The impact of the Ebola virus disease (EVD) epidemic on agricultural production and livelihoods in Liberia

Gatiso, Tsegaye T.; Ordaz‐Németh, Isabel; Grimes, T.; Lormie, Menladi M.; Tweh, Clement; Kühl, Hjalmar S.; Junker, Jessica

doi:10.1371/journal.pntd.0006580

Cited by 46 publications

(43 citation statements)

References 33 publications

(40 reference statements)

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“…Compounding these emotional sequelae is the loss of employment opportunities. A substantial proportion of survivors of EVD lose their livelihood 249 . Many health-care workers who were occupationally exposed and infected were not welcomed back to their previous positions.…”

Section: Mental Health and Psychosocial Sequelaementioning

confidence: 99%

Ebola virus disease

Jacob

Crozier

Fischer

et al. 2020

Nat Rev Dis Primers

414

345

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To date, 12 distinct filoviruses have been described 1. The seven filoviruses that have been found in humans belong either to the genus Ebolavirus (Bundibugyo virus (BDBV), Ebola virus (EBOV), Reston virus (RESTV), Sudan virus (SUDV) and Taï Forest virus (TAFV); Fig. 1) or to the genus Marburgvirus (Marburg virus (MARV) and Ravn virus (RAVV)) 2. The WHO International Classification of Diseases Revision 11 (ICD-11) of 2018 recognizes two major subcategories of filovirus disease (FVD): Ebola disease caused by BDBV, EBOV, SUDV or TAFV, and Marburg disease caused by MARV or RAVV. Ebola virus disease (EVD) is defined as a disease only caused by EBOV. This subcategorization of FVD is largely based on the increasing evidence of molecular differences between ebolaviruses and marburgviruses, differences that may influence virus-host reservoir tropism, pathogenesis and disease phenotype in accidental primate hosts 2. Since the discovery of filoviruses in 1967 (reF. 3), 43 FVD outbreaks (excluding at least five laboratoryacquired infections) have been recorded in or exported from Africa 4. The epidemiological definition of outbreak is one or more cases above the known endemic prevalence. For example, the single case of TAFV infection recorded in a setting in which FVD had never been reported before (Côte d'Ivoire) 5 is still considered an outbreak. All FVD outbreaks, with the exception of that caused by TAFV, were characterized by extremely high case-fatality rates (CFRs, also known as lethality). Until 2013, the most extensive outbreak, caused by SUDV, involved 425 cases and 224 deaths (CFR 52.7%) 6. The overall limited numbers of FVD cases (1967-2013: 2,886 cases including 1,982 deaths 4), the typical remote and rural locations of outbreaks and the often delayed announcement of new outbreaks to the international community 7 have prevented the systematic study of clinical FVD in humans. Thus, the commonly used description of FVD was derived either from observation of small groups of patients in care settings that were not well-equipped for diagnosis, treatment and disease characterization, or from observations of even smaller samples, such as individuals who were transferred from Equatorial Africa to Europe and the USA or who fell sick in Europe or the USA after contracting the virus elsewhere. Pathological characterization of FVD via autopsies has been rare 7,8. In the absence of extensive human clinical data, FVD could only be defined further via the use of experimental animal infections 9,10 .

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Section: Mental Health and Psychosocial Sequelaementioning

confidence: 99%

Ebola virus disease

Jacob

Crozier

Fischer

et al. 2020

Nat Rev Dis Primers

414

345

View full text Add to dashboard Cite

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“…Anthropologists have contributed in key areas, such as bolstering more authentic community engagement in the response [32], reframing harmful terms like "resistance" or "compliance" with response activities [33], and demonstrating the cultural importance of dignified burials [34]. Previous literature in an epidemic context demonstrates how Ebola containment efforts may hinder livelihood opportunities [35], and how livelihood strategies and coping mechanisms make individuals resilient to changes in livelihood [36]. In prior research, mistrust of health workers is contextualized to describe the low community uptake of response efforts [6,[37][38][39].…”

Section: Anthropological Research On Ebolamentioning

confidence: 99%

“…Individuals must instead rely on more informal work, such as market trading, and ultimately have less economic security in the long run. In contrast to previous work on livelihoods and Ebola, which looks specifically at the ways that Ebola hinders livelihood seeking [35], and the ways in which livelihood strategies make individuals more resilient [36], our work looks explicitly at livelihoods and cross-border travel with implication for Ebola control. In a context of Ebola preparedness, strategies should consider how individuals are constricted by economic fragility.…”

Section: Borders and Livelihood Strategies In A Time Of Ebolamentioning

confidence: 99%

Challenges to Ebola preparedness during an ongoing outbreak: An analysis of borderland livelihoods and trust in Uganda

Schmidt‐Sane

Nielsen

Chikombero³

et al. 2020

PLoS ONE

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Ebola Virus Disease in the Democratic Republic of Congo (DRC) was declared a public health emergency of international concern on July 17, 2019. The first case to cross the border into Uganda in June 2019 demonstrates the importance of better understanding border dynamics in a context of Ebola. This paper adopts a political economy approach to contextualize epidemic response programs conducted in moderate-and high-risk border districts in Uganda, through a qualitative study with 287 participants. To that end, our aim was to describe the historical underpinnings of the borderlands context; the role of livelihood strategies in constraining risk avoidance decisions; and the dynamics of trust in authority figures, including health workers. This paper reports that border communities are highly connected, for a variety of social and economic reasons. These daily realities are in direct opposition to guidance to limit travel during an active Ebola epidemic. We argue that an ability to limit movement is constrained by the economic need to seek livelihood strategies wherever that may be. Moreover, border regions are populated by communities with long-standing distrust in authority figures, particularly in fishing areas. This distrust spills over with consequences for Ebola prevention and control activities. This research indexes the importance of tailoring Ebola programming and policies to consider the political and economic dynamics of borderlands.

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“…Studies show that EVD survivors face lifelong health complications such as mental health issues, joint pain, vision problems, among other health issues [4][5][6][7][8][9]. The chronic conditions that survivors face require ongoing care at local health facilities or secondary/tertiary care (e.g.…”

Section: Humanitarian Contextmentioning

confidence: 99%

Conducting mixed-methods research with Ebola survivors in a complex setting in Sierra Leone

et al. 2020

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Background: In late 2015, the Sierra Leone government established the Comprehensive Program for Ebola Survivors (CPES) to improve the well-being of 3466 registered Ebola virus disease (EVD) survivors. This case analysis outlines the challenges of conducting research studies on the health situation of these EVD survivors in a complicated, post-Ebola context. It outlines strategies to address these challenges without compromising research quality. The mixed-methods study sought to determine EVD survivors' access to health services offered through CPES, their health and disability status, and psychosocial and mental health issues faced. Qualitative data from survivors and stakeholders at multiple levels complemented and contextualized the survey results to help understand the unique health and associated socioeconomic challenges that EVD survivors face, which could be applied to other crisis settings. Study findings indicated that CPES had lasting impacts on Sierra Leone's health system, enabling it to respond to EVD survivors, who increasingly accessed health services and showed lower levels of disability after receiving care. Discussion: Understanding the health service needs of this specialized population in a country with an overloaded health system after the Ebola epidemic makes this research study important and timely. The study faced several challenges, including working in a low-resource and low-capacity setting marked by constantly changing priorities and activities of CPES donors and implementers. Further, the study aimed to measure sensitive topics, such as mental health and disability, with standardized tools that required careful contextualization for accurate reporting of findings. Strategies to overcome these challenges included utilizing a mixed-methods approach to contextualize and validate survey results. The study also enabled capacity building of local research teams to ensure that they could follow lines of inquiry and navigate the complex post-Ebola context. Conclusions: Flexibility is paramount when conducting high-quality research for representative and useful results. Timely research and ongoing sharing of the findings with stakeholders is critical to ensure that they benefit study subjects. Furthermore, in such settings, there is a need to balance engagement of stakeholders with maintaining independence and impartiality in the research design and subsequent data produced.

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The impact of the Ebola virus disease (EVD) epidemic on agricultural production and livelihoods in Liberia

Cited by 46 publications

References 33 publications

Ebola virus disease

Ebola virus disease

Challenges to Ebola preparedness during an ongoing outbreak: An analysis of borderland livelihoods and trust in Uganda

Conducting mixed-methods research with Ebola survivors in a complex setting in Sierra Leone

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