{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:13:30Z","timestamp":1791198810647,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH001353"],"award-info":[{"award-number":["GH001353"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Ebola disease survivors often experience stigma in multiple forms, including felt (perceived) stigma, enacted (action-based) stigma, and institutional stigma. On September 20, 2022, Uganda declared a Sudan Virus Disease (species <jats:italic>orthoebolavirus sudanense<\/jats:italic>) outbreak after a patient with confirmed Sudan virus (SUDV) infection was identified in Mubende District. The outbreak led to 142 confirmed and 22 probable cases over the next two months. We examined the types of stigma experienced by survivors and their household members and its effect on their well-being. We conducted a qualitative study during January 2023 in Mubende and Kassanda Districts. We conducted in-depth and key informant interviews with ten SUDV disease survivors, ten household members of SUDV disease survivors, and ten key informants (district officials and health workers in the affected communities). Interviews were recorded, translated, transcribed, and analyzed thematically. Survivors reported experiencing isolation and rejection by community members and loss of work. They reported being denied purchases at shops or having their money collected in a basket and disinfected (enacted stigma), which led to self-isolation (felt stigma). Educational institutions denied admission to some students from affected homes, while parents of children in some affected families stopped sending children to school due to verbal abuse from students and teachers (structural stigma). Prolonged SUDV disease symptoms and additional attention to survivors from responders (including home visits by health workers, public distribution of support items, and conspicuous transport from home to the survivor\u2019s clinic) were perceived as aggravating both felt and enacted stigma. Even after the outbreak had been declared over, survivors felt that they were still considered a threat to the community. Survivors experienced mainly enacted stigma which was aggravated by the outbreak response and control activities such as additional attention to survivors from responders. Strengthening community engagement to counteract stigma, rethinking response activities that aggravate stigma, integrated response interventions by partners, private distribution of support items, and increasing awareness and sensitization could reduce stigma among the Ebola disease survivors in future responses.<\/jats:p>","DOI":"10.1371\/journal.pgph.0003272","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T18:25:57Z","timestamp":1734373557000},"page":"e0003272","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Stigma among ebola disease survivors in Mubende and Kassanda districts, Central Uganda, 2022"],"prefix":"10.1371","volume":"4","author":[{"given":"Marie Gorreti","family":"Zalwango","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Paige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-9521","authenticated-orcid":true,"given":"Richard","family":"Migisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Nakafeero Simbwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7433-4829","authenticated-orcid":true,"given":"Edirisa Junior","family":"Nsubuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Asio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3416-4111","authenticated-orcid":true,"given":"Zainah","family":"Kabami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Frances","family":"Zalwango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Chris","family":"Kawungezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5276-485X","authenticated-orcid":true,"given":"Mercy Wendy","family":"Wanyana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4153-0600","authenticated-orcid":true,"given":"Patrick","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hellen Nelly","family":"Naiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Agaba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5895-5406","authenticated-orcid":true,"given":"Robert","family":"Zavuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9125-4051","authenticated-orcid":true,"given":"Giulia","family":"Earle-Richardson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0400-8635","authenticated-orcid":true,"given":"Benon","family":"Kwesiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Bulage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kadobera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Riolexus","family":"Ario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2496-8441","authenticated-orcid":true,"given":"Julie R.","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,16]]},"reference":[{"issue":"1","key":"pgph.0003272.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41572-020-0147-3","article-title":"Ebola virus disease","volume":"6","author":"ST Jacob","year":"2020","journal-title":"Nature reviews Disease primers"},{"issue":"9","key":"pgph.0003272.ref002","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.medmal.2014.08.005","article-title":"Case fatality rates of Ebola virus diseases: a meta-analysis of World Health Organization data","volume":"44","author":"A Lefebvre","year":"2014","journal-title":"M\u00e9decine et maladies infectieuses"},{"issue":"1","key":"pgph.0003272.ref003","first-page":"81","article-title":"An overview of Ebola virus disease","volume":"2","author":"A Kadanali","year":"2015","journal-title":"Northern clinics of Istanbul"},{"key":"pgph.0003272.ref004","unstructured":"Africa CDC. Ebola Disease Basics2024. Available from: https:\/\/www.cdc.gov\/ebola\/about\/index.html."},{"issue":"2","key":"pgph.0003272.ref005","first-page":"06","article-title":"Ebola virus outbreaks in Africa: past and present","volume":"79","author":"J-J Muyembe-Tamfum","year":"2012","journal-title":"Onderstepoort Journal of Veterinary Research"},{"issue":"1","key":"pgph.0003272.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1744-8603-8-15","article-title":"\u201cA time of fear\u201d: local, national, and international responses to a large Ebola outbreak in Uganda","volume":"8","author":"J. Kinsman","year":"2012","journal-title":"Globalization and health"},{"key":"pgph.0003272.ref007","unstructured":"WHO. Ebola Virus Disease. 2021. p. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ebola-virus-disease?"},{"issue":"12","key":"pgph.0003272.ref008","doi-asserted-by":"crossref","first-page":"e010982","DOI":"10.1136\/bmjgh-2022-010982","article-title":"Sudan virus disease outbreak in Uganda: urgent research gaps","volume":"7","author":"SK Ibrahim","year":"2022","journal-title":"BMJ Global Health"},{"key":"pgph.0003272.ref009","unstructured":"WHO. Uganda declares end of Ebola disease outbreak. 2023 11\/01\/2023."},{"issue":"1","key":"pgph.0003272.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-8279-7","article-title":"An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross-sectional study","volume":"20","author":"PB James","year":"2020","journal-title":"BMC Public Health"},{"issue":"2","key":"pgph.0003272.ref011","doi-asserted-by":"crossref","first-page":"e0246515","DOI":"10.1371\/journal.pone.0246515","article-title":"Assessing anxiety, depression and insomnia symptoms among Ebola survivors in Africa: A meta-analysis","volume":"16","author":"JW Acharibasam","year":"2021","journal-title":"PLoS One"},{"issue":"10","key":"pgph.0003272.ref012","first-page":"LA01","article-title":"The current mental health status of Ebola survivors in Western Africa","volume":"9(","author":"S Yadav","year":"2015","journal-title":"Journal of clinical and diagnostic research: JCDR"},{"key":"pgph.0003272.ref013","unstructured":"Control CfD, Prevention. 2014 Ebola Outbreak in West Africa Epidemic Curves. 2017."},{"issue":"1","key":"pgph.0003272.ref014","first-page":"1","article-title":"Prevalence of anxiety, depression and post-traumatic stress disorder among Ebola survivors in northern Sierra Leone: a cross-sectional study","volume":"20","author":"AJ Bah","year":"2020","journal-title":"BMC public health"},{"key":"pgph.0003272.ref015","author":"JF Dovidio","year":"2000","journal-title":"Stigma: Introduction and overview"},{"issue":"1","key":"pgph.0003272.ref016","doi-asserted-by":"crossref","first-page":"55","DOI":"10.15171\/ijhpm.2014.128","article-title":"Ebola treatment and prevention are not the only battles: understanding Ebola-related fear and stigma","volume":"4","author":"M Karamouzian","year":"2015","journal-title":"International journal of health policy and management"},{"issue":"50","key":"pgph.0003272.ref017","first-page":"1205","article-title":"Support services for survivors of Ebola virus disease\u2014Sierra Leone, 2014","volume":"63","author":"SH Lee-Kwan","year":"2014","journal-title":"Morbidity and Mortality Weekly Report"},{"issue":"2","key":"pgph.0003272.ref018","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1093\/heapro\/dav003","article-title":"A community-engaged infection prevention and control approach to Ebola","volume":"31","author":"F Marais","year":"2015","journal-title":"Health promotion international"},{"key":"pgph.0003272.ref019","unstructured":"Development USAfI. Restoring Hope and Dignity of Ebola Survivors in Uganda: 4 ways USAID support helped them bounce back in life. Kampala; 2022."},{"key":"pgph.0003272.ref020","unstructured":"UNICEF. UNICEF UGANDA: Ebola Virus Diseas (EVD) Update. 2022 07 October 2022."},{"key":"pgph.0003272.ref021","author":"PI Fusch Ph D","year":"2015","journal-title":"Are we there yet? Data saturation in qualitative research"},{"issue":"11","key":"pgph.0003272.ref022","first-page":"e0206595","volume":"13","author":"L Overholt","year":"2018","journal-title":"Stigma and Ebola"},{"key":"pgph.0003272.ref023","doi-asserted-by":"crossref","first-page":"100064","DOI":"10.1016\/j.ssmmh.2022.100064","article-title":"A post-outbreak assessment of exposure proximity and Ebola virus disease-related stigma among community members in Kono District, Sierra Leone: A cross-sectional study","volume":"2","author":"MC Davidson","year":"2022","journal-title":"SSM-Mental Health"},{"issue":"3","key":"pgph.0003272.ref024","doi-asserted-by":"crossref","first-page":"e000108","DOI":"10.1136\/bmjgh-2016-000108","article-title":"\u2018Once there is life, there is hope\u2019Ebola survivors\u2019 experiences, behaviours and attitudes in Sierra Leone, 2015","volume":"1","author":"E Karafillakis","year":"2016","journal-title":"BMJ global health"},{"key":"pgph.0003272.ref025","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.childyouth.2016.11.025","article-title":"In the midst of a \u2018perfect storm\u2019: Unpacking the causes and consequences of Ebola-related stigma for children orphaned by Ebola in Sierra Leone","volume":"73","author":"E Denis-Ramirez","year":"2017","journal-title":"Children and Youth Services Review"},{"issue":"2","key":"pgph.0003272.ref026","doi-asserted-by":"crossref","first-page":"e000410","DOI":"10.1136\/bmjgh-2017-000410","article-title":"Trust, fear, stigma and disruptions: community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015","volume":"3","author":"A Nuriddin","year":"2018","journal-title":"BMJ global health"},{"issue":"3","key":"pgph.0003272.ref027","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/tmi.12825","article-title":"Profile and reintegration experience of Ebola survivors in Guinea: a cross\u2010sectional study","volume":"22","author":"A Delamou","year":"2017","journal-title":"Tropical Medicine & International Health"},{"key":"pgph.0003272.ref028","volume-title":"Open Forum Infectious Diseases","author":"A de St. Maurice","year":"2018"},{"key":"pgph.0003272.ref029","first-page":"187","article-title":"Reintegrating the \u201cOther\u201d Challenges of Stigmatization in Policies and Practice: The Case of Ebola Survivors and Their Relatives During the 2014\u20132016 Epidemic","volume":"2020","author":"A. Tsakiridis","journal-title":"Disaster studies: Exploring intersectionalities in disaster discourse"},{"issue":"8","key":"pgph.0003272.ref030","doi-asserted-by":"crossref","first-page":"e0005845","DOI":"10.1371\/journal.pntd.0005845","article-title":"\" We are survivors and not a virus:\" Content analysis of media reporting on Ebola survivors in Liberia","volume":"11","author":"EA-S Mayrhuber","year":"2017","journal-title":"PLoS Neglected Tropical Diseases"},{"issue":"11","key":"pgph.0003272.ref031","doi-asserted-by":"crossref","first-page":"e0276790","DOI":"10.1371\/journal.pone.0276790","article-title":"Social distancing, community stigma, and implications for psychological distress in the aftermath of Ebola virus disease","volume":"17","author":"TM Crea","year":"2022","journal-title":"Plos one"},{"key":"pgph.0003272.ref032","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3389\/fpubh.2016.00142","article-title":"Psychological Distress among Ebola Survivors Discharged from an Ebola Treatment Unit in Monrovia, Liberia\u2014A Qualitative Study","volume":"4","author":"I Rabelo","year":"2016","journal-title":"Front Public Health"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0003272","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T18:26:06Z","timestamp":1734373566000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0003272"}},"subtitle":[],"editor":[{"given":"Bram","family":"Wispelwey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,16]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0003272","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,16]]}}}