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Stigmatization of Ebola Virus Disease Survivors in 2022, a Cross-Sectional Study of Survivors in Sierra Leone
27 Pages Posted: 2 Aug 2023
More...Abstract
Background: Evidence has demonstrated a high proportion of Ebola Virus Disease (EVD) survivors experienced stigma related to EVD. This study sought to understand the longer-term effects of stigma encountered by survivors of the 2014-2016 EVD epidemic living in Sierra Leone.
Methods: This was a cross-sectional study of 595 EVD survivors and 403 close contacts (n=998) from Sierra Leone. Assessments were conducted using a three-part survey between November 2021 to March 2022. This study sought to explore the socio-demographic factors associated with stigma experienced by EVD survivors.
Findings: 50·6% (n = 301) of EVD survivors reported that they continued to experience at least one aspect of stigma the index. Females were disproportionately affected by stigma, with 45·2% of females reporting isolation from friends and family compared to 33·9% of men (p=0·005). Multivariable logistic regression models revealed those aged 40-44, living rurally, and reporting an acute infection longer than seven days was associated with stigma related to EVD at the time of survey.
Interpretation: This study demonstrates stigma is still prevalent among people who survived EVD in 2022. It also identified socio-demographic factors associated with stigma that can be used for targeting interventions. Importantly, this highlights the continued need for EVD survivors to access mental healthcare and social support systems well after disease recovery.
Funding: Tier Two Canada Research Chair in the Molecular Pathogenesis of Emerging and Re-Emerging Viruses, Tier Two Canada Research Chair in Program Science and Global Public Health, Manitoba Medical Service Foundation, and the Canadian Institutes of Health Research.
Declaration of Interest: The authors declare no competing interests.
Ethical Approval: The University of Manitoba Research Ethics Board [HS24515 (H2020:538)] and the Office of the Sierra Leone Ethics and Scientific Review Committee, Government of Sierra Leone, granted ethical approval for this study. EVD survivors were informed about the scope, expected outcomes of the study, and their ability to end participation at any time without any repercussions via a consent disclosure statement, with continuation only occurring for those participants who consented to participate. Consent to participate in the study was interpreted by checking yes on the consent to participate box following the consent disclosure statement at the beginning of the survey. Both consent and data were captured electronically when service allowed, surveyors had backup hard copies of the survey when this was not possible and recorded both consent and data for upload to REDCap when and where internet service allowed. All research staff who were involved in collection and analysis of study data had training on ethical conduct for research involving humans and applicable personal and health privacy legislation.
Keywords: Ebola virus disease, stigma, long-term complications, viral hemorrhagic fever, filovirus
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