Changes in Health-Seeking Behavior Did Not Result in Increased All-Cause Mortality During the Ebola Outbreak in Western Area, Sierra Leone

Hdl Handle:
http://hdl.handle.net/10144/618805
Title:
Changes in Health-Seeking Behavior Did Not Result in Increased All-Cause Mortality During the Ebola Outbreak in Western Area, Sierra Leone
Authors:
Vygen, S; Tiffany, A; Rull, M; Ventura, A; Wolz, A; Jambai, A; Porten, K
Journal:
American Journal of Tropical Medicine and Hygiene
Abstract:
Little is known about the residual effects of the west African Ebola virus disease (Ebola) epidemic on non-Ebola mortality and health-seeking behavior in Sierra Leone. We conducted a retrospective household survey to estimate mortality and describe health-seeking behavior in Western Area, Sierra Leone, between May 25, 2014, and February 16, 2015. We used two-stage cluster sampling, selected 30 geographical sectors with probability proportional to population size, and sampled 30 households per sector. Survey teams conducted face-to-face interviews and collected information on mortality and health-seeking behavior. We calculated all-cause and Ebola-specific mortality rates and compared health-seeking behavior before and during the Ebola epidemic using χ(2) and Fisher's exact tests. Ninety-six deaths, 39 due to Ebola, were reported in 898 households. All-cause and Ebola-specific mortality rates were 0.52 (95% confidence interval [CI] = 0.29-0.76) and 0.19 (95% CI = 0.01-0.38) per 10,000 inhabitants per day, respectively. Of those households that reported a sick family member during the month before the survey, 86% (73/85) sought care at a health facility before the epidemic, compared with 58% (50/86) in February 2015 (P = 0.013). Reported self-medication increased from 4% (3/85) before the epidemic to 23% (20/86) during the epidemic (P = 0.013). Underutilization of health services and increased self-medication did not show a demonstrable effect on non-Ebola-related mortality. Nevertheless, the residual effects of outbreaks need to be taken into account for the future. Recovery efforts should focus on rebuilding both the formalized health system and the population's trust in it.
Publisher:
American Society of Tropical Medicine and Hygiene
Issue Date:
25-Jul-2016
URI:
http://hdl.handle.net/10144/618805
DOI:
10.4269/ajtmh.16-0295
PubMed ID:
27458039
Additional Links:
http://www.ajtmh.org
Submitted date:
2016-08-03
Language:
en
Description:
We regret that this article is behind a paywall.
ISSN:
1476-1645
Appears in Collections:
Other Diseases

Full metadata record

DC FieldValue Language
dc.contributor.authorVygen, Sen
dc.contributor.authorTiffany, Aen
dc.contributor.authorRull, Men
dc.contributor.authorVentura, Aen
dc.contributor.authorWolz, Aen
dc.contributor.authorJambai, Aen
dc.contributor.authorPorten, Ken
dc.date.accessioned2017-02-22T17:58:45Z-
dc.date.available2017-02-22T17:58:45Z-
dc.date.issued2016-07-25-
dc.date.submitted2016-08-03-
dc.identifier.citationChanges in Health-Seeking Behavior Did Not Result in Increased All-Cause Mortality During the Ebola Outbreak in Western Area, Sierra Leone. 2016: Am. J. Trop. Med. Hyg.en
dc.identifier.issn1476-1645-
dc.identifier.pmid27458039-
dc.identifier.doi10.4269/ajtmh.16-0295-
dc.identifier.urihttp://hdl.handle.net/10144/618805-
dc.descriptionWe regret that this article is behind a paywall.en
dc.description.abstractLittle is known about the residual effects of the west African Ebola virus disease (Ebola) epidemic on non-Ebola mortality and health-seeking behavior in Sierra Leone. We conducted a retrospective household survey to estimate mortality and describe health-seeking behavior in Western Area, Sierra Leone, between May 25, 2014, and February 16, 2015. We used two-stage cluster sampling, selected 30 geographical sectors with probability proportional to population size, and sampled 30 households per sector. Survey teams conducted face-to-face interviews and collected information on mortality and health-seeking behavior. We calculated all-cause and Ebola-specific mortality rates and compared health-seeking behavior before and during the Ebola epidemic using χ(2) and Fisher's exact tests. Ninety-six deaths, 39 due to Ebola, were reported in 898 households. All-cause and Ebola-specific mortality rates were 0.52 (95% confidence interval [CI] = 0.29-0.76) and 0.19 (95% CI = 0.01-0.38) per 10,000 inhabitants per day, respectively. Of those households that reported a sick family member during the month before the survey, 86% (73/85) sought care at a health facility before the epidemic, compared with 58% (50/86) in February 2015 (P = 0.013). Reported self-medication increased from 4% (3/85) before the epidemic to 23% (20/86) during the epidemic (P = 0.013). Underutilization of health services and increased self-medication did not show a demonstrable effect on non-Ebola-related mortality. Nevertheless, the residual effects of outbreaks need to be taken into account for the future. Recovery efforts should focus on rebuilding both the formalized health system and the population's trust in it.en
dc.languageENG-
dc.language.isoenen
dc.publisherAmerican Society of Tropical Medicine and Hygieneen
dc.relation.urlhttp://www.ajtmh.orgen
dc.rightsWe regret that this article is behind a paywall.en
dc.titleChanges in Health-Seeking Behavior Did Not Result in Increased All-Cause Mortality During the Ebola Outbreak in Western Area, Sierra Leoneen
dc.identifier.journalAmerican Journal of Tropical Medicine and Hygieneen

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