Fasina Folorunso Oludayo, Adenubi Olubukola T, Ogundare Samuel T, Shittu Aminu, Bwala Dauda G, Fasina Modupe M
University of Pretoria, Pretoria, South Africa.
J Infect Dev Ctries. 2015 Dec 30;9(12):1298-307. doi: 10.3855/jidc.6484.
Since the first case of Ebola virus disease (EVD) in Guinea in 2013, major outbreaks have been reported in West Africa.
Cases and fatalities of EVD caused by Zaire Ebola virus (ZEBOV) were evaluated, and the risks of dying in the general population and in healthcare workers were assessed.
The case fatality rate estimated for EVD was 76.4% in 20 studies. Cumulative proportion of fatal cases in West Africa was 42.9%, 30.1%, and 64.2% in Liberia, Sierra Leone, and Guinea, respectively. The proportion of total deaths in Liberia, Sierra Leone, and Guinea was 42.5%, 35.8%, and 21.6%, respectively. Healthcare workers were at higher risk of dying compared with the general public, and the same applied to intense transmission countries and to countries with sufficient bed capacities. The declaration of a health emergency "out-of-control" situation by the World Health Organization on 8 August 2014 reduced the risk of death among patients. Factors including deplorable healthcare delivery infrastructure in war-ravaged regions of Africa, the impotence of governments to enforce public health regulations, and the loss of confidence in public healthcare delivery programs were key among others factors that enhanced the spread and magnitude of outbreaks.
The findings underscore the need for an overall re-appraisal of the healthcare systems in African countries and the ability to cope with widespread epidemic challenges. Outbreaks like that of Ebola diseases should be handled not just as a medical emergency but also a socio-economic problem with significant negative economic impacts.
自2013年几内亚出现首例埃博拉病毒病（EVD）以来，西非已报告发生多起重大疫情。
对由扎伊尔埃博拉病毒（ZEBOV）引起的埃博拉病毒病的病例和死亡情况进行评估，并评估普通人群和医护人员的死亡风险。
20项研究估计埃博拉病毒病的病死率为76.4%。西非埃博拉病毒病死亡病例的累计比例在利比里亚、塞拉利昂和几内亚分别为42.9%、30.1%和64.2%。利比里亚、塞拉利昂和几内亚的死亡病例占总死亡人数的比例分别为42.5%、35.8%和21.6%。与普通公众相比，医护人员的死亡风险更高，在疫情传播强烈的国家和病床数量充足的国家也是如此。2014年8月8日世界卫生组织宣布卫生紧急状态“失控”，降低了患者的死亡风险。非洲饱受战争蹂躏地区糟糕的医疗服务基础设施、政府无力执行公共卫生法规以及对公共医疗服务项目失去信心等因素是加剧疫情传播和规模的关键因素。
研究结果强调有必要全面重新评估非洲国家的医疗系统以及应对广泛流行挑战的能力。像埃博拉疫情这样的突发疾病不仅应作为医疗紧急情况来处理，还应作为具有重大负面经济影响的社会经济问题来处理。
