clearance of acute viremia, focused clinical and research attention on the host-EBOV interaction in the unique terrain of ocular immune privilege. Despite the recognition that uveitis is common and consequential in EVD survivors, our understanding of pathogenesis is extremely limited, including the contributions of viral persistence and ocular-specific and systemic immune responses to disease expression. In this study protocol, we outline a multifaceted approach to characterise EVD-associated intraocular inflammation, including the clinical phenotype and complications; the presence of EBOV (or EBOV RNA/antigen) in ocular fluids and tissues; and associated local ocular-specific and peripheral immune responses.
We use an observational cohort design, which includes EVD survivors and close contacts of EVD survivors (ie, no documented history of EVD), and we propose disease (clinical examination and imaging), as well as molecular, virologic and immunologic characterisation, to meet research objectives.
This study has received Institutional Review Board approval from University of Nebraska Medical Centre, Emory University and Sierra Leone Ministry of Health. Findings will be disseminated through peer-reviewed publications.
Health workers (HWs) and their representative health worker organisations (RHWOs) contribute to the design of pharmaceutical policy in low- and middle-income countries (LMICs), but their roles remain underappreciated. HWs and RHWOs can influence drug development, distribution, financing and access; however, which specific aspects HWs and RHWOs contribute to, and how they create change, remains insufficiently mapped within the global health literature. This protocol describes our process for conducting a scoping review to derive, describe, and classify existing literature on how HWs and RHWOs engage in pharmaceutical policy processes in LMICs.
This review will follow the updated Arksey and O’Malley five-stage scoping review framework supported by iterations of methodological guidance and will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We will search Ovid Medline, Ovid Embase and CAB Global Health for English-language peer-reviewed literature published between 2005 and 2025. Studies must discuss HW and RHWO involvement or influence in pharmaceutical policy or describe the roles, governance contexts or strategies of HWs or RHWOs in the context of pharmaceutical policy. Two reviewers will independently screen titles, abstracts and full texts using Covidence software to determine eligibility. We will chart data using Excel and summarise the findings thematically. We will consult stakeholders in the final stage of this review to provide feedback on the results of our review and guide our findings further in terms of actionable policy implications.
Ethics approval is not required for this scoping review of published literature. Findings will be disseminated through peer-reviewed publications, academic presentations and policy engagement with global health actors. This review will inform future research and support evidence-informed pharmaceutical policymaking in LMICs.