The potential risk components and prevention measures of the Ebola virus disease outbreak in Liberia: An in-depth interview with the health workers and stakeholders

Background: The Ebola virus, a highly infectious and deadly pathogen, has posed a
significant public health threat in West Africa for several decades. Liberia is one of the most
severely affected countries. Healthcare personnel, including nurses, are on the front lines of
patient care, and their perspectives are invaluable in understanding the challenges that arise
during outbreaks, especially in implementing prevention measures.
Objective: This study aimed to explore the potential risk components and prevention
measures of the Ebola virus disease (EVD).
Methods: This study used an exploratory descriptive qualitative design. Five stakeholders, ten
doctors and five nurses who had suffered from EVD during the outbreak in Liberia participated
in semi-structured interviews to provide their experience and comprehensive perspectives on
EVD. Data were collected from February 2022-August 2023. NVivo 12 plus was used for
inductive thematic analysis.
Results: Six themes and several subthemes emerged: 1) transmission modes (body contact,
body fluid, sexual intercourse, traditional burial), 2) funeral attendance (traditional practices
and crowded gatherings), 3) community-led prevention (promoting good hygiene practices,
increasing awareness, contact tracing, and surveillance), 4) Ebola virus vaccine (false sense
of security, potential side effects, and limited data), 5) challenges in implementing prevention
measures (inadequate health infrastructures, difficulty of tracing infected people, lack of
resources, and cultural-social barriers), 6) Liberia’s health systems (a weak, underfunded,
fragile health infrastructure, lack of health facilities and shortage of health workers).
Conclusion: Several potential risk components contributing to the EVD outbreak should be a
public concern. Strengthening the current healthcare system supported by local community
and international aid providers (multidisciplinary teams) is needed to anticipate behavioral
problems and to improve the efficacy of the prevention measures appropriate to the conditions
in Liberia. Accordingly, the nurses’ compliance with the recommended prevention practices is
necessary.