5 8 9 32Įbola is primarily transmitted through direct contact with the blood, stool or other bodily fluids of infected persons. Addressing myths, misconceptions and misinformation about the disease was an important aspect of the Ebola response in Sierra Leone. Despite these efforts, public education and social mobilisation campaigns were met with varied reception from communities. 8 Furthermore, community engagement efforts gradually placed increased emphasis on shifting burial and funeral practices that involved contact with corpses. ![]() 5 As the outbreak widened, the focus of community engagement also included educating the public on protective measures while waiting for help to arrive-such as isolating suspected patients. Throughout the Ebola response, the Government of Sierra Leone, development partners and community leaders placed a major focus on educating the public on how to prevent the transmission of Ebola as well as on encouraging people to promptly seek medical care in the event that they experience signs and symptoms associated with Ebola. Specific objectives of this KAP assessment were to quantitatively examine public KAP related to Ebola, identify barriers that hinder the containment of the outbreak, and use the data to set a baseline and inform development of national risk communication and social mobilisation strategies. The present KAP assessment was therefore designed and implemented by the Sierra Leone National Social Mobilisation Pillar, supported by FOCUS 1000, UNICEF, Catholic Relief Services (CRS) and US Centers for Disease Control and Prevention (CDC) as a baseline assessment in August 2014 to inform social mobilisation and community engagement strategies on Ebola prevention, control and treatment in Sierra Leone. 18 While this assessment in Kenema and Kailahun provided useful information less than 1 month into the outbreak in these districts, a national KAP study was needed to inform prevention efforts country-wide. 31 The IFRC survey revealed that less than a third of respondents knew that avoiding contact with corpses of infected persons is a way of preventing the transmission of Ebola. In June 2014, the International Federation of Red Cross and Red Crescent Societies (IFRC) conducted a small-scale KAP study with a small convenience sample in the initial epicentres of Kailahun and Kenema districts in Sierra Leone. ![]() The present study represents the first national Ebola KAP survey in Sierra Leone-conducted in August 2014-within the first 3 months of a prolonged epidemic that lasted over a year. 26–30 However, few national-level KAP studies have been conducted in Ebola affected countries during periods of active transmission. Other studies have also measured Ebola-related KAP within different populations in sub-Saharan Africa 15–25 and other parts of the world. 5 The importance of public education and community engagement in outbreak responses is well established 6–9 and KAP surveys have helped to inform many outbreak responses. 4 Widespread community level social mobilisation efforts had not yet been launched and little was known about public knowledge, attitudes and practices (KAP) related to Ebola. 3 In the initial months of the epidemic, response efforts were limited and poorly coordinated. 2 The epidemic was also affecting Guinea and Liberia, and was already the largest outbreak of Ebola since the first identified case of Ebola in Zaire in 1976. 1 By mid-August 2014, when the present assessment was being conducted, Sierra Leone had recorded nearly 730 confirmed cases of Ebola. By the end of the epidemic, 28 646 cases and over 11 000 deaths were officially reported. The 2014–2015 Ebola virus disease (Ebola) epidemic in West Africa was the largest outbreak of Ebola in recorded history.
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