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The effect of community-based prevention and care on ebola transmission in Sierra Leone

Author

Listed:
  • Pronyk, P.
  • Rogers, B.
  • Lee, S.
  • Bhatnagar, A.
  • Wolman, Y.
  • Monasch, R.
  • Hipgrave, D.
  • Salama, P.
  • Kucharski, A.
  • Chopra, M.

Abstract

Objectives. To examine the acceptability, use, effects on early isolation, and contribution to Ebola virus disease (EVD) transmission of Community Care Centers (CCCs), which were rapidly deployed in Sierra Leone during an accelerated phase of the 2014-2015 EVD epidemic. Methods. Focus group discussions, triads, and key informant interviews assessed acceptability of the CCCs. Facility registers, structured questionnaires, and laboratory records documented use, admission, and case identification. We estimated transmission effects by comparing time between symptom onset and isolation at CCCs relative to other facilities with the national Viral Hemorrhagic Fever data set. Results. Between November 2014 and January 2015, 46 CCCs were operational. Over 13 epidemic weeks, 6129 patients were triaged identifying 719 (12%) EVD suspects. Community acceptance was high despite initial mistrust. Nearly all patients presented to CCCs outside the national alert system. Isolation of EVD suspects within 4 days of symptoms was higher in CCCs compared with other facilities (85% vs 49%; odds ratio = 6.0; 95% confidence interval = 4.0, 9.1), contributing to a 13% to 32% reduction in the EVD reproduction number (Ro). Conclusions. Community-based approaches to prevention and care can reduce Ebola transmission.

Suggested Citation

  • Pronyk, P. & Rogers, B. & Lee, S. & Bhatnagar, A. & Wolman, Y. & Monasch, R. & Hipgrave, D. & Salama, P. & Kucharski, A. & Chopra, M., 2016. "The effect of community-based prevention and care on ebola transmission in Sierra Leone," American Journal of Public Health, American Public Health Association, vol. 106(4), pages 727-732.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.303020_5
    DOI: 10.2105/AJPH.2015.303020
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    Cited by:

    1. Upasak Das & Prasenjit Sarkhel & Sania Ashraf, 2020. "Love Thy Neighbor? Perceived Community Abidance and Private Compliance to COVID-19 Norms in India," Papers 2010.12350, arXiv.org.
    2. Jinyi Kuang & Sania Ashraf & Upasak Das & Cristina Bicchieri, 2020. "Awareness, Risk Perception, and Stress during the COVID-19 Pandemic in Communities of Tamil Nadu, India," IJERPH, MDPI, vol. 17(19), pages 1-11, September.
    3. Mayhew, Susannah H. & Balabanova, Dina & Vandi, Ahmed & Mokuwa, Gelejimah Alfred & Hanson, Tommy & Parker, Melissa & Richards, Paul, 2022. "(Re)arranging “systems of care” in the early Ebola response in Sierra Leone: An interdisciplinary analysis," Social Science & Medicine, Elsevier, vol. 300(C).
    4. Stéphanie Paillard-Borg & Jessica Holmgren & Panu Saaristo & Eva von Strauss, 2020. "Nurses in an Ebola Viral Hemorrhagic Fever Outbreak: Facing and Preparing for Psychosocial Challenges," SAGE Open, , vol. 10(2), pages 21582440209, May.
    5. Upasak Das & Prasenjit Sarkhel & Sania Ashraf, 2022. "Love Thy Neighbour? Perceived Community Abidance and Private Compliance to COVID-19 Norms in India," South Asia Economic Journal, Institute of Policy Studies of Sri Lanka, vol. 23(1), pages 30-51, March.

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