Karafillakis Emilie, Jalloh Mohamed F, Nuriddin Azizeh, Larson Heidi J, Whitworth Jimmy, Lees Shelley, Hageman Kathy M, Sengeh Paul, Jalloh Mohammad B, Bunnell Rebecca, Carroll Dianna D, Morgan Oliver
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
FOCUS 1000, Freetown, Sierra Leone.
BMJ Glob Health. 2016 Nov 18;1(3):e000108. doi: 10.1136/bmjgh-2016-000108. eCollection 2016.
In Sierra Leone, over 4000 individuals survived Ebola since the outbreak began in 2014. Because Ebola survivorship was largely unprecedented prior to this outbreak, little is known about survivor experiences during and post illness.
To assess survivors' experiences and attitudes related to Ebola, 28 in-depth interviews and short quantitative surveys with survivors from all four geographic regions of Sierra Leone were conducted in May 2015.
Survivor experiences, emotions and attitudes changed over time as they moved from disease onset to treatment, discharge and life post-discharge. Survivors mentioned experiencing acute fear and depression when they fell ill. Only half reported positive experiences in holding centres but nearly all were positive about their treatment centre experiences. Survivor euphoria on discharge was followed by concerns about their financial situation and future. While all reported supportive attitudes from family members, about a third described discrimination and stigma from their communities. Over a third became unemployed, especially those previously engaged in petty trade. Survivor knowledge about sexual transmission risk reflected counselling messages. Many expressed altruistic motivations for abstinence or condom use. In addition, survivors were strongly motivated to help end Ebola and to improve the healthcare system. Key recommendations from survivors included improved counselling in holding centres and long-term government support for survivors, including opportunities for participation in Ebola response efforts.
Survivors face myriad economic, social and health challenges. Addressing survivor concerns, including the discrimination they face, could facilitate their reintegration into communities and their contributions to future Ebola responses.
自2014年埃博拉疫情爆发以来，在塞拉利昂有4000多人从埃博拉病毒感染中幸存下来。由于在此次疫情爆发之前，埃博拉幸存者的情况在很大程度上是前所未有的，因此对于幸存者在患病期间及康复后的经历知之甚少。
为了评估幸存者与埃博拉相关的经历和态度，2015年5月对来自塞拉利昂所有四个地理区域的幸存者进行了28次深入访谈和简短的定量调查。
随着幸存者从疾病发作到接受治疗、出院以及出院后的生活，他们的经历、情绪和态度随时间发生了变化。幸存者提到患病时经历了极度恐惧和抑郁。只有一半的人报告在隔离中心有积极的经历，但几乎所有人对他们在治疗中心的经历都持积极态度。幸存者出院时的欣喜之后是对其财务状况和未来的担忧。虽然所有人都报告了家庭成员的支持态度，但约三分之一的人描述了来自社区的歧视和污名。超过三分之一的人失业，尤其是那些以前从事小买卖的人。幸存者关于性传播风险的知识反映了咨询信息。许多人表达了禁欲或使用避孕套的利他动机。此外，幸存者强烈希望帮助终结埃博拉疫情并改善医疗保健系统。幸存者提出的主要建议包括在隔离中心加强咨询服务，以及政府为幸存者提供长期支持，包括参与埃博拉应对工作的机会。
幸存者面临着无数的经济、社会和健康挑战。解决幸存者所关切的问题，包括他们所面临的歧视，有助于他们重新融入社区，并为未来的埃博拉应对工作做出贡献。
