Liberia Health Events

Outbreaks of viral, bacterial, and parasitic diseases occur in Liberia with high regularity. The most common illness both in fatalities and total number of cases is malaria, which accounts for 41 percent of inpatient deaths among individuals aged five or younger and 33 percent of inpatient fatalities overall. In 2010, the number of reported cases across all counties ranged from 20,748 in Grand Kru to 255,748 in Montserrado. Given malaria’s prevalence, it is necessary to calculate annual infection and fatality totals rather than individual spikes in order to gain a complete understanding of the disease's distribution.Though Lassa fever, yellow fever, cholera, tuberculosis, and measles outbreaks occur less frequently than malaria, they are still considered pressing health concerns. Of these diseases, the most severe by total number of cases are cholera—with outbreaks in Montserrado in 2003 and Sinoe and 2005—and tuberculosis, which struck Maryland county in 2013. The current Ebola crisis, the worst epidemic in recent history, has laid waste to a multitude of West African nations. Doctors Without Borders believes that the outbreak began in a village near Guéckédou. The rapidity of transmission and infection is most apparent in the capital city of Monrovia, where the disease was identified in June. Montserrado county, where Monrovia is located, now account for roughly 40 percent of the total number of Ebola-related deaths in Liberia since the epidemic began. Ebola’s presence is felt in each of Liberia’s 15 counties; however in six counties the total number of suspected, probable, or confirmed cases remains in the single-digit range. These locations are primarily focused in the southern portion of the country with the exception of Gbarpolu, which is surprising seeing as the isolated county is surrounded by areas with significantly higher infection rates. The greatest rates of infection and the most worrying are those counties located in the center of Liberia. In addition to housing the largest number of infected individuals, Montserrado County has also seen the most deaths (925) resulting in a mortality rate of 66.4 percent, almost 13 percent above the national mean of 53.6 percent. There is a great deal of concern as even conservative estimates predict the epidemic will continue for the next five months if immediate and radical action were taken, which is highly unlikely. Concerns should also be growing internationally as multiple Liberian counties that border neighboring countries have a strong presence of the virus, namely Nimba (243 cases), Bong (316 cases), and Lofa (783 cases). The government of Liberia has taken the following steps to curb the spread of the disease:-Closed all borders except major entry points (Roberts International Airport, James Spriggs Payne Airport, Foya Crossing, Bo Waterside Crossing, and Ganta Crossing).-Instituted prevention and screening measures at entry points that remain open. -Instituted restrictions on public and other mass gatherings.-Instituted quarantine measures for communities heavily affected by Ebola.-Authorized military personnel to help enforce these and other prevention and control measures.When the epidemic began in Liberia, the country’s medical infrastructure was subpar, wherein the doctor to patient ratio was roughly 1:100,000. The infection or death of any medical professional in Liberia marks a tremendous loss in fight against Ebola. Furthermore, employees at Liberia’s largest treatment clinic, Island Clinic in Monrovia, have threatened to walk off their job over salary issues. The actual disease itself is also very difficult to treat and diagnose as it is highly mutagenic. A study of the initial patients diagnosed with the disease discovered almost 400 genetic variations. On top of an extremely unprepared medical infrastructure and an aggressive pathogen with no known cure, common cultural beliefs have become massive obstacles. The majority of Liberians thought the disease was made up as a scam for the government to collect massive amounts of foreign aid. Thus precautionary information disseminated was largely ignored. As the disease became a major issue, many believed government officials dispatched to assess the situation or facilities to treat the infected were actually bringing the virus and subsequently attacked. A large number of those infected try to hide their symptoms in order to not be taken to a facility where they believe they will die, and instead infect others they come in contact with. As foreign aid begins to pour into the country and the region as a whole, the aim should be to not just build the capacities of the medical infrastructure, but to assist in changing public perceptions of the government as a trustworthy institution.Attribute Table Field DescriptionsISO3 - International Organization for Standardization 3-digit country code ADM0_NAME - Administration level zero identification / name AREA_AFF - Location affected by health event TYPE - Type of health event DISEASE - Specific disease being described START_DT - Start date of the health event END_DT - End date of the health event TL_AFFECT - Total number of individuals affected by the health event FATALITY - Total number of fatalities affected by the health event COMMENTS - Comments regarding health event SOURCE_DT - Primary source creation date SOURCE - Primary source SOURCE2_DT - Secondary source creation date SOURCE2 - Secondary source CollectionAs the Ebola epidemic is still not contained, the information is from the most recent available SITREP from Liberia's Ministry of Health and Social Welfare dated 17 September 2014. The figures within the data and any subsequent evaluations based on the data (including mortality rates) do not include Health Care Workers per the original source. Information on those individuals is included in the comment section for each county. Of note between September 17 and September 26 the number of cases increased by over 600.The data included herein have not been derived from a registered survey and should be considered approximate unless otherwise defined. While rigorous steps have been taken to ensure the quality of each dataset, DigitalGlobe is not responsible for the accuracy and completeness of data compiled from outside sources.Sources (HGIS)“Cholera Epidemic After Increased Civil Conflict --- Monrovia, Liberia, June – September 2003.” Centers for Disease Control and Prevention. November 13, 2003. Accessed October 07, 2014. http://www.cdc.gov.“Country Profiles: Reported malaria cases by county.” World Health Organization Regional Office for Africa: African Health Observatory. December 31, 2010. Accessed October 07, 2014. http://www.aho.afro.who.int.“Global Alert and Response.” World Health Organization. 2014. Accessed October 07, 2014. http://www.who.int.“Liberia: Cholera epidemic kills 134 in south-east.” IRIN News. Accessed October 07, 2014. http://www.irinnews.org."Liberia Ebola SitRep No. 125." Ministry of Health and Social Welfare. September 26, 2014. Accessed September 29, 2014. www.mohsw.gov.lr.“Liberia.” MD Travel Health. Accessed October 07, 2014. http://www.mdtravelhealth.com.“Margibi Health Officer Confirms Lass Fever Death.” Liberia News Agency. March 27, 2014. Accessed October 07, 2014. http://ww.liberianewsagency.org.“NaTHNaC Outbreak Report: Outbreaks of Lassa fever between 7 April 2014 and 7 October 2014.” National Travel Health Network and Centre. October 07, 2014. Accessed October 07, 2014. http://www.nathnac.org.Shaka, L. “Measles Kill 5 in Liberia.” Vaccine Times. February 11, 2011. Accessed October 07, 2014. http://www.vaccinetimes.com.Verdier II, Lewis S. “Liberia: TB On the Rise in Pleebo.” All Africa. March 28, 2013. Accessed October 07, 2014. http://www.allafrica.com.Sources (Metadata)Arsenault, Adrienne. "Ebola Outbreak: Liberia's Newest, Largest Treatment Clinic Already at Capacity." CBCnews. September 29, 2014. Accessed September 29, 2014. www.cbc.ca.Blake, Matthew. "Dogs EATING Corpses of Ebola Victims in Liberia... and Now the Deadly Virus Has Reached Senagal." Mail Online. August 29, 2014. Accessed September 29, 2014. www.dailymail.co.uk.“Country Profiles: Reported malaria cases by county.” World Health Organization Regional Office for Africa: African Health Observatory. December 31, 2010. Accessed October 07, 2014. http://www.aho.afro.who.int."Ebola in Liberia." Centers for Disease Control and Prevention. September 11, 2014. Accessed September 29, 2014. wwwnc.cdc.gov."Ebola Quarantine in Liberia's Capital Sparks Violence in Slum." The Guardian. August 22, 2014. Accessed September 29, 2014. www.theguardian.com.Hauser, Annie. "Ebola Patients Vanish in Liberia; Crisis Continues - Weather.com." The Weather Channel. August 25, 2014. Accessed September 29, 2014. www.weather.com.Jerving, Sara. "Why Liberians Thought Ebola Was a Government Scam to Attract Western Aid." The Nation. September 16, 2014. Accessed September 29, 2014. www.thenation.com."Liberia's Ebola Problem Far Worse than Imagined, Says WHO." American Association for the Advancement of Science. September 8, 2014. Accessed September 29, 2014. news.sciencemag.org.“Liberia: Malaria Indicator Survey.” National Malaria Control Program Ministry of Health and Social Welfare, Liberia Institute of Statistics and Geo-Information Services, ICF International. June 01, 2012. Accessed October 07, 2014. http://www.dhsprogram.com.Maron, Dina Fine. "New Figures Paint Even Bleaker Picture for Ebola Crisis." Scientific American Global RSS. September 23, 2014. Accessed September 29, 2014. www.scientificamerican.com."Report: Armed Men Attack Liberia Ebola Clinic, Freeing Patients." CBSNews. August 17, 2014. Accessed September 29, 2014. www.cbsnews.com.Russell, Artimus. “Minimizing the Impact of Malaria in Communities around Monrovia, Liberia.” Cedar Crest College. 2013. Accessed October 07, 2014. http://www.cedarcrest.edu."Struggling to Contain the Ebola Epidemic in West Africa." MSF USA. July 8, 2014. Accessed September 29, 2014. http://www.doctorswithoutborders.org.