WHO , 2016. WHO Situation Report: Ebola Virus Disease. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/208883/ebolasitrep_10Jun2016_eng.pdf;jsessionid=56E8AD39CA7BCF6B762FDE9D0E851240?sequence=1. Accessed June 14, 2020.
Bah OM et al.2017. The influence of the Ebola outbreak on presumptive and active tuberculosis in Bombali District, Sierra Leone. Public Health Action 7: S3–S9.
Ansumana R et al.2017. Impact of infectious disease epidemics on tuberculosis diagnostic, management, and prevention services: experiences and lessons from the 2014–2015 Ebola virus disease outbreak in West Africa. Int J Infect Dis 56: 101–104.
Parpia AS , Ndeffo-Mbah ML , Wenzel NS , Galvani AP , 2016. Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerg Infect Dis 22: 433–441.
Sylvester Squire J , Hann K , Denisiuk O , Kamara M , Tamang D , Zachariah R , 2017. The Ebola outbreak and staffing in public health facilities in rural Sierra Leone: who is left to do the job? Public Health Action 7: S47–S54.
Briand S et al.2014. The international Ebola emergency. N Engl J Med 371: 1180–1183.
Elston JWT et al.2016. Impact of the Ebola outbreak on health systems and population health in Sierra Leone. J Public Health 38: 673–678.
Edelstein M , Angelides P , Heymann DL , 2015. Ebola: the challenging road to recovery. Lancet 385: 2234–2235.
Wilhelm JA , Helleringer S , 2019. Utilization of non-Ebola health care services during Ebola outbreaks: a systematic review and meta-analysis. J Glob Health 9: 010406.
WHO , 2012. World Health Organization (WHO) Estimates of Tuberculosis Incidence by Country, 2012. London, United Kingdom: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/332777/TB_Worldwide_by_Country_2012.pdf. Accessed July 12, 2020.
Corbett EL et al.2003. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 163: 1009–1021.
UNAIDS , 2015. Sierra Leone National AIDS Response Progress Report 2015. Geneva, Switzerland: UNAIDS. Available at: https://www.unaids.org/sites/default/files/country/documents/SLE_narrative_report_2015.pdf. Accessed October 1, 2020.
WHO , 2013. Global Tuberculosis Report 2013. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/91355/9789241564656_eng.pdf?sequence=1. Accessed June 14, 2020
WHO , 2014. Global Tuberculosis Report 2014. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/tb/publications/global_report/gtbr14_main_text.pdf. Accessed October 1, 2020.
Cilloni L et al.2020. The potential impact of the COVID-19 pandemic on tuberculosis: a modelling analysis. EClinicalMedicine 28: 100603.
Robinson C , 2019. Primary health care and family medicine in Sierra Leone. Afr J Prim Health Care Fam Med 11: e1–e3.
Nabieu PF et al.2016. Lower limb amputation at the 34 Military Hospital in Freetown, Sierra Leone: causes and indications. Sierra Leone J Biomed Res 8: 9–17.
WHO , 2014. Statement on the 1st Meeting of the IHR Emergency Committee on the 2014 Ebola Outbreak in West Africa. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/. Accessed June 18, 2020.
Kwak C , Clayton-Matthews A , 2002. Multinomial logistic regression. Nurs Res 51: 404–410.
WHO , 2014. Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children, 2nd edition. Geneva, Switzerland: World Health Organization. Available at: https://www.ncbi.nlm.nih.gov/books/NBK214446/. Accessed November 11, 2019.
Burnham KP , Anderson DR , 2002. Model Selection and Multimodel Inference: A Practical Information-Theoretic Approach, 2nd edition. New York, NY: Springer-Verlag.
Venables B , Ripley B , 2002. Modern Applied Statistics with S. New York, NY: Springer Science+Business.
R Core Team , 2019. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing. Available at: http://www.R-project.org/.
Nagel E , Blackowicz MJ , Sahr F , Jarrett OD , 2019. Impact of the Ebola epidemic on clinical outcomes of HIV-infected soldiers and their dependents in Sierra Leone. Int J STD AIDS 30: 106–112.
Ortuno-Gutierrez N et al.2016. Upholding tuberculosis services during the 2014 Ebola storm: an encouraging experience from Conakry, Guinea. PLoS One 11: e0157296.
Tweya H et al.2013. Comparison of treatment outcomes of new smear-positive pulmonary tuberculosis patients by HIV and antiretroviral status in a TB/HIV Clinic, Malawi. PLoS One 8: e56248.
Kliiman K , Altraja A , 2009. Predictors of poor treatment outcome in multi- and extensively drug-resistant pulmonary TB. Eur Respir J 33: 1085–1094.
Negin J , Abimbola S , Marais BJ , 2015. Tuberculosis among older adults—time to take notice. Int J Infect Dis 32: 135–137.
Blumberg HM , Ernst JD , 2016. The challenge of latent TB infection. JAMA 316: 931–933.
Podewils LJ , Gler MTS , Quelapio MI , Chen MP , 2013. Patterns of treatment interruption among patients with multidrug-resistant TB (MDR TB) and association with interim and final treatment outcomes. PLoS One 8: e70064.
Konwloh PK et al.2017. Influence of Ebola on tuberculosis case finding and treatment outcomes in Liberia. Public Health Action 7: S62–S69.
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The impact and disruption of infectious disease outbreaks stretch far beyond their direct death toll, as they often overburden health systems, reduce treatment seeking behaviors, and interrupt treatment regimens. This study examines the impact of the 2014–2016 Ebola virus outbreak on tuberculosis (TB) treatment outcomes at the 34 Military Hospital in Freetown, Sierra Leone. We used retrospective data from 1,085 TB patient outcome data registers to build a multinomial logistic regression model to evaluate the change in TB treatment outcomes before and after the Public Health Emergency of International Concern (PHEIC) declaration in August 2014. These results showed that HIV status, patient age, whether patients had active versus latent TB, and the time since the start of the outbreak were significantly associated with TB treatment outcomes. The model showed an increase in probability of unknown and unsuccessful (died or treatment failed) treatment outcomes with each month after the PHEIC declaration, across age groups, TB status, and HIV status.
These authors contributed equally to this work.
Disclosure: This study received ethical approval from the George Mason University Institutional Review Board, IRB#1191092-1.
Authors’ addresses: Kathryn M. Hogan and Michael E. von Fricken, Department of Global and Community Health, George Mason University, Fairfax, VA, E-mails: khogan20@gmu.edu and mvonfric@gmu.edu. Henry Saidu Bangura and Mohamed Akmed Salim Kamara, Public Health Department, 34 Military Hospital, Freetown, Sierra Leone, E-mails: henrybangura53@gmail.com and mohamedakmedsalimkamara@yahoo.com. Jing Li and Jiafu Jiang, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China, E-mails: lijpbs@163.com and jiangjf2008@gmail.com. Edu.
WHO , 2016. WHO Situation Report: Ebola Virus Disease. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/208883/ebolasitrep_10Jun2016_eng.pdf;jsessionid=56E8AD39CA7BCF6B762FDE9D0E851240?sequence=1. Accessed June 14, 2020.
Bah OM et al.2017. The influence of the Ebola outbreak on presumptive and active tuberculosis in Bombali District, Sierra Leone. Public Health Action 7: S3–S9.
Ansumana R et al.2017. Impact of infectious disease epidemics on tuberculosis diagnostic, management, and prevention services: experiences and lessons from the 2014–2015 Ebola virus disease outbreak in West Africa. Int J Infect Dis 56: 101–104.
Parpia AS , Ndeffo-Mbah ML , Wenzel NS , Galvani AP , 2016. Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerg Infect Dis 22: 433–441.
Sylvester Squire J , Hann K , Denisiuk O , Kamara M , Tamang D , Zachariah R , 2017. The Ebola outbreak and staffing in public health facilities in rural Sierra Leone: who is left to do the job? Public Health Action 7: S47–S54.
Briand S et al.2014. The international Ebola emergency. N Engl J Med 371: 1180–1183.
Elston JWT et al.2016. Impact of the Ebola outbreak on health systems and population health in Sierra Leone. J Public Health 38: 673–678.
Edelstein M , Angelides P , Heymann DL , 2015. Ebola: the challenging road to recovery. Lancet 385: 2234–2235.
Wilhelm JA , Helleringer S , 2019. Utilization of non-Ebola health care services during Ebola outbreaks: a systematic review and meta-analysis. J Glob Health 9: 010406.
WHO , 2012. World Health Organization (WHO) Estimates of Tuberculosis Incidence by Country, 2012. London, United Kingdom: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/332777/TB_Worldwide_by_Country_2012.pdf. Accessed July 12, 2020.
Corbett EL et al.2003. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 163: 1009–1021.
UNAIDS , 2015. Sierra Leone National AIDS Response Progress Report 2015. Geneva, Switzerland: UNAIDS. Available at: https://www.unaids.org/sites/default/files/country/documents/SLE_narrative_report_2015.pdf. Accessed October 1, 2020.
WHO , 2013. Global Tuberculosis Report 2013. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/91355/9789241564656_eng.pdf?sequence=1. Accessed June 14, 2020
WHO , 2014. Global Tuberculosis Report 2014. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/tb/publications/global_report/gtbr14_main_text.pdf. Accessed October 1, 2020.
Cilloni L et al.2020. The potential impact of the COVID-19 pandemic on tuberculosis: a modelling analysis. EClinicalMedicine 28: 100603.
Robinson C , 2019. Primary health care and family medicine in Sierra Leone. Afr J Prim Health Care Fam Med 11: e1–e3.
Nabieu PF et al.2016. Lower limb amputation at the 34 Military Hospital in Freetown, Sierra Leone: causes and indications. Sierra Leone J Biomed Res 8: 9–17.
WHO , 2014. Statement on the 1st Meeting of the IHR Emergency Committee on the 2014 Ebola Outbreak in West Africa. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/. Accessed June 18, 2020.
Kwak C , Clayton-Matthews A , 2002. Multinomial logistic regression. Nurs Res 51: 404–410.
WHO , 2014. Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children, 2nd edition. Geneva, Switzerland: World Health Organization. Available at: https://www.ncbi.nlm.nih.gov/books/NBK214446/. Accessed November 11, 2019.
Burnham KP , Anderson DR , 2002. Model Selection and Multimodel Inference: A Practical Information-Theoretic Approach, 2nd edition. New York, NY: Springer-Verlag.
Venables B , Ripley B , 2002. Modern Applied Statistics with S. New York, NY: Springer Science+Business.
R Core Team , 2019. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing. Available at: http://www.R-project.org/.
Nagel E , Blackowicz MJ , Sahr F , Jarrett OD , 2019. Impact of the Ebola epidemic on clinical outcomes of HIV-infected soldiers and their dependents in Sierra Leone. Int J STD AIDS 30: 106–112.
Ortuno-Gutierrez N et al.2016. Upholding tuberculosis services during the 2014 Ebola storm: an encouraging experience from Conakry, Guinea. PLoS One 11: e0157296.
Tweya H et al.2013. Comparison of treatment outcomes of new smear-positive pulmonary tuberculosis patients by HIV and antiretroviral status in a TB/HIV Clinic, Malawi. PLoS One 8: e56248.
Kliiman K , Altraja A , 2009. Predictors of poor treatment outcome in multi- and extensively drug-resistant pulmonary TB. Eur Respir J 33: 1085–1094.
Negin J , Abimbola S , Marais BJ , 2015. Tuberculosis among older adults—time to take notice. Int J Infect Dis 32: 135–137.
Blumberg HM , Ernst JD , 2016. The challenge of latent TB infection. JAMA 316: 931–933.
Podewils LJ , Gler MTS , Quelapio MI , Chen MP , 2013. Patterns of treatment interruption among patients with multidrug-resistant TB (MDR TB) and association with interim and final treatment outcomes. PLoS One 8: e70064.
Konwloh PK et al.2017. Influence of Ebola on tuberculosis case finding and treatment outcomes in Liberia. Public Health Action 7: S62–S69.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 3192 | 2086 | 75 |
Full Text Views | 129 | 12 | 0 |
PDF Downloads | 99 | 13 | 0 |