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Psychological distress among adults from the urban and rural areas affected by the Ebola virus disease in the Democratic Republic of the Congo

Social Psychiatry and Psychiatric Epidemiology volume 56, pages 57–62 (2021)Cite this article

Abstract

Purpose

Ebola virus disease (EVD) is associated with high anxiety and multiple bereavement that can induce severe psychological distress (SPD) in individuals living in affected communities. Using data from the EVD and Mental Health project (EboMH), this study assessed the prevalence and determinants of SPD symptoms in a representative sample of adults in communities affected by EVD.

Methods

A representative sample of 1614 adults (50% women) aged 18–85 years completed measures assessing exposure level to EVD, stigmatization related to EVD, and psychological distress.

Results

In total, 45.58% of individuals from the cities and villages affected by EVD reported SPD. Results showed significant differences for residence area, employment, age, education level, and religion, but not for gender. Exposure level to EVD (β = 0.11, p < 0.001; OR = 1.12, 95% CI [1.08–1.16]), stigmatization related to EVD (β = 0.06, p < 0.001; OR = 1.06, 95% CI [1.05–1.07]), and living in rural areas (β = 0.67, p < 0.001; OR = .51, 95% CI [.36–.72]) predicted SPD symptoms.

Conclusions

Evidence-based global mental health programs in high-risk mortality epidemic contexts should take into account the high psychological distress in the affected areas.

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References

  1. Centers for Disease Control and Prevention (2016) 2014 Ebola Outbreak in West Africa Epidemic Curves Error processing SSI file

  2. Etard J-F, Sow MS, Leroy S et al (2017) Multidisciplinary assessment of post-Ebola sequelae in Guinea (Postebogui): an observational cohort study. Lancet Infect Dis 17:545–552. https://doi.org/10.1016/S1473-3099(16)30516-3

    Article  PubMed  Google Scholar 

  3. World Health Organization (2016) Ebola virus disease. Situation Report 10 June 2016. Geneva

  4. DR Congo Ministry of Health, WHO-Africa (2019) Ebola in DR Congo North-Kivu 2019 Surveillance Dashboard. https://who.maps.arcgis.com/apps/opsdashboard/index.html#/e70c3804f6044652bc37cce7d8fcef6c. Accessed 18 May 2020

  5. Keita MM, Taverne B, Sy Savané S et al (2017) Depressive symptoms among survivors of Ebola virus disease in Conakry (Guinea): preliminary results of the PostEboGui cohort. BMC Psychiatry 17:127. https://doi.org/10.1186/s12888-017-1280-8

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lötsch F, Schnyder J, Goorhuis A, Grobusch MP (2017) Neuropsychological long-term sequelae of Ebola virus disease survivors—a systematic review. Travel Med Infect, Dis

    Book  Google Scholar 

  7. James PB, Wardle J, Steel A, Adams J (2019) Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review. Trop Med Int Heal 24:671–691. https://doi.org/10.1111/tmi.13226

    CAS  Article  Google Scholar 

  8. Lehmann M, Bruenahl CA, Löwe B et al (2015) Ebola and psychological stress of health care professionals. Emerg Infect Dis 21:913–914. https://doi.org/10.3201/eid2105.141988

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  9. Jagadesh S, Sevalie S, Fatoma R et al (2018) Disability among Ebola survivors and their close contacts in Sierra Leone: a retrospective case-controlled cohort study. Clin Infect Dis 66:131–133. https://doi.org/10.1093/cid/cix705

    Article  PubMed  Google Scholar 

  10. Waterman S, Hunter ECM, Cole CL et al (2018) Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone. Int J Soc Psychiatry. https://doi.org/10.1177/0020764017752021

    Article  PubMed  Google Scholar 

  11. Howlett PJ, Walder AR, Lisk DR et al (2018) Case series of severe neurologic sequelae of Ebola Virus disease during epidemic, Sierra Leone. Emerg Infect Dis 24:1412–1421. https://doi.org/10.3201/eid2408.171367

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wilson HW, Amo-Addae M, Kenu E et al (2018) Post-Ebola syndrome among Ebola Virus disease survivors in Montserrado County, Liberia 2016. Biomed Res Int 2018:1–8. https://doi.org/10.1155/2018/1909410

    Article  Google Scholar 

  13. Kamara S, Walder A, Duncan J et al (2017) Mental health care during the Ebola virus disease outbreak in Sierra Leone. Bull World Heal Organ 95:842–847. https://doi.org/10.2471/BLT.16.190470

    Article  Google Scholar 

  14. Cénat JM, Felix N, Blais-Rochette C et al (2020) Prevalence of mental health problems in populations affected by Ebola virus disease: a systematic review and meta-analysis. Psychiatry Res. https://doi.org/10.1016/j.psychres.2020.113033

    Article  PubMed  PubMed Central  Google Scholar 

  15. Mohammed A, Sheikh TL, Gidado S et al (2015) An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study—2014. BMC Public Health. https://doi.org/10.1186/s12889-015-2167-6

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cénat JM, Balayulu-Makila O, Derivois D et al (2019) The mental health professional at the feet of the Ebola virus: individual treatment and global mental challenges. Br J Psychiatry. https://doi.org/10.1192/bjp.2019.122

    Article  PubMed  Google Scholar 

  17. Cénat JM, Derivois D (2014) Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults survivors of earthquake in Haiti after 30 months. J Affect Disord 159:111–117. https://doi.org/10.1016/j.jad.2014.02.025

    Article  PubMed  Google Scholar 

  18. World Health Organization (2019) Ebola virus disease—Democratic Republic of the Congo: External Situation Report 34. In: WHO. https://apps.who.int/iris/bitstream/handle/10665/311507/SITREP_EVD_DRC_20190326-eng.pdf?ua=1. Accessed 5 Dec 2018

  19. Bardosh K, Gercama I, Bedford J (2019) Social Science and Behavioural Data Compilation, DRC Ebola Outbreak, June 2019–August 2019

  20. Kessler RC, Andrews G, Colpe LJ et al (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. https://doi.org/10.1017/S0033291702006074

    Article  PubMed  Google Scholar 

  21. Hoskins S (2014) Monitoring the treatment and health of patients accessing HIV care in low and middle-income countries. UCL (University College London)

  22. Cénat JM, Blais M, Lavoie F et al (2018) Cyberbullying victimization and substance use among Quebec high schools students: the mediating role of psychological distress. Comput Human Behav 89:207–212. https://doi.org/10.1016/J.CHB.2018.08.014

    Article  Google Scholar 

  23. Hugo M, Declerck H, Fitzpatrick G et al (2015) Post-traumatic stress reactions in Ebola virus disease survivors in Sierra Leone. Emerg Med Open Access. https://doi.org/10.4172/2165-7548.1000285

    Article  Google Scholar 

  24. Brewin CR, Andrews B, Valentine JD et al (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68:748–766. https://doi.org/10.1037/0022-006X.68.5.748

    CAS  Article  PubMed  Google Scholar 

  25. Olowookere SA, Abioye-Kuteyi EA, Adepoju OK et al (2015) Knowledge, attitude, and practice of health workers in a tertiary hospital in Ile-Ife, Nigeria, towards Ebola viral disease. J Trop Med 2015:1–6. https://doi.org/10.1155/2015/431317

    Article  Google Scholar 

  26. Englert EG, Kiwanuka R, Neubauer LC (2019) ‘When I die, let me be the last’. Community health worker perspectives on past Ebola and Marburg outbreaks in Uganda. Glob Public Health 14:1182–1192. https://doi.org/10.1080/17441692.2018.1552306

    Article  PubMed  Google Scholar 

  27. Denis-Ramirez E, Sørensen KH, Skovdal M (2017) In the midst of a ‘perfect storm’: unpacking the causes and consequences of Ebola-related stigma for children orphaned by Ebola in Sierra Leone. Child Youth Serv Rev 73:445–453. https://doi.org/10.1016/J.CHILDYOUTH.2016.11.025

    Article  Google Scholar 

  28. Lopes Cardozo B, Gotway Crawford C, Eriksson C et al (2012) Psychological distress, depression, anxiety, and burnout among international humanitarian aid workers: a longitudinal study. PLoS ONE 7:e44948. https://doi.org/10.1371/journal.pone.0044948

    Article  PubMed  PubMed Central  Google Scholar 

  29. Cénat JM, Mukunzi JN, Noorishad P-G et al (2020) A systematic review of mental health programs among populations affected by the Ebola virus disease. J Psychosom Res 131:109966. https://doi.org/10.1016/j.jpsychores.2020.109966

    Article  PubMed  Google Scholar 

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Acknowledgements

This article was supported by the Grant # 108968 from the International Development Research Center (IDRC), in collaboration with the Social Sciences and Humanities Research Council (SSHRC) and the Canadian Institutes of Health Research (CIHR).

Author information

Affiliations

  1. School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4017, Vanier Hall, Ottawa, ON, K1N 6N5, Canada

    Jude Mary Cénat, Sara- Emilie McIntee & Mireille Guerrier

  2. Laboratory of Psychology Psy-DREPI (EA 7458), Université Bourgogne Franche Comté, Dijon, France

    Daniel Derivois

  3. Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada

    Cécile Rousseau & Oléa Makila-Balayulu

  4. School of Industrial Relations, University of Montreal, Montreal, Canada

    Rose Darly Dalexis

  5. Department of Psychology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo

    Jacqueline Bukaka & Oléa Makila-Balayulu

Authors
  1. Jude Mary Cénat
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  2. Sara- Emilie McIntee
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  3. Mireille Guerrier
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  4. Daniel Derivois
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  5. Cécile Rousseau
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  8. Oléa Makila-Balayulu
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Correspondence to Jude Mary Cénat.

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Cénat, J.M., McIntee, S.E., Guerrier, M. et al. Psychological distress among adults from the urban and rural areas affected by the Ebola virus disease in the Democratic Republic of the Congo. Soc Psychiatry Psychiatr Epidemiol 56, 57–62 (2021). https://doi.org/10.1007/s00127-020-01904-x

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  • DOI: https://doi.org/10.1007/s00127-020-01904-x

Keywords

  • Ebola virus disease
  • Psychological distress
  • Exposure to Ebola virus disease
  • Stigmatization related to Ebola virus disease