The Role of Fear-Related Behaviors in the 2013–2016 West Africa Ebola Virus Disease Outbreak

Shultz, James M.; Cooper, Julian; Baingana, Florence; Oquendo, María A.; Espinel, Zelde; Althouse, Benjamin M.; Marcelin, Louis Herns; Towers, Sherry; Espinola, Maria; McCoy, Clyde B.; Mazurik, Laurie; Wainberg, Milton L.; Neria, Yuval; Rechkemmer, Andreas

doi:10.1007/s11920-016-0741-y

Cited by 261 publications

(251 citation statements)

References 80 publications

(146 reference statements)

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“…4,[15][16][17] The 2013-2016 West Africa EVD outbreak surpassed all previous outbreaks combined in numbers of EVD cases, deaths, and survivors (Table 3).…”

Section: Total Populationmentioning

confidence: 99%

“…Centers for Disease Control and Prevention (CDC), to remark retrospectively on "how close the world came to a global catastrophe." 10,17 CDC professionals described the interlocking elements that comprised the disease control intervention: 1) conducting aggressive community-based surveillance to identify and isolate persons with EVD infection; 2) implementing "contact tracing" for all contacts of EVD cases and monitoring these individuals for the full 21-day Ebola incubation period; 3) investigating current and past EVD cases with trace-backs to identify active "chains" of transmission; 4) tracking deaths and bringing trained burial teams to safely handle the cadavers of the deceased; 5) maintaining daily case reporting; 6) educating and updating health-care workers about infection control practices; and 7) training health workers on safe procedures for donning, doffing, and working in personal protective equipment, for the mutual protection of staff and patients. 6,19 This multi-faceted approach, drawing upon local, regional, and international assets, was able to stop the epidemic spread of the Ebola virus.…”

Section: Public Health Responsementioning

confidence: 99%

“…4,[15][16][17] These epidemiologic patterns have guided our collaborators and are shared for the benefit of investigators for whom this information provides useful context and for a broader readership with interest in the dynamics of this outbreak.…”

Section: Author Notementioning

confidence: 99%

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Distinguishing epidemiological features of the 2013–2016 West Africa Ebola virus disease outbreak

et al. 2016

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The 2013-2016 West Africa Ebola virus disease epidemic was notable for its scope, scale, and complexity. This briefing presents a series of distinguishing epidemiological features that set this outbreak apart.Compared to one concurrent and 23 previous outbreaks of the disease over 40 years, this was the only occurrence of Ebola virus disease involving multiple nations and qualifying as a pandemic. Across multiple measures of magnitude, the 2013-2016 outbreak was accurately described using superlatives: largest and deadliest in terms of numbers of cases and fatalities; longest in duration; and most widely dispersed geographically, with outbreak-associated cases occurring in 10 nations.In contrast, the case-fatality rate was much lower for the 2013-2016 outbreak compared to the other 24 outbreaks. A population of particular interest for ongoing monitoring and public health surveillance is comprised of more than 17,000 "survivors," Ebola patients who successfully recovered from their illness.The daunting challenges posed by this outbreak were met by an intensive international public health response. The near-exponential rate of increase of incident Ebola cases during mid-2014 was successfully slowed, reversed, and finally halted through the application of multiple disease containment and intervention strategies.

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“…4,[15][16][17] The 2013-2016 West Africa EVD outbreak surpassed all previous outbreaks combined in numbers of EVD cases, deaths, and survivors (Table 3).…”

Section: Total Populationmentioning

confidence: 99%

Section: Public Health Responsementioning

confidence: 99%

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Distinguishing epidemiological features of the 2013–2016 West Africa Ebola virus disease outbreak

et al. 2016

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“…[37] Commonly listed concerns included fear of the disease agent and its reservoirs, its symptoms, the care environment, and the government response (checkpoints, home searches, quarantine, etc.) that resulted in population flight, abandonment of patients by caregivers, hurried and unsafe burial practices, and social stigmata.…”

Section: Ebola Survivorsmentioning

confidence: 99%

Reflections on the ebola public health emergency of international concern, part 2: The unseen epidemic of posttraumatic stress among health-care personnel and survivors of the 2014–2016 Ebola outbreak

Paladino

Sharpe²,

Galwankar

et al. 2017

J Global Infect Dis

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“…In Ebola-affected communities many individuals feared to seek care, even for curable conditions. 4,5 The manner in which the provision and utilisation of programmes were affected by the outbreak was difficult to monitor during the outbreak response, given the state of emergency. All the attention of national and international health care providers was focused on limiting further spread of EVD, and reducing mortality in infected patients.…”

mentioning

confidence: 99%

What was the effect of the West African Ebola outbreak on health programme performance, and did programmes recover?

Decroo

Fitzpatrick

Amone

2017

public health action

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The West African Ebola virus disease (EVD) outbreak was the largest in history. The vast majority of cases were reported in Guinea, Sierra Leone and Liberia. Altogether, 28 646 people were infected and 11 323 died. 1 One of the explanations for the extent of the outbreak was the lack of response of local health systems. These health systems were incapable of responding adequately to the outbreak due to a lack of human resources, information, research, supply of medical products, financing and governance. 2 The devastating effect of the Ebola outbreak stretched far beyond the number of Ebola cases, and resulted in the deterioration of the provision and utilisation of routine health care. On the one hand the EVD outbreak compromised the functioning of the health system, due to the deaths of many health care workers and the closure of health facilities, 3,4 while at the same time communities had little trust in the capacity of providers to secure safe health care. In Ebola-affected communities many individuals feared to seek care, even for curable conditions. 4,5 The manner in which the provision and utilisation of programmes were affected by the outbreak was difficult to monitor during the outbreak response, given the state of emergency. All the attention of national and international health care providers was focused on limiting further spread of EVD, and reducing mortality in infected patients. We therefore studied in retrospect the effect of the Ebola outbreak on health system performance. Two Structured Operational Research Training Initiative (SORT IT) courses were organised, one in Liberia and one in Sierra Leone. The participants, the first authors of the manuscripts included in this supplement, were involved in the local health programmes during the Ebola outbreak. Course participation was defined as successful if the participant submitted a scientific manuscript to a peer-reviewed journal by the end of the course. 6 Sixteen studies were conducted, and are assembled here for this special issue. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Through the study of routine data the performance of a wide range of programmes was assessed before, during and after the outbreak. These studies present data from mother and child health care services, the human immunodeficiency virus (HIV), tuberculosis, vaccination, malaria, malnutrition and non-communicable diseases programmes. In addition, infection prevention monitoring, community health worker programme and performance-based financing are included.The different studies illustrate how service delivery and utilisation of most programmes dropped significantly during the Ebola outbreak. The greater the area affected, the sharper the decline, and the longer it took for performance to recover to pre-Ebola levels. The level of programme performance pre-Ebola also affected recovery post-Ebola. For example, in Liberia the already struggling immunisation programme was further weakened during the outbreak and took significant time to recover post-Ebola. 19 Ne...

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The Role of Fear-Related Behaviors in the 2013–2016 West Africa Ebola Virus Disease Outbreak

Cited by 261 publications

References 80 publications

Distinguishing epidemiological features of the 2013–2016 West Africa Ebola virus disease outbreak

Distinguishing epidemiological features of the 2013–2016 West Africa Ebola virus disease outbreak

Reflections on the ebola public health emergency of international concern, part 2: The unseen epidemic of posttraumatic stress among health-care personnel and survivors of the 2014–2016 Ebola outbreak

What was the effect of the West African Ebola outbreak on health programme performance, and did programmes recover?

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