Value of combining transect counts and telemetry data to determine short-term population trends in a globally threatened species.

To evaluate conservation interventions, it is necessary to obtain reliable population trends for short (<10 years) time scales. Telemetry can be used to estimate short-term survival rates and is a common tool for assessing population trends, but it has limitations and can be biased toward specific behavioral traits of tagged individuals. Encounter rates calculated from transects can be useful for assessing changes across multiple species, but they can have large confidence intervals and be affected by variations in survey conditions. The decline of African vultures has been well-documented, but understanding of recent trends is lacking. To examine population trends, we used survival estimates from telemetry data collected over 6 years (primarily for white-backed vultures [Gyps africanus]) and transect counts conducted over 8 years (for 7 scavenging raptors) in 3 large protected areas in Tanzania. Population trends were estimated using survival analysis combined with the Leslie Lefkovitch matrix model from the telemetry data and using Bayesian mixed effects generalized linear regression models from the transect data. Both methods showed significant declines for white-backed vultures in Ruaha and Nyerere National Parks. Only telemetry estimates suggested significant declines in Katavi National Park. Encounter rates calculated from transects also showed declines in Nyerere National Park for lappet-faced vultures (38% annual declines) and Bateleurs (18%) and in Ruaha National Park for white-headed vultures (Trigonoceps occipitalis) (19%). Mortality rates recorded and inferred from telemetry suggested that poisoning is prevalent. However, only 6 mortalities of the 26 presumed mortalities were confirmed to be caused by poisoning, highlighting the challenges of determining the cause of death when working across large landscapes. Despite declines, our data provide evidence that southern Tanzania has higher current encounter rates of African vultures than elsewhere in East Africa. Preventing further declines will depend greatly on mitigating poisoning. Based on our results, we suggest that the use of multiple techniques improves understanding of population trends over the short term.

Importancia de combinar los conteos de transectos y los datos de telemetría para determinar las tendencias poblacionales a corto plazo de especies amenazadas a nivel mundial Resumen Para evaluar las intervenciones de conservación es necesario obtener tendencias poblacionales confiables para escalas temporales cortas (<10 años). La telemetría puede usarse para estimar las tasas de supervivencia a corto plazo, además de que es una herramienta común para analizar las tendencias poblacionales, pero tiene limitantes y puede sesgarse con el comportamiento específico de los individuos marcados. Las tasas de encuentro calculadas a partir de transectos pueden ser útiles para analizar cambios en varias especies, aunque pueden tener intervalos grandes de confianza y verse afectadas por las variantes en las condiciones del censo. La declinación de los buitres africanos está bien documentada, pero hace falta el conocimiento sobre las tendencias recientes. Usamos las estimaciones de supervivencia tomadas de datos telemétricos recolectados durante seis años (principalmente del buitre Gyps africanus) y los conteos de transecto de siete especies carroñeras realizados durante ocho años en tres áreas protegidas en Tanzania. Estimamos las tendencias poblacionales con la combinación de análisis de supervivencia y el modelo de matriz Leslie Lefkovitch hecho con los datos telemétricos y usando modelos bayesianos de regresión lineal generalizada de efectos mixtos hechos con los datos de los transectos. Ambos métodos indicaron declinaciones significativas de Gyps africanus en los Parques Nacionales Ruaha y Nyerere. Sólo las estimaciones telemétricas sugirieron una declinación significativa en el Parque Nacional Katavi. Las tasas de encuentro calculadas a partir de los transectos también indicaron declinaciones de Torgos tracheliotos (38% de declinaciones anuales) y de Terathopius ecaudutus (18%) en el Parque Nacional Nyerere y de Trigonoceps occipitalis (19%) en el Parque Nacional Ruaha. Las muertes registradas e inferidas a partir de la telemetría sugieren que el envenenamiento es prevalente. Sin embargo, sólo se confirmaron seis muertes por envenenamiento de las 26 supuestas, lo que resalta los obstáculos para determinar la causa de muerte cuando se trabaja en paisajes amplios. A pesar de las declinaciones, nuestros datos proporcionan evidencia de que el sur de Tanzania tiene tasas actuales de encuentro con buitres africanos más altas que en cualquier otra parte del occidente de África. La prevención de declinaciones en el futuro dependerá principalmente de evitar el envenenamiento. Con base en nuestros resultados, sugerimos que el uso de técnicas múltiples incrementa el conocimiento sobre las tendencias poblacionales a corto plazo.

Exploring the behaviors and social preferences of a large, multigenerational herd of zoo-housed southern white rhinoceros (Ceratotherium simum simum).

The zoo-housed southern white rhinoceros (SWR) population is of special concern due to their lack of consistent breeding success. An enhanced understanding of SWR social preferences could better inform management planning by promoting natural social relationships, which can positively affect their well-being. The large, multigeneration herd housed at the North Carolina Zoo provides an ideal opportunity to examine rhino sociality across different ages, kin types, and social groupings. Eight female rhinos' social and nonsocial behaviors were recorded from November 2020 through June 2021 across 242 h. Activity budget analyses revealed strong seasonal and temporal variations in grazing and resting behaviors, with no stereotypic behaviors recorded. Bond strength calculations suggested that each female maintained strong social bonds with one to two partners. Beyond mother-nursing calf bonds, we found that the strongest social ties were maintained between calf-less adults and subadults in these dyads. Considering these findings, we recommend that management plans attempt to house immature females with calf-less adult females, as they may be necessary to the social landscape of immature females and, ultimately, improve their welfare.

Ready, willing, and able: California college campus law enforcement officers' respond to the opioid overdose attitudes scale.

BackgroundCollege campus police departments are providing law enforcement officers the authority to administer naloxone, the antidote to opioid overdose. This study explored the competence, concerns, and readiness among college campus-based law enforcement officers in Northern California to administer naloxone in case of an opioid overdose on campus. METHODS: Using a quantitative, cross sectional design, law enforcement officers from seven Northern California college campus-based police departments were recruited for this study. Participants completed sociodemographic information and the Opioid Overdose Attitudes Scale (OOAS) electronically. RESULTS: Forty law enforcement officers completed questionnaires. Findings suggested officers were ready and willing to assist opioid overdose victims, had sufficient naloxone administration training, and were not concerned with consequences of precipitating withdrawal symptoms or harm to a student after administering naloxone. CONCLUSIONS: College campus-based law enforcement officers had positive attitudes regarding handling opioid overdose situations and felt mostly comfortable administering naloxone.

Historic redlining in Columbus, Ohio associated with stroke prevalence.

BACKGROUND: Racial disparities exist in stroke and stroke outcomes. In an ecologic study, using the Home Owners' Loan Corporation (HOLC) "redlining" scores, as indicator of historic racialized lending practices, we hypothesized that census tracts with high historic redlining are associated with higher stroke prevalence. METHODS: Weighted historic redlining scores (HRS) were calculated using the proportion of 1930s HOLC residential security grades contained within 2010 census tract boundaries of Columbus, Ohio. Stroke prevalence (adults >=18) was obtained at the census tract-level from the CDC's 500 Cities Project. Sociodemographic census tract level data (American Community Survey 2014-2018) were considered mediators in the causal association between historic redlining and stroke prevalence and were not controlled for in regression analysis. HRS and stroke prevalence associations were evaluated with and without adjustment for proportion of census tract 65 years and older. RESULTS: Census tracts in the highest quartile of HRS (greater redlining) had 1.73% higher stroke prevalence compared to those in the lowest quartile (95% CI:0.41,3.05) adjusting for proportion 65 years and older. No other interquartile differences were observed. CONCLUSIONS: Historic redlining practices are a form of structural racism that established geographic systems of disadvantage and consequently, poor health outcomes. Our findings demonstrate disparate stroke prevalence by degree of historic redlining in census tracts across Columbus, Ohio.

Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan.

BACKGROUND: Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity after successful malaria treatment. HRP2 tests are also threatened by the emergence of Plasmodium that do not carry pfhrp2 or pfhrp 3 genes. Plasmodium lactate dehydrogenase (pLDH)-based tests are promising alternatives, but less available. This study assessed the performances of HRP2 and pLDH(pan) tests under field conditions. METHODS: The study performed a prospective facility-based diagnostic evaluation of two malaria RDTs in Aweil, South Sudan, during the high transmission season. Capillary blood by fingerprick was collected from 800 children under 15 years of age with fever and no signs of severity. SD Bioline HRP2 and CareStart pLDH(pan) RDTs were performed in parallel, thick and thin smears for microscopy were examined, and dried blood was used for PCR testing. RESULTS: Using microscopy as the gold standard, the sensitivity of both tests was estimated at > 99%, but the specificity of each was lower: 55.0% for the pLDH test and 61.7% for the HRP2 test. When using PCR as the gold standard, the sensitivity of both tests was lower than the values assessed using microscopy (97.0% for pLDH and 96.5% for HRP2), but the specificity increased (65.1% for pLDH and 72.9% for HRP2). Performance was similar across different production lots, sex, and age. Specificity of both the pLDH and HRP2 tests was significantly lower in children who reported taking a therapeutic course of anti-malarials in the 2 months prior to enrollment. The prevalence of pfhrp2/3 deletions in the study population was 0.6%. CONCLUSIONS: The low specificity of the pLDH RDT in this setting confirms previous results and suggests a problem with this specific test. The prevalence of pfhrp2/3 deletions in the study area warrants continued monitoring and underscores the relevance of assessing deletion prevalence nationally. Improved malaria RDTs for high-transmission environments are needed.

Sex-specific links between the social landscape and faecal glucocorticoid metabolites in semi-captive Asian elephants.

Although social behaviour is common in group-living mammals, our understanding of its mechanisms in long-lived animals is largely based on studies in human and non-human primates. There are health and fitness benefits associated with strong social ties, including increased life span, reproductive success, and lower disease risk, which are attributed to the proximate effects of lowered circulating glucocorticoid hormones. However, to deepen our understanding of health-social dynamics, we must explore species beyond the primate order. Here, using Asian elephants as a model species, we combine social data generated from semi-captive timber elephants in Myanmar with measurements of faecal glucocorticoid metabolite (FGM) concentrations. These data enable a "natural experiment" because individuals live in work groups with different demographic compositions. We examine sex-specific FGM concentrations for four different aspects of an individuals' social world: general sociality, work group size, sex ratio and the presence of immatures (<5 years) within the work group. Males experienced lower FGM concentrations when engaged in more social behaviours and residing in female-biased work groups. Surprisingly, females only exhibited lower FGM concentrations when residing with calves. Together, our findings highlight the importance of sociality on individual physiological function among elephants, which may have broad implications for the benefits of social interactions among mammals.

Lipocalin 2 stimulates bone fibroblast growth factor 23 production in chronic kidney disease.

Bone-produced fibroblast growth factor 23 (FGF23) increases in response to inflammation and iron deficiency and contributes to cardiovascular mortality in chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL or lipocalin 2; LCN2 the murine homolog) is a pro-inflammatory and iron-shuttling molecule that is secreted in response to kidney injury and may promote CKD progression. We investigated bone FGF23 regulation by circulating LCN2. At 23 weeks, Col4a3KO mice showed impaired kidney function, increased levels of kidney and serum LCN2, increased bone and serum FGF23, anemia, and left ventricular hypertrophy (LVH). Deletion of Lcn2 in CKD mice did not improve kidney function or anemia but prevented the development of LVH and improved survival in association with marked reductions in serum FGF23. Lcn2 deletion specifically prevented FGF23 elevations in response to inflammation, but not iron deficiency or phosphate, and administration of LCN2 increased serum FGF23 in healthy and CKD mice by stimulating Fgf23 transcription via activation of cAMP-mediated signaling in bone cells. These results show that kidney-produced LCN2 is an important mediator of increased FGF23 production by bone in response to inflammation and in CKD. LCN2 inhibition might represent a potential therapeutic approach to lower FGF23 and improve outcomes in CKD.

The legacy of structural racism: Associations between historic redlining, current mortgage lending, and health.

Structural racism, which is embedded in past and present operations of the U.S. housing market, is a fundamental cause of racial health inequities. We conducted an ecologic study to 1) examine historic redlining in relation to current neighborhood lending discrimination and three key indicators of societal health (mental health, physical health, and infant mortality rate (IMR)) and 2) investigate sustained lending disinvestment as a determinant of current neighborhood health in one of the most hypersegregated metropolitan areas in the United States, Milwaukee, Wisconsin. We calculated weighted historic redlining scores from the proportion of 1930s Home Owners' Loan Corporation residential security grades contained within 2010 census tract boundaries. We combined two lending indicators from 2018 Home Mortgage Disclosure Act data to capture current neighborhood lending discrimination: low lending occurrence and high cost loans (measured via loan rate spread). Using historic redlining score and current lending discrimination, we created a 4-level hierarchical measure of lending trajectory. In Milwaukee neighborhoods, greater historic redlining was associated with current lending discrimination (OR = 1.73, 95%CI: 1.16, 2.58) and increased prevalence of poor physical health (ß = 1.34, 95%CI: 0.40, 2.28) and poor mental health (ß = 1.26, 95%CI: 0.51, 2.01). Historic redlining was not associated with neighborhood IMR (ß = -0.48, 95%CI: -2.12, 1.15). A graded association was observed between lending trajectory and health: neighborhoods with high sustained disinvestment had worse physical and mental health than neighborhoods with high investment (poor physical health: ß = 5.33, 95%CI: 3.05, 7.61; poor mental health: ß = 4.32, 95%CI: 2.44, 6.20). IMR was highest in 'disinvested' neighborhoods (ß = 5.87, 95%CI: 0.52, 11.22). Our findings illustrate ongoing legacies of government sponsored historic redlining. Structural racism, as manifested in historic and current forms of lending disinvestment, predicts poor health in Milwaukee's hypersegregated neighborhoods. We endorse equity focused policies that dismantle and repair the ways racism is entrenched in America's social fabric.

Hepatitis C viraemic and seroprevalence and risk factors for positivity in Northwest Cambodia: a household cross-sectional serosurvey.

BACKGROUND: Despite a dramatic reduction in HCV drug costs and simplified models of care, many countries lack important information on prevalence and risk factors to structure effective HCV services. METHODS: A cross-sectional, multi-stage cluster survey of HCV seroprevalence in adults 18 years and above was conducted, with an oversampling of those 45 years and above. One hundred forty-seven clusters of 25 households were randomly selected in two sets (set 1=24 clusters ≥18; set 2=123 clusters, ≥45). A multi-variable analysis assessed risk factors for sero-positivity among participants ≥45. The study occurred in rural Moung Ruessei Health Operational District, Battambang Province, Western Cambodia. RESULTS: A total of 5098 individuals and 3616 households participated in the survey. The overall seroprevalence was 2.6% (CI95% 2.3-3.0) for those ≥18 years, 5.1% (CI95% 4.6-5.7) for adults ≥ 45 years, and 0.6% (CI95% 0.3-0.9) for adults 18-44. Viraemic prevalence was 1.9% (CI95% 1.6-2.1), 3.6% (CI95% 3.2-4.0), and 0.5% (CI95% 0.2-0.8), respectively. Men had higher prevalence than women: ≥18 years male seroprevalence was 3.0 (CI95% 2.5-3.5) versus 2.3 (CI95% 1.9-2.7) for women. Knowledge of HCV was poor: 64.7% of all respondents and 57.0% of seropositive participants reported never having heard of HCV. Risk factor characteristics for the population ≥45 years included: advancing age (p< 0.001), low education (higher than secondary school OR 0.7 [95% CI 0.6-0.8]), any dental or gum treatment (OR 1.6 [95% CI 1.3-1.8]), historical routine medical care (medical injection after 1990 OR 0.7 [95% CI 0.6-0.9]; surgery after 1990 OR 0.7 [95% CI0.5-0.9]), and historical blood donation or transfusion (blood donation after 1980 OR 0.4 [95% CI 0.2-0.8]); blood transfusion after 1990 OR 0.7 [95% CI 0.4-1.1]). CONCLUSIONS: This study provides the first large-scale general adult population prevalence data on HCV infection in Cambodia. The results confirm the link between high prevalence and age ≥45 years, lower socio-economic status and past routine medical interventions (particularly those received before 1990 and 1980). This survey suggests high HCV prevalence in certain populations in Cambodia and can be used to guide national and local HCV policy discussion.

The intersectional effect of poverty, home ownership, and racial/ethnic composition on mean childhood blood lead levels in Milwaukee County neighborhoods.

Environmental conditions that contribute to childhood lead exposure are spatially patterned. Socioeconomic and racial inequities in childhood lead exposure have been well documented, however childhood lead exposure in Milwaukee is understudied. As a segregated rustbelt metropolitan area with childhood lead exposure concerns, Milwaukee is uniquely positioned to evaluate the synergistic effects of racial and economic drivers of childhood lead exposure. Using surveillance data from the Wisconsin Department of Health Services, Division of Public Health and the US Census Bureau, this cross-sectional study determined the intersectional effect of poverty, home ownership, and racial/ethnic composition on childhood lead exposure in Milwaukee County neighborhoods using linear regression adjusting for average census tract housing age and number of children. The final analytical sample consisted of 48,393 individual childhood blood lead levels aggregated to 215 Milwaukee County census tracts. Census tracts with mean childhood blood lead levels greater than or equal to 5 µg/dL were predominantly low home ownership, high poverty, and majority non-White census tracts. The effects of low home ownership, high poverty, and majority non-White census tracts were synergistic, producing 1.78 (95% CI: 1.44, 2.11) µg/dL higher mean childhood blood lead level than high home ownership, low poverty, and majority White census tracts (referent). This research reveals that social determinants at the neighborhood level co-occur and interact to produce inequities in childhood lead exposure. Lead prevention efforts should align with equity-focused housing and economic policies that target primary prevention in neighborhoods disproportionately burdened by childhood lead exposure.

Evolutionary significance of maternal kinship in a long-lived mammal.

Preferential treatment of kin is widespread across social species and is considered a central prerequisite to the evolution of cooperation through kin selection. Though it is well known that, among most social mammals, females will remain within their natal group and often bias social behaviour towards female maternal kin, less is known about the fitness consequences of these relationships. We test the fitness benefits of living with maternal sisters, measured by age-specific female reproduction, using an unusually large database of a semi-captive Asian elephant ( Elephas maximus) population. This study system is particularly valuable to an exploration of reproductive trends in a long-lived mammal, because it includes life-history data that span multiple generations, enabling a study of the effects of kinship across a female's lifespan. We find that living near a sister significantly increased the likelihood of annual reproduction among young female elephants, and this effect was strongest when living near a sister 0-5 years younger. Our results show that fitness benefits gained from relationships with kin are age-specific, establish the basis necessary for the formation and maintenance of close social relationships with female kin, and highlight the adaptive importance of matriliny in a long-lived mammal. This article is part of the theme issue 'The evolution of female-biased kinship in humans and other mammals'.

Responding to excessive alcohol consumption in third-level (REACT): a study protocol.

BACKGROUND: Problem alcohol use is an ongoing, worldwide phenomenon of considerable concern. Throughout the past 20 years, national policies have noted the importance of students when tackling alcohol consumption. Considering alcohol is a multifaceted issue, a multi-component response is required to combat its excessive use. This protocol sets out the approach used for developing, implementing and evaluating the REACT (Responding to Excessive Alcohol Consumption in Third-level) Programme. METHODS/DESIGN: This evaluation will provide the evidence base for programme development, implementation and improvement. Stage one involved defining the multi-component intervention. This was developed following a systematic review of existing literature and a Delphi-consensus workshop involving university students, staff and relevant stakeholders. Following this, the programme is being implemented across the Higher Education sector in Ireland. A number of Higher Education Institutes have declined the invitation to participate in the programme. These institutions will act as control sites. Each intervention site will have a steering committee whose membership will include a mix of students and academic and student service staff. This steering committee will report to the REACT research team on the implementation of mandatory and optional action points at local sites. An online cross-sectional study at baseline and two-years post intervention will be utilised to determine the impact of the REACT programme. The impact assessment will focus on (1) whether the intervention has reduced alcohol consumption among third-level students (2); whether the programme altered students attitudes toward alcohol and (3) whether the programme has decreased the second-hand effects associated with excessive consumption. Finally, qualitative research will focus on factors influencing the take-up and implementation of this programme as well as students' views on the initiative. DISCUSSION: Alcohol consumption has remained on the policy agenda at both national and international level over recent decades. Students are regularly among the highest alcohol consumers, yet university management and public policymakers struggle to tackle this burgeoning issue. The REACT Programme provides a structure to translate policy into practice for those seeking to reduce hazardous alcohol consumption and related harms among third-level students.

Transition to a new electronic health record and pediatric medication safety: lessons learned in pediatrics within a large academic health system.

Objective: While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic. Methods: Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR. Data was reviewed and compiled by theme. Results: After implementation, there was a 5-fold increase in the overall number of medication safety reports; by the third month the rate of reported medication errors had returned to baseline. The majority of reports were near misses. Three major safety themes arose: (1) enterprise logic in rounding of doses and dosing volumes; (2) ordering clinician seeing a concentration and product when ordering medications; and (3) the need for standardized dosing units through age contexts created issues with continuous infusions and pump library safeguards. Conclusions: Future research and work need to be focused on standards and guidelines on implementing an EHR that encompasses all age contexts.

The impact of parental investment on lifetime reproductive success in Iceland.

BACKGROUND: Demonstrating the impact that parents have on the fitness of their children is a crucial step towards understanding how parental investment has affected human evolution. Parents not only transfer genes to their children, they also influence their environments. By analyzing reproductive patterns within and between different categories of close relatives, this study provides insight into the genetic and environmental effects that parents have on the fitness of their offspring. METHODS: We use data spanning over two centuries from an exceptionally accurate Icelandic genealogy, Íslendingabók, to analyze the relationship between the fertility rates of close relatives. Also, using genetic data, we determine narrow sense heritability estimates (h2) to further explore the genetic impact on lifetime reproductive success. Finally, we construct four simulations to model the expected contribution of genes and resources on reproductive success. RESULTS: The relationship between the reproduction of all full sibling pairs was significant and positive across all birth decades (r = 0.19) while the reproductive relationship between parents and offspring was often negative across many decades and undetectable overall (r = 0.00) (Fig. 1 and Table 1). Meanwhile, genetic data among 8,456 pairs of full siblings revealed a narrow sense heritability estimate (h2) of 0.00 for lifetime reproductive success. A resources model (following the rule that resources are transmitted from parents to children, distributed equally among siblings, and are the only factor affecting reproductive success) revealed a similar trend: a negative relationship between parent and offspring reproduction (r =  - 0.35) but a positive relationship among full siblings (r = 0.28). The relationship between parent and offspring lifetime reproductive success (LRS) and full sibling LRS was strongly and positively correlated across time (r = 0.799, p < 0.001). Similarly, the LRS among full siblings was positively correlated with both the LRS among half siblings (r = 0.532, p = 0.011) and the relationship between the LRS of aunts and uncles with their nieces and nephews (r = 0.438, p = 0.042). DISCUSSION: We show that an individual's lifetime reproductive success is best predicted by the reproduction of their full and half siblings, but not their parents, grandparents or aunts and uncles. Because all siblings share at least one parent, we believe parental investment has had an important impact on fitness. Overall, these results indicate that direct parental investment, but not genes, is likely to have had an important and persistent impact on lifetime reproductive success across more than two centuries of Icelandic history.

Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Survey.

Between March 2014 and July 2015 at least 10,500 Ebola cases including more than 4,800 deaths occurred in Liberia, the majority in Monrovia. However, official numbers may have underestimated the size of the outbreak. Closure of health facilities and mistrust in existing structures may have additionally impacted on all-cause morbidity and mortality. To quantify mortality and morbidity and describe health-seeking behaviour in Monrovia, Médecins sans Frontières (MSF) conducted a mobile phone survey from December 2014 to March 2015. We drew a random sample of households in Monrovia and conducted structured mobile phone interviews, covering morbidity, mortality and health-seeking behaviour from 14 May 2014 until the day of the survey. We defined an Ebola-related death as any death meeting the Liberian Ebola case definition. We calculated all-cause and Ebola-specific mortality rates. The sample consisted of 6,813 household members in 905 households. We estimated a crude mortality rate (CMR) of 0.33/10,000 persons/day (95%CI:0.25-0.43) and an Ebola-specific mortality rate of 0.06/10,000 persons/day (95%-CI:0.03-0.11). During the recall period, 17 Ebola cases were reported including those who died. In the 30 days prior to the survey 277 household members were reported sick; malaria accounted for 54% (150/277). Of the sick household members, 43% (122/276) did not visit any health care facility. The mobile phone-based survey was found to be a feasible and acceptable alternative method when data collection in the community is impossible. CMR was estimated well below the emergency threshold of 1/10,000 persons/day. Non-Ebola-related mortality in Monrovia was not higher than previous national estimates of mortality for Liberia. However, excess mortality directly resulting from Ebola did occur in the population. Importantly, the small proportion of sick household members presenting to official health facilities when sick might pose a challenge for future outbreak detection and mitigation. Substantial reported health-seeking behaviour outside of health facilities may also suggest the need for adapted health messaging and improved access to health care.