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Knowledge, Attitudes, and Practices among Members of Households Actively Monitored or Quarantined to Prevent Transmission of Ebola Virus Disease — Margibi County, Liberia: February-March 2015

Published online by Cambridge University Press:  27 July 2017

Jason A. Wilken ,
Paran Pordell ,
Brant Goode ,
Rachel Jarteh ,
Zayzay Miller ,
Benjamin G. Saygar Sr. ,
Leroy Maximore ,
Watta M. Borbor ,
Moses Carmue  and
Gregory W. Walker
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Jason A. Wilken*
Affiliation:
Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, Atlanta, GeorgiaUSA
Paran Pordell
Affiliation:
Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia USA
Brant Goode
Affiliation:
Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, Atlanta, GeorgiaUSA
Rachel Jarteh
Affiliation:
Peace Corps Liberia, Monrovia, Liberia
Zayzay Miller
Affiliation:
Peace Corps Liberia, Monrovia, Liberia
Benjamin G. Saygar Sr.
Affiliation:
Margibi County Health Team, Kakata, Margibi, Liberia
Leroy Maximore
Affiliation:
Margibi County Health Team, Kakata, Margibi, Liberia
Watta M. Borbor
Affiliation:
Peace Corps Liberia, Monrovia, Liberia
Moses Carmue
Affiliation:
Margibi County Health Team, Kakata, Margibi, Liberia
Gregory W. Walker
Affiliation:
Margibi County Health Administration, Kakata, Margibi, Liberia
Adolphus Yeiah
Affiliation:
Margibi County Health Team, Kakata, Margibi, Liberia
*
Correspondence: Jason A. Wilken, PhD, MPH Centers for Disease Control and Prevention Office of Public Health Preparedness and Response Atlanta, Georgia USA E-mail: vxj9@cdc.gov
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Abstract

Background

In early 2015, a patient from a cluster of cases of Ebola Virus Disease (EVD) in Monrovia, Liberia traveled to a rural village in Margibi County, potentially exposing numerous persons. The patient died in the village and post-mortem testing confirmed Ebola Virus infection.

Problem

The Margibi County Health Team (CHT; Kakata, Margibi, Liberia) needed to prevent further transmission of EVD within and outside of the affected villages, and they needed to better understand the factors that support or impede compliance with measures to stop the spread of EVD.

Methods

In February-March 2015, the Margibi CHT instituted a 21-day quarantine and active monitoring for two villages where the patient had contact with numerous residents, and a 21-day active monitoring for five other villages where the patient had possible contact with an unknown number of persons. One contact developed EVD and quarantine was extended an additional 12 days in one village. In April 2015, the Margibi CHT conducted a household-based EVD knowledge, attitudes, and practices (KAP) survey of the seven villages. From April 24-29, 2015, interview teams approached every household in the seven villages and collected information on demographics, knowledge of EVD, attitudes about quarantine to prevent the spread of EVD, and their quarantine experiences and practices. Descriptive statistics were calculated.

Results

One hundred fifteen interviews were conducted, representing the majority of the households in the seven villages. Most (99%) correctly identified touching an infected person’s body fluids and contact with the body of someone who has died from EVD as transmission routes. However, interviewees sometimes incorrectly identified mosquito bites (58%) and airborne spread (32%) as routes of EVD transmission, and 72% incorrectly identified the longest EVD incubation period as ≤seven days. Eight of 16 households in the two quarantined villages (50%) reported times when there was not enough water or food during quarantine. Nine of 16 (56%) reported that a household member had illnesses or injuries during quarantine; of these, all (100%) obtained care from a clinic, hospital, or Ebola treatment unit (ETU).

Conclusion

Residents’ knowledge of EVD transmission routes and incubation period were suboptimal. Public health authorities should consider assessing residents’ understanding of Ebola transmission routes and effectively educate them to ensure correct understanding. Quarantined residents should be provided with sufficient food, water, and access to medical care.

WilkenJA, PordellP, GoodeB, JartehR, MillerZ, SaygarBGSr., MaximoreL, BorborWM, CarmueM, WalkerGW, YeiahA. Knowledge, Attitudes, and Practices among Members of Households Actively Monitored or Quarantined to Prevent Transmission of Ebola Virus Disease — Margibi County, Liberia: February-March 2015. Prehosp Disaster Med. 2017;32(6):673–678.

Keywords

Ebola Virus Diseasequarantinetransmission
Type
Brief Reports
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 6 , December 2017 , pp. 673 - 678
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (Atlanta, Georgia USA). The authors declare no conflicts of interest.

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