Random Analytica

Sherlock Holmes was famously quoted as saying that ‘when you have eliminated the impossible, whatever remains, however improbable, must be the truth?’

Yesterday I had a Twitter conversation with virologist Ian M Mackay and currently Sierra Leone deployed health reporter Jennifer Yang about the disconnect between the official World Health Organisation figures and the Sierra Leone Ministry of Health updates. In brief, the Sierra Leone MoH figures are always lower than those presented by WHO which made no sense to me given that the MoH should be data-prime. The numbers anomaly had recently been noted by key Flublogist Crawford Kilian on his blog H5N1.

During the conversation a number of theories were put forward by various parties including a lack of capacity on the ground, data-chain promulgation/speed issues and even a conspiracy theory where-by the Ebola outbreak is linked to central government suppression of the Kailahun/Kenema districts (which border both Guinea/Liberia) as both districts are opposition strongholds.

Although there is certainly issues around ‘boots on the ground’ capacity (see Jennifer’s excellent article from Sierra Leone) the answer to the question as to why there was a significant difference between the Sierra Leone MoH and the WHO numbers turned out to be blindingly obvious.

Most of the reports coming out directly from Sierra Leone are the Ministerial statements which only include confirmed numbers whereas if you dig a little further you can find the full updates including suspected and probable cases in the Ebola Situation Reports.

Here is the look at the situation in Sierra Leone by District based on the most updated Ebola Situation Report (Vol. 78 dated 14 August 2014).

The above infographic details the cases and fatalities from Ebola in Sierra Leone. Cases include all suspected, probably and confirmed cases and the provisional CFR is based on those total numbers.

As you can see the Kailahun and Kenema Districts are the most impacted regions with Sierra Leone accounting for 84.7% of all cases and 95.8% of all fatalities.

Data Sources

[1] Government of Sierra Leone Ministry of Health and Sanitation. EBOLA VIRUS DISEASE – SITUATION REPORT (Sit-Rep) – 14August, 2014. Government of Sierra Leone. Accessed 15 August 2014.