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

Menelas Nkeshimana, Deborah Igiraneza, David Turatsinze, Otto Niyonsenga, Deborah Abimana, Cyprien Iradukunda, Emmanuel Bizimana, Jean Muragizi, Lise Mumporeze, Laurent Lussungu, Hackim Mugisha, Elizabeth Mgamb, Noella Bigirimana, Edison Rwagasore, Swaibu Gatare, Hassan Mugabo, Olivier Nsekuye, Muhammed Semakula, Augustin Sendegeya, Ephraim Rurangwa, Edgar Kalimba, Sanctus Musafiri, Corneille Ntihabose, Eric Seruyange, Charlotte Bavuma, Theogene Twagirumugabe, Daniel Nyamwasa and Sabin Nsanzimana
Additional contact information
Menelas Nkeshimana: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
Deborah Igiraneza: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
David Turatsinze: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
Otto Niyonsenga: School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda
Deborah Abimana: Nyarugenge District Hospital, Kigali 5634, Rwanda
Cyprien Iradukunda: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
Emmanuel Bizimana: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
Jean Muragizi: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
Lise Mumporeze: School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda
Laurent Lussungu: Hôpital La Croix du Sud, Kigali 3377, Rwanda
Hackim Mugisha: Rwanda Joint Task Force for COVID-19, Case Management Sub-Cell, Kigali 84, Rwanda
Elizabeth Mgamb: World Health Organization, Asmara 5561, Eritrea
Noella Bigirimana: Rwanda Biomedical Center, Kigali 7162, Rwanda
Edison Rwagasore: Rwanda Biomedical Center, Kigali 7162, Rwanda
Swaibu Gatare: Rwanda Biomedical Center, Kigali 7162, Rwanda
Hassan Mugabo: Rwanda Biomedical Center, Kigali 7162, Rwanda
Olivier Nsekuye: Rwanda Biomedical Center, Kigali 7162, Rwanda
Muhammed Semakula: Rwanda Biomedical Center, Kigali 7162, Rwanda
Augustin Sendegeya: Clinical Services Division, Centre Hospitalier Universitaire de Butare, Huye 254, Rwanda
Ephraim Rurangwa: Rwanda Military Hospital, Kigali 3377, Rwanda
Edgar Kalimba: King Faisal Hospital, Kigali 2534, Rwanda
Sanctus Musafiri: Clinical Services Division, Centre Hospitalier Universitaire de Kigali, Kigali 655, Rwanda
Corneille Ntihabose: Rwanda Ministry of Health, Kigali 84, Rwanda
Eric Seruyange: School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda
Charlotte Bavuma: Clinical Services Division, Centre Hospitalier Universitaire de Kigali, Kigali 655, Rwanda
Theogene Twagirumugabe: School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda
Daniel Nyamwasa: Rwanda Ministry of Health, Kigali 84, Rwanda
Sabin Nsanzimana: Rwanda Biomedical Center, Kigali 7162, Rwanda

IJERPH, 2022, vol. 19, issue 3, 1-12

Abstract: 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.

Keywords: COVID-19; interventions; outcomes; monoclonal antibodies; guidelines; Rwanda (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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