Assessment of ebola virus disease, health care infrastructure, and preparedness - four counties,Southeastern Liberia, august 2014

Abstract

Ebola virus disease (Ebola) is a multisystem disease caused by a virus of the genus Ebolavirus. In late March 2014, Ebola cases were described in Liberia, with epicenters in Lofa County and later in Montserrado County. While information about case burden and health care infrastructure was available for the two epicenters, little information was available about remote counties in southeastern Liberia. Over 9 days, August 6-14, 2014, Ebola case burden, health care infrastructure, and emergency preparedness were assessed in collaboration with the Liberian Ministry of Health and Social Welfare in four counties in southeastern Liberia: Grand Gedeh, Grand Kru, River Gee, and Maryland. Data were collected by health care facility visits to three of the four county referral hospitals and by unstructured interviews with county and district health officials, hospital administrators, physicians, nurses, physician assistants, and health educators in all four counties. Local burial practices were discussed with county officials, but no direct observation of burial practices was conducted. Basic information about Ebola surveillance and epidemiology, case investigation, contact tracing, case management, and infection control was provided to local officials.

FIGURE 1

Location of the four counties assessed for Ebola virus disease case burden, health care infrastructure, and preparedness — Liberia, August 2014

FIGURE 2

Residents use one of the bamboo hand washing stations* that were erected to improve health care practices at entrances to hospitals, county checkpoints, and in towns — Liberia, August 2014 * The diaphragms in the upper part of the bamboo stem are perforated to create a tube that can be filled with water. A hole is drilled just above the lowest intact diaphragm, then plugged with a small stick. The plug is removed to produce a stream of water.