The 2014-2016 Ebola Epidemic in West Africa. How did cultural factors contribute to an escalation of the outbreak?

Abstract

Background The 2014-2016 Ebola epidemic is the biggest known outbreak since 1976. The transmission from a bush animal to one human eventually caused 28 652 cases and 11 325 deaths. It is necessary to investigate how one case could cause that many infected people and deaths, and this study aims to identify the most important cultural factors that contributed to these high numbers.

Method This thesis is a literature review, mainly based on studies conducted during or after the 2014-2016 Ebola epidemic in West Africa. The articles were found using PubMed and using the references of these articles for further reviews. All articles somehow highlight cultural aspects of the 2014-2016 epidemic, except for two articles. The results of these articles have been compared and seen in a cultural context.

Results Burials and funeral rituals has had an impact on the transmission of EVD, and it is estimated that without SDBs there would have been 1 411 to 10 452 cases more. People who had contact with an infected person both before and after death had a 2,63-5,97 times higher chance of being infected, compared to those who only had contact after death. Survivors mentioned that messages conflicting with their culture were difficult to follow. Fear and stigma played a part in making people avoid healthcare facilities.

Conclusion Cultural factors such as burials and funeral rituals, caregiving, fear and stigmatization and communication conflicts have definitely had an effect on the transmission of EVD. To prevent this in a potential new outbreak, it will be important to understand the cultural context of the epidemic, and intervene thereafter.