As Guinea residents’ Ebola knowledge improves, misconceptions linger
Toward the end of the massive Ebola outbreak in Guinea in August 2015, most residents who were surveyed appeared to understand the causes, transmission and prevention of Ebola, but almost half thought the virus could be transmitted by mosquitoes or that it was airborne. Ebola-related knowledge, attitudes and practices also varied regionally in the country, according to data published in a recent MMWR.
“Health communication and social mobilization efforts to improve the public’s knowledge, attitudes and practices (KAP) regarding Ebola virus disease were important in controlling the 2014-2016 Ebola epidemic in Guinea, which resulted in 2,544 deaths,” Mohamed F. Jalloh, MPH, from the division of Global Health Protection at CDC’s Center for Global Health, and colleagues wrote. “Most Ebola cases in Guinea resulted from the washing and touching of persons and corpses infected with Ebola without adequate infection control precautions at home, at funerals and in health facilities.”
In August 2015, as the 18-month Ebola epidemic waned in Guinea, researchers surveyed 5,733 residents from different regions in Guinea about Ebola transmission and prevention.
The results showed that although most participants understood aspects about transmission and prevention, misconceptions persisted in some regions. A significant number of participants had misconceptions about disease transmission or had expressed reticence being in close proximity to Ebola survivors. Almost half of participants believed that mosquitoes or ambient air could transmit Ebola. Most participants reported washing their hands more often and avoiding physical contact with those suspected of having Ebola, while almost all participants reported that they knew to seek specialized treatment for family members with suspected Ebola and special burial teams if someone died from Ebola in their household. Over half of residents knew to keep a safe distance from corpses affected by Ebola and avoid contact; however, regions differed in that finding.
“Regional variations in the epidemic and related response activities might have resulted in the regional differences in attitudes and suggest that targeting health communication by region might be more effective than a uniform, national approach. Underlying differences in customs and traditions across different ethnic populations might have contributed to regional variation in attitudes and behaviors, especially regarding burials,” Jalloh and colleagues wrote. “Such rapid KAP surveys, conducted during an outbreak, can provide important information for health communications efforts that can contribute to controlling an outbreak at its source, and thereby enhance global health security.”
In a recent report published in PLoS Neglected Tropical Diseases, researchers said they identified several approaches to messaging that were helpful in dispelling misconceptions about Ebola in Sierra Leone, another country hit hard by the epidemic. After conducting numerous focus group discussions and individual interviews, the researchers crafted messages to educate the public about the epidemic, which were later field tested and refined.
The researchers identified four major principles of message development:
- use of trusted messengers such as imams and pastors to speak to the community;
- two-way communication, such as social media posts, radio or television call-in shows and town hall meetings, in addition to broadcasting campaigns or billboards;
- quality operational services to back up the credibility of public service announcements; and
- accounting for local factors, such as avoiding the use of colors favored by political parties and producing messages in the local language or dialect.
The researchers emphasized that understanding a community’s perceptions of a health crisis “should lie at the core” of any effort to educate the public.
“The recommendations could be far-reaching as they represent an evidence-based approach to message development and implementation during public health emergencies, including other infectious disease outbreaks,” Muriel J. Harris, PhD, associate professor at the University of Louisville School of Public Health and Information Sciences, said in a press release. – by Savannah Demko and Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.