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Knowledge, Attitudes, and Practices among Members of Households Actively Monitored or Quarantined to Prevent Transmission of Ebola Virus Disease — Margibi County, Liberia: February-March 2015

  • Jason A. Wilken (a1), Paran Pordell (a2), Brant Goode (a1), Rachel Jarteh (a3), Zayzay Miller (a3), Benjamin G. Saygar (a4), Leroy Maximore (a4), Watta M. Borbor (a3), Moses Carmue (a4), Gregory W. Walker (a5) and Adolphus Yeiah (a4)...

In early 2015, a patient from a cluster of cases of Ebola Virus Disease (EVD) in Monrovia, Liberia traveled to a rural village in Margibi County, potentially exposing numerous persons. The patient died in the village and post-mortem testing confirmed Ebola Virus infection.


The Margibi County Health Team (CHT; Kakata, Margibi, Liberia) needed to prevent further transmission of EVD within and outside of the affected villages, and they needed to better understand the factors that support or impede compliance with measures to stop the spread of EVD.


In February-March 2015, the Margibi CHT instituted a 21-day quarantine and active monitoring for two villages where the patient had contact with numerous residents, and a 21-day active monitoring for five other villages where the patient had possible contact with an unknown number of persons. One contact developed EVD and quarantine was extended an additional 12 days in one village. In April 2015, the Margibi CHT conducted a household-based EVD knowledge, attitudes, and practices (KAP) survey of the seven villages. From April 24-29, 2015, interview teams approached every household in the seven villages and collected information on demographics, knowledge of EVD, attitudes about quarantine to prevent the spread of EVD, and their quarantine experiences and practices. Descriptive statistics were calculated.


One hundred fifteen interviews were conducted, representing the majority of the households in the seven villages. Most (99%) correctly identified touching an infected person’s body fluids and contact with the body of someone who has died from EVD as transmission routes. However, interviewees sometimes incorrectly identified mosquito bites (58%) and airborne spread (32%) as routes of EVD transmission, and 72% incorrectly identified the longest EVD incubation period as ≤seven days. Eight of 16 households in the two quarantined villages (50%) reported times when there was not enough water or food during quarantine. Nine of 16 (56%) reported that a household member had illnesses or injuries during quarantine; of these, all (100%) obtained care from a clinic, hospital, or Ebola treatment unit (ETU).


Residents’ knowledge of EVD transmission routes and incubation period were suboptimal. Public health authorities should consider assessing residents’ understanding of Ebola transmission routes and effectively educate them to ensure correct understanding. Quarantined residents should be provided with sufficient food, water, and access to medical care.

Wilken JA , Pordell P , Goode B , Jarteh R , Miller Z , Saygar BG Sr. , Maximore L , Borbor WM , Carmue M , Walker GW , Yeiah A . Knowledge, Attitudes, and Practices among Members of Households Actively Monitored or Quarantined to Prevent Transmission of Ebola Virus Disease — Margibi County, Liberia: February-March 2015. Prehosp Disaster Med. 2017;32(6):673678.

Corresponding author
Correspondence: Jason A. Wilken, PhD, MPH Centers for Disease Control and Prevention Office of Public Health Preparedness and Response Atlanta, Georgia USA E-mail:
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Conflicts of interest/disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (Atlanta, Georgia USA). The authors declare no conflicts of interest.

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1. Nyenswah, T, Fallah, M, Sieh, S, et al. Controlling the last known cluster of Ebola Virus Disease – Liberia: January-February 2015. MMWR. 2015;64(18):500-504.
2. Borchert, M, Mutyaba, I, Van Kerkhove, MD, et al. Ebola hemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned. BMC Infect Dis. 2011;11:357.
3. Reaves, EJ, Mabande, LG, Thoroughman, DA, Arwady, MA, Montgomery, JM. Control of Ebola virus disease - Firestone district, Liberia, 2014. MMWR. 2014;63(42):959-965.
4. Dosso, Z. Resentment simmers in Liberia’s “Ebola jail town.” Yahoo! News; September 7, 2014.
5. Onishi, N. Quarantine for Ebola lifted in Liberia slum. New York Times. August 29, 2014.
6. Nyenswah, T, Blackley, DJ, Freeman, T, et al. Community quarantine to interrupt Ebola virus transmission - Mawah Village, Bong County, Liberia, August-October, 2014. MMWR. 2015;64(7):179-182.
7. Gostin, LO. Public Health Law: Power, Duty, Restraint. Revision and expanded 2nd ed. Berkeley New York Milbank Memorial Fund: University of California Press; 2008.
8. Viens, AM, Bensimon, CM, Upshur, REG. Your liberty or your life: reciprocity in the use of restrictive measures in contexts of contagion. J Bioetical Inq. 2009;6:207-217.
9. Eba, PM. Ebola and human rights in West Africa. Lancet. 2014;384(9960):2091-2093.
10. Thompson, AK. Bioethics meets Ebola: exploring the moral landscape. British Medical Bulletin. 2016;117(1):5-13.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
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Centers for Disease Control and Prevention
  • County Health Team
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    County Health Team
  • Ebola treatment unit
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    Ebola treatment unit
  • Ebola Virus Disease
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    Ebola Virus Disease
  • knowledge, attitudes, and practices
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    knowledge, attitudes, and practices
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