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Impact of the Ebola Virus Outbreak on Tuberculosis Treatment Adherence and Outcomes in a Military Hospital in Freetown, Sierra Leone

Kathryn M. HoganDepartment of Global and Community Health, George Mason University, Fairfax, Virginia;

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Henry Saidu BanguraPublic Health Department, 34 Military Hospital, Freetown, Sierra Leone;

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Jing LiBeijing Institute of Microbiology and Epidemiology, Beijing, P. R. China

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Mohamed Akmed Salim KamaraPublic Health Department, 34 Military Hospital, Freetown, Sierra Leone;

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Jiafu JiangBeijing Institute of Microbiology and Epidemiology, Beijing, P. R. China

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Michael E. von FrickenDepartment of Global and Community Health, George Mason University, Fairfax, Virginia;

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ABSTRACT.

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.

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Author Notes

Address correspondence to Michael E. von Fricken, Department of Global and Community Health, George Mason University, 4400 University Avenue, MS5B7, Fairfax, VA 22030. E-mail: mvonfric@gmu.edu

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.

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