Lessons from the West Africa Ebola Epidemic: A Systematic Review of Epidemiological and Social and Behavioral Science Research Priorities

Abstract

This systematic literature review compared the epidemiological (EPI) research and the qualitative social and behavioral science (SBS) research published during the West Africa Ebola virus disease (EVD) epidemic. Beginning with an initial capture of over 2000 articles, we extracted 236 EPI and 171 SBS studies to examine how disciplinary priorities affected research conducted during the EVD response, with implications for epidemic response effectiveness. Building on this research, we set forth a roadmap for the closer integration of EPI and SBS research in all aspects of epidemic preparedness and response that incorporates the lessons of the West Africa EVD outbreak. Key priorities include the following: (1) developing the capacity to systematically quantify qualitative sociocultural variables; (2) establishing interdisciplinary collaborations to improve "risk segmentation" practices; (3) creating and prepositioning qualitative indicators and composite sociocultural indexes for rapid deployment in outbreaks; (4) integrating novel systems with community resources; (5) developing new techniques for modeling social mobilization and community engagement; (6) prioritizing good data and complex analyses early in emergencies; and (7) learning from past experiences. Our findings support a program of action that situates data collection and analysis in real-time, recursive, integrated efforts to move community attitudes, behaviors, and responses into epidemiological research. We offer recommendations to improve coordinated, multidisciplinary approaches to health emergencies.

Perceptions of postoutbreak management by management and healthcare workers of a Middle East respiratory syndrome outbreak in a tertiary care hospital: a qualitative study

“…Open access reflected our data and, as studies and systematic reviews indicate concur with other accounts of major outbreaks such as ebola. [31][32][33] As such, our findings reiterate the imperative of addressing these transcending aspects across different types of infection outbreaks.…”

“…This research documented learning from an unusual, burdensome and serious infection outbreak and used methods recognised to be well suited to explore the complexities of outbreaks. 31 32 Similar to other 'rapid' qualitative accounts of major outbreaks with high mortality notably ebola, 31 this study addresses key interdisciplinary aspects of perceived outbreak causes, infrastructure, IC, facilities and health needs. 32 Unlike this previous work, the rigour of this study was increased via comprehensive details of the sample, participants and context.…”

Social resistance drives persistent transmission of Ebola virus disease in Eastern Democratic Republic of Congo: A mixed-methods study

“…Rather than build local capacity, the emphasis was on emergency containment, which ultimately became counter-productive as communities resisted the “top-down” control effort. Finally, real-time data collection, capturing emergent, on-the-ground, local barriers and facilitators [22] should be used to integrate community attitudes, behaviors, and responses into epidemiological research [41]. Our mixed-method study is a model that could be followed in future epidemics to complement biomedical approaches toward an effective outbreak response.…”

The Unlikely Saviour: Portugal’s National Health System and the Initial Impact of the COVID-19 Pandemic?

“…The same applies to COVID-19. In the Ebola case, the timely and close collaboration between anthropological science and the institutions on the ground generated better understanding and trustful liaisons between international health organizations and communities, thus contributing to a shortening of the epidemic (Abramowitz et al 2018a). Trust is a voluntary relational notion that links different individuals and/or institutions and it involves vulnerability and risk.…”