In an open letter published in The Lancet, researchers in Sierra Leone have underlined an urgent need for priority actions, including improvements in access to diagnostic technologies and health-care resources and improved disease surveillance and health communication, to tackle the ongoing Ebola crisis in West Africa.
At present, there is little incentive for patients to seek professional diagnosis of suspected Ebola, say the authors, with most people with febrile (fever-causing) illnesses in Sierra Leone treated at home, and the true extent of the outbreak therefore very difficult to determine. Moreover, disease surveillance systems in the region are inadequate, despite research (conducted by the authors and others) suggesting that mobile phones and smartphones can be effectively deployed in routine collection of surveillance data.
The authors also highlight a shortage of medical personnel and access to healthcare facilities for most people in the region, writing that, "The relatively few physicians, nurses, and healthcare providers attending to these underserved populations often have poor access to basic personal protective equipment, and might therefore be understandably unwilling to provide direct care for patients suspected to have Ebola. There is an urgent need to provide reliable and constant access to personal protective equipment in health-care centres across the region. "Finally, the authors suggest that early disease control policies to restrict border crossings and sales of bushmeat have been ineffective. They write that, "What is certain is that these policies (and the ways that they were communicated) raised anxiety and, in some places, fuelled rumours that led to counter-productive behaviours. Improved communication by health officials with the media, community leaders, health professionals, and the general public is necessary to reduce misinformation and improve compliance with prevention and control measures that have been proven effective."