TITLE:
Ebola Response in Liberia; Field Experiences, Challenges and Lessons Learnt during the Response, 2014-2015
AUTHORS:
Mutaawe Lubogo, Donewell Bangure, Justin Maeda, Sasita Shabani, Theophile C. Malibiche, Herilinda Temba, Lucas Godbless, Naod Bruhan, Oketta Julius
KEYWORDS:
Ebola, Liberia, Field Experiences, Challenges
JOURNAL NAME:
Open Journal of Epidemiology,
Vol.6 No.1,
February
25,
2016
ABSTRACT: The 2014-2015 Ebola Virus Disease (EVD)
outbreaks which began in Guinea and later spread to Liberia, Sierra Leona and
other countries have been responsible for a number of infections and deaths
among the communities including health workers. The natural host of the EVD
virus has not been identified even when scientific evidence points to bats as
the natural reservoirs to similar strains of EVD virus. EVD male survivors have
also been identified as a potential source of infection among the populations.
Some of the reasons attributed to this rapid spread of EVD to other countries
have been weak early warning systems to identify and notify health authorities
of such diseases of high epidemic potential. Liberia has been one of the
countries to be declared EVD free on two different occasions in 2015 each with
a different epicenter. Despite a number of international organizations coming
together to support control efforts in Liberia, the coordination of response
activities by the Ministry of Health and Social Welfare and replicated at all
levels of the surveillance systems was the key in suppressing the outbreak.
Adoption of the Integrated Disease Surveillance and Response (IDSR) guidelines
as recommended by World Health Organization (WHO/AFRO) was a positive step towards
the structuring of response activities. Capacity building of health workers in
infection control and prevention and surveillance was important to improve
skills of health workers to triage EVD cases as recommended by WHO. Training
community health volunteers in contact tracing and active case search was
important in strengthening the Early Warning Disease surveillance system.
Decentralization of response activities in addition to establishing Ebola
Treatment units and Community Care Centers in all counties was vital in
containing the spread of infection. Even when EVD was associated to high levels
of stigma, community and individual counseling sessions led by community
leaders enabled building community trust to refer cases for treatment. The EVD
survivors distributed in different parts of the country are potential sources
of new EVD infections. This will require strengthening early warning systems
and response capacity at all levels.