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. 2016 Jun 9;1(1):e000030.
doi: 10.1136/bmjgh-2016-000030. eCollection 2016.

Ebola Holding Units at government hospitals in Sierra Leone: evidence for a flexible and effective model for safe isolation, early treatment initiation, hospital safety and health system functioning

Oliver Johnson  1 , Daniel Youkee  1 , Colin S Brown  1   2 , Marta Lado  1 , Alie Wurie  3 , Donald Bash-Taqi  3 , Andy Hall  1 , Eva Hanciles  4 , Isata Kamara  4 , Cecilia Kamara  4 , Amardeep Kamboz  1 , Ahmed Seedat  1 , Suzanne Thomas  1 , T B Kamara  4   5 , Andrew J M Leather  1 , Brima Kargbo  3
Affiliations

Ebola Holding Units at government hospitals in Sierra Leone: evidence for a flexible and effective model for safe isolation, early treatment initiation, hospital safety and health system functioning

Oliver Johnson et al. BMJ Glob Health. .

Abstract

The 2014-2015 West African outbreak of Ebola Virus Disease (EVD) claimed the lives of more than 11,000 people and infected over 27,000 across seven countries. Traditional approaches to containing EVD proved inadequate and new approaches for controlling the outbreak were required. The Ministry of Health & Sanitation and King's Sierra Leone Partnership developed a model for Ebola Holding Units (EHUs) at Government Hospitals in the capital city Freetown. The EHUs isolated screened or referred suspect patients, provided initial clinical care, undertook laboratory testing to confirm EVD status, referred onward positive cases to an Ebola Treatment Centre or negative cases to the general wards, and safely stored corpses pending collection by burial teams. Between 29th May 2014 and 19th January 2015, our five units had isolated approximately 37% (1159) of the 3097 confirmed cases within Western Urban and Rural district. Nosocomial transmission of EVD within the units appears lower than previously documented at other facilities and staff infection rates were also low. We found that EHUs are a flexible and effective model of rapid diagnosis, safe isolation and early initial treatment. We also demonstrated that it is possible for international partners and government facilities to collaborate closely during a humanitarian crisis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Simplified patient flow within an Ebola Holding Unit (EHU). DSOs, disease surveillance officers.
Figure 2
Figure 2
Ebola Holding Unit (EHU) Bed Capacity in the Western Area Urban and Rural Districts (hospital, date opened, total bed numbers—red line KSLP-supported MOHS sites, blue line—other MOHS and NGO sites) mapped against total number of suspect cases in Sierra Leone. KSLP, KSLP, King's Sierra Leone Partnership; MOHS, Ministry of Health and Sanitation.
Figure 3
Figure 3
KSLP-supported MOHS Ebola Holding Units (EHUs). KSLP, King's Sierra Leone Partnership.
See this image and copyright information in PMC

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