T Sesay1, O Denisiuk2, K K Shringarpure3, B S Wurie1, P George1, M I Sesay1, R Zachariah4. 1. District Health Management Team, Ministry of Health and Sanitation, Port Loko, Sierra Leone. 2. Alliance for Public Health, Kiev, Ukraine. 3. Department of Preventive and Social Medicine, Baroda Medical College, Vadodara, India. 4. Operational Research Unit, Médecins Sans Frontières, Brussels Operational Centre, Luxembourg.
Abstract
Setting: All peripheral health units countrywide in Sierra Leone and one hospital in Port Loko. Objectives: Sierra Leone was severely affected by the 2014-2015 Ebola outbreak, whose impact on paediatric care and mortality reports merits assessment. We sought to compare the periods before, during and after the Ebola outbreak, the countrywide trend in morbidities in children aged < 5 years and exit outcomes in one district hospital (Port Loko). During the Ebola outbreak period, gaps in district death reporting within the routine Health Management Information System (HMIS) were compared with the Safe and Dignified Burials (SDB) database in Port Loko. Design: This was a retrospective records analysis. Results: The average number of monthly consultations during the Ebola outbreak period declined by 27% for malaria and acute respiratory infections and 38% for watery diarrhoea, and did not recover to the pre-Ebola levels. For measles, there was an 80% increase during Ebola, which multiplied by 6.5-fold post-Ebola. The number of unfavourable hospital exit outcomes was 52/397 (13%) during Ebola, which was higher than pre-Ebola (47/496, 9%, P = 0.04). Of 6565 deaths reported in the Port Loko SDB database, only 2219 (34%) appeared in the HMIS, a reporting deficit of 66%. Conclusion: The Ebola disease outbreak was associated with reduced utilisation of health services, and appears to have triggered a measles epidemic. Almost 70% of deaths were missed by the HMIS during the Ebola outbreak period. These findings could guide health system responses in future outbreaks.
Setting: All peripheral health units countrywide in Sierra Leone and one hospital in Port Loko. Objectives: Sierra Leone was severely affected by the 2014-2015 Ebola outbreak, whose impact on paediatric care and mortality reports merits assessment. We sought to compare the periods before, during and after the Ebola outbreak, the countrywide trend in morbidities in children aged < 5 years and exit outcomes in one district hospital (Port Loko). During the Ebola outbreak period, gaps in district death reporting within the routine Health Management Information System (HMIS) were compared with the Safe and Dignified Burials (SDB) database in Port Loko. Design: This was a retrospective records analysis. Results: The average number of monthly consultations during the Ebola outbreak period declined by 27% for malaria and acute respiratory infections and 38% for watery diarrhoea, and did not recover to the pre-Ebola levels. For measles, there was an 80% increase during Ebola, which multiplied by 6.5-fold post-Ebola. The number of unfavourable hospital exit outcomes was 52/397 (13%) during Ebola, which was higher than pre-Ebola (47/496, 9%, P = 0.04). Of 6565 deaths reported in the Port Loko SDB database, only 2219 (34%) appeared in the HMIS, a reporting deficit of 66%. Conclusion: The Ebola disease outbreak was associated with reduced utilisation of health services, and appears to have triggered a measles epidemic. Almost 70% of deaths were missed by the HMIS during the Ebola outbreak period. These findings could guide health system responses in future outbreaks.
Entities:
Keywords:
SORT IT; health systems; operational research; vital registration
Authors: B B Ngoy; R Zachariah; S G Hinderaker; M Khogali; M Manzi; J van Griensven; L Ayada; J P Jemmy; A Maalim; H Amin Journal: Public Health Action Date: 2013-06-21
Authors: David Leuenberger; Jean Hebelamou; Stefan Strahm; Nathalie De Rekeneire; Eric Balestre; Gilles Wandeler; François Dabis Journal: AIDS Date: 2015-09-10 Impact factor: 4.177
Authors: Michael K Mwaniki; Hellen W Gatakaa; Florence N Mturi; Charles R Chesaro; Jane M Chuma; Norbert M Peshu; Linda Mason; Piet Kager; Kevin Marsh; Mike English; James A Berkley; Charles R Newton Journal: BMC Public Health Date: 2010-10-06 Impact factor: 3.295
Authors: Silvia Dallatomasina; Rosa Crestani; James Sylvester Squire; Hilde Declerk; Grazia Marta Caleo; Anja Wolz; Kathryn Stinson; Gabriela Patten; Raphael Brechard; Osman Bamba-Moi Gbabai; Armand Spreicher; Michel Van Herp; Rony Zachariah Journal: Trop Med Int Health Date: 2015-02-03 Impact factor: 2.622
Authors: Mateusz M Plucinski; Timothée Guilavogui; Sidibe Sidikiba; Nouman Diakité; Souleymane Diakité; Mohamed Dioubaté; Ibrahima Bah; Ian Hennessee; Jessica K Butts; Eric S Halsey; Peter D McElroy; S Patrick Kachur; Jamila Aboulhab; Richard James; Moussa Keita Journal: Lancet Infect Dis Date: 2015-06-23 Impact factor: 25.071
Authors: Bruce Aylward; Philippe Barboza; Luke Bawo; Eric Bertherat; Pepe Bilivogui; Isobel Blake; Rick Brennan; Sylvie Briand; Jethro Magwati Chakauya; Kennedy Chitala; Roland M Conteh; Anne Cori; Alice Croisier; Jean-Marie Dangou; Boubacar Diallo; Christl A Donnelly; Christopher Dye; Tim Eckmanns; Neil M Ferguson; Pierre Formenty; Caroline Fuhrer; Keiji Fukuda; Tini Garske; Alex Gasasira; Stephen Gbanyan; Peter Graaff; Emmanuel Heleze; Amara Jambai; Thibaut Jombart; Francis Kasolo; Albert Mbule Kadiobo; Sakoba Keita; Daniel Kertesz; Moussa Koné; Chris Lane; Jered Markoff; Moses Massaquoi; Harriet Mills; John Mike Mulba; Emmanuel Musa; Joel Myhre; Abdusalam Nasidi; Eric Nilles; Pierre Nouvellet; Deo Nshimirimana; Isabelle Nuttall; Tolbert Nyenswah; Olushayo Olu; Scott Pendergast; William Perea; Jonathan Polonsky; Steven Riley; Olivier Ronveaux; Keita Sakoba; Ravi Santhana Gopala Krishnan; Mikiko Senga; Faisal Shuaib; Maria D Van Kerkhove; Rui Vaz; Niluka Wijekoon Kannangarage; Zabulon Yoti Journal: N Engl J Med Date: 2014-09-22 Impact factor: 91.245
Authors: Mohamed F Jalloh; Mohammad B Jalloh; Alison Albert; Brent Wolff; Amy Callis; Aparna Ramakrishnan; Emily Cramer; Paul Sengeh; Samuel Abu Pratt; Lansana Conteh; Rana Hajjeh; Rebecca Bunnell; John T Redd; Anna Mia Ekström; Helena Nordenstedt Journal: Vaccine Date: 2019-02-10 Impact factor: 3.641
Authors: Bradley H Wagenaar; Orvalho Augusto; Jason Beste; Stephen J Toomay; Eugene Wickett; Nelson Dunbar; Luke Bawo; Chea Sanford Wesseh Journal: PLoS Med Date: 2018-02-20 Impact factor: 11.069
Authors: Gustaf Drevin; Helle Mölsted Alvesson; Alex van Duinen; Håkon A Bolkan; Alimamy P Koroma; Johan Von Schreeb Journal: BMJ Glob Health Date: 2019-07-19
Authors: Hong Xiao; Xiaochen Dai; Bradley H Wagenaar; Fang Liu; Orvalho Augusto; Yan Guo; Joseph M Unger Journal: Lancet Reg Health West Pac Date: 2021-03-24