Understanding Knowledge, Attitudes and Practices on Ebola Virus Disease: A Multi-Site Mixed Methods Survey on Preparedness in Rwanda

Abstract

AbstractThe overall goal of this survey was to understand the Ebola Virus Disease (EVD) - related knowledge, attitudes, and practices (KAP) at individual, inter-personal, institutional, and societal levels in Rwanda. This cross-sectional mixed-methods survey was conducted in five selected districts: Rusizi, Karongi, Rubavu, Burera and Gasabo. Quantitative data was collected from 1,010 participants using a structured questionnaire and Kobo Collect. Qualitative data was collected from 98 participants through Key Informant Interviews and Focus Group Discussions using a semi structured interview guide. Among the 1,010 surveyed respondents, 56% were male, 70.3% were married, and 50% had primary education. An important finding was the high level of Ebola awareness and knowledge in all the five districts, with 99.6% reporting having previously heard of Ebola, which indicates previous awareness-raising efforts were successful. More than 54% of respondents indicated that Ebola is caused by a virus which originates from wild animal animals (42.1%). Furthermore, fever (85%), bleeding (87.7), and vomiting (40.2%) were cited as the primary signs and symptoms for Ebola. Most of the respondents were knowledgeable regarding prevention measures for Ebola. Despite this, 80% of the survey respondents had not received formal training or health education on Ebola. The majority of respondents (78.2%) reported having a positive attitude towards EVD survivors. Many respondents (90%) believe that the country is at risk of an EVD outbreak and about 87.8% think that they are personally at risk of contracting Ebola. Most respondents reported adopting habits that included avoiding physical contact with the patients and reducing unnecessary movements/travel throughout the Ebola-affected regions. At the community level, participants state that they participate in the sharing of Ebola-related information and reporting suspected cases to relevant authorities. Additionally, many participants know the necessary emergency contact number (114) for assistance and reporting of EVD-related information. Most respondents (97.2%) believed that it is important to be vaccinated to prevent Ebola, and around 93.3% are ready/willing to be vaccinated once the EVD vaccine is available. While the radio is the preferred source for Ebola-related information, the most trusted sources are the ministry of health and governmental institutions, such as the Rwanda Biomedical Centre. Our results show that there was high EVD-related knowledge and awareness among the general population in Rwanda. However, for strong public health awareness, preparedness, and protection, there is a need to implement public sensitization programmes that address EVD-related misconceptions and discriminatory attitudes toward EVD patients.