Did the Ebola outbreak disrupt immunisation services? A case study from Liberia
Compares routine facility-based and outreach immunisations and measles cases before, during and after the outbreak
Abstract
Setting
All health facilities providing routine immunisation services in Liberia.
Objective
To compare the number of routine facility-based and outreach immunisations and measles cases before, during and after the Ebola outbreak.
Design
A descriptive cross-sectional study.
Results
Immunisation coverage for fully immunised children before the Ebola outbreak was 73%. Immunisation coverage for all antigens declined by half compared to baseline during the outbreak. These findings were similar in facility-based and outreach immunisations. During the outbreak, the proportion of fully immunised children dropped by respectively 58%, 33% and 39% in the most, moderately and least Ebola-affected counties. Immunisation rate of recovery in the post-Ebola period was respectively 82%, 21% and 9% in the most, moderately and least affected counties compared to the Ebola-outbreak period. Outreach immunisation recovered slowly compared to facility-based immunisation. The mean number of measles cases reported per month was 12 pre-Ebola, 16 Ebola and 60 post-Ebola.
Conclusion
This study provides insights into the possible impact of an Ebola outbreak on countrywide immunisation. The outbreak weakened a struggling national immunisation programme, and post-outbreak recovery took significant time, which likely contributed to the measles epidemic. Recommendations for the improvement of immunisation services that could limit further preventable epidemics in Liberia and similar contexts at risk for Ebola are provided.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Wesseh CS, Najjemba R, Edwards JK, Owiti P, Tweya H, Bhat P. Did the Ebola outbreak disrupt immunisation services? A case study from Liberia. Public Health Action. 2017;7(1):82–7.
Links
Did the Ebola outbreak disrupt immunisation services? A case study from Liberia