Abstract
Background: Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality in the world. During infectious disease outbreaks, such as the Ebola virus disease outbreak in West Africa from 2014-2015, the health system is often strained, and diagnosis, management and care of NCDs may be compromised. This study assessed numbers and distribution of NCDs in all health facilities in the Western-Area District, Sierra Leone, in the post-Ebola period (June-December 2015) comparing findings with the pre-Ebola (June-December 2013) and Ebola outbreak (June-December 2014) periods. Methods: This was a cross-sectional study using secondary data from routine records of aggregate monthly NCD reports. Data were analysed using Open EPI and comparisons were made between the post-Ebola and pre-Ebola/Ebola periods using the chi square test. Results: There were 10,011 people reported with NCDs during the three six-month periods, with 6194 (62%) presenting at peripheral health units (PHU). Reported NCDs decreased during Ebola and increased post-Ebola, but did not recover to pre-Ebola levels. Hypertension cases remained fairly constant throughout being mainly managed at PHU. Numbers with diabetes mellitus generally stayed the same except for a significant post-Ebola increase in tertiary hospitals. Small numbers were reported with mental health disorders across all facilities in all time periods. Conclusion: NCD reporting is recovering in the immediate post-Ebola period. Decentralization of NCD care is welcome and is an effective strategy for management as evidenced by hypertension. To be successful, this must be supported by strengthening other elements of the health system such as training of health workers, robust information and referral systems and reliable medicine supply chains.
Highlights
Non-communicable diseases (NCDs) are the leading causes of morbidity and account for 70% of worldwide deaths, with the major burden felt in low- and middle-income countries (LMICs)[1]
In 2017, we reported on the burden and distributions of selected NCDs in a sample of health facilities in the Western-Area District, Sierra Leone, before and during the Ebola outbreak[6]
There was a marked decline in reported NCD numbers in the Ebola compared with the preEbola periods, and this was especially observed for hypertension (HTN) and diabetes mellitus (DM) and in secondary and tertiary hospitals compared with peripheral health units (PHUs)
Summary
2. Priyakanta Nayak, Centers for Disease Control and Prevention, Dhaka, Bangladesh. Any reports and responses or comments on the article can be found at the end of the article. Successful, this must be supported by strengthening other elements of the health system such as training of health workers, robust information and referral systems and reliable medicine supply chains. Keywords SORT IT, operational research, Sustainable Development Goals, Universal Health Coverage, health systems. This article is included in the TDR gateway. This article is included in the Emerging Diseases and Outbreaks gateway. This article is included in the Ebola Virus collection
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