Risk behaviour associated with contracting the Ebola virus at funerals: a study of Liberians attending the funerals of individuals deceased from Ebola.

Introduction: Funeral practices were identified as a significant source of Ebola transmission during the 2014-2016 West Africa Ebola outbreak. This study investigated behaviours and contributing factors leading to Ebola exposure during funerals in Montserrado County, Liberia. Methods: In 2024, a cross-sectional study was conducted using face-to-face interviews with 200 participants (mean age:51 years; 69.5% male) from Clara Town and Vai Town with family members of EVD victims and community leaders in Clara Town and Vai Town. Results: High-risk behaviour, defined as kissing or touching the deceased without gloves, was reported by 29.5% of participants. In unadjusted analysis, males (COR = 2.40, 95% CI: 1.14-5.03), the Kpelle tribe (COR = 3.17, 95% CI: 1.66-6.05), Christians (COR = 2.69, 95% CI: 1.42-5.09), and community leaders (COR = 2.31, 95% CI: 1.23-4.32) were more likely to engage in high-risk behaviours. In multivariate analysis, only religion remained independently associated; Christians were more likely than Muslims to engage in such behaviours (AOR = 2.70, 95% CI: 1.40-5.18). Discussion: Kissing the deceased was the main risk behaviour. The study highlights the influence of cultural traditions on Ebola spread and calls for culturally sensitive prevention strategies.