ArticleBMJ open2022
Cross-sectional study of mental health and sexual behaviours for Ebola Survivors in Beni, Butembo and Katwa health zones of the Democratic Republic of Congo.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Gender differences in the prevalence of anxiety and post-traumatic stress disorder and associated factors among adults in sub-Saharan Africa: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Pooled it
- Ebola Virus Disease and Pediatric Mental Health: Long-Term Mediating Effects of Caregiver Mental Health.Journal of the American Academy of Child and Adolescent Psychiatry · 2026Article
- Ebola disease stigma: mixed methods insights from the 2022 Sudan ebolavirus outbreak.BMJ open · 2025Article
- Ebola Stigma and Its Impact on Outbreak Control: Lessons From Key Informant Interviews in Central Uganda.Tropical medicine & international health : TM & IH · 2025Article
- A qualitative study of Ebola survivors' psychological experiences of evacuation, treatment and community reintegration: Lessons in holistic person-centred care from the 2022 outbreak in Uganda.PLOS mental health · 2025Article
- The Influence of the COVID-19 Pandemic on the Sexual Lives of Polish Young Adults.Journal of clinical medicine · 2024Article
- Mental health outcomes, literacy and service provision in low- and middle-income settings: a systematic review of the Democratic Republic of the Congo.Npj mental health research · 2024Review
- Prevalence and determinants of anxiety, depression and comorbid anxiety-depression symptoms among adolescents in Ebola-affected zones.BJPsych open · 2023Article
- Addressing stigma in infectious disease outbreaks: a crucial step in pandemic preparedness.Frontiers in public health · 2023Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo understand the prevalence of mental health disorders in Ebola-affected communities and their association with condom use.
designCross-sectional study.
settingBeni, Butembo and Katwa health zones, Democratic Republic of Congo (DRC).
participants223 adult Ebola survivors, 102 sexual partners and 74 comparison respondents. PRIMARY AND SECONDARY OUTCOME MEASURES: Post-traumatic stress disorder (PTSD), depression, anxiety, substance use, suicidal ideation and attempts, stigma, condom use and sexual behaviour.
resultsMost respondents reported to be married, Christian, from the Nande ethnic group, and farmers/herders. Survivors met symptom criteria for depression at higher rates than partners (23.5% (95% CI 18.0 to 29.1) vs 5.7 (1.2 to 10.1); p<0.001). PTSD symptom criteria for survivors (24.1%, 95% CI 18.5% to 29.7%) and partners (16.7%, 95% CI 9.4% to 23.9%) were four times greater than the comparison participants (6.0%, 95% CI 0.6% to 11.4%). Two times as many survivors as partners reported that sexual activity precautions were discussed at discharge (71.5% (95% CI 65.6 to 77.5) vs 36.2% (95% CI 26.9 to 45.5); p<0.001). The majority of survivors (95.0 (95% CI 85.1% to 98.5%) and partners 98.5% (95% CI 89.6% to 99.8%; p=0.26) participated in risky sexual behaviour after the survivor left the Ebola treatment centre. The ability to refuse sex or insist on condom use before Ebola had a threefold increase in the odds of condom use (adjusted OR 3.3, 95% CI 1.7 to 6.1, p<0.001). Up to 36% of the comparison group held discriminatory views of survivors.
conclusionsThe new outbreaks in both Guinea and DRC show Ebola remains in semen longer than previously known. Understanding and addressing condom non-use and updating condom use guidelines are necessary to protect against future Ebola outbreaks, especially among sexual partners who did not have similar access to health information regarding sexual transmission of Ebola. Mental health treatment and decreasing stigma in Ebola areas is a priority.
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