title: Beyond Knowledge and Awareness: Addressing Misconceptions in Ghana's Preparation towards an Outbreak of Ebola Virus Disease.
abstract: BACKGROUND
  Ebola Virus Disease (EVD) is not new to the world. However, the West African EVD epidemic which started in 2014 evolved into the largest, most severe and most complex outbreak in the history of the disease. The three most-affected countries faced enormous challenges in stopping the transmission and providing care for all patients. Although Ghana had not recorded any confirmed Ebola case, social factors have been reported to hinder efforts to control the outbreak in the three most affected countries. This qualitative study was designed to explore community knowledge and attitudes about Ebola and its transmission.
  
  
  METHODS
  This study was carried out in five of the ten regions in Ghana. Twenty-five focus group discussions (N = 235) and 40 in-depth interviews were conducted across the five regions with community members, stakeholders and opinion leaders. The interviews were recorded digitally and transcribed verbatim. Framework analysis was adopted in the analysis of the data using Nvivo 10.
  
  
  RESULTS
  The results showed a high level of awareness and knowledge about Ebola. The study further showed that knowledge on how to identify suspected cases of Ebola was also high among respondents. However, there was a firm belief that Ebola was a spiritual condition and could also be transmitted through air, mosquito bites and houseflies. These misconceptions resulted in perceptions of stigma and discrimination towards people who may get Ebola or work with Ebola patients.
  
  
  CONCLUSIONS
  We conclude that although knowledge and awareness about Ebola is high among Ghanaians who participated in the study, there are still misconceptions about the disease. The study recommends that health education on Ebola disease should move beyond creating awareness to targeting the identified misconceptions to improve future containment efforts.
authors.affiliation: Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana.
authors.forename: Philip Baba
authors.initials: PB
authors.lastname: Adongo
authors.affiliation: Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana.
authors.forename: Philip Teg-Nefaah
authors.initials: PT
authors.lastname: Tabong
authors.affiliation: Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Asampong
authors.affiliation: World Health Organization Country Office for Ghana, Accra, Ghana.
authors.forename: Joana
authors.initials: J
authors.lastname: Ansong
authors.affiliation: World Health Organization Country Office for Ghana, Accra, Ghana.
authors.forename: Magda
authors.initials: M
authors.lastname: Robalo
authors.affiliation: Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Adanu
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D029043:Ebolavirus / Q000502:physiology*; D005260:Female; D017144:Focus Groups; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D008297:Male; D057545:Social Stigma