In a 2018 study, researchers describe the devastating and far-reaching impacts of the 2014 Ebola outbreak in West Africa, including more than half a million people experiencing food insecurity, school closures lasting more than 7 months, tens of thousands of children orphaned, and a huge proportion of the health workforce killed by the disease, leading to infant, maternal, and child deaths due to a lack of skilled health workers and a 97% reduction in surgical capacity.
In a comprehensive accounting of the costs of the 2014 Ebola outbreak in West Africa, Huber et al. estimate the economic and social costs to have been US$53 billion, of which US$18.8 billion was attributed to non-Ebola deaths.
Using data on the spread of Ebola from person to person during historical Ebola outbreaks to compare vaccination strategies, researchers found that prophylatically vaccinating all healthcare workers would have decreased the number of disease cases in the 2014 epidemics in Guinea and Nigeria by 60-80%.
In a systematic review of qualitative research from low- and middle-income countries, women’s low social status was shown to be a barrier to their children accessing vaccinations. Specific barriers included access to education, income, resource allocation, and autonomous decision-making related to time. The authors suggest that expanding the responsibility for children’s health to both parents (mothers and fathers) may be one important element in removing persistent barriers to immunization often faced by mothers.
An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.
In a systematic literature review of studies in Africa, it was found that 25% of children who survived pneumococcal or Hib meningitis had neuropsychological deficits.
A systematic literature review analyzing data from 21 African countries revealed that bacterial meningitis is associated with high case fatality and frequent neurophysiological sequelae. Pneumococcal and Hib meningitis contribute to one third of disease related mortality. They also cause clinically evident sequalae in 25% of survivors prior to hospital discharge. The three main causes of bacterial meningitis- Haemophilus influenzae type B; Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are vaccine preventable, routine use of conjugate vaccines have potential for significant health and economic benefits.
Neuropsychological sequelae includes hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delays/impairment, and seizures.
An analysis of the association between undernutrition and mortality in young children revealed that in 60% of deaths due to diarrhea, 52% of deaths due to pneumonia, 45% of deaths due to measles and 57% of deaths attributable to malaria, undernutrition was a contributing factor.