RT Journal Article
SR Electronic
T1 Enhancing Ebola virus disease surveillance and prevention in counties without confirmed cases in rural Liberia: Experiences from Sinoe County during the flare-up in Monrovia, April to June, 2016
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 139154
DO 10.1101/139154
A1 Vera Darling Weah
A1 John S. Doedeh
A1 Samson Q. Wiah
A1 Emmanuel Nyema
A1 Siafa Lombeh
A1 Jeremias Naiene
YR 2017
UL http://biorxiv.org/content/early/2017/05/19/139154.abstract
AB Introduction During the flare-ups of Ebola virus disease (EVD) in Liberia, Sinoe County reactivated the multi-sectorial EVD control strategy in order to be ready to respond to the eventual reintroduction of cases.This paper describes the impacts of the interventions implemented in Sinoe County during the last flare-up in Monrovia, from April 1 to June 9, 2016, using the resources provided during the original outbreak that ended one year back.Methods We conducted a descriptive study to describe the key interventions implemented in Sinoe County, the capacity available, the implications for the reactivation of the multi-sectoral EVD control strategy, and the results of the same. We also conducted a cross-sectional study to analyze the impact of the interventions on the surveillance and on infection prevention and control (IPC).Results The attrition of the staff trained during the original outbreak was low, and most of the supplies, equipment, and infrastructure from the original outbreak remained available.With an additional US$1755, improvements were observed in the IPC indicators of triage, which increased from a mean of 60% during the first assessment to 77% (P=0.002). Additionally, personal/staff training improved from 78% to 89% (P=0.04).The percentage of EVD death alerts per expected deaths investigated increased from 62% to 147% (P<0.0001).Discussion The small attrition of the trained staff and the availability of most of the supplies, equipment, and infrastructure made the reactivation of the multi-sectoral EVD control strategy fast and affordable. The improvement of the EVD surveillance was possibly affected by the community engagement activities, awareness and mentoring of the health workers, and improved availability of clinicians in the facilities during the flare-up. The community engagement may contribute to the report of community-based events, specifically community deaths. The mentoring of the staff during the supportive supervisions also contributed to improve the IPC indicators.