October 19, 2015
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Ebola treatment beds prevented 56,000 cases, 40,000 deaths in Sierra Leone

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Thousands of Ebola treatment beds introduced in Sierra Leone likely prevented more than 56,000 new cases and 40,000 deaths, according to a recent study.

“Our findings show the unprecedented local and international response led to a substantial decline in Ebola transmission,” Adam J. Kucharski, PhD, from the department of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, said in a press release. “Given the rapid growth of the outbreak in Sierra Leone, if those beds hadn’t been in place to isolate the ill and avert further infections, the epidemic could have been much worse.”

 Adam J. Kucharski, PhD

Adam J. Kucharski*

Government and nongovernmental officials from the United Kingdom and Sierra Leone supplied Ebola holding centers and community care centers with more than 1,500 beds, and larger treatment units with 1,200 beds, between June 2014 and February, Kucharski and colleagues wrote. To estimate the impact of bed capacities on EVD transmission, the researchers developed a stochastic mathematical model based on the weekly rate of confirmed and probable EVD cases that occurred within 12 districts. They assumed that 60% of infectious patients were treated for approximately 10.9 days, until death or discharge. The amount of time between onset of EVD and admission to a health care facility was assessed, and declined over time based on reported values. The mean duration for patients with confirmed EVD to be transferred to an available treatment unit was 2 days. The results were based on the presumption that patients remained in the community if no beds were available in health care facilities.

The impact of treatment beds varied by region, according to the data. Areas with ongoing transmission yielded a lower number of averted cases and mortalities compared with districts where larger outbreaks occurred. Across all districts, an estimated 56,600 (95% CI, 48,300-84,500) cases were prevented.

“Given that the case fatality rate of Ebola in Sierra Leone is near 70%, this suggests that the scale-up of local and international efforts to combat the epidemic is likely to have averted over 40,000 Ebola deaths in the country between June 2014 and February 2015,” Kucharski and colleagues wrote. “Moreover, the reduction in Ebola transmission will also have halted the damaging secondary effects of the epidemic, including the suspension of access to maternal health and vaccination programs.”

Further model predictions estimated that 12,500 additional EVD cases (OR = 69,100; 95% CI, 59,500-122,000) would have been prevented if beds were introduced 4 weeks earlier during the epidemic. – by Stephanie Viguers

Disclosure: The researchers report no relevant financial disclosures.

(*Photo courtesy of Adam J. Kucharski, PhD)