The authors declare that they have no competing interests.
AM conceived the study and developed the initial and subsequent drafts. TLS, SG, GP, PN, AO and CO actively participated in protocol development, and drafts development. NW, FS, JA and FD guided outbreak investigation, data analysis and draft review. OU and AA involved in data cleaning and analysis and outbreak response. SBN, CKN, AN, AO, OG and IAA guided outbreak investigation and collation of the line lists. ROO contributed with review of the initial and final draft. All the authors read and approved the final manuscript.
A.M. is amember of the clinical management team (Psychosocial) of the Nigerian Ebola Emergency Operation Center Lagos. He is presently a consultant Psychiatrist with the Federal neuro-psychiatry hospital, Kaduna and holds the position of the head of Research, Training and Statistics of the institution. He is a Fellow of the West African College of Physicians (Psychiatry). He is a trained medical epidemiologist with Master in Public Health (Field Epidemiology). He also has a master in Health Planning and Management.
Previous presentation: Association of Psychiatrists in Nigeria (APN) meeting in Kaduna, Nigeria, December 2014.
Location of work and address for reprints: This work was conducted at the Ebola Emergency Operation Center (EEOC), Lagos, Nigeria. Correspondence and reprint request should be sent to Abdulaziz Mohammed, Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria.
By September 2014, an outbreak of Ebola Viral Disease (EVD) in West African countries of Guinea, Liberia, Sierra Leone, Senegal and Nigeria, had recorded over 4500 and 2200 probable or confirmed cases and deaths respectively. EVD, an emerging infectious disease, can create fear and panic among patients, contacts and relatives, which could be a risk factor for psychological distress. Psychological distress among this subgroup could have public health implication for control of EVD, because of potential effects on patient management and contact tracing. We determined the Prevalence, pattern and factors associated with psychological distress among survivors and contacts of EVD and their relatives.
In a descriptive cross sectional study, we used General Health Questionnaire to assess psychological distress and Oslo Social Support Scale to assess social support among 117 participants who survived EVD, listed as EVD contacts or their relatives at Ebola Emergency Operation Center in Lagos, Nigeria. Factors associated with psychological distress were determined using chi square/odds ratio and adjusted odds ratio.
The mean age and standard deviation of participants was 34 +/ - 9.6 years. Of 117 participants, 78 (66.7 %) were females, 77 (65.8 %) had a tertiary education and 45 (38.5 %) were health workers. Most frequently occurring psychological distress were inability to concentrate (37.6 %) and loss of sleep over worry (33.3 %). Losing a relation to EVD outbreak (OR = 6.0, 95 % CI, 1.2–32.9) was significantly associated with feeling unhappy or depressed while being a health worker was protective (OR = 0.4, 95 % CI, 0.2–0.9). Adjusted Odds Ratio (AOR) showed losing a relation (AOR = 5.7, 95 % CI, 1.2–28.0) was a predictor of “feeling unhappy or depressed”, loss of a relation (AOR = 10.1, 95 % CI, 1.7–60.7) was a predictor of inability to concentrate.
Survivors and contacts of EVD and their relations develop psychological distress. Development of psychological distress could be predicted by loss of family member. It is recommended that psychiatrists and other mental health specialists be part of case management teams. The clinical teams managing EVD patients should be trained on recognition of common psychological distress among patients. A mental health specialist should review contacts being monitored for EVD for psychological distress or disorders.