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. 2024 Dec;14(4):1518-1524.
doi: 10.1007/s44197-024-00302-9. Epub 2024 Oct 9.

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

Helen Nelly Naiga  1 , Jane Frances Zalwango  2 , Brian Agaba  2 , Saudah N Kizito  2 , Brenda N Simbwa  2 , Maria Goretti Zalwango  2 , Rebecca Akunzirwe  2 , Zainah Kabami  2 , Peter Chris Kawugenzi  2 , Robert Zavuga  2 , Mackline Ninsiima  2 , Patrick King  2 , Mercy Wendy Wanyana  2 , Thomas Kiggundu  2 , Richard Migisha  2 , Doreen Gonahasa  2 , Irene Kyamwine  2 , Benon Kwesiga  2 , Daniel Kadobera  2 , Lilian Bulage  2 , Alex Ario Riolexus  2 , Sarah B Paige  3 , Julie R Harris  2   4
Affiliations

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

Helen Nelly Naiga et al. J Epidemiol Glob Health. 2024 Dec.

Abstract

Background: On September 20, 2022, Uganda declared an Sudan Virus Disease (SVD) outbreak in Mubende District. Another eight districts were infected September-November 2022. We examined how Ugandan community beliefs and practices spread Sudan Ebola Virus (SUDV) in 2022.

Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. Nine focus group discussions and six key informant interviews were held. We investigated whether community beliefs and practices contributed to spreading Sudan Ebola Virus (SUDV). Interviews were recorded, translated, transcribed, and thematically analyzed.

Results: The community deaths, later found to be due to Sudan Virus Disease(SVD), were often attributed to witchcraft or poisoning. Key informants reported that SVD patients often sought traditional healers or spiritual leaders before or after formal healthcare failed. They also found that traditional healers treated SVD patients without precautions. Religious leaders praying for SVD patients and their symptomatic contacts, SVD patients hiding in friends' homes, and exhuming SVD patients from safe and dignified burials to allow traditional burials were other themes.

Conclusion: Diversity in community beliefs and culture likely contributed to spreading the 2022 Ugandan SVD outbreak. Public health systems, traditional healers, and religious leaders can help Uganda control ebolavirus outbreaks by identifying socially acceptable and scientifically supported infection control methods.

Keywords: Beliefs; Ebola; Outbreak; Practices; Sudan virus; Traditional healers; Uganda.

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Conflict of interest statement

Declarations. Ethics Approval and Consent to Participate: The Ministry of Health of Uganda gave the directive and approval to carry out this investigation. Further approval to conduct this study was obtained from Mubende and Kassanda District offices, Mubende Regional Referral Hospital case management team, the National Institute of Public Health and Uganda Ministry of Health. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.§. §See e.g., 45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. §241(d); 5 U.S.C. §552a; 44 U.S.C. §3501 et seq. “Sarah Paige was employed by USAID when the research for the current paper was conducted. The views and opinions expressed in this paper are those of the authors and not necessarily the views and opinions of the United States Agency for International Development." Copyright and Licensing: All materials in the Uganda National Institute of Public Health Quarterly Epidemiological Bulletin is in the public domain and may be used and reprinted without permission; citation as to source; however, is appreciated. Any article can be re-printed or published. It should be referenced in the original form if cited as a reprint. Consent for Publication: Not applicable. Competing Interests: The authors declare no competing interests.

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