All SPSS Tables and Outputs from Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July–August 2015

The border region of Forécariah (Guinea) and Kambia (Sierra Leone) was of immense interest to the West Africa Ebola response. Cross-sectional household surveys with multi-stage cluster sampling procedure were used to collect random samples from Kambia (<i>n</i> = 635) in July 2015 and Forécariah (<i>n</i> = 502) in August 2015 to assess public knowledge, attitudes and practices related to Ebola. Knowledge of the disease was high in both places, and handwashing with soap and water was the most widespread prevention practice. Acceptance of safe alternatives to traditional burials was significantly lower in Forécariah compared with Kambia. In both locations, there was a minority who held discriminatory attitudes towards survivors. Radio was the predominant source of information in both locations, but those from Kambia were more likely to have received Ebola information from community sources (mosques/churches, community meetings or health workers) compared with those in Forécariah. These findings contextualize the utility of Ebola health messaging during the epidemic and suggest the importance of continued partnership with community leaders, including religious leaders, as a prominent part of future public health protection.This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’

Rapid deployment of a mobile biosafety level-3 laboratory in Sierra Leone during the 2014 Ebola virus epidemic

<div><p>Background</p><p>Ebola virus emerged in West Africa in December 2013. The high population mobility and poor public health infrastructure in this region led to the development of the largest Ebola virus disease (EVD) outbreak to date.</p><p>Methodology/Principal findings</p><p>On September 26, 2014, China dispatched a Mobile Biosafety Level-3 Laboratory (MBSL-3 Lab) and a well-trained diagnostic team to Sierra Leone to assist in EVD diagnosis using quantitative real-time PCR, which allowed the diagnosis of suspected EVD cases in less than 4 hours from the time of sample receiving. This laboratory was composed of three container vehicles equipped with advanced ventilation system, communication system, electricity and gas supply system. We strictly applied multiple safety precautions to reduce exposure risks. Personnel, materials, water and air flow management were the key elements of the biosafety measures in the MBSL-3 Lab. Air samples were regularly collected from the MBSL-3 Lab, but no evidence of Ebola virus infectious aerosols was detected. Potentially contaminated objects were also tested by collecting swabs. On one occasion, a pipette tested positive for EVD. A total of 1,635 suspected EVD cases (824 positive [50.4%]) were tested from September 28 to November 11, 2014, and no member of the diagnostic team was infected with Ebola virus or other pathogens, including Lassa fever. The specimens tested included blood (69.2%) and oral swabs (30.8%) with positivity rates of 54.2% and 41.9%, respectively. The China mobile laboratory was thus instrumental in the EVD outbreak response by providing timely and reliable diagnostics.</p><p>Conclusions/Significance</p><p>The MBSL-3 Lab significantly contributed to establishing a suitable laboratory response capacity during the emergence of EVD in Sierra Leone.</p></div

Layout of the mobile biosafety level-3 laboratory.

<p>The main and auxiliary containers were connected by an airtight soft connection and together formed a complete biosafety level-3 (BSL-3) lab. The instruments represented by letters were listed in <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0005622#pntd.0005622.s003" target="_blank">S1 Table</a>.</p

Schematic diagram of the “Four Flows”.

<p>Personnel, materials, water and air flow management were the key elements of biosafety measures in the MBSL-3 Lab.</p

Diagnostic algorithm for laboratory testing.

<p>Diagnostic algorithm for laboratory testing.</p

Overview of the China mobile laboratory diagnostic team’s composition and their tasks.

<p>Overview of the China mobile laboratory diagnostic team’s composition and their tasks.</p

Mobile biosafety level-3 laboratory at its mission in Sierra Leone.

<p>(A) Exterior of the mobile biosafety level-3 laboratory. (B) View to the biosafety level-3 laboratory. Two different perspectives (B1 and B2) were shown. (C) View to the auxiliary container. C1) Pass box (left) and expanded-metal door (middle). C2) Monitoring unit and table for experimental preparation. C3) Shower cubicle. C4) Waste treatment room. (D) View to the command container. D1) Room for meeting or for watching monitoring videos. D2) “King View” industry control software. D3) Real-time surveillance video.</p

Samples and test results from September 28 to November 11, 2014.

<p>Samples and test results from September 28 to November 11, 2014.</p

Worksite layout for the China mobile laboratory diagnostic team.

<p>Worksite layout for the China mobile laboratory diagnostic team.</p