Department of Environmental Health Sciences

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    Africa’s COVID-19 third wave: A coupled behavior-disease system in a mutual feedback loop
    (2021-10-30) Kangbai, Jia Bainga
    A year after COVID-19 was declared a pandemic much of the Africa continent started experiencing spikes in the number of COVID-19 cases and related deaths in what was referred to as the third wave of the pandemic. These spikes came right behind the heels of a second wave of the pandemic that barely went unnoticed in Africa. As of July 2021, Morocco, South Africa, Tunisia, Egypt, Nigeria, Libya, Kenya, Algeria, Zambia and Ethiopia accounted for approximately 86% of the reported increase in COVID-19; these countries were aptly described as being at the forefront of the continent’s third wave of the COVID-19 pandemic. Unlike those countries in Asia and Latin America that experienced what may generally being described as autochthonous COVID-19 third wave, Africa’s third wave COVID-19 cases are widely believed to have been triggered by imported cases. Africa like the rest of the world relaxed its COVID-19 restrictions almost at the same time; hence the continent’s spikes of COVID-19 cases and related deaths during the third wave of the pandemic have raised some questions.
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    Agro-industrial accidents linked to length of service, operation site and confidence in employer adherence to safety rules
    (BioMed Central, 2020-04-30) Koroma, Emmanuel Tamba
    Background Agriculture consistently ranks among the most hazardous occupational industries globally with high risk of job-related injuries, illnesses, disability, and death. In 2015, the agricultural fatal work injury rate in the United States was 22.8 per 100,000 full-time equivalent workers; seven times the all-worker fatal injury rate of 3.4 per 100,000 full-time equivalent workers. In this study we identified those factors that are associated with workplace accident and injuries at the Goldtree (SL) Limited Company- a private international agro-industrial palm company operating in Sierra Leone.Methods This is a descriptive research that made use of both qualitative and quantitative research technique to collect occupation related accident and injuries from workers at the Goldtree (SL) Limited Company international palm oil producing and marketing company in Sierra Leone. We analyzed the responses of 100 workers at the Goldtree (SL) Limited Company regarding their work safety, adherence to work safety guidelines as well as working habit.Results Thirty nine (39.0%) of the workers interviewed in this study said they had been involved in some forms of occupational accident; (33.3%) of those involved in some form of occupational accident have been working in the company for 3 – 5 years, 22.0% have been working at the company for at least 2 years; 7.7% have been working for 6 – 8 years (X 2 = 9.88, p-value = 0.02).Conclusion Workers who have spent few years in the job, have confidence that management is committed to addressing health and safety issues, believed that their working tools were in excellent condition, or agreed that they have rights and responsibilities for an effective workplace health and safety system have decreased odds of experiencing occupational accidents or injury.
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    Analysing the association between perceived knowledge, and attitudes on Lassa Fever infections and mortality risk factors in lower Bambara Chiefdom
    (BioMed Central, 2024-06-24) Kamara, Abu-Bakarr S
    BACKGROUND: Lassa fever (LF) presents significant public health challenges in Sierra Leone, particularly in the Lower Bambara Chiefdom. This study aims to deeply understand how knowledge and attitudes towards LF correlate with community-driven prevention and control measures. METHODS: A descriptive cross-sectional quantitative approach was used to conduct the research. Data from 2167 participants were collected using an Android-based survey from 1st February 2022 to 14th February 2022. Respondents' knowledge of LF causes, risk factors, transmission modes, and preventive measures were evaluated through a multiple-choice questionnaire, and attitudes toward prevention and control were measured on a 5-point Likert scale. Quantitative data were analyzed using SPSS version 26.0 and frequencies were presented in count, percentage, and table. Chi-square statistics were used to test for associations. RESULTS: Among the 2167 participants, over half were males (1184, 54.60%), farmers (1406, 64.90%), married (monogamous) (1428, 65.90%), and had never attended school (1336, 61.70%). Respondents demonstrated high knowledge levels of LF across socio-demographic groups (33% to 100%) and shared a positive attitude towards prevention and control (mean score of 26.77 on a 5-40 scale). Educational level, religious beliefs, and occupational status significantly influenced LF knowledge (p < 0.05). Specifically, illiterates had a high knowledge score of 48.24%, while those with tertiary education had the highest score at 83.33%. Additionally, a Pearson correlation analysis revealed a positive linear relationship between the degree of knowledge and positive attitude towards LF infection and mortality risk factors (r = 0.090, p = 0.02). CONCLUSION: High LF knowledge in Lower Bambara Chiefdom positively influences prevention attitudes. Education, religion, and occupation are key factors. Tailored interventions enhance public health efforts.
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    Assessing the impact of COVID-19 on routine immunization in Sierra Leone
    (BioMed Central, 2024-07-05) Sesay, Umaru
    BACKGROUND: The COVID-19 pandemic had a profound impact on healthcare systems and services, including routine immunization (RI). To date, there is limited information on the effects of the COVID-19 pandemic on RI in West African countries such as Sierra Leone, which had already experienced public health emergencies that disrupted its healthcare system. Here, we describe the impact of the COVID-19 pandemic on the RI of key antigens in Sierra Leone. METHODS: We used vaccination data from the District Health Information System for BCG, measles-rubella 1 and 2, and pentavalent 1 and 3 antigens. We compared 2019, 2020, 2021, and 2022 annual coverage rates for the selected antigens at the national and district levels. We used the Pearson chi-square test to assess the difference between annual coverage rates between 2019 and 2020, 2020-2021, and 2021-2022. RESULTS: National coverage rates for all antigens declined in 2019-2020, notably measles-rubella 1 and pentavalent 3 (-5.4% and - 4.9%). Between 2020 and 2021, there was an overall increase in coverage (+ 0.2% to + 2.5%), except for measles-rubella 2 (-1.8%). Measles-rubella antigens rebounded in 2021-2022, while others decreased between - 0.5 and - 1.9% in coverage. Overall, all district-level coverage rates in 2022 were lower than those in 2019. Most districts decreased between 2019 and 2022, though a few had a continuous increase; some had an increase/recovery between 2020 and 2021; some districts had recovered 2019 levels by 2022. CONCLUSION: The COVID-19 pandemic impacted Sierra Leone's national BCG, measles-rubella, and pentavalent antigen immunization, which were not fully restored in 2022. Most districts experienced notable coverage declines during the pandemic, though a few reached or surpassed 2019 rates in 2022. Examining pandemic impact can benefit from a focus beyond the national level to identify vulnerable regions. Sierra Leone's post-pandemic RI reestablishment needs targeted strategies and continual investments for equitable access and coverage, as well as to prevent vaccine-preventable diseases.
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    Births and deaths must be registered in Africa
    (Elsevier BV, 2019-12-12) Sankoh, Osman
    Goal 3 of the Sustainable Development Goals (SDGs) aims to “ensure healthy lives and promote well-being for all at all ages” by 2030.1 The goal includes targets related to reducing maternal and child mortality, ending lethal epidemics such as HIV/AIDS and malaria, reducing mortality from non-communicable diseases, and curbing the number of deaths caused by traffic accidents and environmental contamination. SDG 16, which aims to build peaceful, just, and inclusive societies, includes a target to reduce the number of deaths caused by violence.
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    COMMERCIAL DRINKING WATER QUALITY AND SAFETY IN BO CITY, SIERRA LEONE
    (African Journals OnLine, 2016-08-16) Kamara, Abu-Bakarr S.
    Many people who lack reliable access to a quality and safe drinking water source in or near the home rely on commercial drinking water products, such as machine-filled sachet water, that may be of variable quality.A participatory geographic information system was used in conjunction with distribution point and vendor census in the study area to identify a total of 36 water sources across Bo city that are used for commercial water production. These include 6 water sources and the production facilities for 10 brands of machine-filled factory-produced water sachets as well as the 10 sources and finished samples for 10hand-tied plastic-bagged water producers. Water samples from all 16 water sources and 20 commercial water products purchased from randomly-selected retail outlets and street vendors were tested for microbiological and physicochemical properties. Workers at all of these facilities were also interviewed about their knowledge and practices.All of the machine-filled sachet waters were free of microbial contamination, but several of the hand- tied water sachets, all filled from unlined local wells, and had coliform bacteria. Both machine-filled sachet water and hand-tied sachet water had pH levels that were below the World Health Organization’s recommended range. Water with acidic pH can cause corrosion of the metal pipes used with wells and can release those potentially harmful minerals into drinking water. Water factory workers used a variety of water treatment methods to purify their products; hand-tied sachets generally used only cloth filters to purify the water and often stored water in open containers. Improved quality of commercial water products would improve health in Sierra Leone.
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    Epidemiological characteristics, clinical manifestations, and treatment outcome of 139 paediatric Ebola patients treated at a Sierra Leone Ebola treatment center
    (BioMed Central, 2019-01-24) Kangbai, Jia Bainga
    BACKGROUND: The West Africa Ebola Virus Disease (EVD) outbreak in 2014-2016 was declared by the World Health Organization (WHO) a public health emergency of international concern. Most of the previous studies done in Sierra Leone relating to the clinical and epidemiological features of EVD during the 2014-2016 West African outbreak focused on adult EVD patients. There have been conflicting reports about the effects of EVD on children during previous outbreaks. METHODS: This is an observational retrospective analysis of medical data of all laboratory confirmed paediatric EVD patients below 15 years of age who were admitted at the 34 Military Hospital Ebola Treatment Center (ETC) in Wilberforce, Sierra Leone between June 2014 to April 2015. We analyzed the sociodemographic and clinical characteristics of paediatric EVD cases contained in case report forms that were collected by Ebola surveillance officers and clinicians at the 34 Military Hospital ETC. Both univariate and multivariate logistic regression models were used to determine the sociodemographic and clinical characteristics of paediatric EVD patients that were associated with EVD facility-based mortality. RESULTS: The majority of the paediatric EVD cases in this study were female (56.1%), pupils (51.1%), and 43.2% belonged to the age group between 10 years and below 15 years. The median age of the paediatric EVD cases was 9 years (interquartile range = 4 to 11 years). Adjusting for other covariates in the model, male paediatric EVD patient (AOR = 13.4, 95% CI = \[2.07-156-18\], p < 0.05), EVD patient with abdominal pain (AOR = 11.0, 95% CI = \[1.30-161.81\], p < 0.05), vomiting (AOR = 35.7, 95% CI = \[3.43-833.73\], p < 0.05), signs of conjunctivitis (AOR = 17.4, 95% CI = \[1.53-342.21\], p < 0.05) and difficulty in breathing (AOR = 23.3, 95% CI = \[1.92-713.01\], p < 0.05) at the time of admission had increased odds of dying during EVD treatment. CONCLUSIONS: We recommend the adoption of case definitions currently in vigour to cater for specific characteristics of paediatric patients. Subgroups that can be identified by applying the model developed in this study may require special attention and intensified care.
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    Epidemiological Markers for HIV Infection among First-Time Antenatal Attendees in Sierra Leone: 2012-2015 Longitudinal Study
    (2018-03-31) Kangbai, Jia Bainga
    Globally it is estimated that 10% of Human Immunodeficiency Virus (HIV) infected patients are coinfected with Hepatitis B Virus (HBV) which is the leading cause of chronic liver diseases including liver cirrhosis and hepatocellular carcinoma. In countries with high HBV endemicity the seroprevalence rate can be as high as 25% with approximately 10% of the HIV infected population coinfected with HBV. HIV and HBV shares similar transmission route and co-infection is common.
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    Factors associated with length of stay and treatment outcome of Ebola patients treated at an Ebola treatment center in Sierra Leone during the peak period of the West African Ebola outbreak 2013–2016
    (BioMed Central, 2021-07-12) Kangbai, Jia Bainga
    BACKGROUND: The World Health Organization (WHO) declared the West Africa Ebola epidemic as a Public Health Emergency of International Concern in August 2014. During the outbreak period, there were calls for the affected countries to construct Ebola treatment centres and reliable diagnostic laboratories closer to areas of transmission in order to improve the quality care of Ebola Virus Disease (EVD) patients. Delay in seeking treatment has been reported to have led to poor treatment outcome of EVD patients. Sierra Leone recorded more than 8000 probable and confirmed cases and more than 4000 EVD -related deaths nation-wide. METHODS: In this retrospective study, we investigated the effects of treatment delay, length of symptomatic period, EVD patients' sex, age, occupation, region of residence, and clinical characteristics on the treatment outcome of 205 laboratory-confirmed EVD patients who were admitted at the Kenema Government Hospital Ebola Treatment Center (KGHETC) from 13/09/2014-26/11/2014; i.e. during the peak of 2013-2016 EVD outbreak in Sierra Leone. Specifically also, we determined the factors that were associated with the length of stay for EVD treatment for patients who were discharged alive. RESULTS: Majority (66.3%, n = 205/309) of the 309 suspected EVD patients with medical records at the KGHETC triage during the period under review were tested positive for EVD using reverse-transcriptase-polymerase chain reaction (RT-PCR) and had a definitive treatment outcome. Few (33.7%, n = 104/309) suspected EVD patients were not included in our analysis and were classified thus: 29.1% (n = 90/309) suspect EVD cases with negative RT-PCR results, 4.5% (n = 14/309) suspect cases with non-available RT-PCR result. Of the 205 patients, 99 (48.3%) had a fatal outcome. For EVD patients that survived, we recorded a significant association (- 0.06, 95% Confidence Interval (CI) = - 0.14 - - 0.02, p = 0.004) between the Length of Stay (LOS) and for each kilometer travelled to seek treatment at the KGHETC. However, the association between EVD patients that were low skilled workers (- 5.91, 95% CI = - 24.60 - 12.79, p = 0.73), EVD patients who were children and pupils in junior school (- 0.86, 95% CI = - 12.86 - 11.14, p = 0.73), health seeking delay for EVD patients who resided in Kenema District where the KGHETC was located (- 0.49, 95% CI = - 0.12 - 1.09, p = 0.24), sex (- 1.77, 95% CI = - 8.75 - 5.21, p = 0.50), age (0.21, 95% CI = - 0.36 - 0.77, p = 0.57), referral status (1.21, 95% CI = - 17.67 - 20.09, p = 0.89) and the LOS in surviving patients were not statistically significant. CONCLUSION: The high LOS for either treatment outcome for EVD patients that resided in the district in which the EVD treatment facility was located compared to those patients from other districts implies that health authorities should consider intensive health education with high priority given to seeking early EVD treatment, and the construction of strategic ETCs as important components in their response strategy.
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    Health Care Facility Network Efficiency and Location Crucial for Ebola Treatment Outcome
    (OMICS Publishing Group, 2018) Kangbai, Jia Bainga
    **Background:** The application of network analysis in public health research is gaining popularity with the belief that health problems are a product of complex social, political and economic causes.Organisational networks can be used in public health to design and evaluate public health programs.There have been multiple studies in the past relating to public health organisations and HIV/AIDS using organisational networking method.Here we use social network analysis to analyse the association between the network positions of health care facilities and the treatment outcome of Ebola patients from these health care facilities in Sierra Leone. **Methods:** We extracted and later analysed treatment outcome data obtained from the Case Report Forms (CRF) of 117 Ebola patients who sought Ebola treatment at the Kenema Government Hospital from June 2014 to April 2015.For ego network purpose, we considered each Ebola referral health care facility as an ego.Poisson regression analysis was used to determine the association between Ebola mortality rates in a health care facility and the ego's structural holes.Results: The median age, length of stay during Ebola treatment, and the period it takes an Ebola patient to survive treatment following from onset of signs and symptoms were 20 (IQR=17.5 years), 15 (IQR=11 days) and 7 (IQR=5.3days) respectively.There were differences in ego, network efficiency, effective size and constraint for the factors associated with mortality rates for Ebola patients treated at the Kenema Government Hospital.Conclusion: Establishing non-redundant contacts within a health care facility network and expanding their locations can reduce Ebola mortality rates during outbreak.
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    Prevalence and associated influential factors of mental health problems among Chinese college students during different stages of COVID-19 pandemic: A systematic review
    (Elsevier BV, 2022-11-13) Conteh, Ishmail
    This systematic review aims to take China as an example to determine the prevalence of mental health problems and associated influential factors of college students in different stages of the COVID-19 pandemic and provide a reference for effective intervention in the future. A systematic search was conducted on PubMed, Web of Science, Scopus, Science Direct, and Google scholar. A total of 30 articles were included. 1,477,923 Chinese college students were surveyed. In the early stage, the prevalence rates of depression, anxiety, stress, and PTSD ranged from 9.0% to 65.2%, 6.88%-41.1%, 8.53%-67.05%, and 2.7%-30.8%, respectively. Major risk factors were being a female, a medical student, isolation or quarantine, having family members or friends infected with COVID-19, and challenges of online learning. During the normalization stage, depression, anxiety, and insomnia prevalence rates ranged from 8.7% to 50.2%, 4.2%-34.6%, and 6.1%-35.0%, respectively. The main risk factors were self-quarantined after school reopening, regular taking temperature, and wearing face masks. The prevalence rates of mental health problems and associated influential factors unveiled in both stages showed that the students' mental health status was greatly affected. Therefore, a combination of efforts from the government, universities, and families or communities is highly needed to alleviate the mental health sufferings of students.
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    Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone
    (Hindawi Publishing Corporation, 2018) James, Peter Bai
    In resource‐poor countries where access to infertility care is limited, women may turn to traditional medicine to achieve motherhood. It is unknown whether Sierra Leonean women with such condition use herbal medicine. This study investigates the prevalence and factors associated with herbal medicine use among women seeking care for infertility. This was a questionnaire‐based cross‐sectional study conducted among women seeking care for infertility at various clinics within Freetown, Sierra Leone. Data analysis included Chi‐square tests and logistic regression. Out of the 167 women that participated, 36.5% used herbal medicine for infertility treatment. Women with no formal (AOR 4.03, CL: 1.38–11.76, p = 0.011), primary education (AOR: 6.23, CL: 2.02–19.23, p = 0.001) and those that visited a traditional medicine practitioner (AOR: 20.05, CL: 2.10–192.28, p = 0.009) as well as women suffering from other reproductive health problems (AOR: 2.57, CL: 1.13–5.83, p = 0.024) were more likely to use herbal medicines. Friends and family (n = 57, 96.7%) were the main influencers of herbal medicine use. Only (n = 12) 19.7% of users disclosed their status to their healthcare provider. Over half (n = 32, 52.5%) could not remember the name of the herb they used. Luffa acutangula (n = 29, 100%) was the herbal medicinal plant users could recall. Herbal medicine use among women seeking care for infertility in Freetown is common. Healthcare providers should be aware of the potential dyadic use of herbal and allopathic medicines by their patients and be knowledgeable about commonly used herbal remedies as well as being proactive in communicating the potential risks and benefits associated with their use.
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    Prevalence of Hypertension Among People of the Southern Province of Sierra Leone
    (RELX Group (Netherlands), 2024) Williams, Samuel Maxwell Tom
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    Re-reading ACT, BCG, and Low COVID-19 in Africa
    (Springer Nature, 2021) Kangbai, Jia Bainga
    October 11, 2020, marks the seventh month since the World Health Organization (WHO) officially declared COVID-19 a pandemic. Unlike other coronavirus diseases, there is a geographically disproportionate distribution of the incidence of COVID-19 cases around the world. We observed a significantly high COVID-19 cases and deaths in countries and territories with no or very small number of malaria cases or no or low national TB cases in 2018. We speculate that the high incidence of COVID-19 cases and deaths in countries less affected by malaria is partly due to overexposure to malaria which led to the regular use of the artemisinin anti-malaria drugs as well as the regular use of bacillus Calmette-Guérin (BCG) vaccine for TB prevention. The vaccine produced an almost life-long immunity to TB and meningitis to its recipients. We are thus calling for a COVID-19 containment and clinical management protocol that will incorporate the use of the anti-malaria ACT drug cocktail and BCG vaccine on compassionate ground.
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    Regression Modelling and Analysis of Cell phone-Based Syndromic Surveillance Data for Ebola in Sierra Leone
    (OMICS Publishing Group, 2016) Kangbai, Jia Bainga
    **Aim:** To determine the out degree centrality for multivariate analysis, examine the demographic differences and characteristics of callers who make more calls, and determine callers who are more likely to make at least one positive Ebola call.Methods: Surveillance data for 393 suspected Ebola cases (192 males, 201 females) were collected from October 23, 2014 to June 28, 2015 using cell phone technology.UCINET and Net Draw software were used to determine the out degree centrality used for multivariate analysis.Poisson and logistic regression analyses were used to do multivariable analysis.Result: Women (AOR=0.33,95% CI \[0.14, 0.81\]) was associated with decreased odds of making at least one positive Ebola surveillance call compared to men.Women (IR= 0.63, 95% CI \[0.49, 0.82\]) was also associated with making fewer Ebola surveillance calls compared to men. **Conclusion:** This study shows that the combination of cell phone technology with user-friendly and open-source social network software such as UCINET and Net draw will provide an important adjunct to the traditional measures of epidemiologic surveillance.
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    Role and strategies of international humanitarian organisations in handling the Liberia Ebola outbreak
    (2022-02-15) Alameldeen, Ahmed
    In Early August 2014, the World Health Organisation declared an Ebola Virus Disease (EVD) outbreak in the region of West Africa. The West African EVD outbreak was the largest, most severe, and complex in the nearly four-decade history of this disease. The management of EVD cases in Liberia was similar to the other affected West African countries. We reviewed the method and strategies used by some of the international humanitarian organisations in handling the 2013-2016 Ebola outbreak in Liberia. This report is a collection of personal field experiences in Liberia as well as personal interviews of healthcare personnel working for some of these international organisations working on the Ebola emergency in Liberia.Medecins Sans Frontieres (MSF) was the first humanitarian NGO to deploy medical staff to the field in Liberia during the 2013-2016 EVD outbreak. MSF staffs were already operating in Liberia even before the declaration of the outbreak in August 2014.The slow response by the international humanitarian organisations to lend their support in bringing the EVD outbreak to and exhibited the fear the international community have for deadly infectious diseases more than armed conflicts.We recommend regularly training in public health emergency preparedness for third world countries that are highly susceptible to health emergencies such as Ebola outbreak to help prepared them ahead of such outbreak.
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    Severity score for predicting in-facility Ebola treatment outcome
    (Elsevier BV, 2020-08-04) Kangbai, Jia Bainga
    Purpose Sierra Leone recorded the highest incidence rate for the 2013-2016 West African Ebola outbreak. In this investigation, we used the medical records of Ebola patients with different sociodemographic and clinical features to determine the factors that are associated with Ebola treatment outcome during the 2013-2016 West African Ebola outbreak in Sierra Leone and constructed a predictive in-facility mortality score. Methods We used the anonymized medical records of 1077 laboratory-confirmed pediatric and adult patients with EVD who received treatment at the 34 Military Hospital and the Police Training School Ebola Treatment Centers in Sierra Leone between the period of June 2014 and April 2015. We later determined the in-facility case fatality rates for Ebola, the odds of dying during Ebola treatment, and later constructed a predictive in-facility mortality score for these patients based on their clinical and sociodemographic characteristics. Results We constructed a model that partitioned the study population into three mortality risk groups of equal patient numbers, based on risk scoring: low (score ≤ -5), medium (score -4 to 1), and high-risk group (score ≥ 2). The CFR of patients with EVD belonging to the low- (≤-5), medium (-4 to 1), and high- (≥2) risk groups were 0.56%, 9.75%, and 67.41%, respectively. Conclusions We succeeded in designing an in-facility mortality risk score that reflects EVD clinical severity and can assist in the clinical prioritization of patients with EVD.
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    Sociodemographic and clinical determinants of in-facility case fatality rate for 938 adult Ebola patients treated at Sierra Leone Ebola treatment center
    (BioMed Central, 2020-04-21) Kangbai, Jia Bainga
    BACKGROUND: The 2013-2016 West Africa Ebola Virus Disease (EVD) outbreak recorded the highest incidence and mortality since the discovery of the virus in Zaire in 1976; with more than 28,000 probable and confirmed EVD cases and 11,000 deaths. Studies relating to previous outbreaks usually involved small sample sizes. In this study we are set to identify those sociodemographic and clinical features that predict in-facility mortality among EVD patients using a large sample size. METHODS: We analysed the anonymized medical records of 938 laboratory-confirmed EVD patients 15 years old and above who received treatment at The 34 Military Hospital and The Police Training School EVD Treatment Centers in Sierra Leone in the period June 2014 to April 2015. We used both univariable and multivariable logistic regression to determine the predictors for in-facility mortality of these patients based on their sociodemographic and clinical characteristics. RESULTS: The median age of the EVD cases was 33 years (interquartile range = 25 to 40 years). The majority of the EVD cases were male (59.0%) and had secondary level education (79.3%). We reported a low overall in-facility case fatality rate of 26.4%. The associations between case fatality rates and EVD patients who reported fever, abdominal pain, cough, diarrhoea, vomiting, fatigue, haemorrhage, dysphagia, conjunctival injection, dyspnea, and skin rash at the time of admission were all statistically significant (p < 0.05). Our preferred model with the age group 65 years and above alongside the following clinical symptoms; diarrhoea, vomiting, fatigue, dysphagia, conjunctival injection, dyspnea and cough produced a receiver operating characteristic (ROC) curve with an AUC (area under the curve) value of 0.93. CONCLUSIONS: We constructed a simple model that can be optimally used alongside other rapid EVD diagnostic tools to identify EVD in-facility treatment mortality predictors based on the sociodemographic characteristics and clinical symptoms of adult EVD patients. We also reported low EVD cases among patients with secondary and tertiary education. These subpopulations of our patients who are generally informed about the signs and symptoms of EVD, alongside our treatment regimen may have been responsible for our comparatively lower case fatality rate.