title: Social pathways for Ebola virus disease in rural Sierra Leone, and some implications for containment.
abstract: The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact. Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed. The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic-the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure. Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties. A concluding discussion relates the information presented to plans for halting the disease. Local consultation and access are seen as major challenges to be addressed.
authors.affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.
authors.forename: Paul
authors.initials: P
authors.lastname: Richards
authors.affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.
authors.forename: Joseph
authors.initials: J
authors.lastname: Amara
authors.affiliation: Anthropology Department, University of California, Berkeley, Berkeley, California, United States of America.
authors.forename: Mariane C
authors.initials: MC
authors.lastname: Ferme
authors.affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.
authors.forename: Prince
authors.initials: P
authors.lastname: Kamara
authors.affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.
authors.forename: Esther
authors.initials: E
authors.lastname: Mokuwa
authors.affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.
authors.forename: Amara Idara
authors.initials: AI
authors.lastname: Sheriff
authors.affiliation: School of Environmental Sciences, Njala University, Njala University Campus, Njala, Sierra Leone.
authors.forename: Roland
authors.initials: R
authors.lastname: Suluku
authors.affiliation: Development Economics Group, Wageningen University, Wageningen, The Netherlands; Department of Land Economy, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Maarten
authors.initials: M
authors.lastname: Voors
mesh_terms: D016358:Contact Tracing / Q000379:methods*; D003430:Cross-Sectional Studies; D058872:Epidemics / Q000517:prevention & control*; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006801:Humans; D012111:Residence Characteristics; D012307:Risk Factors; D012424:Rural Population; D012807:Sierra Leone / Q000453:epidemiology