Abstract
Introduction: The current Ebola outbreak represents the largest in history. Understanding psychologicalreactions among EVD survivors may provide relevant information about post-treatment adjustment and possible psychological preventative measures. We therefore studied the psychological reactions in Ebola Virus Disease survivors following their discharge from an Ebola treatment centre in Sierra Leone. Methods: Immediately following discharge, survivors met with the psychologist to discuss their experiences in the case management centre and the challenges they may face returning to their communities. Of 74 survivors discharged in the study period, 24 were followed up at home for a psychological consultation three to four weeks after discharge. During the home visit the psychologist applied an adaptation of the trauma screening questionnaire and explored number of family deaths from Ebola Virus Disease, stigma, the meaning they attached to the causation of their illness and general post illness adjustment. Results: All survivors had lost immediate family members to Ebola Virus Disease. Most (16; 67%) had also witnessed their deaths. Eight (32%) survivors had experienced stigma when returning to their communities. Seventeen (71%) survivors experienced arousal and re-experiencing reactions during the first two days post discharge. Five (21%) reported clinically important post traumatic reactions between three and four weeks post discharge predicting a risk of developing post-traumatic stress disorder. Conclusion: Although this study represents a snapshot of post-traumatic stress reactions observed in Ebola survivors, it does demonstrate the need to consider the likelihood of psychological sequelae in EVD survivors. Long term follow-up of is needed to understand psychological care needs of Ebola survivors.
Highlights
The current Ebola outbreak represents the largest in history
Survivors were defined as those patients admitted to the Medecins Sans Frontieres (MSF) case management centre (CMC) who was confirmed positive for Ebola virus by polymerase chain reaction (PCR), recovered from the disease, and were discharged with a negative PCR result
Understanding psychological reactions that are characteristic of Ebola Virus Disease (EVD) survivors may provide relevant information about post-treatment adjustment and possible psychological preventative measures
Summary
The current Ebola outbreak represents the largest in history. Understanding psychological reactions among EVD survivors may provide relevant information about post-treatment adjustment and possible psychological preventative measures. This Ebola Virus Disease (EVD) epidemic represents the largest in history [1]. EVD survivors are significant in number and their illness experience is potentially traumatizing [3] They have faced a life threatening event, been exposed to death and extreme suffering and most have witnessed the death of family members, other community members, and patients admitted in the CMC. Most survivors regard discharge as a time for celebration and relief, but it can be a time when they begin to process distressing memories of their inpatient experience They are confronted by the realities of lost loved ones and may face discrimination and stigmatization on returning to their communities. There is increasing evidence supporting the cross-cultural validity of trauma related diagnostic psychological disorders and post-traumatic reactions can be ameliorated, if not prevented [5]
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