Do memories of the Ebola virus disease outbreak influence post-Ebola health seeking behaviour in the epicentre in Guinea?

Prof. Junko Okumura (Institute of Tropical Medicine/School of Tropical Medicine and Global Health) and her colleagues have conducted a household survey at the epicenter of the 2013–2015 Ebola Virus Disease (EVD) outbreak in Guinea in order to assess whether EVD-related memories affect post-outbreak health-seeking behaviours for children under five years of age with febrile illnesses there.

This cross-sectional study was conducted by surveying caregivers of children under five years of age in the sub-district most affected by the EVD outbreak (Guèndembou) and the least affected sub-district (Bolodou) in Guéckédou district. Memories of the outbreak were referred to as EVD-related fears in the post-EVD period, which was based on a series of questions regarding current feelings.

While the majority of caregivers sought care for their children with febrile illness in both districts, a statistically significantly higher proportion of caregivers in Guèndembou sought care, compared to caregivers in Bolodou.. More caregivers in Guèndembou (19.9%; n=39) reported the death of family members or friends due to EVD compared to Bolodou (6.9%; n=14; P<0.001). The mean EVD fear score of caregivers was significantly higher in Guèndembou (3.0; SD: 3.0) than in Bolodou (2.0; SD: 1.1) (p<0.001). Caregivers with a fear score above the median were 1.68 times more likely to seek care than those whose fear score was equal to or below the median; however, this difference was not statistically significant. Caregivers who reported family members’ or friends’ death due to EVD were also more likely to seek care (AOR=2.12; 95%CI: 0.91-4.91), however, with no statistical significance. Only residing in the EVD-most affected sub-district of Guèndembou (AOR=1.74; 95%CI: 1·09-2.79) was positively associated with seeking care.

This study reveals that community members in the rural district of Guéckédou still live with fear related to EVD nearly two years after the outbreak. It calls for more efforts in the health domain to preserve communities’ key values and address the psychosocial effect of EVD in rural Guinea.   

Figure: Conceptual framework of factors influencing post-EVD care seeking behaviors

Bienvenu Salim Camara, Junko Okumura, and Alexandre Delamou. Do memories of the Ebola virus disease outbreak influence post-Ebola health seeking behavior in Guéckédou district  (epicentre) in Guinea? A cross-sectional  study of children with febrile illness.

BMC Public Health ((2020) 20:1298.(August 27, 2020)
https://doi.org/10.1186/s12889-020-09359-0

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