Ebola-Related Knowledge, Attitudes, Intentions, and Self-Reported Behaviors in 6 Districts in Uganda, 2020
| All Districts, % (95% CI) (N=3,485) | Low-Risk Districts, % (95% CI) (N=1,227) | High-Risk Districts, % (95% CI) (N=2,258) | P Valuea | |
|---|---|---|---|---|
| Knowledge of EVD signs/symptomsb,c | ||||
| Vomiting | 51.0 (47.9, 54.1) | 57.6 (52.2, 62.8) | 49.7 (46.1, 53.3) | .02 |
| Diarrhea | 50.4 (45.0, 55.7) | 50.3 (44.7, 55.9) | 50.4 (44.1, 56.7) | .99 |
| Fever | 43.6 (40.3, 46.9) | 30.5 (25.7, 35.7) | 46.1 (42.3, 50.0) | .001 |
| Severe headache | 21.5 (19.5, 23.6) | 22.9 (18.8, 27.7) | 21.2 (19.0, 23.6) | .50 |
| Knowledge of all 4 above signs/symptoms | 4.8 (3.4, 6.7) | 5.0 (3.1, 7.8) | 4.7 (3.2, 7.1) | .87 |
| Knowledge of EVD prevention and treatment | ||||
| Early medical care increases chance of survivalb | 85.4 (83.3, 87.2) | 80.2 (77.2, 82.9) | 86.4 (84.0, 88.5) | .001 |
| Early medical care reduces household transmissionb | 82.2 (79.3, 84.9) | 78.5 (75.2, 81.6) | 83.0 (79.4, 86.0) | .06 |
| EVD prevention by avoiding contact with infected corpsesb | 76.8 (74.0, 79.4) | 68.7 (63.1, 73.8) | 78.4 (75.2, 81.3) | .001 |
| Knowledge of all 3 EVD knowledge measuresb | 63.0 (60.1, 65.8) | 54.7 (49.2, 60.1) | 64.7 (61.4, 67.8) | .002 |
| Misconceptions of EVD | ||||
| EVD is transmissible by airb | 22.2 (19.6, 25.0) | 42.6 (35.8, 49.8) | 18.1 (15.4, 21.2) | <.001 |
| Spiritual healers can successfully treat EVDb | 9.7 (7.9, 11.8) | 7.7 (5.5, 10.7) | 10.1 (8.0, 12.6) | .18 |
| Traditional healers can successfully treat EVDb | 2.9 (2.3, 3.7) | 4.7 (3.0, 7.5) | 2.6 (2.0, 3.4) | .03 |
| Rejection of all 3 EVD misconception measures | 70.4 (67.6, 73.0) | 56.6 (51.0, 62.0) | 73.1 (69.9, 76.0) | <.001 |
| Comprehensive knowledged | 45.4 (41.8, 49.2) | 32.1 (26.2, 38.7) | 48.1 (43.8, 52.3) | .001 |
| Attitudes toward EVD survivors | ||||
| Would welcome back survivor into the communityb | 61.8 (58.4, 65.2) | 57.3 (52.2, 62.3) | 62.8 (58.8, 66.6) | .09 |
| Ebola survivor student does not put class at risk of EVDb | 56.4 (52.0, 60.6) | 46.8 (42.5, 51.3) | 58.3 (53.1, 63.2) | .001 |
| Would buy fresh vegetables from survivor shopkeeperb | 47.3 (43.8, 50.9) | 50.0 (45.2, 54.9) | 46.8 (42.6, 51.0) | .31 |
| Attitudes toward safe burial practices | ||||
| Accept safe alternatives to traditional burial rituals | 80.6 (77.1, 83.6) | 82.9 (78.2, 86.7) | 80.1 (76.1, 83.6) | .34 |
| Intention if family member is suspected of EVDb,c | ||||
| Take the family member to a health facility | 52.4 (46.3, 58.5) | 64.5 (58.2, 70.3) | 50.0 (42.9, 57.2) | .003 |
| Report to district health authorities | 43.3 (38.8, 48.0) | 39.2 (35.3, 43.3) | 44.2 (38.8, 49.6) | .15 |
| Avoid all physical contact | 10.3 (7.8, 13.6) | 8.0 (5.9, 10.8) | 10.8 (7.8, 14.8) | .18 |
| Do nothing | 5.2 (3.8, 6.9) | 9.6 (6.9, 13.2) | 4.3 (2.9, 6.4) | .002 |
| Help care for the family member at home | 2.6 (1.7,4.0) | 5.1 (3.4, 7.6) | 2.1 (1.1, 3.9) | .02 |
| Hide the EVD suspected family member | <0.1 (<0.1, 0.1) | 0.1 (<0.1, 0.5) | <0.1 (<0.1, 0.1) | .07 |
| Self-reported participation in recent funeral or burial | ||||
| Self-reported participation in a funeral/burial in past month | 39.3 (35.7, 43.0) | 41.3 (35.7, 47.1) | 38.9 (34.8, 43.2) | .51 |
| Religious leader prayed for the deceasedc,e | 84.9 (78.7, 89.5) | 90.5 (86.7, 93.4) | 83.8 (76.3, 89.2) | .05 |
| Family members observed burial from a distancec,e | 6.2 (3.8, 9.9) | 10.0 (6.0, 16.2) | 5.4 (2.9, 10.0 | .13 |
| Attendees performed rituals involving contact with corpsed,f | 25.5 (17.4, 35.8) | 18.5 (13.0, 25.7) | 26.9 (17.3, 39.1) | .18 |
| Attendees touched each other (e.g., hugs and handshakes)c,e | 50.8 (42.7, 58.8) | 61.2 (54.3, 67.7) | 48.7 (39.2, 58.3) | .04 |
| Respondent had physical contact with the corpsee | 11.1 (8.4, 14.7) | 10.1 (7.2, 14.0) | 11.3 (8.1, 15.6) | .63 |
| Self-reported EVD prevention practicesc,f | ||||
| Self-reported any Ebola prevention practice | 67.3 (63.3, 71.1) | 72.4 (64.3, 79.2) | 66.3 (61.7, 70.6) | .18 |
| Wash hands with soap and water more frequently | 57.1 (52.0, 62.0) | 57.2 (46.1, 67.6) | 57.0 (51.3, 62.5) | .98 |
| Avoid physical contact with suspected Ebola patients | 22.9 (19.3, 26.8) | 26.7 (20.0, 34.7) | 22.1 (18.2, 26.6) | .28 |
| Avoid burials that involve contact with a corpse | 13.3 (10.1, 17.2) | 12.6 (8.7, 17.0) | 13.4 (9.8, 18.1) | .80 |
| Reported all 3 prevention practices | 4.0 (2.0, 7.8) | 2.5 (1.1, 6.0) | 4.3 (2.0, 9.0) | .37 |
Abbreviation: CI, confidence interval; EVD, Ebola virus disease.
↵a Design-based F-statistic P values; comparing high-risk versus low-risk districts. P<.05 is significant and P≥.05 is not significant (at 5% level).
↵b Missing values: Knowledge of EVD prevention and treatment (n=66, 2%); knowledge of EVD signs/symptoms (n=792, 23%); traditional healers can successfully treat EVD (n=66, 2%); spiritual healers can successfully treat EVD (n=66, 2%); EVD is transmissible by air (n=518, 15%); comprehensive knowledge (n=523, 15%). Would welcome back EVD survivor into the community (n=79, 2%); would buy fresh vegetables from EVD survivor. shopkeeper (n=91, 3%), Ebola survivor student does not put class at risk of EVD (n=92, 3%); would avoid touching or washing the corpse of a family member (n=48, 1%); intended practice if family member is suspected of EVD (n=627, 18%); participated in a funeral/burial in past month (n=30, <1%); features of the funeral/burial ceremony (n=64, 4%); respondents had physical contact with corpse at the funeral/burial (n=33, 2%).
↵c Multiple response questions: Only the key items presented here. Detailed responses are presented in Supplement 2.
↵d Comprehensive knowledge is defined as composite of knowledge of all 3 EVD knowledge measures and rejection of all 3 EVD misconception measures.
↵e Denominator is number of respondents who reported to have participated in a funeral/burial in past month.
↵f Denominator is number of respondents who reported that they took action to avoid getting EVD.