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. 2018 May 24;13(5):e0198235.
doi: 10.1371/journal.pone.0198235. eCollection 2018.

WASH activities at two Ebola treatment units in Sierra Leone

Michaela Mallow  1 , Lee Gary  1   2 , Timmy Jeng  3 , Bob Bongomin Jr  1 , Miriam Tamar Aschkenasy  1   4 , Peter Wallis  1 , Hilarie H Cranmer  1   4 , Estifanos Debasu  1 , Adam C Levine  1   3
Affiliations

WASH activities at two Ebola treatment units in Sierra Leone

Michaela Mallow et al. PLoS One. .

Abstract

Purpose: The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest in history. Starting in September 2014, International Medical Corps (IMC) operated five Ebola treatment units (ETUs) in Sierra Leone and Liberia. This paper explores how future infectious disease outbreak facilities in resource-limited settings can be planned, organized, and managed by analyzing data collected on water, sanitation, and hygiene (WASH) and infection prevention control (IPC) protocols.

Design/methodology/approach: We conducted a retrospective cohort study by analyzing WASH/IPC activity data routinely recorded on paper forms or white boards at ETUs during the outbreak and later merged into a database from two IMC-run ETUs in Sierra Leone between December 2014 and December 2015.

Findings: The IMC WASH/IPC database contains data from over 369 days. Our results highlight parameters key to designing and maintaining an ETU. High concentration chlorine solution usage was highly correlated with both daily patient occupancy and high-risk zone staff entries; low concentration chlorine usage was less well explained by these measures. There is high demand for laundering and disinfecting of personal protective equipment (PPE) on a daily basis and approximately 1 (0-4) piece of PPE is damaged each day.

Research limitations/implications: Lack of standardization in the type and format of data collected at ETUs made constructing the WASH/IPC database difficult. However, the data presented here may help inform humanitarian response operations in future epidemics.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Usage of high concentration (0.5%) chlorine vs. occupancy in Sierra Leone ETUs.
Fig 1 demonstrates daily patient occupancy (x-axis) as compared to the usage of high concentration (0.5%) chlorine in liters (y-axis) for the two ETUs studied.
Fig 2
Fig 2. Usage of high concentration (0.5%) chlorine vs. total hrz staff entries in Sierra Leone ETUs.
Fig 2 demonstrates the number of times staff entered the high-risk zone each day as compared to the total usage of high concentration (0.5%) chlorine in liters (y-axis) for the two ETUs studied.
Fig 3
Fig 3. Usage of low concentration (0.05%) chlorine vs. occupancy in Sierra Leone ETUs.
Fig 3 demonstrates daily patient occupancy (x-axis) as compared to the usage of low concentration (0.05%) chlorine in liters (y-axis) for the two ETUs studied.
Fig 4
Fig 4. Usage of low concentration (0.05%) chlorine vs. total HRZ staff entries in Sierra Leone ETUs.
Fig 4 demonstrates the number of times staff entered the high-risk zone each day as compared to the total usage of low concentration (0.05%) chlorine in liters (y-axis) for the two ETUs studied.
See this image and copyright information in PMC

References

    1. WHO. Ebola virus disease in West Africa—the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481–95. doi: 10.1056/NEJMoa1411100 - DOI - PMC - PubMed
    1. WHO. Ebola Situation Report—30 March 2016 2016 [Available from: http://apps.who.int/ebola/current-situation/ebola-situation-report-30-ma....
    1. Lu HJ, Qian J, Kargbo D, Zhang XG, Yang F, Hu Y, et al. Ebola Virus Outbreak Investigation, Sierra Leone, September 28-November 11, 2014. Emerg Infect Dis. 2015;21(11):1921–7. doi: 10.3201/eid2111.150582 - DOI - PMC - PubMed
    1. WHO. Ebola virus disease: Fact sheet. 2016.
    1. WHO. Statement on the 3rd meeting of the IHR Emergency Committee regarding the 2014 Ebola outbreak in West Africa. WHO. 2014.

MeSH terms