The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015
Abstract Background During December 2014–February 2015, an Ebola outbreak in a village in Kono district, Sierra Leone, began following unsafe funeral practices after the death of a person later confirmed to be infected with Ebola virus. In response, disease surveillance officers and community health...
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| Format: | Article |
| Language: | English |
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BMC
2016-10-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-016-1941-0 |
| _version_ | 1828868191300878336 |
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| author | Tasha Stehling-Ariza Alexander Rosewell Sahr A. Moiba Brima Berthalomew Yorpie Kai David Ndomaina Kai Samuel Jimissa Eva Leidman Dingeman J. Rijken Colin Basler James Wood Dumbuya Manso |
| author_facet | Tasha Stehling-Ariza Alexander Rosewell Sahr A. Moiba Brima Berthalomew Yorpie Kai David Ndomaina Kai Samuel Jimissa Eva Leidman Dingeman J. Rijken Colin Basler James Wood Dumbuya Manso |
| author_sort | Tasha Stehling-Ariza |
| collection | DOAJ |
| description | Abstract Background During December 2014–February 2015, an Ebola outbreak in a village in Kono district, Sierra Leone, began following unsafe funeral practices after the death of a person later confirmed to be infected with Ebola virus. In response, disease surveillance officers and community health workers, in collaboration with local leadership and international partners, conducted 1 day of active surveillance and health education for all households in the village followed by ongoing outreach. This study investigated the impact of these interventions on the outbreak. Methods Fifty confirmed Ebola cases were identified in the village between December 1, 2014 and February 28, 2015. Data from case investigations, treatment facility and laboratory records were analyzed to characterize the outbreak. The reproduction number (R) was estimated by fitting to the observed distribution of secondary cases. The impact of the active surveillance and health education was evaluated by comparing two outcomes before and after the day of the interventions: 1) the number of days from symptom onset to case-patient isolation or death and 2) a reported epidemiologic link to a prior Ebola case. Results The case fatality ratio among the 50 confirmed Ebola cases was 64.0 %. Twenty-three cases occurred among females (46.0 %); the mean age was 39 years (median: 37 years; range: 5 months to 75 years). Forty-three (87.8 %) cases were linked to the index case; 30 (61.2 %) were either at the funeral of Patient 1 or had contact with him while he was ill. R was 0.93 (95 % CI: 0.15–2.3); excluding the funeral, R was 0.29 (95 % CI: 0.11–0.53). The mean number of days in the community after onset of Ebola symptoms decreased from 4.0 days (median: 3 days; 95 % CI: 3.2–4.7) before the interventions to 2.9 days (median: 2 days; 95 % CI: 1.6–4.3) afterward. An epidemiologic link was reported in 47.6 % of case investigations prior to and 100 % after the interventions. Conclusions Initial case investigation and contact tracing were hindered by delayed reporting and under-reporting of symptomatic individuals from the community. Active surveillance and health education contributed to quicker identification of suspected cases, interrupting further transmission. |
| first_indexed | 2024-12-13T05:26:31Z |
| format | Article |
| id | doaj.art-0d2287ad46eb46169475ec2909b9eb9e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T05:26:31Z |
| publishDate | 2016-10-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-0d2287ad46eb46169475ec2909b9eb9e2022-12-21T23:58:10ZengBMCBMC Infectious Diseases1471-23342016-10-011611710.1186/s12879-016-1941-0The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015Tasha Stehling-Ariza0Alexander Rosewell1Sahr A. Moiba2Brima Berthalomew Yorpie3Kai David Ndomaina4Kai Samuel Jimissa5Eva Leidman6Dingeman J. Rijken7Colin Basler8James Wood9Dumbuya Manso10Centers for Disease Control and PreventionSchool of Public Health and Community Medicine, University of New South WalesDistrict Health Management Team, Ministry of Health and SanitationDistrict Health Management Team, Ministry of Health and SanitationDistrict Health Management Team, Ministry of Health and SanitationDistrict Health Management Team, Ministry of Health and SanitationCenters for Disease Control and PreventionInternational Federation of Red Cross and Red Crescent SocietiesCenters for Disease Control and PreventionSchool of Public Health and Community Medicine, University of New South WalesDistrict Health Management Team, Ministry of Health and SanitationAbstract Background During December 2014–February 2015, an Ebola outbreak in a village in Kono district, Sierra Leone, began following unsafe funeral practices after the death of a person later confirmed to be infected with Ebola virus. In response, disease surveillance officers and community health workers, in collaboration with local leadership and international partners, conducted 1 day of active surveillance and health education for all households in the village followed by ongoing outreach. This study investigated the impact of these interventions on the outbreak. Methods Fifty confirmed Ebola cases were identified in the village between December 1, 2014 and February 28, 2015. Data from case investigations, treatment facility and laboratory records were analyzed to characterize the outbreak. The reproduction number (R) was estimated by fitting to the observed distribution of secondary cases. The impact of the active surveillance and health education was evaluated by comparing two outcomes before and after the day of the interventions: 1) the number of days from symptom onset to case-patient isolation or death and 2) a reported epidemiologic link to a prior Ebola case. Results The case fatality ratio among the 50 confirmed Ebola cases was 64.0 %. Twenty-three cases occurred among females (46.0 %); the mean age was 39 years (median: 37 years; range: 5 months to 75 years). Forty-three (87.8 %) cases were linked to the index case; 30 (61.2 %) were either at the funeral of Patient 1 or had contact with him while he was ill. R was 0.93 (95 % CI: 0.15–2.3); excluding the funeral, R was 0.29 (95 % CI: 0.11–0.53). The mean number of days in the community after onset of Ebola symptoms decreased from 4.0 days (median: 3 days; 95 % CI: 3.2–4.7) before the interventions to 2.9 days (median: 2 days; 95 % CI: 1.6–4.3) afterward. An epidemiologic link was reported in 47.6 % of case investigations prior to and 100 % after the interventions. Conclusions Initial case investigation and contact tracing were hindered by delayed reporting and under-reporting of symptomatic individuals from the community. Active surveillance and health education contributed to quicker identification of suspected cases, interrupting further transmission.http://link.springer.com/article/10.1186/s12879-016-1941-0Ebola virus diseaseSierra LeoneSurveillanceHealth education |
| spellingShingle | Tasha Stehling-Ariza Alexander Rosewell Sahr A. Moiba Brima Berthalomew Yorpie Kai David Ndomaina Kai Samuel Jimissa Eva Leidman Dingeman J. Rijken Colin Basler James Wood Dumbuya Manso The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015 BMC Infectious Diseases Ebola virus disease Sierra Leone Surveillance Health education |
| title | The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015 |
| title_full | The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015 |
| title_fullStr | The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015 |
| title_full_unstemmed | The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015 |
| title_short | The impact of active surveillance and health education on an Ebola virus disease cluster — Kono District, Sierra Leone, 2014–2015 |
| title_sort | impact of active surveillance and health education on an ebola virus disease cluster kono district sierra leone 2014 2015 |
| topic | Ebola virus disease Sierra Leone Surveillance Health education |
| url | http://link.springer.com/article/10.1186/s12879-016-1941-0 |
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