AJPHlogoBeginning in early 2014, West Africa experienced the largest outbreak of Ebola virus disease in history. According to a new study in the American Journal of Public Health, community-based approaches to prevention and care were able to reduce Ebola transmission in Sierra Leone — the most-affected country in terms of total cases — during the epidemic in 2014-2015.

Researchers from UNICEF used qualitative data, structured questionnaires, facility registers and laboratory records to assess the acceptability and use of 46 Community Care Centers – or CCCs – that were rapidly deployed in Sierra Leone during the Ebola epidemic from November 2014 through January 2015. Transmission effects were estimated by comparing time between symptom onset and isolation at CCCs relative to other facilities with the national Viral Hemorrhagic Fever data set.

Results showed that over the 13 epidemic weeks that the CCCs were operational, 6,129 patients were triaged and 719 Ebola suspects were identified. Nearly all patients lived nearby and were self-referred, accessing CCCs outside the national alert system. Isolation of Ebola suspects within four days of symptoms was significantly higher in CCCs compared to other facilities, contributing to a 13-32 percent reduction in transmission in districts where they were deployed.

“West Africa’s Ebola virus disease epidemic is unprecedented in scale and intensity and larger than all previous EVD epidemics combined,” the study’s authors explain. “Experience in Sierra Leone suggests that a decentralized, rapidly deployed, community-owned strategy for Ebola control was feasible and effective. Within the overall Ebola response architecture, such decentralized triage and referral networks are a vital complement to more centralized treatment centers.”

For more about this study and the latest public health research, visit the American Journal of Public Health online. And check out APHA’s new communicable disease topics page to learn about preventing and controlling the spread of infectious diseases including Ebola, Zika and more.