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    Jan 16, 2021
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    Changes in Health-Seeking Behavior Did Not Result in Increased All-Cause Mortality During the Ebola Outbreak in Western Area, Sierra Leone

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    Authors
    Vygen, S
    Tiffany, A
    Rull, M
    Ventura, A
    Wolz, A
    Jambai, A
    Porten, K
    Issue Date
    2016-07-25
    Submitted date
    2016-08-03
    
    Metadata
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    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
    URI
    http://hdl.handle.net/10144/618805
    DOI
    10.4269/ajtmh.16-0295
    PubMed ID
    27458039
    Additional Links
    http://www.ajtmh.org
    Language
    en
    Description
    We regret that this article is behind a paywall.
    ISSN
    1476-1645
    ae974a485f413a2113503eed53cd6c53
    10.4269/ajtmh.16-0295
    Scopus Count
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