Quaglio GianLuca, Pizzol Damiano, Bome David, Kebbie Atiba, Bangura Zainab, Massaquoi Vandi, Frasson Clara, Dalla Riva Donata, Putoto Giovanni
Directorate-General for Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium.
Operational Research Unit, Doctors with Africa, Padova, Italy.
PLoS Curr. 2016 Jun 2;8:ecurrents.outbreaks.d67aea257f572201f835772d7f188ba5. doi: 10.1371/currents.outbreaks.d67aea257f572201f835772d7f188ba5.
During the Ebola outbreak the overall confidence of the population in the national health system declined in Sierra Leone, with a reduction in the use of health services. The objective of this study is to provide information on understanding of how Ebola impacted maternal and child health services in Sierra Leone. Data come from an operational setting which is representative of the communities affected by the outbreak.
By integrating hospital registers and contact tracing form data with healthcare workers and local population interviews, the transmission chain was reconstructed. Data on the utilization of maternal and neonatal health services were collected from the local district's Health Management Information System. The main measures put in place to control the Ebola epidemic were: the organization of a rapid response to the crisis by the local health authorities; triage, contact tracing and quarantine; isolation, clinical management and safe burials; training and community sensitization.
A total of 49 case patients were registered between July and November 2014 in the Pujehun district. Hospitalization rate was 89%. Overall, 74.3% of transmission events occurred between members of the same family, 17.9% in the community and 7.7% in hospital. The mean number of contacts investigated per case raised from 11.5 in July to 25 in September 2014. The 2014 admission trend in the pediatric ward shows a decrease after beginning of June: the reduction was almost significant in the period July-December (p 0.05). The admission in the maternity ward showed no statistical differences in comparison with the previous year (p 0.07). Also the number of deliveries appeared to be similar to the previous year, without significant variations (p 0.41).
The Ebola outbreak reduced the number of patients at hospital level in Pujehun district. However, the activities undertaken to manage Ebola, reduced the spread of infection and the impact of the disease in mothers and children. A number of reasons which may explain these results are presented and discussed.
在埃博拉疫情期间，塞拉利昂民众对国家卫生系统的总体信心下降，卫生服务的使用减少。本研究的目的是提供有关了解埃博拉如何影响塞拉利昂母婴健康服务的信息。数据来自一个具有疫情影响社区代表性的实际工作环境。
通过将医院登记册和接触者追踪表格数据与医护人员及当地居民访谈相结合，重建了传播链。从当地地区的卫生管理信息系统收集了孕产妇和新生儿健康服务利用情况的数据。为控制埃博拉疫情采取的主要措施包括：当地卫生当局组织对危机的快速反应；分诊、接触者追踪和隔离；隔离、临床管理和安全埋葬；培训和社区宣传。
2014年7月至11月期间，普杰洪区共登记了49例病例患者。住院率为89%。总体而言，74.3%的传播事件发生在同一家族成员之间，17.9%发生在社区，7.7%发生在医院。每个病例调查的平均接触者数量从7月的11.5人增加到2014年9月的25人。儿科病房2014年的入院趋势显示，6月初开始后有所下降：7月至12月期间下降几乎显著（p<0.05）。产科病房的入院情况与上一年相比无统计学差异（p>0.07）。分娩数量似乎也与上一年相似，无显著变化（p>0.41）。
埃博拉疫情减少了普杰洪区医院层面的患者数量。然而，为管理埃博拉所开展的活动减少了感染传播以及该疾病对母亲和儿童的影响。文中提出并讨论了一些可能解释这些结果的原因。
