Do memories of the Ebola virus disease outbreak influence post-Ebola health seeking behaviour in Guéckédou district (epicentre) in Guinea? A cross-sectional study of children with febrile illness

Abstract Background The 2013–2015 Ebola Virus Disease (EVD) outbreak in Guinea resulted in community mistrust that influenced health care service utilization. This study aimed to assess whether EVD-related memories affect post-outbreak health-seeking behaviours for children under five years of age with febrile illnesses in Guéckédou district, Guinea. Methods This cross-sectional study was conducted by interviewing caregivers of children under five years of age in the sub-district most affected by the EVD outbreak (Guèndembou) and the least affected sub-district (Bolodou) in Guéckédou district. Memories of the outbreak were referred to as EVD-related fears in the post-EVD period, which was based on a series of questions regarding current feelings. Results More caregivers in Guèndembou (19.9%; n=39) reported the death of family members or friends due to EVD compared to Bolodou (6.9%; n=14; P<0.001). The mean EVD fear score of caregivers was significantly higher in Guèndembou (3.0; SD: 3.0) than in Bolodou (2.0; SD: 1.1) (p<0.001). Caregivers with a fear score above the median were 1.68 times more likely to seek care than those whose fear score was equal to or below the median; however, this difference was not statistically significant. Caregivers who reported family members’ or friends’ death due to EVD were also more likely to seek care (AOR=2.12; 95%CI: 0.91-4.91), however, with no statistical significance. Only residing in the EVD-most affected sub-district of Guèndembou (AOR=1.74; 95%CI: 1·09-2.79) was positively associated with seeking care.Conclusions This study reveals that community members in the rural district of Guéckédou still live with fear related to EVD nearly two years after the outbreak. It calls for more efforts in the health domain to preserve communities’ key values and address the psychosocial effect of EVD in rural Guinea.

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Memories of the Ebola Virus Disease outbreak affect decisions regarding health care service utilization in Guéckédou district (epicentre) in Guinea: A cross-sectional study of children with febrile illness

10.21203/rs.2.12713/v1 ◽

2019 ◽

Author(s):

Bienvenu Salim CAMARA ◽

Junko Okumura ◽

Alexandre Delamou

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Care Service ◽

Health Care Service ◽

Febrile Illness ◽

Cross Sectional Study ◽

Sectional Study ◽

Health Seeking ◽

Cross Sectional ◽

Health Care Service Utilization

Abstract Background The 2013–2015 Ebola Virus Disease (EVD) outbreak in Guinea resulted in community mistrust that influenced health care service utilization. This study aimed to assess whether EVD-related memories affect post-outbreak health-seeking behaviours for children under five years of age with febrile illnesses in Guéckédou district, Guinea. Methods This cross-sectional study was conducted by interviewing caregivers of children under five years of age in the sub-district most affected by the EVD outbreak (Guèndembou) and the least affected sub-district (Bolodou) in Guéckédou district. Memories of the outbreak were referred to as EVD-related fears in the post-EVD period, which was based on a series of questions regarding current feelings. Results While the majority of caregivers sought care for their children with febrile illness in both districts, a statistically significantly higher proportion of caregivers in Guèndembou sought care, compared to caregivers in Bolodou. Though not statistically significant, caregivers with a fear score above the median and those who reported the death of family members or friends due to EVD were more likely to seek care. Conclusions This study found that the presence of EVD memories is likely to have a positive influence on health-seeking behaviour in the rural district of Guéckédou. However, the findings call for more efforts to preserve communities’ key values and address the psychosocial effects of EVD in rural Guinea.

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