Knockdown and recovery of malaria diagnosis and treatment in Liberia during and after the 2014 Ebola outbreak
Consequences of the Ebola outbreak on Liberia’s National Malaria Programme and its post-Ebola recovery
Abstract
Setting
The malaria-endemic country of Liberia, before, during and after the 2014 Ebola outbreak.
Objective
To describe the consequences of the Ebola outbreak on Liberia’s National Malaria Programme and its post-Ebola recovery.
Design
A retrospective cross-sectional study using routine countrywide programme data
Results
Malaria caseloads decreased by 47% during the Ebola outbreak and by 11% after, compared to the pre-Ebola period. In those counties most affected by Ebola, a caseload reduction of 20% was sustained for 12 consecutive months, while this lasted for only 4 consecutive months in the counties least affected by Ebola. Linear regression of monthly proportions of confirmed malaria cases—as a proxy indicator of programme performance—over the pre- and post-Ebola periods indicated that the malaria programme could require 26 months after the end of the acute phase of the Ebola outbreak to recover to pre-Ebola levels
Conclusions
The differential persistence of reduced caseloads in the least- and most-affected counties, all of which experienced similar emergency measures, suggest that factors other than Ebola-related security measures played a key role in the programme’s reduced performance. Clear guidance on when to abandon the emergency measures after an outbreak may be needed to ensure faster recovery of malaria programme performance.
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
Dunbar NK, Richards EE, Woldeyohannes D, Van den Bergh R, Wilkinson E, Tamang D, Owiti P. Knockdown and recovery of malaria diagnosis and treatment in Liberia during and after the 2014 Ebola outbreak. Public Health Action. 2017;7(1):76–81.