The Effect of Community-Based Prevention and Care on Ebola Transmission in Sierra Leone

Bibliographic Data

ID11035358
AuthorsPaul Pronyk (0000-0001-7591-2627, Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Braeden Rogers (0000-0003-4581-7359, Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Sylvia Lee (0000-0003-3855-7085, Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Aarunima Bhatnagar (Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Yaron Wolman (Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Roeland Monasch (Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), David Hipgrave (0000-0002-4880-0029, Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Peter Salama (Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Adam Kucharski (0000-0001-8699-7566, Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), Adam J Kucharski (0000-0001-8814-9421, United Nations Children's Fund), Mickey Chopra (0000-0003-4020-2937, Paul Pronyk, Braeden Rogers, Mickey Chopra, David Hipgrave, and Peter Salama are with UNICEF Headquarters, New York, NY. Paul Pronyk is also with the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. Sylvia Lee, Aarunima Bhatnagar, Yaron Wolman, and Roeland Monasch are with UNICEF Sierra Leone, Freetown. Adam Kucharski is with Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England.), on behalf of the UNICEF Sierra Leone Ebola Response Team
Year2016
Volume106
Issue4
Pages727-732
Publication date2016-04-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2015.303020
PMID26890176
OpenAlexW2283596520
LanguageEN
Citations received12
References cited13

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 (R o ). Conclusions. Community-based approaches to prevention and care can reduce Ebola transmission

Confidence interval · Disease · Ebola virus · Environmental health · Family medicine · Isolation (microbiology) · Medical emergency · Odds ratio · Sierra leone · Transmission (telecommunications) · Demography · Disaster Response and Management · Emergency Medicine · Global Health and Surgery · Internal Medicine · Medicine · Viral Infections and Outbreaks Research

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