Assessing the Direct Effects of the Ebola Outbreak on Life Expectancy in Liberia, Sierra Leone and Guinea

Discussion Whereas prior outbreaks of EVD in sub-Saharan countries have had limited impact on mortality at the population-level, the 2014 West African EVD outbreak likely caused significant declines in life expectancy in Liberia and Sierra Leone. EVD deaths in 2014 likely resulted in e0 reductions between 1.63 to 5.56 years in Liberia and between 1.38 to 5.10 years in Sierra Leone, depending on assumptions about the under-reporting and the mortality of EVD cases. Compared to IHME estimates of trends in life expectancy since 1990 in LSLG,32 life expectancy may thus have declined in Sierra Leone and Liberia to levels these two countries had not experienced since 2001-2003 (see appendix figure 3), i.e., the end of their respective civil wars. In Guinea, the direct effects of EVD deaths on e0 in 2014 were more limited, i.e., < 1.2 year. These calculations present several important limitations however. First, we focused on analyzing 3 scenarios defined by varying levels of under-reporting of EVD cases and CFR. We did not seek to identify the most likely estimate of the direct effects of EVD on e0 through more complex statistical models (e.g., maximum likelihood methods). Such models will likely require further empirical investigations of the extent of under-reporting of EVD cases during this outbreak, as well as additional assessments of mortality among EVD cases. Second, our 3 scenarios may not adequately capture the uncertainty associated with the number of EVD deaths in 2014...
Source: PLOS Currents Outbreaks - Category: Epidemiology Authors: Source Type: research