免疫生物学杂志

Health Care Facility Network Efficiency and Location Crucial for Ebola Treatment Outcome

Abstract

Jia Bainga Kangbai, Sulaiman Mandoh and John L McBrayer

Background: The application of network analysis in public health research is gaining popularity with the belief that health problems are a product of complex social, political and economic causes. Organisational networks can be used in public health to design and evaluate public health programs. There have been multiple studies in the past relating to public health organisations and HIV/AIDS using organisational networking method. Here we use social network analysis to analyse the association between the network positions of health care facilities and the treatment outcome of Ebola patients from these health care facilities in Sierra Leone.
Methods: We extracted and later analysed treatment outcome data obtained from the Case Report Forms (CRF) of 117 Ebola patients who sought Ebola treatment at the Kenema Government Hospital from June 2014 to April 2015. For ego network purpose, we considered each Ebola referral health care facility as an ego. Poisson regression analysis was used to determine the association between Ebola mortality rates in a health care facility and the ego’s structural holes.
Results: The median age, length of stay during Ebola treatment, and the period it takes an Ebola patient to survive treatment following from onset of signs and symptoms were 20 (IQR=17.5 years), 15 (IQR=11 days) and 7 (IQR=5.3 days) respectively. There were differences in ego, network efficiency, effective size and constraint for the factors associated with mortality rates for Ebola patients treated at the Kenema Government Hospital.
Conclusion: Establishing non-redundant contacts within a health care facility network and expanding their locations can reduce Ebola mortality rates during outbreak.