Medicine and Health Sciences Commons^™

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

Assessing The Impact Of Ebola Virus Inoculum Size On Likelihood Of Infection, Joseph Lukowski

Capstone Experience

Background: Indirect transmission of Ebola virus disease (EVD) is not uncommon but is poorly understood. Improving the understanding of the potential risk of EVD transmission from fomites should result in new or updated prevention or control measures for suspected or confirmed EVD cases or outbreaks.

Objective: This study aims to compile and understand pertinent data from peer-reviewed literature, establish the dose-response relationship between inoculum doses introduced to mucous membranes, and finally estimate the risk of EVD transmission from fomites.

Methods: A literature search was conducted through PubMed to obtain relevant data. This study employed this data to perform Poisson regression …

The Impact Of Emergency Response Trainees During The Ebola Outbreak In Sierra Leone, 2014-2016, Abbey Whitcomb

Undergraduate Honors Theses

This research aimed to address the impact of non-health trainees as a part of the emergency health response during the Ebola outbreak within Sierra Leone. The non-health trainees, including sanitation workers within health settings, ambulance drivers, burial teams, prison officers, community engagement staff, border officers, traditional birth assistants, etc. was contrasted with individuals receiving clinical and patient-care training. The data were taken from weekly situation reports published by the Internal Organization for Migration in 2015. Using a negative binomial model, we sought to determine the incidence rate ratio of weekly cases and deaths as a result of new trainees. Trainees …

The Policy Of Substance Abuse In Liberia: Analysis And Recommendations, Yamah Dolo

Community Engagement Student Work

Countries all over the globe are affected by substance abuse. Substance abuse is a traumatic issue that people around the world battle. Substance use has occurred for many years and seems to keep increasing. According to Parekh, “Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence.” (Parekh, 2017). Substance abuse has a significant effect on health, an individual’s well-being, families, relationships, and the post-war community. However, with the information on Liberia, little is known about the substance abuse cases. Liberia is a country that has no health, and there …

Demographic Characteristics And Response Preparedness Of Employed Adults To Ebola Virus Disease In Monrovia, Liberia, Beth Ann Sexton

Walden Dissertations and Doctoral Studies

AbstractEbola virus disease (EVD) is a deadly disease with no known cure and it caused an outbreak from 2014-2016 in Western Africa. Liberia had the highest morbidity and mortality; its capital city, Monrovia, was the focus of this study. The purpose of this research was to explore the association between sociodemographic and socioeconomic factors (gender, religion, age, occupation, education, and ward) and the use of preventative hygiene measures and understanding of EVD among working Monrovian adults. This population was chosen because 97% of the Monrovian population is employed, and thus serves as a good source for future public health campaigns. …

Diversification Of Research Methodological Approach During Model Enhancements In Health Information System Research, Uche Ikenyei

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

The Problem With Relying On Profit-Driven Models To Produce Pandemic Drugs, Ana Santos Rutschman

All Faculty Scholarship

The longstanding problems of relying on a market response to a pandemic are becoming readily apparent in the United States, which has quickly become the epicenter of the COVID-19 outbreak. The problems are particularly pronounced in pharmaceutical markets, where we are pinning our hopes for both cures and vaccines. In previous work we have shown how characteristics of healthcare markets in the United States create a divergence between the private incentives of for-profit companies and public health needs, leading to sub-optimal health outcomes in what is a uniquely market-driven healthcare system. In this Essay, written as the COVID-19 pandemic unfolds, …

A Case-Study Approach To Investigate Transmission, Co-Infection, And Clinical Sequelae During Epidemics Of Dengue And Ebola Virus Disease, Jennifer Elizabeth Giovanni

LSU Doctoral Dissertations

From within their ecologic niches, zoonotic viruses emerge from animal reservoirs into the edges and centers of human habitation to exploit opportunities for unabated transmission within immunologically–naïve populations. Our understanding of where, in whom, and how these viruses emerge is under direct challenge, driving the evolution of modern infectious disease epidemiology within a rapidly-connected global community. The studies presented herein are based on analyses of both aggregate and case-level data, which, we argue, provide unique insight into the complexities of transmission, co-infection, and clinical sequelae occurring within, and arising from, epidemics of emerging zoonotic viruses. In Chapter II, we investigate …

Playing To Live: Outcome Evaluation Of A Community-Based Psychosocial Expressive Arts Program For Children During The Liberian Ebola Epidemic, Caroline A. Decosimo, J. Hanson, Megan Quinn, P. Badu, E. G. Smith

ETSU Faculty Works

Background. This paper reviews the efficacy of a community psychosocial arts program focused on building mental health capacity within post-Ebola Liberia. The aim of this paper was to evaluate the outcome effects of two groups using pre- and post-treatment data. We hypothesized that there would be a difference in symptoms pre- and post-treatment, and the longer program would yield more significant results.

Methods. There was a total of 870 child participants. Of 40 sites, 24 were selected for a 5-month treatment (TG1) while the remaining 16 sites received 3 months of treatment (TG2). Paired t tests and a mixed-model analysis …

Predictors And Risk Factors Of Ebola Virus Disease In Sierra Leone, Kandeh Kamara

Walden Dissertations and Doctoral Studies

Sierra Leone had the highest number of cases of Ebola virus disease in history during the 2014 Ebola epidemic. The purpose of this quantitative, cross-sectional study was to examine the relationship between sociocultural and behavioral risk factors and Ebola status among women and men ages 15 to 49 years in Sierra Leone. The ecological model served as the theoretical framework. Secondary data were collected from the Sierra Leone Ebola Disease Survey. Results of chi-square tests revealed that attending a funeral (p = .001), touching a dead body at a funeral (p = .023), contact with a sick person (p = …

New Filovirus Disease Classification And Nomenclature, Jens H. Kuhn, Takuya Adachi, Neill K.J. Adhikari, Jose R. Arribas, Ibrahima Elhadj Bah, Daniel G. Bausch, Nahid Bhadelia, Matthias Borchert, Arne Broch Brantsæter, David Brett-Major, Timothy H. Burgess, Daniel S. Chertow, Christopher G. Chute, Theodore J. Cieslak, Robert Colebunders, Ian Crozier, Richard T. Davey, Hilde De Clerck, Rafael Delgado, Laura Evans, Mosoka Fallah, William A. Fischer, Tom E. Fletcher, Robert A. Fowler, Thomas Grünewald, Andy Hall, Angela L. Hewlett, Andy I.M. Hoepelman, Catherine F. Houlihan, Giuseppe Ippolito, Shevin T. Jacob, Michael Jacobs, Robert Jakob, Frederique A. Jacquerioz, Laurent Kaiser, Andre C. Kalil, Rashidatu F. Kamara, Jimmy Kapetshi, Hans-Dieter Klenk, Gary Kobinger, Mark G. Kortepeter, Colleen S. Kraft, Thomas Kratz, Henry S. Kyobe Bosa, Marta Lado, François Lamontagne, H. Cliff Lane, Leslie Lobel, Julius Lutwama, G. Marshall Lyon, Moses B.F. Massaquoi, Thomas A. Massaquoi, Aneesh K. Mehta, Vital Mondonge Makuma, Srinivas Murthy, Tonny Seikikongo Musoke, Jean-Jacques Muyembe-Tamfum, Phiona Nakyeyune, Carolina Nanclares, Miriam Nanyunja, Justus Nsio-Mbeta, Tim O'Dempsey, Janusz T. Pawęska, Clarence J. Peters, Peter Piot, Christophe Rapp, Bertrand Renaud, Bruce Ribner, Pardis C. Sabeti, John S. Schieffelin, Werner Slenczka, Moses J. Soka, Armand Sprecher, James Strong, Robert Swanepoel, Timothy M. Uyeki, Michel Van Herp, Pauline Vetter, David A. Wohl, Timo Wolf, Anja Wolz, Alie H. Wurie, Zabulon Yoti

Journal Articles: Epidemiology

The recent large outbreak of Ebola virus disease (EVD) in Western Africa resulted in greatly increased accumulation of human genotypic, phenotypic and clinical data, and improved our understanding of the spectrum of clinical manifestations. As a result, the WHO disease classification of EVD underwent major revision.

Using "Outbreak Science" To Strengthen The Use Of Models During Epidemics., Caitlin Rivers, Jean-Paul Chretien, Steven Riley, Julie A. Pavlin, Alexandra Woodward, David Brett-Major, Irina Maljkovic Berry, Lindsay Morton, Richard G. Jarman, Matthew Biggerstaff, Michael A. Johansson, Nicholas G. Reich, Diane Meyer, Michael R. Snyder, Simon Pollett

Journal Articles: Epidemiology

Infectious disease modeling has played a prominent role in recent outbreaks, yet integrating these analyses into public health decision-making has been challenging. We recommend establishing ‘outbreak science’ as an inter-disciplinary field to improve applied epidemic modeling.

Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade

Walden Dissertations and Doctoral Studies

The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs …

Ebola: Africa, James Goodwin

Global Issues in Public Health

In this paper, I talk about the Ebola Hemorrhagic Fever. Ebola is a rare virus that spreads through the immune system and can be fatal. Ebola is a pathogen from Africa, specifically West Africa. There has been almost 32,000 cases since 1976. Symptoms include, Fever, Headache, Muscle pain, Fatigue, Diarrhea, Vomiting, Stomach pain, and Bleeding/Bruising. Transmission happens during close or direct contact. World Health Organization has been making efforts to handle outbreaks such as the outbreak in 2014. World Health Organization mobilized and set up relief efforts. Education is a key idea for my thoughts on how we can intervene …

Catching Chances: The Movement To Be On The Ground And Research Ready Before An Outbreak, David Brett-Major, James V. Lawler

Journal Articles: Epidemiology

After more than 28,000 Ebola virus disease cases and at least 11,000 deaths in West Africa during the 2014⁻2016 epidemic, the world remains without a licensed vaccine or therapeutic broadly available and demonstrated to alleviate suffering. This deficiency has been felt acutely in the two, short, following years with two Ebola virus outbreaks in the Democratic Republic of Congo (DRC), and a Marburg virus outbreak in Uganda. Despite billions of U.S. dollars invested in developing medical countermeasures for filoviruses in the antecedent decades, resulting in an array of preventative, diagnostic, and therapeutic products, none are available on commercial shelves. This …

Evidence-Based Guidelines For Supportive Care Of Patients With Ebola Virus Disease, François Lamontagne, Robert A. Fowler, Neill K. Adhikari, Srinivas Murthy, David Brett-Major, Michael Jacobs, Timothy M. Uyeki, Constanza Vallenas, Susan L. Norris, William A. Fischer, Thomas E. Fletcher, Adam C. Levine, Paul Reed, Daniel G. Bausch, Sandy Gove, Andrew Hall, Susan Shepherd, Reed A. Siemieniuk, Marie-Claude Lamah, Rashida Kamara, Phiona Nakyeyune, Moses J. Soka, Ama Edwin, Afeez A. Hazzan, Shevin T. Jacob, Mubarak Mustafa Elkarsany, Takuya Adachi, Lynda Benhadj, Christophe Clément, Ian Crozier, Armando Garcia, Steven J. Hoffman, Gordon H. Guyatt

Journal Articles: Epidemiology

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive …

In Liberia: A Silent Health Care Catastrophe Replaces A Viral One, Clarissa Sosin

Capstones

Underfunded and understaffed, the structural issues within the Liberian healthcare system were first exposed during the 2014 Ebola Epidemic when the system collapsed under the pressure. Its failure to respond effectively resulted in the deaths of nearly 5,000 people, the highest fatality rate out of the three countries most affected by the epidemic. Years later, despite efforts to rebuild and strengthen the system, many of the issues still remain.

http://www.clarissasosin.com/liberianhealthcare

A Process Description Of Playing To Live! A Community Psychosocial Arts Program During Ebola, C. Alexis Decosimo, Jessi E. Hanson, Catherine Reilly Boland, Deborah L. Slawson, Mary Ann Littleton, Megan Quinn

ETSU Faculty Works

From 2014 to 2015, Liberia experienced the largest Ebola epidemic in world history. The impact of this disease was not only physical; it created fear, loss, and trauma throughout the country. This article will describe the process of three phases of a community-based psychosocial expressive arts program, which used theory from the fields of expressive arts therapy to build mental health capacity during and after the epidemic. This article will highlight the background of Ebola virus disease and the Ebola virus disease epidemic, provide an overview of current theory and research for expressive arts therapy and the impact of trauma, …

Liberia : Maternal Health & Ebola, Chelsey Hernandez

Global Public Health

Throughout the world, many low-income countries suffer from poor nutrition, lack of health resources, and little to no access to other valuable resources. Previous research has demonstrated the poor state of health in Liberia as a result of these various socioeconomic factors. Although Liberia faces many public health issues, the 2014 Ebola epidemic reversed whatever progress was made. Maternal and child health in particular has severely decreased, especially in recent years. This brief focuses on the impact of the 2014 Ebola epidemic had on maternal health.

Analysis Of The Liberian Ebola Survivors Support System (Esss), Jessi Hanson, Patrick Seeco Faley, Megan Quinn

ETSU Faculty Works

A systems theoretical analysis to capture the evolution and transition of the network systems supporting Ebola survivors and their affected communities, during the 2014-15 Ebola outbreak and recovery phases. The qualitative analysis includes a literature review, archival review, and interviews with representatives of key actors operating in strategic action fields. This paper uses a series of Diagrams that visually illustrate the various complex phases and their network changes that occurred and were established during the outbreak. This case analysis provides crucial phase information that both captures the historical events that informed the systems changes, including the development of the Ebola …

Diminished Quality Of Life Among Women Affected By Ebola, Jessi Hanson, Alexis Decosimo, Megan Quinn

Journal of Social, Behavioral, and Health Sciences

This article analyzes data collected from Liberian women afflicted by the Ebola virus disease, survivors of the virus and noninfected persons living in Ebola-affected homes. This research is one of the first statistical analyses examining factors diminishing quality of life: negative experiences, stigma, and psychosocial symptoms among females affected by the virus after the outbreak. The research presents a thorough literature review, including research related to other infectious diseases like HIV/AIDS, to inform the gap in studies on Ebola’s effects on quality of life. Women who are Ebola virus disease survivors demonstrate significant differences in stigma and psychosocial stress when …

How We’Ll Fight The Next Deadly Virus Ted Talk Annotated Resource List, Susie Roy

Undergraduate Research Award

No abstract provided.

Ebola And Social Media, Kathryn C. Finch

GS4 Georgia Southern Student Scholars Symposium

We were interested in knowing the impact of social media during the 2014-2015 West Africa Ebola epidemic. The aim of this systematic review is to provide clinicians, public health practitioners and policy-makers with a comprehensive overview of the up-to-date literature on Ebola and social media. We critically appraised the quality and utility of these studies, and identified the gaps in our current understanding that invite further research efforts. In particular, we focused on the research questions and the methods of the studies: a) What were the research questions of a given study? b) What study design and research methods were …

Diminished Quality Of Life Among Women Affected By Ebola, Jessi Hanson, Alexis Decosimo, Megan Quinn

ETSU Faculty Works

This article analyzes data collected from Liberian women afflicted by the Ebola virus disease, survivors of the virus and noninfected persons living in Ebola-affected homes. This research is one of the first statistical analyses examining factors diminishing quality of life: negative experiences, stigma, and psychosocial symptoms among females affected by the virus after the outbreak. The research presents a thorough literature review, including research related to other infectious diseases like HIV/AIDS, to inform the gap in studies on Ebola’s effects on quality of life. Women who are Ebola virus disease survivors demonstrate significant differences in stigma and psychosocial stress when …

Ebola Virus Disease And Critical Illness, Aleksandra Leligdowicz, William A. Fischer, Timothy M. Uyeki, Thomas E. Fletcher, Neill K.J. Adhikari, Gina Portella, Francois Lamontagne, Christophe Clement, Shevin T. Jacob, Lewis Rubinson, Abel Vanderschuren, Jan Hajek, Srinivas Murthy, Mauricio Ferri, Ian Crozier, Elhadj Ibrahima, Marie-Claire Lamah, John S. Schieffelin, David Brett-Major, Daniel G. Bausch, Nikki Shindo, Adrienne K. Chan, Tim O'Dempsey, Sharmistha Mishra, Michael Jacobs, Stuart Dickson, G. Marshall Lyon, Robert A. Fowler

Journal Articles: Epidemiology

As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury. Hypoxia and ventilation failure occurs most often with severe illness and …

Factors Underlying Ebola Virus Infection Among Health Workers, Kenema, Sierra Leone, 2014-2015, Mikiko Senga, Kimberly Pringle, Andrew Ramsay, David Brett-Major, Robert A. Fowler, Issa French, Mohamed Vandi, Josephine Sellu, Christian Pratt, Josephine Saidu, Nahoko Shindo, Daniel G. Bausch, Sierra Leone Kenema District Task Force And Kenema Government Hospital

Journal Articles: Epidemiology

BACKGROUND: Ebola virus disease (EVD) in health workers (HWs) has been a major challenge during the 2014-2015 outbreak. We examined factors associated with Ebola virus exposure and mortality in HWs in Kenema District, Sierra Leone.

METHODS: We analyzed data from the Sierra Leone National Viral Hemorrhagic Fever Database, contact tracing records, Kenema Government Hospital (KGH) staff and Ebola Treatment Unit (ETU) rosters, and burial logs.

RESULTS: From May 2014 through January 2015, 600 cases of EVD originated in Kenema District, including 92 (15%) HWs, 66 (72%) of whom worked at KGH. Among KGH medical staff and international volunteers, 18 of …

Clinical Profile And Containment Of The Ebola Virus Disease Outbreak In Two Large West African Cities, Nigeria, July-September 2014, Chima Ohuabunwo, Celestine Ameh, Oyin Oduyebo, Anthony Ahumibe, Bamidele Mutiu, Adebola Olayinka, Wasiu Gbadamosi, Erika Garcia, Carolina Nanclares, Wale Famiyesin, Abdulaziz Mohammed, Patrick Nguku, Richard I. Koko, Joshua Obasanya, Durojaye Adebayo, Yemi Gbadegesin, Oni Idigbe, Olukayode Oguntimehin, Sara Nyanti, Charles Nzuki, Ismail Abdus-Salam, Joseph Adeyemi, Nnanna Onyekwere, Emmanuel Musa, David Brett-Major, Faisal Shuaib, Abdulsalami Nasidi

Journal Articles: Epidemiology

INTRODUCTION: The Ebola virus disease (EVD) outbreak in Nigeria began when an infected diplomat from Liberia arrived in Lagos, the most populous city in Africa, with subsequent transmission to another large city.

METHODS: First-, second-, and third-generation contacts were traced, monitored, and classified. Symptomatic contacts were managed at Ebola treatment centers as suspected, probable, and confirmed EVD cases using standard operating procedures adapted from the World Health Organization EVD guidelines. Reverse transcription PCR tests confirmed EVD. Socio-demographic, clinical, hospitalization, and outcome data of the July-September 2014 Nigeria EVD cohort were analyzed.

RESULTS: The median age of the 20 EVD cases …

Early Identification And Prevention Of The Spread Of Ebola - United States, Chris A. Van Beneden, Harald Pietz, Robert D. Kirkcaldy, Lisa M. Koonin, Timothy M. Uyeki, Alexandra M. Oster, Deborah A. Levy, Maleeka Glover, Matthew J. Arduino, Toby L. Merlin, David T. Kuhar, Christine Kosmos, Beth P. Bell

Journal Articles: Epidemiology

In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC prepared for the potential introduction of Ebola into the United States. The immediate goals were to rapidly identify and isolate any cases of Ebola, prevent transmission, and promote timely treatment of affected patients. CDC's technical expertise and the collaboration of multiple partners in state, local, and municipal public health departments; health care facilities; emergency medical services; and U.S. government agencies were essential to the domestic preparedness and response to the Ebola epidemic and relied on longstanding partnerships. CDC established a comprehensive response that included two new …

Social Network Analysis Of Cellphone Surveillance Data For Ebola In Sierra Leone, Jia B. Kangbai

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To explore and visualize the connectivity of suspected Ebola cases and surveillance callers who used cellphone technology in Moyamba District in Sierra Leone for Ebola surveillance, and to examine the demographic differences and characteristics of callers who make more calls as well as more likely to make at least one positive Ebola call.

Methods: Surveillance data for 393 suspected Ebola cases (192 males, 201 females) were collected from October 23, 2014 to June 28, 2015 using cellphone technology. UCINET and NetDraw were used to explore and visualize the social connectivity between callers and suspected Ebola cases. Poisson and logistic …

Swords Into Stethoscopes: How The U.S. Military Could Conduct Medical Diplomacy, Oliver Kendall

Political Science Honors Projects

Since the early 1960’s, Cuba and China have won international appreciation by sending doctors abroad to help where they are needed. While there was surprise in some quarters when U.S. military personnel were deployed to combat Ebola in the last months of 2014, the Department of Defense actually has a long history of medical activity. In its current form, DoD medical outreach cannot likely garner soft power in the way that the Chinese and Cuban programs can, but with a few modifications, the U.S. military could be a serious conductor of medical diplomacy that would save countless lives and benefit …