Limits...
Social pathways for Ebola virus disease in rural Sierra Leone, and some implications for containment.

Richards P, Amara J, Ferme MC, Kamara P, Mokuwa E, Sheriff AI, Suluku R, Voors M - PLoS Negl Trop Dis (2015)

Bottom Line: Funerals are known to be a high-risk factor for infection.A concluding discussion relates the information presented to plans for halting the disease.Local consultation and access are seen as major challenges to be addressed.

View Article: PubMed Central - PubMed

Affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.

ABSTRACT
The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact. Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed. The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic-the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure. Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties. A concluding discussion relates the information presented to plans for halting the disease. Local consultation and access are seen as major challenges to be addressed.

Show MeSH

Related in: MedlinePlus

a-c: Distance to Chiefdom headquarters town.Source: Figure plots the distance frequencies to the Chiefdom headquarter towns for villages with an Agri-Business Center (Panel A (S3 Dataset), villages without an Agri-Business center (Panel B, (S3 Dataset)) and villages around the GRNP (Panel C, Household Survey (S5 Dataset)).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4401769&req=5

pntd.0003567.g005: a-c: Distance to Chiefdom headquarters town.Source: Figure plots the distance frequencies to the Chiefdom headquarter towns for villages with an Agri-Business Center (Panel A (S3 Dataset), villages without an Agri-Business center (Panel B, (S3 Dataset)) and villages around the GRNP (Panel C, Household Survey (S5 Dataset)).

Mentions: The data are tabulated in Fig 5A–5C, and show the time distance separating the village and chiefdom HQ in the three types of settlement. Even in the case of the best-connected group (agri-business center villages), 10 per cent of settlements were more than two hours to a full day from their chiefdom headquarters. For the Gola forest villages the percentage rises to about one quarter. These distances would be insurmountable by an Ebola victim seeking to walk to voluntary hospitalization sites. A wealthy family might pay for a hammock. Others would be unable to afford to get their patient even to a "local" triage facility. Perhaps only helicopters could solve the problem of timely evacuation from localities that are not reached by motorable roads.


Social pathways for Ebola virus disease in rural Sierra Leone, and some implications for containment.

Richards P, Amara J, Ferme MC, Kamara P, Mokuwa E, Sheriff AI, Suluku R, Voors M - PLoS Negl Trop Dis (2015)

a-c: Distance to Chiefdom headquarters town.Source: Figure plots the distance frequencies to the Chiefdom headquarter towns for villages with an Agri-Business Center (Panel A (S3 Dataset), villages without an Agri-Business center (Panel B, (S3 Dataset)) and villages around the GRNP (Panel C, Household Survey (S5 Dataset)).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401769&req=5

pntd.0003567.g005: a-c: Distance to Chiefdom headquarters town.Source: Figure plots the distance frequencies to the Chiefdom headquarter towns for villages with an Agri-Business Center (Panel A (S3 Dataset), villages without an Agri-Business center (Panel B, (S3 Dataset)) and villages around the GRNP (Panel C, Household Survey (S5 Dataset)).
Mentions: The data are tabulated in Fig 5A–5C, and show the time distance separating the village and chiefdom HQ in the three types of settlement. Even in the case of the best-connected group (agri-business center villages), 10 per cent of settlements were more than two hours to a full day from their chiefdom headquarters. For the Gola forest villages the percentage rises to about one quarter. These distances would be insurmountable by an Ebola victim seeking to walk to voluntary hospitalization sites. A wealthy family might pay for a hammock. Others would be unable to afford to get their patient even to a "local" triage facility. Perhaps only helicopters could solve the problem of timely evacuation from localities that are not reached by motorable roads.

Bottom Line: Funerals are known to be a high-risk factor for infection.A concluding discussion relates the information presented to plans for halting the disease.Local consultation and access are seen as major challenges to be addressed.

View Article: PubMed Central - PubMed

Affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.

ABSTRACT
The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact. Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed. The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic-the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure. Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties. A concluding discussion relates the information presented to plans for halting the disease. Local consultation and access are seen as major challenges to be addressed.

Show MeSH
Related in: MedlinePlus