[Neglected patients, unexpected effects. Ebola virus disease suspected case experience.]

In an epidemic context, the identification of suspected cases, among alert or contact cases, leads to caring for persons for whom only a minority will be confirmed cases, with a laboratory diagnosis positive for Ebola. How are suspected cases treated that are not subsequently confirmed and how do they feel about this experience ? What are the medical or social consequences ?

A qualitative study was conducted in two countries with a high Ebola risk epidemic situation in 2015-2016 (Senegal, Côte d'Ivoire). Based on interviews with suspected cases and caregivers, 12 referral itineraries were identified for 20 people.

Narratives are dominated by the perception of failures at several levels: insufficient means and service preparation; lack of care for patients' vital needs and lack of treatment for their diseases; lack of listening, explanation and consideration for their families; patients' suffering from being isolated and facing violence; unexpected secondary social effects. These findings can be explained partly by caregivers' focus on Ebola diagnosis more than patients, fear of contagion, and by the insufficient preparation of isolation spaces at the time of the survey.

The results show the possible pitfalls of surveillance systems which increase the number of persons identified as suspected cases, if care services are not sufficiently prepared. Recommendations based on these results should be considered particularly to define operational procedures and trainings for health professionals.