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      Ebola virus disease in the eyes of a rural, agrarian community in Western Nigeria: a mixed method study

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          Abstract

          Background

          Ebola virus disease (EVD) is a severe hemorrhagic disease caused by Ebola virus. Several outbreaks have been reported in Africa and often originated from remote agrarian communities where there are enormous misconceptions of the disease, refusal of early isolation and quarantine, and unsafe burial rites practices which aggravates the epidemics. It is on this basis that this study was conducted to (assess) the knowledge, perceptions, beliefs and preventive practices against EVD in a predominantly agrarian rural community in Southwest Nigeria.

          Methods

          This was a cross-sectional study conducted in Igbogila town, Yewa North Local Government Area of Ogun State, Southwest Nigeria in the latter part of 2014 during the EVD outbreak. Mixed methods were used for data collection. Quantitative data collection was done using a pre-tested interviewer administered questionnaire. Four hundred and seven respondents selected by multi-stage sampling technique were interviewed. Descriptive and inferential statistics were done, and the level of significance was set at 0.05. Qualitative data collection involved four focus group discussions a year after the epidemic was declared over in the country. The discussions were recorded, transcribed and analyzed along major themes.

          Results

          All respondents were aware of EVD with radio and television being the major sources of information. Knowledge of the disease was however very poor with many misconceptions and it was significantly influenced by educational level of respondent. EVD survivors will be welcomed back into the community by few residents (36.8%) and a much fewer proportion (27.2%) will freely entertain a survivor in their house. Most would prefer local herbalists over orthodox medical practitioners to care for their loved one in case they contract EVD. Although respondents knew that burying a victim is dangerous, they opposed cremation.

          Conclusion

          There was poor knowledge of EVD with a lot of misconceptions. Community members were not pro-active about prevention with dire consequences in the event of an outbreak. Continuous public education should be done via mass media, traditional institutions and other community-based channels as part of emergency preparedness.

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            Cultural Contexts of Ebola in Northern Uganda

            Technical guidelines for the control of Ebola hemorrhagic fever (EHF) indicate that understanding local views and responses to an outbreak is essential. However, few studies with such information exist. Thus, we used qualitative and quantitative methods to determine how local residents of Gulu, Uganda, viewed and responded to the 2000–2001 outbreak of EHF. Results indicated that Acholi people used at least three explanatory models to explain and respond to the outbreak; indigenous epidemic control measures were often implemented and consistent with those being promoted by healthcare workers; and some cultural practices amplified the outbreak (e.g., burial practices). However, most persons were willing to modify and work with national and international healthcare workers.
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              Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014-2016 Ebola Epidemic.

              During 2014-2016, CDC, working with U.S. and international partners, mounted a concerted response to end the unprecedented epidemic of Ebola virus disease (Ebola) in West Africa. CDC's response, which was the largest in the agency's history, was directed simultaneously at controlling the epidemic in West Africa and strengthening preparedness for Ebola in the United States. Although experience in responding to approximately 20 Ebola outbreaks since 1976 had provided CDC and other international responders an understanding of the disease and how to stop its spread, the epidemic in West Africa presented new and formidable challenges. The initial response was slow and complicated for several reasons, including wide geographic spread of cases, poor public health and societal infrastructure, sociodemographic factors, local unfamiliarity with Ebola, and distrust of government and health care workers. In the United States, widespread public alarm erupted after Ebola cases were diagnosed in Dallas, Texas, and New York City, New York. CDC, in collaboration with its U.S. and international counterparts, applied proven public health strategies as well as innovative new approaches to help control the Ebola epidemic in West Africa and strengthen public health readiness in the United States. Lessons learned include the recognition that West African and other countries need effective systems to detect and stop infectious disease threats, the need for stronger international surge capacity for times when countries are overwhelmed by an outbreak, and the importance of improving infection prevention and control in health care settings. The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).
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                Author and article information

                Contributors
                ipokafor@cmul.edu.ng
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                31 August 2020
                31 August 2020
                2020
                : 20
                : 1321
                Affiliations
                [1 ]GRID grid.411782.9, ISNI 0000 0004 1803 1817, Department of Community Health & Primary Care, College of Medicine, , University of Lagos, ; Lagos, Nigeria
                [2 ]Nigeria Centre for Disease Control, Abuja, Nigeria
                Author information
                http://orcid.org/0000-0003-3664-2825
                Article
                9441
                10.1186/s12889-020-09441-7
                7457215
                cfec5c88-995b-42d5-9dab-188fb9c7d634
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 11 June 2020
                : 25 August 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                ebola,infectious disease,epidemic,rural,knowledge,attitude,nigeria
                Public health
                ebola, infectious disease, epidemic, rural, knowledge, attitude, nigeria

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