Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
Glob Health Sci Pract. 2022 Jun 29;10(3). doi: 10.9745/GHSP-D-21-00661.
During the 2018-2020 Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo, risk communication and community engagement (RCCE) were prioritized in geographic areas in Uganda considered at high risk of introduction of EVD. To inform EVD preparedness in Uganda, we evaluated community perceptions and prevention practices related to EVD in 6 districts in Uganda.
In March 2020, we conducted a population-based survey in 6 purposively selected districts in Uganda using multistage cluster sampling. We examined differences between districts classified as high- versus low risk for EVD in terms of their message exposure from RCCE; risk perception; and EVD knowledge, attitudes, and prevention practices.
A total of 3,485 respondents were interviewed (91% response rate). EVD message exposure was more common in the high- versus low-risk districts. EVD risk perceptions were low overall but greater in the high- versus low-risk districts. Comprehensive knowledge was significantly greater in the high- versus low-risk districts (adjusted prevalence ratio [aPR] 1.61, 95% confidence interval [CI]=1.35, 1.93). Respondents' engagement in all 3 EVD prevention practices (frequent handwashing with soap, avoiding physical contact with suspected Ebola patients, and avoiding burials involving contact with a corpse) was very low (4%). However, respondents with comprehensive knowledge were more likely to engage in all 3 EVD prevention practices compared to respondents without comprehensive knowledge (aPR 1.87, 95% CI=1.08, 3.25).
Our findings suggest that while RCCE efforts as part of EVD outbreak preparedness may have contributed to higher EVD knowledge in the targeted high-risk districts, uptake of prevention behaviors was similarly low across districts. In a non-outbreak setting, implementing targeted RCCE strategies may not be sufficient to motivate people to adopt protective behaviors in the absence of a high threshold of perceived threat such as in an active outbreak.
在 2018-2020 年刚果民主共和国埃博拉病毒病（EVD）疫情期间，在乌干达被认为有埃博拉病毒病输入高风险的地理区域，风险沟通和社区参与（RCCE）被作为重点。为了为乌干达的埃博拉病毒病做好准备，我们评估了乌干达 6 个地区与埃博拉病毒病相关的社区认知和预防实践。
2020 年 3 月，我们在乌干达 6 个有针对性选择的地区使用多阶段聚类抽样进行了一项基于人群的调查。我们研究了从 RCCE 中获得的信息曝光、风险认知以及埃博拉病毒病知识、态度和预防实践方面，高风险和低风险地区之间的差异。
共访谈了 3485 名受访者（91%的回应率）。高风险与低风险地区相比，埃博拉病毒病信息曝光更为常见。总体而言，埃博拉病毒病风险认知较低，但高风险地区更高。高风险地区的综合知识显著高于低风险地区（调整后的患病率比[aPR]为 1.61，95%置信区间[CI]为 1.35，1.93）。所有 3 种埃博拉病毒病预防措施（经常用肥皂洗手、避免与疑似埃博拉患者身体接触以及避免涉及与尸体接触的埋葬）的实施率都非常低（4%）。然而，与没有综合知识的受访者相比，具有综合知识的受访者更有可能采取所有 3 种埃博拉病毒病预防措施（aPR 为 1.87，95%CI=1.08，3.25）。
我们的研究结果表明，虽然 RCCE 作为埃博拉病毒病暴发准备工作的一部分，可能会导致高风险地区的埃博拉病毒病知识有所提高，但预防行为的实施率在各地区相似较低。在非暴发环境中，在没有高感知威胁阈值（如活跃暴发）的情况下，实施有针对性的 RCCE 策略可能不足以促使人们采取保护行为。
