Evidence of behaviour change during an Ebola virus disease outbreak, Sierra Leone

Jalloh, Mohamed F.; Sengeh, Paul; Bunnell, Rebecca; Jalloh, Mohammad B; Monasch, Roeland; Li, Wenshu; Mermin, Jonathan; DeLuca, Nickolas; Brown, Vance; Nur, Sophia A; August, Euna M.; Ransom, Ray; Namageyo-Funa, Apophia; Clements, Sara A; Dyson, Meredith; Hageman, Kathy; Pratt, Samuel Abu; Nuriddin, Azizeh; Carroll, Dianna D.; Hawk, Nicole M; Manning, Craig; Hersey, Sara; Marston, Barbara J.; Kilmarx, Peter H.; Conteh, Lansana; Ekström, Anna Mia; Zeebari, Zangin; Redd, John T.; Nordenstedt, Helena; Morgan, Oliver

doi:10.2471/blt.19.245803

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…The influence of human behaviour on infection transmission has been documented in other public health emergencies prior to the COVID-19 pandemic. [12][13][14][15][16][17] The public's voluntary change in avoidance behaviour (eg, spending more time at home) during the 2009 influenza A/H1N1 epidemic in the USA has been measured by combining data on how people spent their time with epidemiological data that accounted for the potential confounding effect of extreme weather conditions. 12 The findings indicate that voluntary adoption of avoidance behaviours contributed substantially to reducing the attack rate.…”

Section: Behavioural Impact On Infection Transmissionmentioning

confidence: 99%

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

Jalloh

Nur

et al. 2021

BMJ Glob Health

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Human behaviour will continue to play an important role as the world grapples with public health threats. In this paper, we draw from the emerging evidence on behaviour adoption during diverse public health emergencies to develop a framework that contextualises behaviour adoption vis-à-vis a combination of top-down, intermediary and bottom-up approaches. Using the COVID-19 pandemic as a case study, we operationalise the contextual framework to demonstrate how these three approaches differ in terms of their implementation, underlying drivers of action, enforcement, reach and uptake. We illustrate how blended strategies that include all three approaches can help accelerate and sustain protective behaviours that will remain important even when safe and effective vaccines become more widely available. As the world grapples with the COVID-19 pandemic and prepares to respond to (re)emerging public health threats, our contextual framework can inform the design, implementation, tracking and evaluation of comprehensive public health and social measures during health emergencies.

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Section: Behavioural Impact On Infection Transmissionmentioning

confidence: 99%

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

Jalloh

Nur

et al. 2021

BMJ Glob Health

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“…Enforcing radical changes in burial practice during plague outbreak in the early twentieth century in Madagascar was also met with mistrust and confrontation with the colonial authorities which led to hiding of the sick and the dead relatives [ 96 ]. On the other hand, education and community engagement have been demonstrated to change behavioral practice including safe and dignified burial of Ebola victims [ 97 ]. Similar community level cooperation including bans in Northern Kenya on animal slaughter around the time of Eid al-Adha was instrumental in decreasing RVF mortality in Kenya [ 98 ].…”

Section: Discussionmentioning

confidence: 99%

A Review of Infectious Diseases Associated with Religious and Nonreligious Rituals

Gajurel

Deresinski

2021

Interdisciplinary Perspectives on Infectious Diseases

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Rituals are an integral part of human life but a wide range of rituals (both religious and non-religious), from self-flagellation to blood brotherhood to ritual sprinkling of holy water, have been associated with transmission of infections. These infections include angiostrongyliasis, anthrax, brucellosis, cholera, COVID-19, cutaneous larva migrans, Ebola, hepatitis viruses, herpes simplex virus, HIV, human T-cell leukemia virus (HTLV), kuru, Mycobacterium bovis, Naegleria fowleri meningoencephalitis, orf, rift valley fever, and sporotrichosis. Education and community engagement are important cornerstones in mitigating infectious risks associated with rituals.

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“…Analysis of population-based trends in Sierra Leone show a sixfold increase in intention to wait for safe burial teams and twofold increase in self-reported avoidance of unsafe burials in high transmission regions when comparing before and after the peak of the outbreak. 32 …”

Section: Lessons Learntmentioning

confidence: 99%

Community engagement in outbreak response: lessons from the 2014–2016 Ebola outbreak in Sierra Leone

Bedson¹,

Jalloh

Pedi

et al. 2020

BMJ Glob Health

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Documentation of structured community engagement initiatives and real-time monitoring of community engagement activities during large-scale epidemics is limited. To inform such initiatives, this paper analyses the Community Led Ebola Action (CLEA) approach implemented through the Social Mobilization Action Consortium (SMAC) during the 2014–2016 Ebola epidemic in Sierra Leone. The SMAC initiative consisted of a network of 2466 community mobilisers, >6000 religious leaders and 42 local radio stations across all 14 districts of Sierra Leone. Community mobilisers were active in nearly 70% of all communities across the country using the CLEA approach to facilitate community analysis, trigger collective action planning and maintain community action plans over time. CLEA was complemented by interactive radio programming and intensified religious leader engagement.Community mobilisers trained in the CLEA approach used participatory methods, comprised of an initial community ‘triggering’ event, action plan development and weekly follow-ups to monitor progress on identified action items. Mobilisers collected operational and behavioural data on a weekly basis as part of CLEA. We conducted a retrospective analysis of >50 000 weekly reports from approximately 12 000 communities from December 2014 to September 2015. The data showed that 100% of the communities that were engaged had one or more action plans in place. Out of the 63 110 cumulative action points monitored by community mobilisers, 92% were marked as ‘in-progress’ (85%) or ‘achieved’ (7%) within 9 months. A qualitative examination of action points revealed that the in-progress status was indicative of the long-term sustainability of most action points (eg, continuous monitoring of visitors into the community) versus one-off action items that were marked as achieved (eg, initial installation of handwashing station). Analysis of behavioural outcomes of the intervention indicate an increase over time in the fraction of reported safe burials and fraction of reported cases referred for medical care within 24 hours of symptom onset in the communities that were engaged.Through CLEA, we have demonstrated how large-scale, coordinated community engagement interventions can be achieved and monitored in real-time during future Ebola epidemics and other similar epidemics. The SMAC initiative provides a practical model for the design, implementation and monitoring of community engagement, integration and coordination of community engagement interventions with other health emergency response pillars, and adaptive strategies for large-scale community-based operational data collection.

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Evidence of behaviour change during an Ebola virus disease outbreak, Sierra Leone

Cited by 11 publications

References 22 publications

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

A Review of Infectious Diseases Associated with Religious and Nonreligious Rituals

Community engagement in outbreak response: lessons from the 2014–2016 Ebola outbreak in Sierra Leone

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