La surveillance des personnes contacts pour Ébola : effets sociaux et enjeux éthiques au Sénégal

Autor: K. Sow, A. G. Ndione, Alice Desclaux, D. Badji
Rok vydání: 2016
Předmět:
Male
Ébola
Disease Outbreaks
Surveillance des sujets contacts
0302 clinical medicine
Informed consent
Contact follow-up
Health care
030212 general & internal medicine
Social Change
Social isolation
media_common
Socio-anthropology
Sub-Saharan Africa
06 humanities and the arts
Senegal
Africa
Western
Social Isolation
Population Surveillance
Ebola
Quarantine
Female
Public Health
medicine.symptom
Psychology
Autonomy
Adult
medicine.medical_specialty
media_common.quotation_subject
Suivi
Coercion
0603 philosophy
ethics and religion
Pathology and Forensic Medicine
03 medical and health sciences
Sénégal
Nursing
medicine
Humans
Socio-anthropologie
Ethics
Stereotyping
business.industry
Public health
Social change
Hemorrhagic Fever
Ebola
Dakar
Ethique
Guinée
Guinea
Afrique intertropicale
060301 applied ethics
Contact Tracing
business
Anthropologie Médicale / Medical Anthropology
Contact tracing
Zdroj: Bulletin De La Societe De Pathologie Exotique (1990)
ISSN: 1961-9049
0037-9085
Popis: Quarantine has been widely used during the Ebola outbreak in West Africa mainly to control transmission chains. This measure raises ethical issues that require documentation of the modalities of quarantine at the field level and its social effects for contact persons. In Senegal, 74 people were in contact with the Ebola case coming from Guinea in September 2014. Of these, 34 members of the case's household were contained together at home and monitored by officers. The remaining 40 health care workers from two facilities were dispersed in their family households and monitored by telephone or during doctors' visits. The study is based on in-depth interviews with 43 adult contacts about their experiences and perceptions, with additional observation for interpretation and contextualization.Containment at home was applied differently to contacts who lived with patient zero than to professional health care contacts. No coercion was used at first since all contacts adhered to surveillance, but some of them did not fully comply with movement restrictions. Contacts found biosafety precautions stigmatizing, especially during the first days when health workers and contacts were feeling an acute fear of contagion. The material support that was provided-food and money-was necessary since contacts could not work nor get resources, but it was too limited and delayed. The relational support they received was appreciated, as well as the protection from stigmatization by the police and follow-up workers. But the information delivered to contacts was insufficient, and some of them, including health workers, had little knowledge about EVD and Ebola transmission, which caused anxiety and emotional suffering. Some contacts experienced the loss of their jobs and loss of income; several could not easily or fully return to their previous living routines.Beyond its recommendations to enhance support measures, the study identifies the ethical stakes of quarantine in Senegal regarding informed consent and individual autonomy, non-maleficence and benevolence, and equity and adaptation to specific situations. Nevertheless, the balance between preventive benefits and individual inconveniences of quarantine should still be evaluated from a public health perspective.
Databáze: OpenAIRE
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