Attitudes about vaccines to prevent Ebola virus disease in Guinea at the end of a large Ebola epidemic: Results of a national household survey

Irwin, Kathleen L.; Jalloh, Mohamed F.; Corker, Jamaica; Mahmoud, Barry Alpha; Robinson, Susan; Li, Wenshu; James, Nyuma E.; Sellu, Musa; Jalloh, Mohammad B; Diallo, Alpha Ahmadou; Tracy, LaRee; Hajjeh, Rana; VanSteelandt, Amanda; Bunnell, Rebecca; Martel, L. M. V.; Raghunathan, Pratima L.; Marston, Barbara J.

doi:10.1016/j.vaccine.2017.06.026

Cited by 32 publications

(22 citation statements)

References 15 publications

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“…Our study is subject to several limitations. Survey questionnaire items were adapted from prior studies, allowing direct comparison with past studies [20][21][22][23]; however, the instrument has not been formally validated in the DRC. Translation of survey questionnaires and FGD transcripts may have resulted in the loss of some nuanced meanings.…”

Section: Discussionmentioning

confidence: 99%

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'The cat that kills people:’ community beliefs about Ebola origins and implications for disease control in Eastern Democratic Republic of the Congo

Claude

Hawkes

2019

Pathogens and Global Health

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The current Ebola epidemic in Eastern Democratic Republic of Congo (DRC) has surpassed 1 700 deaths. Social resistance, a major barrier to control efforts, invites exploration of community beliefs around Ebola and its origins. We conducted a mixed-methods study, using four focus group discussions (FGDs) involving 20 participants, and a 19-item survey questionnaire, administered to a nonprobability sample of 286 community members throughout the outbreak zone. FGDs and surveys were conducted between 4 and 17 August 2018. FGDs revealed a widespread rumor early in the epidemic of two twins bewitched by their aunt after eating her cat, who developed bleeding symptoms and triggered the epidemic. However, this myth appeared to dissipate as the epidemic progressed and biomedical transmission became generally accepted. In our survey, 6% of respondents endorsed supernatural origins of Ebola. These respondents were more likely to believe that traditional medicine practitioners can cure Ebola. Wild animals were recognized as sources of Ebola by 53% and FGD participants commented that 'Ebola leaves the forest and hides in the hospital,' recognizing that zoonotic origins gave way to nosocomial transmission as the epidemic progressed. Taken together, our findings suggest that a dynamic syncretism of mythical and biomedical understanding of Ebola may have shaped transmission patterns. Mythical conceptions and fear of contagion may have fueled the 'underground' transmission of Ebola, as patients sought care from traditional healers, who are ill-equipped to deal with a highly contagious biohazard. A deeper understanding of beliefs around Ebola origins may illuminate strategies to engage communities in control efforts.

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Section: Discussionmentioning

confidence: 99%

“…A 19-item questionnaire was designed, based in part on past questionnaires used in Guinea, DRC, and Germany [20][21][22][23]. Questions from past surveys included participant characteristics, Ebola-specific knowledge, and attitudes toward response efforts.…”

Section: Survey Questionnairementioning

confidence: 99%

'The cat that kills people:’ community beliefs about Ebola origins and implications for disease control in Eastern Democratic Republic of the Congo

Claude

Hawkes

2019

Pathogens and Global Health

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“…This is perhaps not surprising given the high morbidity and mortality associated with Ebola [24]. More than 6000 individuals participated in a study in Guinea, with most agreeing that vaccines were needed to fight Ebola, reflected again by high acceptability for a hypothetical Ebola vaccine [27]. Interestingly though in a study conducted in Sierra Leone evaluating knowledge, attitudes and acceptability for an Ebola vaccine, 72.5% of the respondents were willing to be vaccinated if the vaccine was free of charge, but only 26.6% would be vaccinated if it was necessary to pay [28].…”

Section: Discussionmentioning

confidence: 99%

Consumer willingness to pay for a hypothetical Zika vaccine in Brazil and the implications

Júnior

Godói

Reis

et al. 2018

Expert Review of Pharmacoeconomics & Outcomes Research

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Background: Zika virus is a newly emerging infection, associated with increasingly large outbreaks especially in tropical countries such as Brazil. A future Zika vaccine can contribute to decreasing the number of cases and associated complications. Information about consumers' willingness to pay (WTP) for a hypothetical Zika vaccine can help price setting discussions in the future in Brazil, starting with the private market. Methods: A cross-sectional study conducted among residents of Minas Gerais, Brazil, regarding their WTP for a hypothetical Zika Vaccine. The mean effective protection was 80%, with the possibility of some local and systemic sideeffects. Results: 517 people were interviewed. However, 30 would not be vaccinated even if the vaccine was free. Most of the resultant interviewees (489) were female (58.2%), had completed high school (49.7%), were employed (71.2%), had private health insurance (52.7%) and did not have Zika (96.9%). The median individual maximum willingness to pay for this hypothetical Zika vaccine (one dose) was US$31.34 (BRL100.00). Conclusion: Such discussions can contribute to decision-making about prices once a Zika vaccine becomes available in Brazil alongside other ongoing programmes to control the virus.

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“…• SIAs vaccinate many people at once, increasing the likelihood of serious adverse events occurrence following immunization (AEFIs), especially in clusters, causing vaccine safety concerns in the community 43 • Sustain mobilization of a wide coalition of stakeholders to prioritize high coverage among target population during the campaign and help achieve targets as well as preventing outbreaks 44 • SIA messages during social mobilization should articulate to caregivers the need to continue with the regularly scheduled doses in the routine schedule • Use social mobilization and immunization activities adapted for difficult contexts (e.g. health days for multiple health services or entering the community on days of tranquility) 46 • Conduct social mobilization and immunization at gathering points (e.g.…”

Section: Supplementary Immunization Activitiesmentioning

confidence: 99%

Mobilize to vaccinate: lessons learned from social mobilization for immunization in low and middle-income countries

Jalloh

Wilhelm

Abad

et al. 2019

Human Vaccines & Immunotherapeutics

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Creating and sustaining demand for immunization services is a global priority to ensure that vaccineeligible populations are fully protected from vaccine-preventable diseases. Social mobilization remains a key health promotion strategy used by low-and middle-income countries (LMICs) to promote vaccination demand. In this commentary, we synthesize illustrative evidence on successful social mobilization efforts promoting the uptake of immunization services in select LMICs. The first example focuses on Sierra Leone's routine immunization program during the Universal Child Immunization initiative in the late 1980s. We then give an example of India's establishment of a social mobilization network in the early-to mid-2000s to support polio elimination in high-risk communities. Thirdly, we highlight the complexities of social mobilization in a humanitarian emergency during the 2017-2018 diphtheria outbreak among displaced Rohingyas in camps and settlements in Bangladesh. Lastly, we draw upon examples from the introduction of the human papillomavirus vaccine in several countries. We then critically examine recurring challenges faced when implementing social mobilization for immunization in LMICs and offer practical recommendations for improvement.

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Attitudes about vaccines to prevent Ebola virus disease in Guinea at the end of a large Ebola epidemic: Results of a national household survey

Abstract: The high acceptability of hypothetical vaccines indicates strong potential for introducing Ebola vaccines across Guinea. Strategies to build public confidence in use of Ebola vaccines should highlight any similarities with safe, effective vaccines routinely used in Guinea.

Cited by 32 publications

References 15 publications

'The cat that kills people:’ community beliefs about Ebola origins and implications for disease control in Eastern Democratic Republic of the Congo

'The cat that kills people:’ community beliefs about Ebola origins and implications for disease control in Eastern Democratic Republic of the Congo

Consumer willingness to pay for a hypothetical Zika vaccine in Brazil and the implications

Mobilize to vaccinate: lessons learned from social mobilization for immunization in low and middle-income countries

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