Article Text
Abstract
Background The 2014–2015 Ebola epidemic in West Africa was the largest ever to occur. In the early phases, little was known about public knowledge, attitudes and practices (KAP) relating to Ebola virus disease (Ebola). Data were needed to develop evidence-driven strategies to address gaps in knowledge and practice.
Methods In August 2014, we conducted interviews with 1413 randomly selected respondents from 9 out of 14 districts in Sierra Leone using multistage cluster sampling. Where suitable, Ebola-related KAP questions were adapted from other internationally validated questionnaires related to infectious diseases.
Results All respondents were aware of Ebola. When asked unprompted, 60% of respondents could correctly cite fever, diarrhoea and vomiting as signs/symptoms of Ebola. A majority of respondents knew that avoiding infected blood and bodily fluids (87%) and contact with an infected corpse (85%) could prevent Ebola. However, there were also widespread misconceptions such as the belief that Ebola can be prevented by washing with salt and hot water (41%). Almost everyone interviewed (95%) expressed at least one discriminatory attitude towards Ebola survivors. Unprompted, self-reported actions taken to avoid Ebola infection included handwashing with soap (66%) and avoiding physical contact with patients with suspected Ebola (40%).
Conclusion Three months into the 2014 Ebola outbreak in Sierra Leone, our findings suggest there was high awareness of the disease but misconceptions and discriminatory attitudes toward survivors remained common. These findings directly informed the development of a national social mobilisation strategy and demonstrated the importance of KAP assessment early in an epidemic.
- ebola
- KAP
- Sierra Leone
- knowledge
- attitude
- practice
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Footnotes
Handling editor Alberto Garcia-Basteiro
Contributors MFJ, PS, RM, MBJ, MD and YS led the conception and design of the survey. PS, MBJ, MFJ, MD, SS, LC, and SG supported the training and supervision of data collection teams. PS led the data analysis with support from MFJ. WL conducted separate analysis of all data to ensure consistency. RB, JM, VB, ND conducted careful reviews of all analysis. All coauthors substantially contributed to the interpretation of the results and to the preparation and writing of the manuscript.
Funding FOCUS 1000 received funding to support data collection from UNICEF and Catholic Relief Services.
Disclaimer The findings and conclusions in this manuscript are those of the authors, and do not necessarily represent an official position of the US centers for Disease Control and Prevention.
Competing interests None declared.
Ethics approval Sierra Leone Ethics and Scientific Review Committee in the Ministry of Health and Sanitation.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data sharing agreement has been developed for the Ebola KAP Assessment in Sierra Leone. All requests to access the data must be processed through the multipartner data sharing mechanism. All data accessibility requests should be directed to the corresponding author.