In the chaos of delayed responses to the Ebola crisis in West Africa, patterns emerged in data from five treatment centers across two of the three most affected countries:
- While women were less likely to come to an Ebola treatment center, those who did were likelier to be sick with the virus;
- Ebola patients between the ages of 15 to 24 were least likely to die from their illness, while children under five, and adults older than 55 had the highest death rates;
- People diagnosed with the virus were likelier to have been to a funeral recently than to have eaten bush meat;
- Patients who turned out not to have the virus were the ones likeliest to have travelled recently.
The information necessary to reach these conclusions and more was shouted over fences separating the sick from the well, recorded by hand on damp pieces of paper in the gloved hands of healthworkers covered from head to toe in protective garb, and then photographed or called back from contaminated zones to safe zones. Synthesizing the data was challenged as well, by inconsistent forms and terminology — “red eyes” for example could be “red-injected eyes,” “conjunctivitis,” and “hemorrhagic eyes.” But analyses of these data, from thousands of patients over the course of a year in the peak of the response to the outbreak in West Africa, will inform and speed future responses, including more efficient screening and triage, during the next large outbreak, authors of a report in Global Health and Science Practice write.
In addition, while the collection of data proved that gathering essential information on patients in settings with limited resources and enormous obstacles can be done, it also pointed to ways to prepare for future outbreaks, including with the advance development of simple and standardized forms, training to use them, and acquisition of handheld tablets to record their data, the authors say.
The report, Successful Implementation of a Multicountry Clinical Surveillance and Data Collection System for Ebola Virus Disease in West Africa: Findings and Lessons Learned comes from efforts to collect patient information at five Ebola treatment facilities operated by International Medical Corps in Sierra Leone and Liberia from September 2014 to September 2015, and its authors include Reshma Roshania of IMC and Nelson Dunbar of Liberia’s Ministry of Health. It reflects the experiences of 2,768 patients, 2,351 of whom were admitted for treatment, 57 percent of whom, confirmed to have Ebola, died, and 8 percent of whom did not have the virus, who also died.