Disease Control and Ebola in West Africa: a Qualitative Evidence Synthesis

Authors

  • Tony Bell University of Oxford
  • Tine Van Bortel De Montfort University
  • Nai Rui Chng University of Glasgow
  • Valerie Wells University of Glasgow

DOI:

https://doi.org/10.31646/gbio.178

Keywords:

ebola virus disease, communicable disease control, health seeking behaviour, evolutionary cultural anthropology, bio-social analysis, qualitative evidence synthesis

Abstract

Aims: The West African Ebola Virus Disease (EVD) outbreak of 2014-2016 was the most disastrous EVD epidemic in history. We aimed to investigate and provide unique theoretical insights which could help inform future responses to EVD outbreaks. Methods: After searching five key databases in May 2021 and February 2022  (Medline, Embase, PubMed, Scopus and Cumulative Index of Nursing and Allied Health Literature (CINAHL)), 412 papers were collected. Following abstract and full text screening, 35 papers were identified for inclusion.  Coded data was synthesised in accordance with the protocol set out by Thomas and Hardon. Findings: Regarding geographical context, most fieldwork underpinning included studies was conducted within Western Urban Area in Sierra Leone, suggesting that some geographical discrepancy exists within the literature base. In terms of quality, some issues were identified regarding researcher reflexivity, ethical procedures and data analysis. Following thematic synthesis, it was found that beliefs and/or practices relating to distrust, fear, socio-cultural considerations and denial hindered engagement with control measures. By contrast, experiencing the virus first-hand and engaging with survivors prompted the uptake of such measures. Building from these findings, we then proposed an amendment to Barry Hewlett’s Evolutionary Cultural Anthropology (ECA) framework, shedding light on the determinants of such beliefs and/or practices. Conclusion: Our review provides a systematic mapping of which beliefs and/or practices either promoted or hindered response efforts during the outbreak as well as an authentic and holistic way of understanding why such beliefs and/or practices emerged, by synthesising Hewlett’s ECA framework with our findings. By drawing from our cross contextual analysis, health professionals throughout West Africa and beyond could use this work in further reflecting on and guiding the implementation of control measures prior or during future EVD outbreaks.

Author Biographies

Tony Bell, University of Oxford

Anthony (Tony) Bell is a probationary DPhil student at the University of Oxford (Infections and Acute Care - Nuffield Department of Primary Care Health Sciences). He has a specific interest in matters of applied medical anthropology and global health. Examples include: the overuse of antibiotics in primary care, bio-social understandings and the control of viral hemorrhagic fevers, palliative and end of life care, and the connection between physical activity and mental health. 

Tine Van Bortel , De Montfort University

Professor Tine Van Bortel is a global health researcher with extensive experience in matters of global mental health. She is based both at De Montfort University, Leicester (Faculty of Health and Life Sciences) and the University of Cambridge (Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine).  

Nai Rui Chng , University of Glasgow

Dr Nai Rui Chng is a research associate at the University of Glasgow (Institute of Health and Wellbeing) who specialises in evaluation science. He is interested in ecological framings of infectious disease, specifically relating to neglected tropical diseases like rabies. 

 

Valerie Wells, University of Glasgow

Ms Valerie Wells is an information specialist who is based at the University of Glasgow (MRC/CSO Social and Public Health Sciences Unit).  

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Published

2022-12-15

How to Cite

Bell, A. . J., Van Bortel , T., Chng , N. R., & Wells, V. (2022). Disease Control and Ebola in West Africa: a Qualitative Evidence Synthesis. Global Biosecurity, 4(1). https://doi.org/10.31646/gbio.178

Issue

Vol. 4 (2022)

Section

Reviews

License

Copyright (c) 2022 The Author(s)

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Received 2022-09-22
Accepted 2022-12-05
Published 2022-12-15