{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:45:16Z","timestamp":1790016316142,"version":"4.0.1"},"reference-count":47,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007843","name":"Direktoratet for Utviklingssamarbeid","doi-asserted-by":"publisher","award":["68802"],"award-info":[{"award-number":["68802"]}],"id":[{"id":"10.13039\/100007843","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2024,11,11]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>During the most recent Ebola virus disease (EVD) outbreak in Uganda, a cluster of community deaths with epidemiological linkages to the first reported case were identified to have occurred in Mubende, Kassanda and Kampala districts in September 2022. This study aimed to explore perceived drivers of EVD outbreak among affected communities in Mubende and Kassanda districts, Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a descriptive qualitative and participatory epidemiology study using focus group discussions (n=4), in-depth interviews (n=12), key informant interviews (n=12) and participatory landscape mapping. The subcounties of Madudu (Mubende district) and Kikandwa (Kassanda district) were purposively selected within each district because Ebola cases were known to have occurred within these areas. The community expressed their own understanding and perceptions of the drivers of Ebola virus outbreak within these subcounties. Qualitative data were analysed using thematic content analysis in Nvivo V.12 software. Data were analysed using both inductive and deductive approaches, where codes, subthemes and themes in the data were merged with global themes. The results were interpreted in the context of the broader literature on the topic using the social-ecological model and the epidemiological triad using the specific experiences and insights of the study participants. Participant responses were categorised in terms of their themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of five themes were identified which described the perceived drivers of Ebola virus outbreaks. These included (1) individual: knowledge about EVD (source of the disease and fear due to death of some suspected cases); (2) interpersonal: perceived sources of Ebola virus spillover (ecological, anthropogenic, environmental and cultural); (3) community: impact of EVD to the community (economic loss and survivors lack of support from the government); (4) organisational: health system challenges in outbreaks (delayed laboratory results, poor recording and reporting systems in the facilities and poor surveillance); and (5) policy: recommendations (use of One Health approach and continuous sensitisation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study underscores the complex interplay of factors shaping the dynamics of EVD. Understanding Ebola requires not only scientific knowledge but also an appreciation of sociocultural contexts and systemic vulnerabilities within health systems. We therefore recommend comprehensive approaches which integrate scientific expertise with community participation, strengthen health systems and foster collaboration across sectors to mitigate the impact of future outbreaks to address these challenges effectively. Additionally, raising awareness, sensitising the public and safeguarding natural habitats are crucial steps to mitigate the risk of future disease outbreaks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-001267","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T07:25:34Z","timestamp":1734161134000},"page":"e001267","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Perceived drivers of the Ebola virus disease outbreak in Mubende and Kassanda districts, Uganda: a qualitative study"],"prefix":"10.1136","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3771-0527","authenticated-orcid":false,"given":"Lesley Rose","family":"Ninsiima","sequence":"first","affiliation":[{"name":"Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan M","family":"Mor","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool, UK"},{"name":"International Livestock Research Institute, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier S\u00e1nchez","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Medical Biology, The Artic University of Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia Nabawanuka","family":"Namakula","sequence":"additional","affiliation":[{"name":"Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clovice","family":"Kankya","sequence":"additional","affiliation":[{"name":"Department of Biosecurity Ecosystems and Veterinary Public Health, Makerere University College of Veterinary Medicine Animal Resources and Biosecurity, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kungu","sequence":"additional","affiliation":[{"name":"Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mugisha","sequence":"additional","affiliation":[{"name":"Department of Wildlife and Aquatic Animal Resources, Makerere University, Kampala, Uganda"},{"name":"Conservation and Ecosystem Health Alliance, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rn","family":"Klein","sequence":"additional","affiliation":[{"name":"University of South-Eastern Norway, Porsgrunn, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Nyakarahuka","sequence":"additional","affiliation":[{"name":"Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"2025083110480309000_2.2.e001267.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003056","article-title":"Outbreak of ebola virus disease in Guinea: where ecology meets economy","volume":"8","author":"Bausch","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"2025083110480309000_2.2.e001267.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-023-05835-1"},{"key":"2025083110480309000_2.2.e001267.3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4081\/jphia.2023.2735","article-title":"Continental concerted efforts to control the seventh outbreak of Ebola Virus disease in Uganda: The first 90 days of the response","volume":"14","author":"Aceng","year":"2023","journal-title":"J Public Health Afr"},{"key":"2025083110480309000_2.2.e001267.4","unstructured":"Johnson B , Wootson K , Mcgill A . 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