Abstract
BackgroundLiberia is among the three west African countries which were crippled by the Ebola Virus Disease (EVD) outbreak of 2014. One of the programs which was affected by the EVD outbreak was the National Leprosy and Tuberculosis Control Program (NLTCP). Determining the magnitude of the impact of EVD on the NLTCP performance is crucial in restoring the service and in devising effective post EVD strategies. The purpose of the study was to analyse the impact of EVD outbreak on the performance of the NLTCP of the Ministry of Health (MOH) OF Liberia.MethodsA cross sectional study design was conducted in 2016 using both quantitative and qualitative methods. Quantitative data was used for the Tuberculosis (TB) program evaluation before EVD (2012–2013) and during EVD (2014–2015). Qualitative data was used to complement the data obtained for the quantitative study. Descriptive statistical analyses of quantitative data were conducted using Microsoft Excel.ResultsNotified TB cases of all forms decreased from 7822 in 2013 to 4763 and 6118 in 2014 and 2015 respectively. The number increased to 7180 and 7728 in 2016 and 2017 respectively. The TB treatment success rate was 71 and 61% in 2014 and 2015 respectively compared to the 83% in 2013. The treatment success rate was 77% in 2016. The loss to follow up (LTFU) was as high as 47% in some regions which were highly affected by the EVD outbreak. The national average LTFU was 5–10% in 2012–2013 and 16 and 21% in 2014 and 2015 respectively. The percentage of TB patients with known HIV result decreased from 75% in 2013 to 74 and 42% in 2014 and 2015 respectively. TB culture and drug susceptibility testing service was interrupted throughout the outbreak. The results of the focal group discussions and interviews conducted in our study also indicated that the TB case finding and the TB treatment outcome was significantly affected by the EVD outbreak.ConclusionNotified TB cases and treatment outcome was significantly affected by the EVD outbreak which occurred in 2014 and 2015 in Liberia. Effective restoration strategies should be developed in order to improve the TB case finding and treatment outcome.
Highlights
Liberia is among the three west African countries which were crippled by the Ebola Virus Disease (EVD) outbreak of 2014
TB/Human immunodeficiency virus (HIV) coinfection and collaboration efforts were analyzed before and after the EVD outbreak to determine the impact of the outbreak on HIV testing of TB patients
The % of HIV + TB patients started or continued on Cotrimoxazole Preventive Therapy (CPT) decreased during the outbreak but the % of HIV+ TB patients started or continued on Anti- Retroviral Therapy (ART) increased during the outbreak as indicated below (Table 1)
Summary
Liberia is among the three west African countries which were crippled by the Ebola Virus Disease (EVD) outbreak of 2014. One of the programs which was affected by the EVD outbreak was the National Leprosy and Tuberculosis Control Program (NLTCP). The purpose of the study was to analyse the impact of EVD outbreak on the performance of the NLTCP of the Ministry of Health (MOH) OF Liberia. TB is a major public health problem worldwide. It affects the health of approximately 10 million people each year and is one of the top ten causes of death worldwide. The NLTCP of Liberia was well functioning starting from its establishment in 1989 under the Department of Preventive Health Services of the Ministry of Health and Social Welfare with TB case detection rate of above 60% and TB treatment success rate of above 70% between the 1990 and 2000 [3, 4]. The notification increased to 5007 and 8132 in 2008 and 2012 respectively
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