Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Survey

Hdl Handle:
http://hdl.handle.net/10144/618732
Title:
Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Survey
Authors:
Kuehne, A; Lynch, E; Marshall, E; Tiffany, A; Alley, I; Bawo, L; Massaquoi, M; Lodesani, C; Le Vaillant, P; Porten, K; Gignoux, E
Journal:
PLoS Neglected Tropical Diseases
Abstract:
Between March 2014 and July 2015 at least 10,500 Ebola cases including more than 4,800 deaths occurred in Liberia, the majority in Monrovia. However, official numbers may have underestimated the size of the outbreak. Closure of health facilities and mistrust in existing structures may have additionally impacted on all-cause morbidity and mortality. To quantify mortality and morbidity and describe health-seeking behaviour in Monrovia, Médecins sans Frontières (MSF) conducted a mobile phone survey from December 2014 to March 2015. We drew a random sample of households in Monrovia and conducted structured mobile phone interviews, covering morbidity, mortality and health-seeking behaviour from 14 May 2014 until the day of the survey. We defined an Ebola-related death as any death meeting the Liberian Ebola case definition. We calculated all-cause and Ebola-specific mortality rates. The sample consisted of 6,813 household members in 905 households. We estimated a crude mortality rate (CMR) of 0.33/10,000 persons/day (95%CI:0.25-0.43) and an Ebola-specific mortality rate of 0.06/10,000 persons/day (95%-CI:0.03-0.11). During the recall period, 17 Ebola cases were reported including those who died. In the 30 days prior to the survey 277 household members were reported sick; malaria accounted for 54% (150/277). Of the sick household members, 43% (122/276) did not visit any health care facility. The mobile phone-based survey was found to be a feasible and acceptable alternative method when data collection in the community is impossible. CMR was estimated well below the emergency threshold of 1/10,000 persons/day. Non-Ebola-related mortality in Monrovia was not higher than previous national estimates of mortality for Liberia. However, excess mortality directly resulting from Ebola did occur in the population. Importantly, the small proportion of sick household members presenting to official health facilities when sick might pose a challenge for future outbreak detection and mitigation. Substantial reported health-seeking behaviour outside of health facilities may also suggest the need for adapted health messaging and improved access to health care.
Publisher:
Public Library of Science
Issue Date:
23-Aug-2016
URI:
http://hdl.handle.net/10144/618732
DOI:
10.1371/journal.pntd.0004899
PubMed ID:
27551750
Submitted date:
2016-08-30
Language:
en
ISSN:
1935-2735
Appears in Collections:
Other Diseases

Full metadata record

DC FieldValue Language
dc.contributor.authorKuehne, Aen
dc.contributor.authorLynch, Een
dc.contributor.authorMarshall, Een
dc.contributor.authorTiffany, Aen
dc.contributor.authorAlley, Ien
dc.contributor.authorBawo, Len
dc.contributor.authorMassaquoi, Men
dc.contributor.authorLodesani, Cen
dc.contributor.authorLe Vaillant, Pen
dc.contributor.authorPorten, Ken
dc.contributor.authorGignoux, Een
dc.date.accessioned2016-12-09T21:35:56Z-
dc.date.available2016-12-09T21:35:56Z-
dc.date.issued2016-08-23-
dc.date.submitted2016-08-30-
dc.identifier.citationMortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Survey. 2016, 10 (8):e0004899 PLoS Negl Trop Disen
dc.identifier.issn1935-2735-
dc.identifier.pmid27551750-
dc.identifier.doi10.1371/journal.pntd.0004899-
dc.identifier.urihttp://hdl.handle.net/10144/618732-
dc.description.abstractBetween March 2014 and July 2015 at least 10,500 Ebola cases including more than 4,800 deaths occurred in Liberia, the majority in Monrovia. However, official numbers may have underestimated the size of the outbreak. Closure of health facilities and mistrust in existing structures may have additionally impacted on all-cause morbidity and mortality. To quantify mortality and morbidity and describe health-seeking behaviour in Monrovia, Médecins sans Frontières (MSF) conducted a mobile phone survey from December 2014 to March 2015. We drew a random sample of households in Monrovia and conducted structured mobile phone interviews, covering morbidity, mortality and health-seeking behaviour from 14 May 2014 until the day of the survey. We defined an Ebola-related death as any death meeting the Liberian Ebola case definition. We calculated all-cause and Ebola-specific mortality rates. The sample consisted of 6,813 household members in 905 households. We estimated a crude mortality rate (CMR) of 0.33/10,000 persons/day (95%CI:0.25-0.43) and an Ebola-specific mortality rate of 0.06/10,000 persons/day (95%-CI:0.03-0.11). During the recall period, 17 Ebola cases were reported including those who died. In the 30 days prior to the survey 277 household members were reported sick; malaria accounted for 54% (150/277). Of the sick household members, 43% (122/276) did not visit any health care facility. The mobile phone-based survey was found to be a feasible and acceptable alternative method when data collection in the community is impossible. CMR was estimated well below the emergency threshold of 1/10,000 persons/day. Non-Ebola-related mortality in Monrovia was not higher than previous national estimates of mortality for Liberia. However, excess mortality directly resulting from Ebola did occur in the population. Importantly, the small proportion of sick household members presenting to official health facilities when sick might pose a challenge for future outbreak detection and mitigation. Substantial reported health-seeking behaviour outside of health facilities may also suggest the need for adapted health messaging and improved access to health care.en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
dc.rightsArchived with thanks to PLoS Neglected Tropical Diseasesen
dc.titleMortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Surveyen
dc.identifier.journalPLoS Neglected Tropical Diseasesen

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