Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015
Open accessAbstract
Background: The mental health impact of the 2014–2016 Ebola epidemic has been described among survivors, family members and healthcare workers, but little is known about its impact on the general population of affected countries. We assessed symptoms of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population in Sierra Leone after over a year of outbreak response. Methods: We administered a cross-sectional survey in July 2015 to a national sample of 3564 consenting participants selected through multistaged cluster sampling. Symptoms of anxiety and depression were measured by Patient Health Questionnaire-4. PTSD symptoms were measured by six items from the Impact of Events Scale-revised. Relationships among Ebola experience, perceived Ebola threat and mental health symptoms were examined through binary logistic regression. Results: Prevalence of any anxiety-depression symptom was 48% (95% CI 46.8% to 50.0%), and of any PTSD symptom 76% (95% CI 75.0% to 77.8%). In addition, 6% (95% CI 5.4% to 7.0%) met the clinical cut-off for anxiety-depression, 27% (95% CI 25.8% to 28.8%) met levels of clinical concern for PTSD and 16% (95% CI 14.7% to 17.1%) met levels of probable PTSD diagnosis. Factors associated with higher reporting of any symptoms in bivariate analysis included region of residence, experiences with Ebola and perceived Ebola threat. Knowing someone quarantined for Ebola was independently associated with anxiety-depression (adjusted OR (AOR) 2.3, 95% CI 1.7 to 2.9) and PTSD (AOR 2.095% CI 1.5 to 2.8) symptoms. Perceiving Ebola as a threat was independently associated with anxiety-depression (AOR 1.69 95% CI 1.44 to 1.98) and PTSD (AOR 1.86 95% CI 1.56 to 2.21) symptoms. Conclusion: Symptoms of PTSD and anxiety-depression were common after one year of Ebola response; psychosocial support may be needed for people with Ebola-related experiences. Preventing, detecting, and responding to mental health conditions should be an important component of global health security efforts.
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Similar mental health effects were seen in past containment efforts during SARS in 2003, the 2009 swine flu pandemic, and the 2014-2016 Ebola epidemic.
“similar mental health effects were seen in past containment efforts during infectious disease outbreaks, such as the severe acute respiratory syndrome (SARS) in 2003 [2, 3], the 2009 swine flu pandemic [4, 5], and the 2014–2016 Ebola epidemic [6].”
From Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review (2023) · cites this paper as [6]
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- Authors
- Jalloh, M. F., Li, W., Bunnell, R. E., Ethier, K. A., O’Leary, A., Hageman, K. M., Sengeh, P., Jalloh, M. B., Morgan, O., Hersey, S., Marston, B. J., Dafae, F., & Redd, J. T.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Emerald Coast Science Center (US)
- Ministry of Health and Sanitation (SL)
- Corresponding author
- Jalloh, Mohamed F
- ORCID
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2018-03
- Volume
- 3
- Issue
- 2
- Pages
- e000471
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC5873549
- OpenAlex
- W2792434433
- Cited by
- 433
- References
- 53
- Citations by year
- 2026: 7 · 2025: 26 · 2024: 37 · 2023: 45 · 2022: 88 · 2021: 129 · 2020: 92 · 2019: 5 · 2018: 2 · 2017: 1
- FWCI
- 66.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- Ebola virus disease, mental health, post-traumatic stress disorder, anxiety, depression, risk perception, threat perception, quarantine, general population, psychosocial support, global health security, Sierra Leone, outbreak response, psychosocial interventions, mental health screening, mental health service delivery, mental health professionals, mental health funding, mental health policy
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