R software package version 3.3.1 [25] was used for all descriptive and regression analyses in this study. The p-values < 0.05 were considered significant for all two-sided statistical tests. We present our descriptive analysis either as frequencies, proportions, means and standard deviations (for normally distributed continuous variables), or medians and interquartile ranges (IQR) for non-normally distributed continuous variables. Chi-square tests (when our sample sizes are 5 and above) and Fisher’s exact test (when our sample sizes were less than 5) were used to determine correlations between categorical variables. Delays and time periods were calculated by subtracting different variables of time point data from each other.

The descriptive part comprises socio-demographic variables (sex, age, occupation, referral status, distance travel and location of residence, potential source of EVD infection), clinical patient characteristics (blind, mutism, anorexic, and admitted in a bad state) and various time periods (Table 1 and Fig. 2).

Full text meaning of abbreviations, description of time periods for Ebola Virus Disease patients treated at the Kenema Government Hospital Ebola Treatment Center and their respective placement in Fig. Fig.22

Treatment associated time points and periods for Ebola Virus Disease patients treated at the Kenema Government Hospital Ebola Treatment Center during the peak period of the West Africa Ebola outbreak 2013–2016

We used logistic regression analysis to determine the relationship between in-facility mortality and EVD health seeking delay for those EVD patients who resided in Kenema District, sex, age, occupation, and the distance travelled to the ETC. We did not include health seeking delay for EVD patients who were residing outside Kenema District but were treated at the KGHETC because this subpopulation of patients had already started seeking treatment prior to their arrival at the KGHETC. We categorised occupation into the following levels; children and pupils in junior school), lower skilled workers (farmers, carpenters, mechanics, drivers, and EVD patients with unspecified jobs), and higher skilled workers (students in higher tertiary schools and institutions, medical personnel and teachers).

We also performed two linear regression analyses to determine the association between the average LOS (separately for EVD patients who were discharged alive, and for EVD patients who died during EVD treatment) and EVD treatment delay, sex, age, occupation, referral status, and the distance to ETC.

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