BackgroundThe outbreak of the Ebola virus disease (EVD) in West Africa in December 2013 was the largest Ebola outbreak in history. This study aimed to measure the underlying contextual and psychosocial factors of intentions to perform Ebola prevention behaviours (not touching people who might be suffering from Ebola, reporting suspected cases to the National Ebola Hotline, NEH) in Guinea-Bissau. Geographical location, cross-border market activities, poor water, sanitation and hygiene (WASH) conditions, and burial practices in some communities pose a serious risk in terms of potential EVD outbreak and seriously hamper its prevention in Guinea-Bissau.MethodsIn July and August 2015, quantitative data from 1369 respondents were gathered by structured face-to-face interviews. The questionnaire was based on the psychosocial factors of the RANAS (risks, attitudes, norms, abilities, and self-regulation) model. Data were analyzed by multiple linear regression analyses.ResultsThe most important predictors for the intention to call the NEH were believing that calling the Hotline would help the infected person, perceiving that important members from the household approve of calling the Hotline, thinking that calling the Hotline is something they should do, and believing that it is important to call the Hotline to report a suspected case. For the intention not to touch someone who might be suffering from Ebola, the most important predictors were health knowledge, the perception of risk with regard to touching a person who might be suffering from Ebola, and the belief that they were able not to touch a possibly infected person. Age in years was the only significant contextual predictor for one of the two behavioural intentions, the intention to call the Hotline. It seems that younger people are more likely to use a service like the NEH than older people.ConclusionsStrengths and gaps were identified in the study population in relation to the intention to perform prevention behaviours. These call for innovative ways of aligning existing hygiene programs with relevant psychosocial factors. This research is relevant to further outbreaks of contagious diseases as it sheds light on important aspects of the impact of public health interventions during emergencies and epidemics.

With relevance to India and more widely, this review article examines links between fecally transmitted infections (FTIs) and undernutrition, presents a new framework for understanding the relative nutritional significance of FTIs, and draws practical implications for professionalism, professionals and research. In India, despite many efforts and programmes to get more and better food into children, stunting has been obstinately resistant, India remaining with about one-third of the undernourished children in the world. Recent research has found strong correlations between open defecation and stunting. This paper reviews published and emerging evidence to explore these correlations through a focus on FTIs. The nutritional significance of FTIs, and so of water, sanitation and hygiene, has been a professional ‘blind spot’. Among FTIs, the visibility, measurability, relative manageability, and lethal potential of diarrhoeas have diverted attention from more continuous and often subclinical conditions of many other FTIs including environmental enteropathy, other intestinal infections, and parasites. Diarrhoeas are only the visible tip of the FTI iceberg. Access to sanitation in India is sharply skewed against the poor. India's proportion of the world's open defecation has risen to 60%. Safe sanitation and hygienic behaviour have become more vital than ever for reducing stunting more effectively.

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