{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:50:17Z","timestamp":1787838617844,"version":"build-2784847793"},"reference-count":55,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K19467"],"award-info":[{"award-number":["19K19467"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>We sought to summarize knowledge, misconceptions, beliefs, and practices about Ebola that might impede the control of Ebola outbreaks in Africa. We searched Medline, EMBASE, CINAHL, and Google Scholar (through May 2019) for publications reporting on knowledge, attitudes, and practices (KAP) related to Ebola in Africa. In total, 14 of 433 articles were included. Knowledge was evaluated in all 14 articles, and they all highlighted that there are misconceptions and risk behaviors during an Ebola outbreak. Some communities believed that Ebola spreads through the air, mosquito bites, malice from foreign doctors, witchcraft, and houseflies. Because patients believe that Ebola was caused by witchcraft, they sought help from traditional healers. Some people believed that Ebola could be prevented by bathing with salt or hot water. Burial practices where people touch Ebola-infected corpses were common, especially among Muslims. Discriminatory attitudes towards Ebola survivors or their families were also prevalent. Some Ebola survivors were not accepted back in their communities; the possibility of being ostracized from their neighborhoods was high and Ebola survivors had to lead a difficult social life. Most communities affected by Ebola need more comprehensive knowledge on Ebola. Efforts are needed to address misconceptions and risk behaviors surrounding Ebola for future outbreak preparedness in Africa.<\/jats:p>","DOI":"10.3390\/ijerph19084714","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T21:33:42Z","timestamp":1649885622000},"page":"4714","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Misconceptions and Rumors about Ebola Virus Disease in Sub-Saharan Africa: A Systematic Review"],"prefix":"10.3390","volume":"19","author":[{"given":"Basilua Andre","family":"Muzembo","sequence":"first","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngangu Patrick","family":"Ntontolo","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Health, Protestant University of Congo, Kinshasa, Democratic Republic of the Congo"},{"name":"Institut M\u00e9dical Evang\u00e9lique (IME), Kimpese, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nlandu Roger","family":"Ngatu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Kagawa University Faculty of Medicine, Miki-cho 761-0793, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2211-8072","authenticated-orcid":false,"given":"Januka","family":"Khatiwada","sequence":"additional","affiliation":[{"name":"Social Work Institute, Nakhu-4, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1420-2298","authenticated-orcid":false,"given":"Tomoko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"},{"name":"Collaborative Research Center of Okayama University for Infectious Diseases in India, Kolkata 700010, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunya","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ichi","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2022, February 21). Ebola Virus Disease. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ebola-virus-disease."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e82","DOI":"10.1016\/S1473-3099(16)00077-3","article-title":"Sequelae of Ebola virus disease: The emergency within the emergency","volume":"16","author":"Vetter","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/S1473-3099(15)70152-0","article-title":"Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: A retrospective cohort study","volume":"15","author":"Clark","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2448","DOI":"10.1056\/NEJMoa1509773","article-title":"Molecular evidence of sexual transmission of Ebola Virus","volume":"373","author":"Mate","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.11604\/pamj.supp.2015.22.1.6652","article-title":"Ebola Virus Diseases in Africa: A commentary on its history, local and global context","volume":"22","author":"Awah","year":"2015","journal-title":"Pan Afr. Med. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Gray, N., Stringer, B., Bark, G., Heller Perache, A., Jephcott, F., Broeder, R., Kremer, R., Jimissa, A.S., and Samba, T.T. (2018). When Ebola enters a home, a family, a community: A qualitative study of population perspectives on Ebola control measures in rural and urban areas of Sierra Leone. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006461"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"488","DOI":"10.2471\/BLT.10.030710","article-title":"Time to put Ebola in context. Interview with Dr Melissa Leach","volume":"88","author":"Leach","year":"2010","journal-title":"Bull. World Health Organ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.jaci.2015.02.015","article-title":"Ebola: A holistic approach is required to achieve effective management and control","volume":"135","author":"Roca","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"20160297","DOI":"10.1098\/rstb.2016.0297","article-title":"The Ebola outbreak, 2013\u20132016: Old lessons for new epidemics","volume":"372","author":"Coltart","year":"2017","journal-title":"Philos. Trans. R. Soc. Lond. B Biol. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"981","DOI":"10.15585\/mmwr.mm6435a6","article-title":"Ebola Virus Disease\u2014Sierra Leone and Guinea, August 2015","volume":"64","author":"Hersey","year":"2015","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Muzembo, B.A., Ntontolo, N.P., Ngatu, N.R., Khatiwada, J., Ngombe, K.L., Numbi, O.L., Nzaji, K.M., Maotela, K.J., Ngoyi, M.J., and Suzuki, T. (2020). Local perspectives on Ebola during its tenth outbreak in DR Congo: A nationwide qualitative study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241120"},{"key":"ref_12","unstructured":"United States Agency for International Development (USAID) (2020, May 22). The KAP Survey Model (Knowledge, Attitudes, and Practices), Available online: https:\/\/www.spring-nutrition.org\/publications\/tool-summaries\/kap-survey-model-knowledge-attitudes-and-practices."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_14","unstructured":"Critical Appraisal Skills Programme (2022, February 14). CASP Qualitative Checklist. Available online: https:\/\/casp-uk.b-cdn.net\/wp-content\/uploads\/2018\/03\/CASP-Qualitative-Checklist-2018_fillable_form.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e011458","DOI":"10.1136\/bmjopen-2016-011458","article-title":"Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS)","volume":"6","author":"Downes","year":"2016","journal-title":"BMJ Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/S0140-6736(18)32419-X","article-title":"Ebola virus epidemic in war-torn eastern DR Congo","volume":"392","author":"Claude","year":"2018","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"336","DOI":"10.3201\/eid2402.171028","article-title":"Risk communication and Ebola-specific knowledge and behavior during 2014\u20132015 outbreak, Sierra Leone","volume":"24","author":"Winters","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1093\/inthealth\/ihy009","article-title":"Effect of knowledge and perceptions of risks on Ebola-preventive behaviours in Ghana","volume":"10","author":"Tenkorang","year":"2018","journal-title":"Int. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e000285","DOI":"10.1136\/bmjgh-2017-000285","article-title":"National survey of Ebola-related knowledge, attitudes and practices before the outbreak peak in Sierra Leone: August 2014","volume":"2","author":"Jalloh","year":"2017","journal-title":"BMJ Glob. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.15585\/mmwr.mm6641a4","article-title":"Knowledge, attitudes, and practices related to Ebola virus disease at the end of a national epidemic\u2014Guinea, August 2015","volume":"66","author":"Jalloh","year":"2017","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20160304","DOI":"10.1098\/rstb.2016.0304","article-title":"Assessments of Ebola knowledge, attitudes and practices in Forecariah, Guinea and Kambia, Sierra Leone, July\u2013August 2015","volume":"372","author":"Jalloh","year":"2017","journal-title":"Philos. Trans. R. Soc. Lond. B Biol. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jiph.2016.05.016","article-title":"Ebola hemorrhagic fever under scope, view of knowledge, attitude and practice from rural Sudan in 2015","volume":"10","author":"Mohamed","year":"2017","journal-title":"J. Infect. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s40249-016-0142-9","article-title":"Rapid assessment of knowledge, attitudes, practices, and risk perception related to the prevention and control of Ebola virus disease in three communities of Sierra Leone","volume":"5","author":"Jiang","year":"2016","journal-title":"Infect. Dis. Poverty"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Adongo, P.B., Tabong, P.T., Asampong, E., Ansong, J., Robalo, M., and Adanu, R.M. (2016). Beyond knowledge and awareness: Addressing misconceptions in Ghana\u2019s preparation towards an outbreak of Ebola virus disease. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0149627"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Iliyasu, G., Ogoina, D., Otu, A.A., Dayyab, F.M., Ebenso, B., Otokpa, D., Rotifa, S., Olomo, W.T., and Habib, A.G. (2015). A Multi-site knowledge attitude and practice survey of Ebola virus disease in Nigeria. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0135955"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"11","DOI":"10.11604\/pamj.supp.2015.22.1.6269","article-title":"Misconceptions about Ebola seriously affect the prevention efforts: KAP related to Ebola prevention and treatment in Kouroussa Prefecture, Guinea","volume":"22","author":"Buli","year":"2015","journal-title":"Pan Afr. Med. J."},{"key":"#cr-split#-ref_27.1","doi-asserted-by":"crossref","unstructured":"Gidado, S., Oladimeji, A.M., Roberts, A.A., Nguku, P., Nwangwu, I.G., Waziri, N.E., Shuaib, F., Oguntimehin, O., Musa, E., and Nzuki, C. (2015). Public knowledge, perception and source of information on Ebola virus disease-Lagos, Nigeria","DOI":"10.1371\/currents.outbreaks.0b805cac244d700a47d6a3713ef2d6db"},{"key":"#cr-split#-ref_27.2","unstructured":"September, 2014. PLoS Curr., 7, ecurrents.outbreaks.0b805cac244d700a47d6a3713ef2d6db."},{"key":"ref_28","first-page":"714","article-title":"Community knowledge, attitudes, and practices regarding Ebola virus disease\u2014Five counties, Liberia, September\u2013October, 2014","volume":"64","author":"Kobayashi","year":"2015","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Nyakarahuka, L., Skjerve, E., Nabadda, D., Sitali, D.C., Mumba, C., Mwiine, F.N., Lutwama, J.J., Balinandi, S., Shoemaker, T., and Kankya, C. (2017). Knowledge and attitude towards Ebola and Marburg virus diseases in Uganda using quantitative and participatory epidemiology techniques. PLoS Negl. Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0005907"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Stehling-Ariza, T., Rosewell, A., Moiba, S.A., Yorpie, B.B., Ndomaina, K.D., Jimissa, K.S., Leidman, E., Rijken, D.J., Basler, C., and Wood, J. (2016). The impact of active surveillance and health education on an Ebola virus disease cluster\u2014Kono District, Sierra Leone, 2014\u20132015. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1941-0"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.outlook.2014.12.013","article-title":"The Ebola epidemic in West Africa: Challenges, opportunities, and policy priority areas","volume":"63","author":"Buseh","year":"2015","journal-title":"Nurs. Outlook"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Hodel, E.M., Kabanywanyi, A.M., Malila, A., Zanolari, B., Mercier, T., Beck, H.P., Buclin, T., Olliaro, P., Decosterd, L.A., and Genton, B. (2009). Residual antimalarials in malaria patients from Tanzania\u2014Implications on drug efficacy assessment and spread of parasite resistance. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0008184"},{"key":"ref_33","first-page":"e00137","article-title":"Transmission of Ebola viruses: What we know and what we do not know","volume":"6","author":"Osterholm","year":"2015","journal-title":"MBio"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1080\/20477724.2019.1650227","article-title":"The cat that kills people: Community beliefs about Ebola origins and implications for disease control in Eastern Democratic Republic of the Congo","volume":"113","author":"Kasereka","year":"2019","journal-title":"Pathog. Glob. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/ijn.12425","article-title":"Perceptions of Ebola virus disease in Nigeria: Understanding the influence of imagination on health orientation","volume":"22","author":"Oduyemi","year":"2016","journal-title":"Int. J. Nurs. Pract."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1056\/NEJMp1508413","article-title":"Community Trust and the Ebola Endgame","volume":"373","author":"Dhillon","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"020311","DOI":"10.7189\/jogh.09.020311","article-title":"Knowledge and beliefs about Ebola virus in a conflict-affected area: Early evidence from the North Kivu outbreak","volume":"9","author":"Oppenheim","year":"2019","journal-title":"J. Glob. Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S1473-3099(19)30063-5","article-title":"Institutional trust and misinformation in the response to the 2018\u201319 Ebola outbreak in North Kivu, DR Congo: A population-based survey","volume":"19","author":"Vinck","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"24366","DOI":"10.1073\/pnas.1913980116","article-title":"The exacerbation of Ebola outbreaks by conflict in the Democratic Republic of the Congo","volume":"116","author":"Wells","year":"2019","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1016\/S0140-6736(19)31364-9","article-title":"Ebola, community engagement, and saving loved ones","volume":"393","author":"Parker","year":"2019","journal-title":"Lancet"},{"key":"ref_41","unstructured":"World Health Organization (WHO) (2020, June 25). Factors That Contributed to Undetected Spread of the Ebola Virus and Impeded Rapid Containment. Available online: https:\/\/www.who.int\/csr\/disease\/ebola\/one-year-report\/factors\/en."},{"key":"ref_42","first-page":"386","article-title":"Ebola transmission linked to a single traditional funeral ceremony\u2014Kissidougou, Guinea, December, 2014\u2013January 2015","volume":"64","author":"Victory","year":"2015","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"9","DOI":"10.11604\/pamj.supp.2015.22.1.6190","article-title":"The impact of traditional and religious practices on the spread of Ebola in West Africa: Time for a strategic shift","volume":"22","author":"Manguvo","year":"2015","journal-title":"Pan Afr. Med. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2471\/BLT.20.263202","article-title":"Engaging religious leaders to promote safe burial practices during the 2014\u20132016 Ebola virus disease outbreak, Sierra Leone","volume":"99","author":"Lyons","year":"2021","journal-title":"Bull. World Health Organ."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/10810730.2016.1209601","article-title":"Facilitators and barriers to community acceptance of safe, dignified medical burials in the context of an Ebola epidemic, Sierra Leone, 2014","volume":"22","author":"DeLuca","year":"2017","journal-title":"J. Health Commun."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S67","DOI":"10.1097\/01.aids.0000327438.13291.62","article-title":"Stigma in the HIV\/AIDS epidemic: A review of the literature and recommendations for the way forward","volume":"22","author":"Mahajan","year":"2008","journal-title":"AIDS"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/S1473-3099(14)71079-5","article-title":"Ebola: Lessons learned from HIV and tuberculosis epidemics","volume":"15","author":"Drain","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1146\/annurev-med-052915-015604","article-title":"Ebola: Anatomy of an epidemic","volume":"68","author":"Lo","year":"2017","journal-title":"Annu. Rev. Med."},{"key":"ref_49","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":"Nuriddin","year":"2018","journal-title":"BMJ Glob. Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/tmi.13226","article-title":"Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: A systematic review","volume":"24","author":"James","year":"2019","journal-title":"Trop. Med. Int. Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1146\/annurev.publhealth.012809.103604","article-title":"The role of behavioral science theory in development and implementation of public health interventions","volume":"31","author":"Glanz","year":"2010","journal-title":"Annu. Rev. Public Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/20477724.2020.1754654","article-title":"Ebola crisis in Eastern Democratic Republic of Congo: Student-led community engagement","volume":"114","author":"Hawkes","year":"2020","journal-title":"Pathog. Glob. Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1177\/1049732307307864","article-title":"Dilemma with the local perception of causes of illnesses in central Africa: Muted concept but prevalent in everyday life","volume":"17","author":"Sabuni","year":"2007","journal-title":"Qual. Health Res."},{"key":"ref_54","first-page":"20","article-title":"Improving burial practices and cemetery management during an Ebola virus disease epidemic\u2014Sierra Leone, 2014","volume":"64","author":"Nielsen","year":"2015","journal-title":"MMWR Morb. Mortal. Wkly. Rep."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/8\/4714\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:53:33Z","timestamp":1760136813000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/8\/4714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,13]]},"references-count":55,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["ijerph19084714"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19084714","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,13]]}}}