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Risk Factors Associated with the Contraction of Ebola Virus Disease in Liberia Beyan Yancy Sana Walden University

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Risk Factors Associated with the Contraction of Ebola Virus Disease in Liberia Beyan Yancy Sana Walden University Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2019 Risk Factors Associated with the Contraction of Ebola Virus Disease in Liberia Beyan Yancy Sana Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Medicine and Health Sciences Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral study by Beyan Y. Sana has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Srikanta Banerjee, Committee Chairperson, Public Health Faculty Dr. Jirina Foltysova, Committee Member, Public Health Faculty Dr. German Gonzalez, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2019 Abstract Risk Factors Associated with the Contraction of Ebola Virus Disease in Liberia by Beyan Y. Sana MPH, Walden University, 2016 BS, University of Maryland School of Medicine, 2008 BS, University of Liberia, 2001 Doctoral Study Proposal Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Walden University May 2019 Abstract Ebola virus disease (EVD) is a highly transmittable disease with high mortality rate. The purpose of this study was to examine risk factors associated with the contraction of EVD in Liberia. A retrospective cross-sectional design was used to analyze secondary data collected on 1,658 patients admitted to Ebola treatment units in Liberia, using the social ecological model as a theoretical framework. Descriptive statistics and the chi-square test for association and logistic regression were used to analyze the data. The findings of this study revealed that funeral attendance, exposure to body fluids, and contact with a living sick person were associated with the contraction of EVD (p < 0.05). The likelihood of contracting EVD is 14.32 times greater among patients exposed to body fluids. The likelihood of contracting EVD is 15.34 times greater among patients exposed to a living sick person. The results failed to identify other factors such as gender, age, and community of residence as factors associated with the contraction of EVD. The findings of this study may foster social change through comprehensive EVD prevention and control programs by focusing on improving the quality of life of underprivileged communities, investing in social, educational, and community-based development programs such as roads, schools, sanitation, and health care facilities. Educational and community-based initiatives can encourage health and wellness by educating communities about the dangers EVD poses to their lives and well-being. Risk Factors Associated with the Contraction of Ebola Virus Disease in Liberia by Beyan Y. Sana MPH, Walden University, 2016 BS, University of Maryland School of Medicine, 2008 BS, University of Liberia, 2001 Doctoral Study Proposal Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Walden University May 2019 Dedication This capstone study is dedicated to my loving children (Joshua, Beyanna, and LeYan Sana); my wife, Roseline; my loving mother, Mrs. Desiree K. Zain; my father, Mr. John S. Sana; my uncle, Mr. G.S. Keamu; my family in Liberia; people that were affected by Ebola virus disease, both survival and deceased; and my entire family and friends around the world. Acknowledgments I would like to express my sincere thanks and appreciation to my Lord and Savior Jesus Christ for granting the strength to accomplish my dream. I want to acknowledge the chair of my committee, Dr. Srikanta Banerjee, my committee member, Dr. Jirina Renger, and my URR, Dr. German Gonzalez for providing their invaluable support during the entire capstone process. Without their valuable contribution, it would have been impossible to complete this capstone research study. Many thanks for all the countless hours spent emailing and calling Dr. Banerjee and Dr. Renger concerning my study. I would also like to thank Dr. Mosoka Fallah, Deputy Director of the National Public Health Institute of Liberia for allowing me to use the Ebola virus disease dataset. I say a big thank you to my employer for providing me with financial support through the Johns Hopkins tuition assistance programs. Finally, I want to acknowledge my beautiful children (Joshua, Beyanna, and LeYan Sana) and wife (Roseline) for their support during this journey. Table of Contents List of Tables .......................................................................................................................v List of Figures ................................................................................................................... vii Section 1: Foundation of the Study and Literature Review Search Strategy .......................1 Introduction ....................................................................................................................1 Problem Statement .........................................................................................................5 Purpose of the Study ......................................................................................................8 Research Questions and Hypotheses ...........................................................................11 Theoretical Foundation for the Study ..........................................................................13 Nature of the Study ......................................................................................................14 Literature Search Strategy............................................................................................16 Literature Review Related to Key Variables and/or Concepts ....................................18 Population and Geographical Location of Liberia ................................................ 18 Epidemiology of Ebola Virus Disease in Liberia ................................................. 20 Gender and Ebola Virus Disease .......................................................................... 21 Age or Age Groups and Ebola Virus Disease ....................................................... 23 Community and County of Residence and Ebola Virus Disease .......................... 28 Funeral Attendance (Burial Rituals) and Ebola Virus Disease Contraction ......... 34 Exposure to Body Fluids and Ebola Virus Disease .............................................. 37 Contact with the Living Sick and Ebola Virus Disease ........................................ 40 Literature Review Summary ................................................................................. 42 Definition of Key Terms Related to the Study ............................................................43 i Assumptions .................................................................................................................46 Scope and Delimitations ..............................................................................................46 Significance of the Study and Implications for Positive Social Change .....................49 Significance to the Theory .................................................................................... 51 Summary and Conclusions ..........................................................................................52 Section 2: Research Design and Data Collection ..............................................................53 Introduction ..................................................................................................................53 Research Design and Rationale ...................................................................................54 Methodology ................................................................................................................54 Study Population ................................................................................................... 55 Sampling and Sampling Procedures ..................................................................... 55 Instrumentation and Operationalization of Constructs ................................................62 Instrumentation ..................................................................................................... 63 Operationalization of Variables ............................................................................ 63 Dependent Variable .............................................................................................. 64 Independent Variables .......................................................................................... 65 Data Analysis Plan .......................................................................................................66 Research Questions and Hypotheses .................................................................... 66 Statistical Tests for the Study Outcome ................................................................ 68 Threats to Validity .......................................................................................................69 Internal Threats to Validity ..................................................................................
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