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Paediatric care in relation to the 2014-2015 Ebola outbreak and general reporting of deaths in Sierra Leone

T Sesay1, O Denisiuk2, K K Shringarpure3

  • 1District Health Management Team, Ministry of Health and Sanitation, Port Loko, Sierra Leone.

Public Health Action
|July 27, 2017
PubMed

Insights

The Ebola epidemic reduced child healthcare use and triggered a measles epidemic in Sierra Leone. Routine health data missed nearly 70% of deaths, highlighting critical gaps in health information systems.

Area of Science:

  • Epidemiology
  • Public Health
  • Pediatric Medicine

Background:

  • Sierra Leone faced a severe impact from the 2014-2015 Ebola outbreak.
  • The outbreak's effect on pediatric care and mortality reporting requires thorough assessment.
  • Understanding these impacts is crucial for future public health interventions.

Purpose of the Study:

  • To compare pediatric healthcare utilization and mortality trends before, during, and after the Ebola outbreak in Sierra Leone.
  • To analyze trends in childhood morbidities and hospital exit outcomes in Port Loko district.
  • To evaluate the accuracy of the Health Management Information System (HMIS) in reporting deaths during the outbreak.

Main Methods:

  • Retrospective analysis of health records from peripheral health units and Port Loko district hospital.
  • Comparison of data from before, during, and after the Ebola outbreak period.
  • Cross-validation of death reporting between the HMIS and the Safe and Dignified Burials (SDB) database.

Main Results:

  • Consultations for malaria, acute respiratory infections, and watery diarrhea decreased significantly during the Ebola outbreak and did not recover to pre-Ebola levels.
  • Measles cases increased by 80% during the outbreak and rose 6.5-fold post-outbreak.
  • Unfavorable hospital exit outcomes increased during the Ebola period (13% vs. 9%).
  • The HMIS captured only 34% of deaths recorded in the SDB database, indicating a 66% reporting deficit.

Conclusions:

  • The Ebola outbreak led to reduced healthcare service utilization for children.
  • The outbreak appears to have initiated a measles epidemic.
  • Significant underreporting of deaths by the HMIS during the Ebola outbreak necessitates improvements in health information systems for future crises.

Keywords:
SORT IThealth systemsoperational researchvital registration

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