Alpren Charles, Jalloh Mohamed F, Kaiser Reinhard, Diop Mariam, Kargbo Sas, Castle Evelyn, Dafae Foday, Hersey Sara, Redd John T, Jambai Amara
Centers for Disease Control and Prevention, Freetown, Sierra Leone.
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
BMJ Glob Health. 2017 Sep 7;2(3):e000392. doi: 10.1136/bmjgh-2017-000392. eCollection 2017.
A toll-free, nationwide phone alert system was established for rapid notification and response during the 2014-2015 Ebola epidemic in Sierra Leone. The system remained in place after the end of the epidemic under a policy of mandatory reporting and Ebola testing for all deaths, and, from June 2016, testing only in case of suspected Ebola. We describe the design, implementation and changes in the system; analyse calling trends during and after the Ebola epidemic; and discuss strengths and limitations of the system and its potential role in efforts to improve death reporting in Sierra Leone. Numbers of calls to report deaths of any cause (death alerts) and persons suspected of having Ebola (live alerts) were analysed by province and district and compared with numbers of Ebola cases reported by the WHO. Nearly 350 000 complete, non-prank calls were made to 117 between September 2014 and December 2016. The maximum number of daily death and live alerts was 9344 (October 2014) and 3031 (December 2014), respectively. Call volumes decreased as Ebola incidence declined and continued to decrease in the post-Ebola period. A national social mobilisation strategy was especially targeted to influential religious leaders, traditional healers and women's groups. The existing infrastructure and experience with the system offer an opportunity to consider long-term use as a death reporting tool for civil registration and mortality surveillance, including rapid detection and control of public health threats. A routine social mobilisation component should be considered to increase usage.
2014 - 2015年塞拉利昂埃博拉疫情期间，建立了一个全国性的免费电话警报系统，用于快速通知和响应。疫情结束后，该系统继续保留，实行所有死亡病例强制报告和埃博拉检测政策，从2016年6月起，仅在疑似埃博拉病例的情况下进行检测。我们描述了该系统的设计、实施和变化；分析了埃博拉疫情期间及之后的呼叫趋势；并讨论了该系统的优势和局限性及其在改善塞拉利昂死亡报告工作中的潜在作用。按省份和地区分析了报告任何原因死亡（死亡警报）和疑似感染埃博拉病毒人员（实时警报）的呼叫数量，并与世界卫生组织报告的埃博拉病例数量进行了比较。2014年9月至2016年12月期间，共向117拨打了近35万个完整、非恶作剧电话。每日死亡警报和实时警报的最大数量分别为9344个（2014年10月）和3031个（2014年12月）。随着埃博拉发病率下降，呼叫量减少，在埃博拉疫情后时期继续下降。一项全国性的社会动员战略特别针对有影响力的宗教领袖、传统治疗师和妇女团体。该系统现有的基础设施和经验为考虑将其长期用作民事登记和死亡率监测的死亡报告工具提供了机会，包括快速发现和控制公共卫生威胁。应考虑设立一个常规的社会动员部门以增加使用率。
