Availability of essential health services in post-conflict Liberia

Kruk, Margaret E; Rockers, Peter C.; Williams, Elizabeth H; Varpilah, S. Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro

doi:10.2471/blt.09.071068

Cited by 97 publications

(90 citation statements)

References 12 publications

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“…Both physical complaints and depression may improve with a combination of medications, physical therapy, and mental health treatment. Liberia has limited mental health care facilities [25], and there are no validated screening tools for depression in this population. Given our findings, mental health care should be strengthened so that depression in EVD survivors can be diagnosed and treated systematically.…”

Section: Discussionmentioning

confidence: 99%

Care of Ebola Survivors and Factors Associated With Clinical Sequelae—Monrovia, Liberia

Maurice

Ervin

Orone³

et al. 2018

Open Forum Infectious Diseases

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BackgroundThe Eternal Love Winning Africa (ELWA) Clinic was the first clinic to provide free, comprehensive care to Ebola virus disease (EVD) survivors in Liberia. The objectives of this analysis were to describe the demographics and symptoms of EVD survivors at ELWA from January 2015 through March 2017 and to identify risk factors for development of sequelae.MethodsPatients’ demographic and clinical information was collected by chart review in June 2016 and March 2017. Associations with clinical sequelae were analyzed using the chi-square test, t test, and multivariate logistic regression.ResultsFrom January 2015 to March 2017, 329 EVD survivors were evaluated at ELWA. Most survivors experienced myalgia/arthralgia (73%; n = 239) and headache (53%; n = 173). The length of time from Ebola Treatment Unit (ETU) discharge to first clinic visit ranged from 0 to 30 months. Many visits (30%) occurred 24 or more months after ETU discharge. The proportion of visits for headache, weight loss, joint pain, visual problems, insomnia, fatigue, memory loss, decreased libido, depression, and uveitis decreased over time. More men than women had visits for depression; however, these differences were not significant. Symptom prevalence differed in adults and children; significantly more adults experienced myalgia/arthralgia (77% vs 44%), visual problems (41% vs 12%), post-EVD-related musculoskeletal pain (42% vs 15%), and insomnia (17% vs 2%).ConclusionsEVD survivors frequented ELWA for EVD-related symptoms many months after ETU discharge, indicating a long-term need for care. Reported symptoms changed over time, which may reflect eventual resolution of some sequelae.

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Section: Discussionmentioning

confidence: 99%

Care of Ebola Survivors and Factors Associated With Clinical Sequelae—Monrovia, Liberia

Maurice

Ervin

Orone³

et al. 2018

Open Forum Infectious Diseases

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“…4 In Liberia, a survey of households and clinics in rural Nimba county found that while most individuals had access to malaria and HIV care, only 12% could access mental health care. 5 …”

Section: Introductionmentioning

confidence: 99%

Assessment of the needs of vulnerable youth populations in post-conflict Liberia

Levey¹,

Borba

Harris³

et al. 2013

Afr. J. Psych

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Objective: The study examined key informants' perceptions of the emotional impact of traumatic events, major problems, functional limitations and appropriate treatment settings for children, adolescents, and young adults in post-conflict Liberia. Method: This research is a based on cross-sectional survey conducted between March 30, 2009 and April 30, 2009 in Liberia with 171 local key Liberian informants. Analysis was conducted using mixed methods. The findings we will report were collected in the qualitative portion of the survey. Results: We found that while different interventions were preferred for different types of young people, some interventions were mentioned for all youth and by all age and gender groups of key informants. These included counseling, education, and skills training. Also frequently chosen were housing, community reintegration, recreation, and medical care. In general, key informants reported similar concerns regardless of their ages or genders. Notable exceptions to this were in interventions for youth who joined fighting forces. Men over 50 were the only ones to recommend apology and reparations. Similarly, in recommendations for criminals and violent youth, a number of men mentioned prison, whereas the women did not. Conclusion: Our findings suggest that the needs of post-conflict Liberian youth span a variety of domains, including physical, emotional, medical, psychological, and educational. These findings can be used to guide the development of treatment programs for these young people.

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“…After 14 years of civil war in Liberia, in 2003, the under-5 mortality rate was 110/1000 live births and the maternal mortality ratio was 994 deaths per 100 000 live births (an increase of 71% from the maternal mortality rate in 2000) 15 27. Even as recently as 2015 and 2010, the under-5 mortality rate and maternal mortality rate remain alarmingly high at 70/1000 live births and 770/100 000 live births, respectively 28 29…”

Section: Global Health Problem Analysismentioning

confidence: 99%

“…http://www.conflictrecovery.org/bin/2003_Hoeffler_Reynal-Measuring_the_Costs_of_Conflict.pdf). 5 8 15 17 32 33…”

Section: Global Health Problem Analysismentioning

confidence: 99%

Complications of dysgerminoma: meeting the health needs of patients in conflict zones

Hayari

Федоренко

et al. 2017

BMJ Case Reports

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A symptom of prolonged conflict is the destruction of infrastructure and healthcare systems. While the need for acute trauma services is obvious in conflict zones, patients with chronic diseases also require care. This report describes the clinical course of a young teenage girl with a large mid pelvic tumour originating from the left ovary and reaching the umbilicus. She presented with acute abdominal pain and underwent surgery in a healthcare facility within a conflict zone. She was then transferred to a neighbouring country for continuing care. The tumour is malignant. After further surgery, she required chemotherapy and will need ongoing surveillance. She has since returned to her home country. It is doubtful that she will be able to access all the care she needs. We describe her healthcare needs and discuss the disastrous effects of conflict on meeting the health needs of civilian populations in war zones.

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Availability of essential health services in post-conflict Liberia

Cited by 97 publications

References 12 publications

Care of Ebola Survivors and Factors Associated With Clinical Sequelae—Monrovia, Liberia

Care of Ebola Survivors and Factors Associated With Clinical Sequelae—Monrovia, Liberia

Assessment of the needs of vulnerable youth populations in post-conflict Liberia

Complications of dysgerminoma: meeting the health needs of patients in conflict zones

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