1921
Volume 97, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

The Ebola virus disease (EVD) epidemic, which began in West Africa in December 2013, claimed more than 11,000 lives, with more than 4,800 of these deaths occurring in Liberia. The epidemic had an additional effect of paralyzing the health-care systems in affected countries, which led to even greater mortality and morbidity. Little is known about the impact that the epidemic had on the provision of basic health care. During the period from March to May 2015, we undertook a nationwide, community-based survey to learn more about health-care access during the EVD epidemic in Liberia. A cluster sampling strategy was used to administer a structured in-person survey to heads of households located within the catchment areas surrounding all 21 government hospitals in Liberia. A total of 543 heads of household from all 15 counties in Liberia participated in the study; more than half (67%) of urban respondents and 46% of rural respondents stated that it was very difficult or impossible to access health care during the epidemic. In urban areas, only 20–30% of patients seeking care during the epidemic received care, and in rural areas, only 70–80% of those seeking care were able to access it. Patients requiring prenatal and obstetric care and emergency services had the most difficulty accessing care. The results of this survey support the observation that basic health care was extremely difficult to access during the EVD epidemic in Liberia. Our results underscore the critical need to support essential health-care services during humanitarian crises to minimize preventable morbidity and mortality.

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2017-09-07
2018-09-24
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References

  1. World Health Organization, 2016. Ebola data and statistics. Available at: http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-latest?lang=en. Assessed June 2, 2017.
  2. WHO EVD Response team, 2014. EVD virus disease in West Africa: to the first 9 months of the epidemic and forward projections N Engl J Med 371 : 14811495.
  3. Gatherer D, , 2014. The 2014 Ebola virus disease outbreak in West Africa. J Gen Virol 95: 16191624.
  4. Arrwady MA, , et al., 2015. Evolution of EVD virus disease from exotic infection to global health priority, Liberia, mid-2014. Emerg Infect Dis 24 : 578584.
  5. Index Mundi. Available at: www.indexmundi.com/liberia/literacy.html. Assessed June 2, 2017.
  6. Walker P, White M, Griffin J, Reynolds A, Ferguson N, Ghani AC, , 2015. Malaria morbidity and mortality in EVD-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis. Lancet Infect Dis 15: 825832.
  7. UNFPA, 2014. Ebola Situation Report 03 Nov 2014. Available at: http://www.unfpa.org/resources/ebola-situation-report-03-nov-2014. Assessed June 2, 20107.
  8. Liberian Ministry of Health and Social Welfare, 2013. Liberia Demographic and Health Survey. Monrovia, Liberia: Liberian Ministry of Health and Social Welfare.
  9. Plucinski MM, , et al., 2015. Effect of the EVD virus disease epidemic on malaria case management in Guinea, 2014: a cross to sectional survey of health facilities Lancet Infect Dis 15 : 1017.
  10. Iyngar P, Kerber K, Jabbe Howe C, Dahn B, , 2015. Services for mothers and newborns during the ebola outbreak in Liberia: the need for improvement in emergencies. PLoS Curr, doi: 10.1371/currents.outbreaks.4ba318308719ac86fbef91f8e56cb66f.
  11. Delamou A, Hammonds RM, Cuelewaerts S, Utz B, , 2014. Africa beyond epidemics, reproductive health in crisis. Lancet 384: 2105.
  12. Menendez C, Lucas A, Munguambe K, , 2015. EVD crisis: the unequal impact on women and children’s health. Lancet Global Health. http://dx.doi.org/10.1016/S0140-6736(14)62364-3.
  13. Hayden E C, , 2015. Maternal health: Ebola’s lasting legacy. Nature 519 (7541): 24–26. Available at: http://www.nature.com/news/maternal_health_EVDs_lasting_legacy-1.17036.
  14. Friedrich MJ, , 2015. Increased measles risk possible in African countries affected by EVD. JAMA 313: 1897.
  15. Liu J, , 2015. Disease outbreak: finish the fight against EVD. Nature 534: 2729.
  16. Takahashi S, Metcalf CJ, Ferrari MJ, Moss WJ, Truelove SA, Tatem AJ, Grenfell BT, Lessler J, , 2015. Reduced vaccination and the risk of measles and other childhood infections post-EVD, Takahashi. Science 347: 12401242.
  17. Suk J, , Jimenez A, Hourouma M, Derrough T, 2016. Post–Ebola measles outbreak in Lola, Guinea, January–June 2015. Emerg Infect Dis 226: 11061108.
  18. Zachariah R, Ortuno N, Hermans V, Desalegn W, Rust S, Reid AJ, Boeree MJ, Harries AD, , 2015. EVD, fragile health systems and tuberculosis care: a call for pre-emptive, action and operational research. Int J Tuberc Lung Dis 19: 12711275.
  19. Kost GJ, Ferguson W, Truong AT, Hoe J, Prom D, Banpavichit A, Kongpila S, , 2015. Molecular detection and point-of-care testing in EVD virus disease and other threats: a new global public health framework to stop outbreaks. Expert Rev Mol Diagn 15: 12451259.
  20. Piot P, Mayembe JJ, Edmunds WJ, , 2014. Ebola in west Africa: from disease outbreak, to humanitarian crisis. Lancet Infect Dis 14: 1034–1035.
  21. Moon S, , et al., 2015.Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSTMH, independent panel on the global response to EVD. Lancet 386: 2204221.
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  • Received : 27 Aug 2016
  • Accepted : 01 May 2017

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