Ebola response in Sierra Leone: The impact on children
Open accessAbstract
The West African Ebola virus disease (EVD) outbreak is the largest ever seen, with over 28,000 cases and 11,300 deaths since early 2014. The magnitude of the outbreak has tested fragile governmental health systems and non-governmental organizations (NGOs) to their limit. Here we discuss the outbreak in the Western Area of Sierra Leone, the shape of the local response and the impact the response had on caring for children suspected of having contracted EVD. Challenges encountered in providing clinical care to children whilst working in the "Red Zone" where risk of EVD is considered to be highest, wearing full personal protective equipment are detailed. Suggestions and recommendations both for further research and for operational improvement in the future are made, with particular reference as to how a response could be more child-focused.
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The unchanged proportion of reproductive-age women facing financial barriers to healthcare access in 2013 and 2019 may be linked to recurrent outbreaks in Sierra Leone over the past decade, particularly the Ebola outbreak.
“A plausible reason for the unchanged proportion of reproductive-age women who faced financial barriers to access healthcare in 2013 and 2019 may be linked to the recurrent outbreaks in Sierra Leone over the past decade.”
From Financial barriers to healthcare access among reproductive-age women in Sierra Leone: evidence from demographic health surveys of 2008, 2013, and 2019 (2026) · cites this paper as [34]
The Introduction’s “Ebola holding unit model” section reports that inpatient admissions in Sierra Leone fell during the Ebola outbreak, supporting a possible link between the outbreak and reduced healthcare use. It does not address financial barriers for reproductive-age women, compare 2013 with 2019, or link an unchanged proportion to recurrent outbreaks. (LLM, conf=0.81)
Experimental — accuracy not yet measuredThe Ebola outbreak severely disrupted the healthcare system's operation and economic activities due to government-enforced measures such as lockdown or stay-at-home orders.
“Studies reported that this outbreak severely disrupted healthcare system’s operation and economic activities due to government-enforced measures such as lockdown or stay-at-home orders [33–35].”
From Financial barriers to healthcare access among reproductive-age women in Sierra Leone: evidence from demographic health surveys of 2008, 2013, and 2019 (2026) · cites this paper as [34]
The Introduction’s “Ebola holding unit model” section reports hospital closures and a 70% drop in inpatient admissions in Sierra Leone, supporting disruption to healthcare. It attributes closures to staff fear of infection, however, and does not report disrupted economic activity or identify lockdowns or stay-at-home orders as the cause. No page number is available in our copy. (LLM, conf=0.88)
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- Authors
- Fitzgerald, F., Awonuga, W., Shah, T., & Youkee, D.
- Affiliations
- Save the Children (US)
- Imperial College Healthcare NHS Trust (GB)
- Corresponding author
- Fitzgerald, Felicity
- Awonuga, Waheed
- Shah, Tejshri
- Youkee, Daniel
- Venue
- Journal of Infection
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 72
- Pages
- S6-S12
- ISSN
- 0163-4453 (ISSN-L)
- PMC
- PMC4930947
- OpenAlex
- W2389162383
- Cited by
- 21
- References
- 33
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 3
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Infection (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Medical Research Council (MR/K023535/1)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Keywords
- Ebola virus disease, 2014 West Africa Ebola outbreak, Sierra Leone, child health, personal protective equipment, red zone, outbreak response, health system fragility, non-governmental organizations
- MeSH terms
- Child Health, Child, Communicable Disease Control, Disease Outbreaks, Humans, Sierra Leone, Hemorrhagic Fever, Ebola, Epidemics
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