Logan Gorbee, Vora Neil M, Nyensuah Tolbert G, Gasasira Alex, Mott Joshua, Walke Henry, Mahoney Frank, Luce Richard, Flannery Brendan
MMWR Morb Mortal Wkly Rep. 2014 Nov 7;63(44):1010-2.
As of October 29, 2014, a total of 6,454 Ebola virus disease (Ebola) cases had been reported in Liberia by the Liberian Ministry of Health and Social Welfare, with 2,609 deaths. Although the national strategy for combating the ongoing Ebola epidemic calls for construction of Ebola treatment units (ETUs) in all 15 counties of Liberia, only a limited number are operational, and most of these are within Montserrado County. ETUs are intended to improve medical care delivery to persons whose illnesses meet Ebola case definitions, while also allowing for the safe isolation of patients to break chains of transmission in the community. Until additional ETUs are constructed, the Ministry of Health and Social Welfare is supporting development of community care centers (CCCs) for isolation of patients who are awaiting Ebola diagnostic test results and for provision of basic care (e.g., oral rehydration salts solutions) to patients confirmed to have Ebola who are awaiting transfer to ETUs. CCCs often have less bed capacity than ETUs and are frequently placed in areas not served by ETUs; if built rapidly enough and in sufficient quantity, CCCs will allow Ebola-related health measures to reach a larger proportion of the population. Staffing requirements for CCCs are frequently lower than for ETUs because CCCs are often designed such that basic patient needs such as food are provided for by friends and family of patients rather than by CCC staff. (It is customary in Liberia for friends and family to provide food for hospitalized patients.) Creation of CCCs in Liberia has been led by county health officials and nongovernmental organizations, and this local, community-based approach is intended to destigmatize Ebola, to encourage persons with illness to seek care rather than remain at home, and to facilitate contact tracing of exposed family members. This report describes one Liberian county's approach to establishing a CCC.
截至2014年10月29日，利比里亚卫生与社会福利部报告称，利比里亚共出现6454例埃博拉病毒病（埃博拉）病例，其中2609人死亡。尽管应对当前埃博拉疫情的国家战略要求在利比里亚所有15个县建设埃博拉治疗单元（ETU），但只有少数几个投入使用，且大多数位于蒙特塞拉多县。埃博拉治疗单元旨在改善对符合埃博拉病例定义患者的医疗服务，同时安全隔离患者，以切断社区内的传播链。在更多埃博拉治疗单元建成之前，卫生与社会福利部正在支持社区护理中心（CCC）的建设，用于隔离等待埃博拉诊断检测结果的患者，并为确诊感染埃博拉且等待转至埃博拉治疗单元的患者提供基本护理（如口服补液盐溶液）。社区护理中心的床位容量通常比埃博拉治疗单元少，且常设在埃博拉治疗单元未覆盖地区；如果建设速度足够快且数量足够多，社区护理中心将使与埃博拉相关的卫生措施惠及更大比例的人口。社区护理中心的人员配备要求通常低于埃博拉治疗单元，因为社区护理中心的设计通常是让患者的朋友和家人而非中心工作人员为患者提供食物等基本需求。（在利比里亚，由朋友和家人为住院患者提供食物是惯例。）利比里亚社区护理中心的创建由县卫生官员及非政府组织牵头，这种基于社区的地方方法旨在消除对埃博拉的污名化，鼓励患病者寻求治疗而非居家，以及便于对接触过的家庭成员进行接触者追踪。本报告描述了利比里亚一个县建立社区护理中心的方法。
