National reporting of deaths after enhanced Ebola surveillance in Sierra Leone.
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
20
02
2020
accepted:
22
07
2020
revised:
09
09
2020
pubmed:
19
8
2020
medline:
6
10
2020
entrez:
19
8
2020
Statut:
epublish
Résumé
Sierra Leone experienced the largest documented epidemic of Ebola Virus Disease in 2014-2015. The government implemented a national tollfree telephone line (1-1-7) for public reporting of illness and deaths to improve the detection of Ebola cases. Reporting of deaths declined substantially after the epidemic ended. To inform routine mortality surveillance, we aimed to describe the trends in deaths reported to the 1-1-7 system and to quantify people's motivations to continue reporting deaths after the epidemic. First, we described the monthly trends in the number of deaths reported to the 1-1-7 system between September 2014 and September 2019. Second, we conducted a telephone survey in April 2017 with a national sample of individuals who reported a death to the 1-1-7 system between December 2016 and April 2017. We described the reported deaths and used ordered logistic regression modeling to examine the potential drivers of reporting motivations. Analysis of the number of deaths reported to the 1-1-7 system showed that 12% of the expected deaths were captured in 2017 compared to approximately 34% in 2016 and over 100% in 2015. We interviewed 1,291 death reporters in the survey. Family members reported 56% of the deaths. Nearly every respondent (94%) expressed that they wanted the 1-1-7 system to continue. The most common motivation to report was to obey the government's mandate (82%). Respondents felt more motivated to report if the decedent exhibited Ebola-like symptoms (adjusted odds ratio 2.3; 95% confidence interval 1.8-2.9). Motivation to report deaths that resembled Ebola in the post-outbreak setting may have been influenced by knowledge and experiences from the prolonged epidemic. Transitioning the system to a routine mortality surveillance tool may require a robust social mobilization component to match the high reporting levels during the epidemic, which exceeded more than 100% of expected deaths in 2015.
Sections du résumé
BACKGROUND
Sierra Leone experienced the largest documented epidemic of Ebola Virus Disease in 2014-2015. The government implemented a national tollfree telephone line (1-1-7) for public reporting of illness and deaths to improve the detection of Ebola cases. Reporting of deaths declined substantially after the epidemic ended. To inform routine mortality surveillance, we aimed to describe the trends in deaths reported to the 1-1-7 system and to quantify people's motivations to continue reporting deaths after the epidemic.
METHODS
First, we described the monthly trends in the number of deaths reported to the 1-1-7 system between September 2014 and September 2019. Second, we conducted a telephone survey in April 2017 with a national sample of individuals who reported a death to the 1-1-7 system between December 2016 and April 2017. We described the reported deaths and used ordered logistic regression modeling to examine the potential drivers of reporting motivations.
FINDINGS
Analysis of the number of deaths reported to the 1-1-7 system showed that 12% of the expected deaths were captured in 2017 compared to approximately 34% in 2016 and over 100% in 2015. We interviewed 1,291 death reporters in the survey. Family members reported 56% of the deaths. Nearly every respondent (94%) expressed that they wanted the 1-1-7 system to continue. The most common motivation to report was to obey the government's mandate (82%). Respondents felt more motivated to report if the decedent exhibited Ebola-like symptoms (adjusted odds ratio 2.3; 95% confidence interval 1.8-2.9).
CONCLUSIONS
Motivation to report deaths that resembled Ebola in the post-outbreak setting may have been influenced by knowledge and experiences from the prolonged epidemic. Transitioning the system to a routine mortality surveillance tool may require a robust social mobilization component to match the high reporting levels during the epidemic, which exceeded more than 100% of expected deaths in 2015.
Identifiants
pubmed: 32810138
doi: 10.1371/journal.pntd.0008624
pii: PNTD-D-20-00273
pmc: PMC7480832
doi:
Banques de données
figshare
['10.6084/m9.figshare.12915293.v1']
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0008624Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
BMJ Glob Health. 2017 Sep 7;2(3):e000392
pubmed: 28948044
BMJ Glob Health. 2017 Dec 4;2(4):e000285
pubmed: 29259820
MMWR Suppl. 2016 Jul 08;65(3):68-74
pubmed: 27386834
PLoS Negl Trop Dis. 2017 Jun 22;11(6):e0005491
pubmed: 28640823
J Health Commun. 2017;22(sup1):24-30
pubmed: 28854130
BMJ Glob Health. 2018 Apr 1;3(2):e000410
pubmed: 29629189
Int J Surg. 2014 Dec;12(12):1500-24
pubmed: 25046751
Glob Health Promot. 2016 Mar;23(1):79-82
pubmed: 26518037
BMJ Glob Health. 2018 Mar 17;3(2):e000471
pubmed: 29607096
BMC Med. 2014 Oct 10;12:196
pubmed: 25300956
Emerg Infect Dis. 2015 Nov;21(11):1897-905
pubmed: 26484940
Curr Opin Virol. 2017 Feb;22:51-58
pubmed: 28012412
MMWR Morb Mortal Wkly Rep. 2015 Jan 16;64(1):20-7
pubmed: 25590682
J Health Commun. 2017;22(sup1):39-50
pubmed: 28854137
PLoS Curr. 2015 May 15;7:
pubmed: 26075140
MMWR Morb Mortal Wkly Rep. 2016 Mar 04;65(8):202-5
pubmed: 26938950
PLoS Negl Trop Dis. 2015 Apr 17;9(4):e0003567
pubmed: 25886400
Lancet. 2015 May 9;385(9980):1884-901
pubmed: 25987157
Emerg Infect Dis. 2017 Dec;23(13):
pubmed: 29155674
Glob Health Sci Pract. 2016 Dec 28;4(4):626-646
pubmed: 28031301
MMWR Morb Mortal Wkly Rep. 2015 Jan 16;64(1):28-9
pubmed: 25590683
Philos Trans R Soc Lond B Biol Sci. 2017 May 26;372(1721):
pubmed: 28396473