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塞拉利昂农村地区埃博拉病毒病的社会传播途径及其对疫情控制的一些启示

Social pathways for Ebola virus disease in rural Sierra Leone, and some implications for containment.

作者信息

Richards Paul, Amara Joseph, Ferme Mariane C, Kamara Prince, Mokuwa Esther, Sheriff Amara Idara, Suluku Roland, Voors Maarten

机构信息

School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.

Anthropology Department, University of California, Berkeley, Berkeley, California, United States of America.

出版信息

PLoS Negl Trop Dis. 2015 Apr 17;9(4):e0003567. doi: 10.1371/journal.pntd.0003567. eCollection 2015 Apr.

Abstract

The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact. Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed. The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic-the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure. Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties. A concluding discussion relates the information presented to plans for halting the disease. Local consultation and access are seen as major challenges to be addressed.

摘要

当前在西非上西部地区爆发的埃博拉病毒病疫情是有记录以来规模最大的一次。分子证据表明,疫情传播几乎完全是通过人际接触实现的。因此,社会因素对于理解此次疫情以及阻止疫情蔓延的方式显然至关重要,但到目前为止,这些因素几乎未得到分析。本文聚焦于塞拉利昂,提供了关于疫情中最不为人所知部分的横断面数据,即埃博拉病毒在农村地区大量未被记录的传播情况。文中描述了农村社区的各种社交网络形式及其对于理解传播途径的相关性。特别关注婚姻、葬礼和土地保有权之间的关系。葬礼已知是感染的高风险因素。研究表明,要改变当地的行为模式,尤其是与葬礼相关的行为模式,仅靠提高风险意识是不够的,因为葬礼对于巩固社区关系至关重要。最后的讨论将所呈现的信息与阻止该疾病传播的计划联系起来。当地的咨询和参与被视为需要应对的主要挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0029/4401769/d8c580ba3f6c/pntd.0003567.g001.jpg

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