RAPID: Cultural Dimensions of Ebola Virus Transmission in Guinea, West Africa

从历史上看，埃博拉病毒在人群中的爆发与接触受感染的野生动物有关，通常仅限于东非的偏远农村地区。 相比之下，2013年12月开始的西非埃博拉病毒疫情已经演变成一场更复杂、更大规模和多国的流行病。此外，国际旅行和医疗救援工作也给美国和欧洲带来了一些埃博拉病毒感染病例。过去，社会科学家发现，要想有效，疾病控制工作必须以了解当地文化信仰为基础，因为这些信仰是土著医疗实践的基础，并影响对公共卫生教育信息的理解。鉴于这些早期的发现，最近埃博拉病毒病的传播表明，需要更多地关注疾病传播的社会和文化层面。该奖项资助的研究响应了这一需求。研究结果将为当前的健康教育工作提供重要的实用信息，有助于改进疾病传播理论，并帮助美国为未来的全球传染病流行做好准备。通过疾病因果关系理论的文化维度，这项研究将文化人类学，生物医学人类学和流行病爆发应对实践与西方医学联系起来。 乔治城大学的Sally Lahm博士和Amira Roess博士将在几内亚的72个选定社区调查和采访居民和卫生保健工作者的样本。拉姆博士之前的研究，在非洲另一个地区的四次埃博拉病毒流行期间，发现紧急公共卫生教育和社会动员工作的有效性部分取决于当地的疾病病因理论，社会经济和政治因素，传统的生存和觅食实践，以及宗教。研究人员将测试这一理论，即几内亚也是如此，这可能是目前流行病持续存在的部分原因。研究结果将有助于科学家寻求整合疾病传播的文化和生物医学疾病模型。国际研究小组将收集有关健康教育和社会动员活动、埃博拉病毒知识、医疗实践、通信和交通系统以及寻求医疗保健行为的数据。此外，该项目还将提供初步数据，说明从几内亚几个地区族裔群体的角度来看疾病、患病经历和健康的不同含义;性别对这些观念的影响;以及当地人如何理解埃博拉病毒作为一种现象。由于区域文化的连续性，研究结果将适用于几内亚以外已知发生埃博拉病毒和其他人畜共患传染病的地区。为了最大限度地扩大影响，项目研究将支持开发一个关于研究村庄埃博拉应对情况的在线开放源地图;开发一个关于使用人类学理论设计健康教育运动并纳入非洲和其他地方中小学课堂的教学模块;并提供政策建议，通过整合西非的人类学研究，将政府、非政府组织、国际和国内行为者。该提案是针对NSF 15 - 006关于埃博拉病毒的亲爱的同事信（DCL）提交的。

Historically, outbreaks of Ebola Virus in human populations have been linked to exposure to infected wildlife and generally limited to isolated rural areas in East Africa. In contrast, the current Ebola Virus outbreak in West Africa, which began in December 2013, has evolved into a more complex, larger, and multi-country epidemic. Furthermore, international travel and medical relief efforts have brought a few cases of Ebola Virus infection to both the United States and Europe. In the past, social scientists have found that to be effective, disease control efforts must be grounded in understanding local cultural beliefs because they underlie indigenous medical practice and influence comprehension of public health education messages. Given these earlier findings, the recent spread of Ebola Virus disease suggests the need for more attention to the social and cultural dimensions of disease transmission. The research funded by this award responds to this need. Results will provide critical practical information for current health education efforts, contribute to improved disease transmission theory, and also help the United States prepare for future global epidemics of infectious diseases. Informed by Cultural Dimensions of Disease Causation Theory, this research bridges cultural anthropology, biomedical anthropology, and epidemiological outbreak response practices aligned with Western medicine. Dr. Sally Lahm and Dr. Amira Roess, both of Georgetown University, will survey and interview a sample of residents and health care workers in 72 selected communities throughout Guinea, the origin country of the current epidemic. Dr. Lahm's previous research, during four Ebola Virus epidemics in another part of Africa, found that the effectiveness of emergency public health education and social mobilization efforts was determined in part by local theories of disease causation, socioeconomic and political factors, traditional subsistence and foraging practices, and religion. The researchers will test the theory that the same is true in Guinea and may account in part for the persistence of the current epidemic. Findings will help scientists who seek to integrate cultural and bio-medical disease models of disease transmission. The international research team will collect data on health education and social mobilization activities, Ebola Virus knowledge, medical practices, communication and transport systems, and health care seeking behavior. In addition, the project will provide preliminary data on the distinct meanings of disease, illness experience, and health from the viewpoint of several regional ethnic groups in Guinea; the effects of gender on these perceptions; and how local people understand Ebola as a phenomenon. Because of regional cultural continuities, results will apply to areas beyond Guinea where Ebola virus and other zoonotic infectious diseases are known to occur. To maximize broader impacts, the project research will support the development of an online, open-source map of Ebola response in study villages; the development of a teaching module on the use of anthropological theory for designing health education campaigns and for integration into primary and secondary school classrooms in Africa and elsewhere; and the provision of policy recommendations to improve public health education campaigns through integration of anthropological research in West Africa, connecting government, non-governmental, international and domestic actors.This proposal was submitted in response to the NSF 15-006 Dear Colleague Letter (DCL) on the Ebola Virus.