Ebola Virus Outbreaks in Western Africa

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Table of Contents

Introduction
Mortality Rate
Symptom Prevalence
Patients’ Recovery
Healthcare staff risks
Conclusion
References

Introduction

Ebola virus disease is a contagious infection, which emerged in several outbreaks in Africa in recent years. A major epidemic, which broke out in several African countries, such as Guinea, Sierra Leone, and Liberia from February 2014 to December 2015, claimed the lives of more than 11 thousand people, the total number of those affected, including suspected and probable cases, accounted for more than 27 thousand people. The World Health Organization recognized the Ebola virus disease as a global menace on August 8, 2014.

It is vital to analyze up-to-date field studies to reduce the spread of the epidemic and to aid effective treatment. All the scholarly sources provided in this essay are evidence-based studies of the Ebola outbreaks in Western Africa with credible statistic data and its analysis. The articles were chosen from the past five years, and they included keywords, such as “Ebola”, “contagious”, and “treatment”. A search strategy was completed using databases, such as MEDLINE, CINAHL, and ProQuest. The themes in this synthesis are mortality rate, symptom prevalence, patients’ recovery, and managing risks for healthcare staff.

Mortality Rate

Ansumana et al. (2015) discussed the differences in statistical data on mortality rates in two healthcare centers. The authors analyzed the mortality rate decrease among Ebola virus disease (EVD) patients. They carried out a case study of 581 people, who “had either died or been discharged after testing negative for the Ebola virus in follow-up laboratory tests” (Ansumana et al., 2015, p. 587). Despite the fact that the researchers observed mortality rate reduction in one of the healthcare centers, its reasons remained unclear. That is why they implemented a package of various measures. In conclusion, this study revealed that the fatality decrease is noted under the given treatment protocol. However, the effectiveness of the approach, which was adopted in the selected facilities, should be further validated.

Symptom Prevalence

Skrable et al. (2017) made a retrospective study “The natural history of acute Ebola Virus Disease among patients managed in five Ebola treatment units in West Africa” to examine the difference in fatality rate among various age groups. The authors stated that all research on EVD that had been conducted previously reflected only one set of symptoms and did not take into account their transformation. These changes occur over time; that is why it was necessary to study patients in different age groups. In other words, the aim of the research was “to expand our understanding of the natural history of EVD from symptom onset to recovery or death” (Skrable et al., 2017, p. 2). This, in turn, may lead to improved observations and clinical management in the case of Ebola outbreaks in the future.

The authors studied 470 patients and divided them into several age blocks before the age of 45. Children younger than five years old were united in one group as the World Health Organization recognized them as an, especially vulnerable age range. After forming the age blocks, nurses and physicians documented patients’ symptoms and clinical signs at least once a day. Key findings of this study confirmed that “the most common signs/symptoms at triage were fever, asthenia (weakness), and anorexia (loss of appetite)” (Skrable et al., 2017, p. 5). However, among survivors, more than half of the patients suffered headaches and anorexia only at the very beginning of the illness. On the third day, fever and weakness increased and continued until the third week. After that, “the prevalence of most symptoms declined thereafter as patients recovered” (Skrable et al., 2017, p. 5). As for lethality cases, more than half of the patients suffered weakness every day of illness until death.

Patients’ Recovery

An article by Rabelo et al. (2016) discusses the emotional and mental conditions of Ebola survivors. This study is aimed at describing the distress experienced by EVD patients during hospitalization and rejoining their communities. The authors chose 17 participants between February and April in 2015 and formed three focus groups depending on patients’ gender. In addition, a “thematic analysis approach was applied to analyze the data” (Rabelo et al., 2016, p. 1). The first block included nine female survivors; the second and third focus groups consisted of male EVD survivors. At first, all the participants were interviewed over several themes, such as “mental health distress during treatment, coping strategies to overcome mental health distress, mental health distress and coping strategies after discharge” from treatment units (Rabelo et al., 2016, p. 2). After that, this data was analyzed, and the authors held discussions to enrich their understanding of the received information.

As a result, it was found that EVD patients often feel abandoned, and they cannot forget their families left their homes far away, while they are fighting for their lives. Moreover, Rabelo et al. (2016) state that “some of the survivors described a sense of numbness and failure to connect with the reality” inside the treatment unit (p. 3). As for coping strategies, a supportive attitude toward patients from the staff was encouraging when fighting the disease. Furthermore, it helps survivors lead a more active lifestyle after their recovery. That is why the most effective ways to reduce the distress of the EVD survivors are through building relationships, peer/community support, trust, and psychosocial care.

Carter et al. (2017) discussed another measure contributing to effective treatment – Community Care Centers (CCCs). They carried out a qualitative study “to understand the perceived impact that proximity to such Centers had on treatment-seeking behavior” (Carter et al., 2017, p.66). The authors collected data in the first half of 2015 on impediments and catalysts to a desire for seeking treatment in three districts of Sierra Leone, which was hardest hit by Ebola. Study participants expressed their concerns about the Ebola Virus Disease itself but also about the treatment system. For example, some people believed that “if you go inside the ambulance, you do not even arrive at the treatment Center; the ambulance will kill you first” (Carter et al., 2017, p. 68). More than that, they did not trust these centers as they were located far from their homes, and no one knew what was happening and who was working there.

The findings of the study demonstrate that physical proximity to Community Care Centers increased patients’ desire to seek treatment due to several reasons. Firstly, new CCCs were located within walking distance, which made it possible for patients to avoid ambulances. People were encouraged to attend Centers even if they did not have Ebola. As a result, it led to improved diagnostic and treatment opportunities. Furthermore, citizens received open access to patient information about their relatives and Centers’ functioning. It was essential for people as before the construction of new Community Care Centers, and they had to wait a long time to learn about their parents, children’s, or spouses’ deaths. Building CCCs near their homes made it possible “to pass messages on to patients, even if through a staff member, helped reduce fear around treatment” (Carter et al., 2017, p. 69). In addition, the founders of Community Care Centers engaged local people in their establishment. This factor contributed to patients’ increased trust in CCCs and encouraged them to attend these facilities regularly.

Healthcare staff risks

Andertun, Hörnsten, and Hajdarevic (2016) addressed the problem of managing contagion risks and developing care strategies for healthcare staff. The purpose of their descriptive and qualitative study was to focus on Norwegian healthcare workers’ involvement in treating EVD patients in Sierra Leone. Eight nurses and one physician with the background of working in Ebola care centers participated in this research. The findings revealed that “Ebola workers were relying highly on safety and used strategies to minimize risks of contagion” (Andertun, Hörnsten, & Hajdarevic, 2016, p. 8). Though they were aware of the risks, they regarded their work as motivating and critical. Appropriate preparedness and training of healthcare staff resulted in their inspiration and personal growth. Moreover, studies based on medical workers’ experiences may be useful for contributing new knowledge and improving the treatment system in other countries.

Conclusion

The synthesis of literature supported the need for a further careful examination of the Ebola Virus Disease. It is clearly identified that there are many efficient ways to eliminate negative factors during and after treatment, such as building new Community Care Centers relationships, enhancing peer and community support, trust, providing high-quality psychosocial care. Various guidelines are supported in this review and will be utilized in the creation and implementation of new programs aimed at helping EVD patients, training healthcare staff. More than that, the findings may be applied to future studies on changes in Ebola symptoms and risk factors.

References

Andertun, S., Hörnsten, Å., & Hajdarevic, S. (2016). Ebola virus disease: caring for patients in Sierra Leone – A qualitative study. Journal of Advanced Nursing, 73(3), 643–652. Web.

Ansumana, R., Jacobsen, K. H., Idris, M. B., Bangura, H., Boie-Jalloh, M., Lamin, J. M., … Sahr, F. (2015). Ebola in Freetown area, Sierra Leone — A case study of 581 patients. New England Journal of Medicine, 372(6), 587–588. Web.

Carter, S. E., O’Reilly, M., Frith-Powell, J., Kargbo, A. U., Byrne, D., & Niederberger, E. (2017). Treatment seeking and Ebola Community Care Centers in Sierra Leone: A qualitative study. Journal of Health Communication, 22(sup1), 66–71. Web.

Rabelo, I., Lee, V., Fallah, M. P., Massaquoi, M., Evlampidou, I., Crestani, R., … Severy, N. (2016). Psychological distress among Ebola survivors discharged from an Ebola treatment unit in Monrovia, Liberia – A qualitative study. Frontiers in Public Health, 4(142). Web.

Skrable, K., Roshania, R., Mallow, M., Wolfman, V., Siakor, M., & Levine, A. C. (2017). The natural history of acute Ebola Virus Disease among patients managed in five Ebola treatment units in West Africa: A retrospective cohort study. PLOS Neglected Tropical Diseases, 11(7). Web.

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