Abstract summary 

Previous research suggests that adult survivors of Ebola Virus Disease (EVD) experience mental health problems following their infection. This study examines long-term mental health consequences of EVD for child survivors, and those affected by EVD but not themselves infected, compared to controls. This study also examines the mediating effects of caregiver mental health on children's mental health outcomes.Using a case-control study design, we recruited 663 children (aged 10-17) and their caregivers at two time points, from six geographically diverse districts in Sierra Leone. Our analytic sample included n=217 EVD-infected children, n=206 EVD-affected children (i.e. children who were not themselves infected but someone in their household was infected), n=230 control children, and one caregiver per child (N=653). Using a Structural Equation Model, we examined the mediating effects of caregiver anxiety and depression at Time 1 on the relationship between study condition and children's prosocial behaviors and behavioral difficulties at Time 2, controlling for child's age, gender, household wealth, urban vs. rural, and district.EVD-infected and -affected children were more likely to demonstrate behavioral difficulties compared to controls. Caregiver depression mediated the relationship between being affected by EVD and children's behavioral problems. Caregiver anxiety mediated the relationship between being EVD-affected and children's prosocial behaviors.The mental health consequences of EVD are long-lasting for EVD child survivors and those affected, as well as caregivers. Policy and programmatic responses need to account for the heightened vulnerability introduced not just to survivors after an infectious disease outbreak, but to their families and household members.

Authors & Co-authors:  Crea Thomas M TM Okunoren Oladoyin O Klein Elizabeth K EK Collier K Megan KM McTernan Melissa M Sevalie Stephen S Molleh Bailah B Kabba Yusuf Y Kargbo Abdulai A Bangura Joseph J Gbettu Henry H Grant Donald S DS Samuels Robert J RJ Simms Stewart S Drury Stacy S Schieffelin John S JS Betancourt Theresa S TS

Study Outcome 

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