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

PLoS Negl Trop Dis. 2015 Apr 17;9(4):e0003567. doi: 10.1371/journal.pntd.0003567. eCollection 2015 Apr.

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Contact Tracing / methods*
  • Cross-Sectional Studies
  • Epidemics / prevention & control*
  • Hemorrhagic Fever, Ebola / epidemiology*
  • Humans
  • Residence Characteristics
  • Risk Factors
  • Rural Population*
  • Sierra Leone / epidemiology

Grant support

This work was funded by the International Initiative for Impact Evaluation (3ie) through the Global Development Network (GDN) grant #TW1.1042 to MV and PR, http://www.3ieimpact.org/en/ UK Economic and Social Research Council (ESRC) grant # ES/J017620/1 to MV and PR, http://www.esrc.ac.uk/ National Science Foundation, grant # 1430959 to MF, http://www.nsf.gov/ FAO and Irish Aid funs to EM and PR, http://www.fao.org/home/en/, https://www.irishaid.ie/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.