PARIS, France – Many cases of Ebola in Sierra Leona may be going
undetected, grassroots doctors warned in The Lancet on Saturday, July 5,
as they highlighted the impoverished country's problems in combatting
the virus.
The journal published the letter on the heels of ministerial talks in
Ghana, where a senior UN health official on Thursday, July 3, said
the outbreak in West Africa, the worst in the history of Ebola, may persist for several more months.
Sierra Leone, one of the poorest countries in the world, suffers a
chronic lack of doctors, diagnostic tools, a disease-monitoring network
and even clothing to protect health workers, the letter said.
"Many cases meeting the case definition for suspected Ebola might be
going undetected and unreported because ill people and their families
are opting for self-treatment with over-the-counter drugs or traditional
medicine," it said.
"At present, there is little incentive for patients to seek
professional diagnosis of suspected Ebola. Laboratory testing can be
expensive (especially when a panel of tests is required for differential
diagnosis), is unlikely to change the course of treatment, and might
stigmatize an infected patient and their family."
It added: "Even if a patient wanted to be tested for Ebola, few (if
any) laboratories in the region have the capacity to safely test a
biosafety level 4 pathogen."
The warning came from four doctors working at the Mercy Hospital
Research Laboratory in the city of Bo. The letter is headed by an
American-based specialist, Karen Jacobsen at George Mason University in
Fairfax, Virginia.
Bo has fewer than 15 doctors for a population of more than 150,000, a
situation that is common across Sierra Leone as well as in Guinea and
Liberia, the other countries where the epidemic is unfolding, the letter
said.
"There is an urgent need to provide reliable and constant access to
personal protective equipment in health-care centers across the region,"
it added.
The letter observed that early attempts to impose controls against
the disease, by restrictions of border crossings and of sales of
bushmeat had not worked – and indeed may have backfired.
"What is certain is that these policies (and the ways that they were
communicated) raised anxiety and, in some places, fueled rumors that led
to counter-productive behaviors."
The World Health Organization (WHO) gives a toll of 467 fatalities
from Ebola, a total comprising confirmed or suspected cases. Ninety-nine
have occurred in Sierra Leone.
Keiji Fukuda, the UN agency's assistant director-general of health
security, said at the close of the 12-nation conference in Accra on
Thursday it was "impossible to give a clear answer" on how far the
epidemic could spread or when it might begin to retreat.
"I certainly expect that we are going to be dealing with this
outbreak minimum for a few months to several months," he told Agence
France-Presse. "I really hope for us to see a turnaround where we begin
to see a decrease in cases in the next several weeks."
– Rappler.com http://www.rappler.com/world/regions/africa/62443-ebola-experts-highlight-problems-sierra-leone