Da ebolaen brød ud i Sierra Leone i foråret 2014, var der smittede, der aldrig kom i kontakt med sundhedspersonale og tilfælde af sygdommen, der ikke blev rapporteret. Nu iværksætter landet et system med lokalt udpegede ”ebola-opsynsmænd”.
Inden for 24 timer efter mulig ebola-smitte er blevet rapporteret fra en landsby ankommer en supervisor for at undersøge sagen nærmere. (Foto: Rachel Unkovic/IRC).
NEW YORK, 9. February 2015 (International Rescue Committee): When Ebola first reached Sierra Leone in May 2014, health officials in a country recovering from 11 years of civil war struggled to identify new cases quickly enough to prevent the virus from spreading.
They relied primarily on tracing those who came in direct contact with a sick Ebola patient and on people calling a toll-free number to report suspected Ebola cases.
But misconceptions about Ebola kept many Sierra Leoneans with symptoms from calling or visiting a health center.
Countless cases went unreported as the virus spread through their communities. And as the epidemic escalated, an increasing number of those infected were not being identified as having Ebola.
To help detect Ebola cases earlier in the course of the disease, the International Rescue Committee (IRC) and the U.S. Centers for Disease Control and Prevention worked with local health management teams to bolster national surveillance efforts with a community-based “early warning system.”
Sierra Leone’s ministry of health piloted this new community health monitoring approach in the southern Bo District in January and is now rolling it out to other districts across the country with the IRC’s support.
Ebola early warning system: how it works
Village chiefs and other community leaders nominate community health workers who already have the trust of their neighbors to receive additional training as Ebola “health monitors.”
Rather than report suspected Ebola cases, these health monitors flag unusual events in their villages or neighborhoods that might indicate the presence of Ebola.
For example, if people become ill after attending a funeral where they might have had direct contact with the deceased, a health monitor reports this “trigger event” using a mobile phone provided for the task.
Within 24 hours, a surveillance supervisor arrives to investigate the report.
If the supervisor suspects Ebola, the patients’ families receive bleach to disinfect their homes and the patients are transported to an Ebola isolation unit where they receive medical care and are tested for the virus. Patients who test positive are immediately referred to an Ebola treatment center.
Patients are asked to provide a list of their contacts so that they can be monitored for Ebola symptoms.
IRC epidemiologist Ruwan Ratnayake believes community health monitoring will be especially important in districts where Ebola is waning and people might lower their guard. “There is a very real risk of the re-establishment of disease transmission,” he said. “This new system should add vigilance.”
