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. 2019 Jan:147:e103.
doi: 10.1017/S0950268819000177.

The Ebola virus disease outbreak in Tonkolili district, Sierra Leone: a retrospective analysis of the Viral Haemorrhagic Fever surveillance system, July 2014-June 2015

Alessandro Miglietta  1 , Angelo Solimini  2 , Ghyslaine Bruna Djeunang Dongho  2 , Carla Montesano  3 , Giovanni Rezza  4 , Vincenzo Vullo  2 , Vittorio Colizzi  3 , Gianluca Russo  2
Affiliations

The Ebola virus disease outbreak in Tonkolili district, Sierra Leone: a retrospective analysis of the Viral Haemorrhagic Fever surveillance system, July 2014-June 2015

Alessandro Miglietta et al. Epidemiol Infect. 2019 Jan.

Abstract

In Sierra Leone, the Ebola virus disease (EVD) outbreak occurred with substantial differences between districts with someone even not affected. To monitor the epidemic, a community event-based surveillance system was set up, collecting data into the Viral Haemorrhagic Fever (VHF) database. We analysed the VHF database of Tonkolili district to describe the epidemiology of the EVD outbreak during July 2014-June 2015 (data availability). Multivariable analysis was used to identify risk factors for EVD, fatal EVD and barriers to healthcare access, by comparing EVD-positive vs. EVD-negative cases. Key-performance indicators for EVD response were also measured. Overall, 454 EVD-positive cases were reported. At multivariable analysis, the odds of EVD was higher among those reporting contacts with an EVD-positive/suspected case (odds ratio (OR) 2.47; 95% confidence interval (CI) 2.44-2.50; P < 0.01) and those attending funeral (OR 1.02; 95% CI 1.01-1.04; P < 0.01). EVD cases from Kunike chiefdom had a lower odds of death (OR 0.22; 95% CI 0.08-0.44; P < 0.01) and were also more likely to be hospitalised (OR 2.34; 95% CI 1.23-4.57; P < 0.05). Only 25.1% of alerts were generated within 1 day from symptom onset. EVD preparedness and response plans for Tonkolili should include social-mobilisation activities targeting Ebola/knowledge-attitudes-practice during funeral attendance, to avoid contact with suspected cases and to increase awareness on EVD symptoms, in order to reduce delays between symptom onset to alert generation and consequently improve the outbreak-response promptness.

Keywords: Analysis of data; Ebola virus; outbreaks; surveillance system.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Number of alerts by epi-week, months, year and EVD case definition. Tonkolili, Sierra Leone, 1 July 2014–30 June 2015 (n = 4550). EVD+, Ebola laboratory-confirmed cases; EVD−, Ebola laboratory-excluded cases; PROB and SUSP, Ebola probable and suspected cases.
See this image and copyright information in PMC

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