Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015.
BACKGROUND:During the Ebola virus disease (EVD) epidemic in Liberia, contact tracing was implemented to rapidly detect new cases and prevent further transmission. We describe the scope and characteristics of contact tracing in Liberia and assess its performance during the 2014-2015 EVD epidemic. MET...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2018
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0006762 https://doaj.org/article/3452b17d9db04db897f12d83587cd5dd |
id |
ftdoajarticles:oai:doaj.org/article:3452b17d9db04db897f12d83587cd5dd |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:3452b17d9db04db897f12d83587cd5dd 2023-05-15T15:14:30+02:00 Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. Krista C Swanson Chiara Altare Chea Sanford Wesseh Tolbert Nyenswah Tashrik Ahmed Nir Eyal Esther L Hamblion Justin Lessler David H Peters Mathias Altmann 2018-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006762 https://doaj.org/article/3452b17d9db04db897f12d83587cd5dd EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6152989?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006762 https://doaj.org/article/3452b17d9db04db897f12d83587cd5dd PLoS Neglected Tropical Diseases, Vol 12, Iss 9, p e0006762 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006762 2022-12-31T11:55:26Z BACKGROUND:During the Ebola virus disease (EVD) epidemic in Liberia, contact tracing was implemented to rapidly detect new cases and prevent further transmission. We describe the scope and characteristics of contact tracing in Liberia and assess its performance during the 2014-2015 EVD epidemic. METHODOLOGY/PRINCIPAL FINDINGS:We performed a retrospective descriptive analysis of data collection forms for contact tracing conducted in six counties during June 2014-July 2015. EVD case counts from situation reports in the same counties were used to assess contact tracing coverage and sensitivity. Contacts who presented with symptoms and/or died, and monitoring was stopped, were classified as "potential cases". Positive predictive value (PPV) was defined as the proportion of traced contacts who were identified as potential cases. Bivariate and multivariate logistic regression models were used to identify characteristics among potential cases. We analyzed 25,830 contact tracing records for contacts who had monitoring initiated or were last exposed between June 4, 2014 and July 13, 2015. Contact tracing was initiated for 26.7% of total EVD cases and detected 3.6% of all new cases during this period. Eighty-eight percent of contacts completed monitoring, and 334 contacts were identified as potential cases (PPV = 1.4%). Potential cases were more likely to be detected early in the outbreak; hail from rural areas; report multiple exposures and symptoms; have household contact or direct bodily or fluid contact; and report nausea, fever, or weakness compared to contacts who completed monitoring. CONCLUSIONS/SIGNIFICANCE:Contact tracing was a critical intervention in Liberia and represented one of the largest contact tracing efforts during an epidemic in history. While there were notable improvements in implementation over time, these data suggest there were limitations to its performance-particularly in urban districts and during peak transmission. Recommendations for improving performance include integrated surveillance, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 9 e0006762 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Krista C Swanson Chiara Altare Chea Sanford Wesseh Tolbert Nyenswah Tashrik Ahmed Nir Eyal Esther L Hamblion Justin Lessler David H Peters Mathias Altmann Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:During the Ebola virus disease (EVD) epidemic in Liberia, contact tracing was implemented to rapidly detect new cases and prevent further transmission. We describe the scope and characteristics of contact tracing in Liberia and assess its performance during the 2014-2015 EVD epidemic. METHODOLOGY/PRINCIPAL FINDINGS:We performed a retrospective descriptive analysis of data collection forms for contact tracing conducted in six counties during June 2014-July 2015. EVD case counts from situation reports in the same counties were used to assess contact tracing coverage and sensitivity. Contacts who presented with symptoms and/or died, and monitoring was stopped, were classified as "potential cases". Positive predictive value (PPV) was defined as the proportion of traced contacts who were identified as potential cases. Bivariate and multivariate logistic regression models were used to identify characteristics among potential cases. We analyzed 25,830 contact tracing records for contacts who had monitoring initiated or were last exposed between June 4, 2014 and July 13, 2015. Contact tracing was initiated for 26.7% of total EVD cases and detected 3.6% of all new cases during this period. Eighty-eight percent of contacts completed monitoring, and 334 contacts were identified as potential cases (PPV = 1.4%). Potential cases were more likely to be detected early in the outbreak; hail from rural areas; report multiple exposures and symptoms; have household contact or direct bodily or fluid contact; and report nausea, fever, or weakness compared to contacts who completed monitoring. CONCLUSIONS/SIGNIFICANCE:Contact tracing was a critical intervention in Liberia and represented one of the largest contact tracing efforts during an epidemic in history. While there were notable improvements in implementation over time, these data suggest there were limitations to its performance-particularly in urban districts and during peak transmission. Recommendations for improving performance include integrated surveillance, ... |
format |
Article in Journal/Newspaper |
author |
Krista C Swanson Chiara Altare Chea Sanford Wesseh Tolbert Nyenswah Tashrik Ahmed Nir Eyal Esther L Hamblion Justin Lessler David H Peters Mathias Altmann |
author_facet |
Krista C Swanson Chiara Altare Chea Sanford Wesseh Tolbert Nyenswah Tashrik Ahmed Nir Eyal Esther L Hamblion Justin Lessler David H Peters Mathias Altmann |
author_sort |
Krista C Swanson |
title |
Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. |
title_short |
Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. |
title_full |
Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. |
title_fullStr |
Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. |
title_full_unstemmed |
Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015. |
title_sort |
contact tracing performance during the ebola epidemic in liberia, 2014-2015. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006762 https://doaj.org/article/3452b17d9db04db897f12d83587cd5dd |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 9, p e0006762 (2018) |
op_relation |
http://europepmc.org/articles/PMC6152989?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006762 https://doaj.org/article/3452b17d9db04db897f12d83587cd5dd |
op_doi |
https://doi.org/10.1371/journal.pntd.0006762 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
12 |
container_issue |
9 |
container_start_page |
e0006762 |
_version_ |
1766344946359468032 |