RAPID: Cultural Dimensions of Ebola Virus Transmission in Guinea, West Africa

George Washington University, Washington DC

Investigators

Abstract

Historically, outbreaks of Ebola Virus in human populations have been linked to exposure to infected wildlife and generally limited to isolated rural areas in East Africa. In contrast, the current Ebola Virus outbreak in West Africa, which began in December 2013, has evolved into a more complex, larger, and multi-country epidemic. Furthermore, international travel and medical relief efforts have brought a few cases of Ebola Virus infection to both the United States and Europe. In the past, social scientists have found that to be effective, disease control efforts must be grounded in understanding local cultural beliefs because they underlie indigenous medical practice and influence comprehension of public health education messages. Given these earlier findings, the recent spread of Ebola Virus disease suggests the need for more attention to the social and cultural dimensions of disease transmission. The research funded by this award responds to this need. Results will provide critical practical information for current health education efforts, contribute to improved disease transmission theory, and also help the United States prepare for future global epidemics of infectious diseases. Informed by Cultural Dimensions of Disease Causation Theory, this research bridges cultural anthropology, biomedical anthropology, and epidemiological outbreak response practices aligned with Western medicine. Dr. Sally Lahm and Dr. Amira Roess, both of Georgetown University, will survey and interview a sample of residents and health care workers in 72 selected communities throughout Guinea, the origin country of the current epidemic. Dr. Lahm's previous research, during four Ebola Virus epidemics in another part of Africa, found that the effectiveness of emergency public health education and social mobilization efforts was determined in part by local theories of disease causation, socioeconomic and political factors, traditional subsistence and foraging practices, and religion. The researchers will test the theory that the same is true in Guinea and may account in part for the persistence of the current epidemic. Findings will help scientists who seek to integrate cultural and bio-medical disease models of disease transmission. The international research team will collect data on health education and social mobilization activities, Ebola Virus knowledge, medical practices, communication and transport systems, and health care seeking behavior. In addition, the project will provide preliminary data on the distinct meanings of disease, illness experience, and health from the viewpoint of several regional ethnic groups in Guinea; the effects of gender on these perceptions; and how local people understand Ebola as a phenomenon. Because of regional cultural continuities, results will apply to areas beyond Guinea where Ebola virus and other zoonotic infectious diseases are known to occur. To maximize broader impacts, the project research will support the development of an online, open-source map of Ebola response in study villages; the development of a teaching module on the use of anthropological theory for designing health education campaigns and for integration into primary and secondary school classrooms in Africa and elsewhere; and the provision of policy recommendations to improve public health education campaigns through integration of anthropological research in West Africa, connecting government, non-governmental, international and domestic actors. This proposal was submitted in response to the NSF 15-006 Dear Colleague Letter (DCL) on the Ebola Virus.