What Is the Impact of the Ebola Virus Disease Outbreak on Cancer Management in Guinea?

ABSTRACT

PURPOSE: To assess the impact of the Ebola virus disease outbreak (EVDO) on cancer management at the surgical oncology unit of Donka National Hospital. METHODS: This was a retrospective and comparative analysis of cancer consultation and care data before (2012-2013), during (2014-2015), and after (2016-2017) the EVDO. The number of cancer occurrences, referral mode, origin, main activities (consultations, surgery, chemotherapy), and access of radiotherapy were analyzed. The Mann-Whitney U test with independent samples used was considered as significant if P was ≤ .05. RESULTS: From 2012 to 2017, 4,977 patients were admitted, including 2,254 with cancer. The variations observed were a decrease in consultations by 2.3% during the EVDO versus an increase by 46.9% after the outbreak (P < .001). We found decreases of 0.7% and 12.5% during and increases of 253.8% and 15.4% after the EVDO from level 1 and 2 and from level 3 health facilities, respectively (P < .001). A total of 251 surgeries were performed, and 1,463 received chemotherapy. There was 5.2% more chemotherapy use during and 33.7% more after the EVDO (P < .001). The number of surgeries increased by 35.8% and decreased by 40.0% during and after the EVDO, respectively (P < .001). We evacuated 36 patients for radiotherapy, which reflected a decrease of 42.1% and 45.5% during and after the EVDO (P < .001). CONCLUSION: Cancer management slowed down during the EVDO. This change requires organization of the fight against cancer through the institutionalization and decentralization of its management.