Stillbirths and neonatal deaths surveillance during the 2014-2015 Ebola virus disease outbreak in Sierra Leone.

Abstract

To determine the rate of stillbirth and neonatal death reporting and testing for Ebola virus during the 2014-2015 Ebola virus disease (EVD) outbreak in Sierra Leone. A cross-sectional study was performed using information from the Sierra Leone National Ebola Laboratory database to identify stillbirths and neonatal deaths that had been tested for Ebola virus from July 2, 2014, to October 18, 2015. Outcomes included the percentage of all tested deaths attributable to stillbirths and neonatal deaths, the proportion of stillbirths and neonatal deaths attributable to Ebola virus, and the annualized rate of stillbirths and neonatal deaths. In total, 1726 stillbirths and 4708 neonatal deaths were tested for Ebola virus, representing 2.6% and 7.2% of the total deaths tested (n=65585), respectively. Of these, 25 stillbirths and neonatal deaths tested positive, accounting for 0.3% of EVD cases. In 2015, the annualized total number of reported stillbirths was higher than expected (3079 vs 1634), whereas reported neonatal deaths were lower (6351 vs 7770). Stillbirth and neonatal death reporting and testing improved over time. Systematic recording of these indicators might be used alongside retrospective surveillance to respond to the adverse effects of EVD on maternal and child health and guide response efforts for subsequent outbreaks.