Effects of the 2014/2015 Ebola Outbreak on Malaria Management in Pregnant Women: A Comparative Study of an Ebola Affected and Unaffected Rural District of Guinea

This study aimed to measure the effects of Ebola outbreak on antenatal care attendance and malaria management in pregnant women in Guinea. A retrospective cross-sectional study was conducted in two rural malaria-endemic health districts: on the epicentre of the West African Ebola outbreak (Gueckedou) and the other spared by Ebola (Koubia). Data were compared over similar periods of high malaria transmission before, during and after the Ebola outbreak. There were substantial declines in antenatal care visits in Gueckedou, from a monthly average number of 7,208 before the outbreak to 3,151 (57% decrease) during and 2,843 visits (61% decrease) after it while this indicator increased across the same periods in Koubia. In Gueckedou, the number of SP first doses provided dropped from 2,566 before the outbreak to 1,263 (51% decrease) during and 1,010 (61% decrease) after the Ebola outbreak (P < 0.001) while in Koubia, the decline was by 13% and 24% during and after the outbreak from an average number of 499 doses before it (P < 0.001). Fever cases increased by 43% and 38% during and after the outbreak respectively in Gueckedou and by 28% during and 11% after the outbreak in Koubia. Untreated malaria cases represented 11% and 12% of confirmed malaria cases during and after the outbreak respectively compared to 3% before it in Gueckedou, while in Koubia no untreated case was seen across these periods. There is need to uphold malaria services during future outbreaks.