Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017

Abstract

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Impact of pandemics and disruptions to vaccination on infectious diseases epidemiology past and present

“…The impact of historical disease outbreaks (pre-COVID) on vaccine-preventable disease epidemiology was reported in three studies all of which focused on the impact of NPIs during the 2014 to 2015 Ebola outbreak across Africa 24–26 ( Table 1 ).…”

“…In addition, the establishment of Ebola treatment centers and the re-deployment of healthcare workers to these centers led to the closure of healthcare facilities and the postponement of vaccination activities resulting in non-Ebola infectious disease outbreaks and a resurgence across various vaccine-preventable diseases. 24–26 In Liberia, the mean coverage of the first dose of measles-containing vaccine (MCV1) during the outbreak in 2015 was 16% lower than in the 2 years preceding the outbreak. Correspondingly, the incidence of measles increased from zero cases in 2013 to 2014, to 108.5 cases per million in 2015.…”

“… 25 , 26 , 28–32 , 34–36 , 40 , 43 , 44 , 47 Low vaccine uptake and/or coverage can have many causes (e.g., lack of vaccination policy, political conflicts, parental vaccine refusal, vaccine procurement problems, antivaccination sentiments, vaccine safety concerns, and changes in vaccine schedule), but regardless of the cause, evidence gathered in this TLR shows that low vaccination rates have contributed to increased infectious disease burden particularly in vulnerable population groups such as young children and older adults and in some cases leading to local and regional outbreaks of diseases previously brought under control. 24–47 …”

Community-based trial assessing the impact of annual versus semiannual mass drug administration with ivermectin plus albendazole and praziquantel on helminth infections in northwestern Liberia

“…For example, MDA rounds for NTD control were missed and delivery of bed nets for mosquito control and malaria prevention was interrupted during this period. Health workers who were normally employed as community drug distributors were redeployed to focus on efforts aimed at bringing the outbreak under control ( Thomas et al., 2017 ; Hotez, 2015 ; Gray et al., 2021 ). At the end of the outbreak, when it was safe to return to the field, our team conducted a survey in Lofa County to assess community attitude towards restarting MDA and the general preparedness for resuming public health programs in this area ( Bogus et al., 2016 ).…”