Page 64 - GHES-2-2

Global Health Econ Sustain Attributes of Ebola epidemic in West Africa

disease resulted in a mortality rate of 53% over 5 months behavioral, environmental, and socioeconomic factors
in Sudan. In the Democratic Republic of Congo, 284 of 318 associated with confirmed cases and deaths from Ebola
infected individuals succumbed to the disease, leading to a infection in 2014. This study design (i.e., correlational
mortality rate of 89% over 2 months (Pourrut et al., 2005). study or aggregate study) employed population-level data
Since its discovery, the Ebola virus has caused at least to examine the relationships between exposure rates and
14 outbreaks between 1976 and 2006 in Africa (Legrand disease rates (Jacobsen, 2021).
et al., 2007). The 2014 outbreak originated in Gueckedou, Data for this study were sourced from three Western
Guinea, and spread to neighboring countries such as African countries significantly impacted by the 2014
Liberia and Sierra Leone, as well as other West African Ebola epidemic: Liberia, Sierra Leone, and Nigeria.
countries (Alexander et al., 2015). This outbreak has These countries were selected based on the following
been considered one of the most severe outbreaks, with criteria: (i) English speaking, (ii) experiencing widespread
approximately 28,616 confirmed, suspected, and probable transmission with the highest confirmed cases and deaths,
cases reported in Guinea (3,814), Liberia (10,678), and and (iii) affected by secondary infection with the highest
Sierra Leone (14,124) as of early 2016. Among these cases, confirmed cases and deaths. Data on the Ebola virus
15,227 were laboratory-confirmed, resulting in 11,310 outbreak were collected for each district within Liberia,
deaths (Centers for Disease Control and Prevention, 2019; Nigeria, and Sierra Leone from the daily outbreak reports
2020). of each country’s Ministry of Health. Determinants of
Thus far, there is very little known about this highly transmission were collected from surveys conducted
contagious and deadly disease, which claims between 50% by each country’s Ministry of Health, with assistance
and 90% of the infected (Legrand et al., 2007). Research from credible international agencies such as the World
discoveries have predominantly focused on the biological Bank and the United Nations. The available information
and epidemiological features of the virus and the disease. on behavioral, socioeconomic, and environmental
Factors related to the rapid spread of the virus remain determinants from each country was used for the study.
relatively unknown. Sociocultural factors contribute
significantly to the spread of the disease, especially cultural 2.2. Variables and measurements
practices within the region (Chowell & Nishiura, 2014; The disease progression and definition within the region
Hewlett & Amola, 2003). Researchers have provided were divided into confirmed Ebola cases and confirmed
limited information regarding how cultural practices such Ebola deaths. Confirmed cases encompassed any suspected
as burial rituals, funerals, the use of traditional healers or probable cases that yielded a positive laboratory test
and remedies, and the consumption of “bush meat” have result (i.e., positive immunoglobulin M antibody, positive
affected the rapid spread of the Ebola virus (Alexander polymerase chain reaction, or viral isolation for the Ebola
et al., 2015; Hewlett & Amola, 2003; Jones, 2011). virus) (World Health Organization [WHO], 2014).
Unfortunately, there is also very limited research on The possible determinants are divided and defined as
the behavioral, environmental, and socioeconomic factors behavioral, environmental, and socioeconomic factors
affecting the spread and transmission of the virus. This that could be associated with the spread of the Ebola virus.
study aimed to bridge this gap by examining three West Behavioral factors pertain to personal or community
African countries – Liberia, Nigeria, and Sierra Leone – behaviors that might facilitate the transmission of the
that were affected by the Ebola outbreak. Guided by the virus. In this study, behavioral factors include household
Socioecological Model of Health, which conceptualizes handwashing practices (National Population Commission
health as affected by the interplay between the individual, [NPC] [Nigeria] & ICF International, 2014; Statistics Sierra
the group/community, and the physical, social, and Leone (SSL), Ministry of Health and Sanitation [Sierra
political environments, this study addressed the behavioral, Leone] and ICF International, 2014), recent or last sexual
environmental, and socioeconomic factors associated with intercourse among women and men aged 15 – 49, methods
mortality and morbidity during the outbreak.
of disposing of children’s stools, and the employment status
2. Methods for both men and women (Liberia Institute of Statistics
and Geo-Information Services, Ministry of Health and
2.1. Study design Social Welfare [Liberia], National AIDS Control Program
The human subject protection protocol was reviewed and [Liberia], & ICF International, 2014; National Population
approved as an exemption by the Institutional Review Commission [NPC] [Nigeria] & ICF International, 2014;
Board of the University of Toledo (Approval ID: #200599). Statistics Sierra Leone [SSL], Ministry of Health and
An ecological study was conducted to investigate the Sanitation [Sierra Leone] & ICF International, 2014).

Volume 2 Issue 2 (2024) 2 https://doi.org/10.36922/ghes.2107