Overcoming Operational Challenges to Ebola Case Investigation in Sierra Leone

Boland, Samuel; Polich, Erin; Connolly, Allison; Hoar, Adam; Sesay, Tom; Tran, Anh-Minh A

doi:10.9745/ghsp-d-17-00126

Cited by 13 publications

(14 citation statements)

References 1 publication

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“…i) Addressing human resource issues is key especially the dissatisfaction with the level of financial reimbursement for the role, travel to often remote locations and hostility from local communities. These personnel challenges have been reported in other studies on Ebola contact tracing [2, 5, 7–10, 36].…”

Section: Discussionsupporting

confidence: 67%

“…However, our study was motivated by recognised challenges in this system, including in-built delays such as the physical collection of forms from the DHMT each morning (a round trip of approximately 5–6 h depending on the Chiefdom). The geographical challenges particular to Port Loko District and the challenges for surveillance activities have been reported by others involved in surveillance activities in the District [36].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of a mobile application for Ebola contact tracing and monitoring in northern Sierra Leone: a proof-of-concept study

Danquah

Hasham

Macfarlane³

et al. 2019

BMC Infect Dis

120

131

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Background The 2014–2016 Ebola epidemic in West Africa was the largest Ebola epidemic to date. Contact tracing was a core surveillance activity. Challenges with paper-based contact tracing systems include incomplete identification of contacts, delays in communication and response, loss of contact lists, inadequate data collection and transcription errors. The aim of this study was to design and evaluate an electronic system for tracing contacts of Ebola cases in Port Loko District, Sierra Leone, and to compare this with the existing paper-based system. The electronic system featured data capture using a smartphone application, linked to an alert system to notify the District Ebola Response Centre of symptomatic contacts. Methods The intervention was a customised three-tier smartphone application developed using Dimagi’s CommCare platform known as the Ebola Contact Tracing application (ECT app). Eligible study participants were all 26 Contact Tracing Coordinators (CTCs) and 86 Contact Tracers (CTs) working in the 11 Chiefdoms of Port Loko District during the study period (April–August 2015). Case detection was from 13th April to 17th July 2015. The CTCs and their CTs were provided with smartphones installed with the ECT app which was used to conduct contact tracing activities. Completeness and timeliness of contact tracing using the app were compared with data from April 13th-June 7th 2015, when the standard paper-based system was used. Results For 25 laboratory-confirmed cases for whom paper-based contact tracing was conducted, data for only 39% of 408 contacts were returned to the District, and data were often incomplete. For 16 cases for whom app-based contact tracing was conducted, 63% of 556 contacts were recorded as having been visited on the app, and the median recorded duration from case confirmation to first contact visit was 70 h. Conclusion There were considerable challenges to conducting high-quality contact tracing in this setting using either the paper-based or the app-based system. However, the study demonstrated that it was possible to implement mobile health (mHealth) in this emergency setting. The app had the benefits of improved data completeness, storage and accuracy, but the challenges of using an app in this setting and epidemic context were substantial.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Use of a mobile application for Ebola contact tracing and monitoring in northern Sierra Leone: a proof-of-concept study

Danquah

Hasham

Macfarlane³

et al. 2019

BMC Infect Dis

120

131

View full text Add to dashboard Cite

show abstract

“…50 To be effective, CEBS required local buy-in and relied on relationships among volunteers, communities, and external stakeholders to supplement HIS that tracked clinical and epidemiological data but lacked social context. 51 Integrated HIS could thus provide guidance to collect and monitor more context-specific information.…”

Section: Community Engagement Ebolamentioning

confidence: 99%

Optimizing Pandemic Preparedness and Response Through Health Information Systems: Lessons Learned From Ebola to COVID-19

Lal

Ashworth

Dada³

et al. 2020

Disaster med. public health prep.

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Strengthening health systems and maintaining essential service delivery during health emergencies response is critical for early detection and diagnosis, prompt treatment, and effective control of pandemics, including the novel coronavirus disease (COVID-19). Health information systems (HIS) developed during recent Ebola outbreaks in West Africa and the Democratic Republic of the Congo (DRC) provided opportunities to collect, analyze, and distribute data to inform both day-to-day and long-term policy decisions on outbreak preparedness. As COVID-19 continues to sweep across the globe, HIS and related technological advancements remain vital for effective and sustained data sharing, contact tracing, mapping and monitoring, community risk sensitization and engagement, preventive education, and timely preparedness and response activities. In reviewing literature of how HIS could have further supported mitigation of these Ebola outbreaks and the ongoing COVID-19 pandemic, three key areas were identified: governance and coordination, health systems infrastructure and resources, and community engagement. In this concept paper, we outline scalable HIS lessons from recent Ebola outbreaks and early COVID-19 responses along these three domains, synthesizing recommendations to offer clear, evidence-based approaches on how to leverage HIS to strengthen the current pandemic response and foster community health systems resilience moving forward.

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“…[ 51 ] In Sierra Leone, researchers addressed the operational challenges during the Ebola outbreak, highlighting the need for proper communication resources to resolve challenges in Ebola case investigations. [ 52 ]…”

Section: Discussionmentioning

confidence: 99%

Health communication in low-income countries: A 60-year bibliometric and thematic analysis

Mheidly

Fares

2020

J Edu Health Promot

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BACKGROUND: Health communication is a field that uses social and behavioral models to improve health outcomes and raise awareness on major health risks that threaten human well-being. Low-income countries (LICs) suffer from the effects of communicable and noncommunicable diseases that are exacerbated by weak health-care systems, lack of awareness campaigns, and ineffective communication tactics. This work aims to explore health communication research in LICs to find strategies that help improve health outcomes in the future. MATERIALS AND METHODS: The PubMed database was explored systematically for publications related to health communication from LICs between January 1, 1960, and January 1, 2020. Publications were categorized according to country of origin and were analyzed with respect to population size, gross domestic product (GDP), and primary school enrollment of each state as obtained from the World Bank Open Data. RESULTS: Collectively, LICs published 796 contributions, comprising 1.08% of the total biomedical research published by LICs and 0.27% of the world's health communication research. Malawi had the highest number of publications per GDP, with 32.811 publications per billion US$. Uganda had the most contributions per population, with 9.579 publications per million persons. Ethiopia had the highest amount of contributions per primary school enrollment with a ratio of 2.461 publications per %gross. The role of health communication in promoting HIV awareness and prevention was the most common theme explored. Other infectious diseases, such as malaria, tuberculosis, and Ebola, were also highlighted. Improving communication in health education was also explored. CONCLUSION: Health communication is a rising field in LICs, with research focusing on disease prevention. Efforts to amplify research are key to effectively utilize the health communication models and improve health outcomes in LICs.

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Overcoming Operational Challenges to Ebola Case Investigation in Sierra Leone

Cited by 13 publications

References 1 publication

Use of a mobile application for Ebola contact tracing and monitoring in northern Sierra Leone: a proof-of-concept study

Use of a mobile application for Ebola contact tracing and monitoring in northern Sierra Leone: a proof-of-concept study

Optimizing Pandemic Preparedness and Response Through Health Information Systems: Lessons Learned From Ebola to COVID-19

Health communication in low-income countries: A 60-year bibliometric and thematic analysis

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