Memories of the Ebola Virus Disease Outbreak Affect Decisions Regarding Health Care Service Utilization in Guéckédou District (Epicentre) in Guinea: A Cross-Sectional Study of Children with Febrile Illness

Abstract

Background: The 2013-2015 Ebola Virus Disease (EVD) outbreak in Guinea resulted in community mistrust that influenced health care service utilization. This study aimed to assess whether EVD-related memories affect post-outbreak health-seeking behaviours for children under five years of age with febrile illnesses in Gueckedou district, Guinea. Methods: This cross-sectional study was conducted by interviewing caregivers of children under five years of age in the sub-district most affected by the EVD outbreak (Guendembou) and the least affected sub-district (Bolodou) in Gueckedou district. Memories of the outbreak were referred to as EVDrelated fears in the post-EVD period, which was based on a series of questions regarding current feelings. While the majority of caregivers sought care for their children with febrile illness in both districts, a statistically significantly higher proportion of caregivers in Guendembou sought care, compared to caregivers in Bolodou. Though not statistically significant, caregivers with a fear score above the median and those who reported the death of family members or friends due to EVD were more likely to seek care. Interpretation: This study found that the presence of EVD memories is likely to have a positive influence on health-seeking behaviour in the rural district of Gueckedou. However, the findings call for more efforts to preserve communities' key values and address the psychosocial effects of EVD in rural Guinea. Funding Statement: This study was partially funded by the School of Tropical Medicine and Global Health, Nagasaki University, Japan. The deficit part was paid by the authors. Declaration of Interests: The authors state: None. Ethics Approval Statement: The study protocol was approved by the National Ethical Committee for Health Research of Guinea. It also fulfilled the requirements of the Ethical Review Board of the Institute of Tropical Medicine, Nagasaki University, Japan. Verbal informed consent was obtained for each participant prior to data collection and data were anonymized prior to analysis.