Factors Associated with the Ebola Viral Disease Outbreak in Montserrado County, Liberia

Abstract

The 2014 Ebola Virus Disease (EVD) outbreak went on record as the most distressing epidemic in the 41 years history of Ebola following its discovery in DRC and South Sudan. Liberia, one of the three nations at the epicentre of the EVD outbreak, grapples with poverty and is still recovering from civil war that ended in 2003, suffers a weak health system. Montserrado County in Liberia was one of the three counties that were hit hardest by the outbreak, the others being Lofa and Margibi. The primary objective of this study was to assess the aspects linked to the identification and response patterns with regards to the EVD outbreak in Montserrado County, Liberia. This was necessitated by the dire need for effective infectious disease detection and control. A cross-sectional design was adopted. Primary data was collected from nurses in Montserrado and further secondary data was abstracted from County health records. Montserrado recorded a case fatality rate of 44.7%. Analysis showed that the odds of females dying from EVD were 21% lower than for men. Age and location decreased odds to 16% though not at a statistically significant level. Longer time to detection meant higher chances of fatality; mean days to detection for those who recovered was 5.49±4.02 and 5.82±4.18 for fatalities. Lack of diagnostic capacity, fear, limited knowledge of the disease, and sociocultural beliefs presented as some of the key barriers to detection and response. There is need to improve the health system in Liberia, conduct more rigorous health education, strengthen disease surveillance, and break barriers to detection and response for better preparedness.

Keywords: Ebola virus disease, outbreak, Montserrado, Liberia