ABSTRACT

The second largest Ebola virus disease (EVD) epidemic occurred in the Democratic Republic of the Congo (DRC) from 2018–20. The Bambuti, a hunter population in the Ituri Forest of the DRC, may be vulnerable to the zoonotic spread of EVD due to their frequent handling of forest animals. We conducted five focus group discussions and surveyed 113 Bambuti and 91 Bantu (control group), to discern how the Bambuti perceived and responded to EVD. Thematic analysis of focus group discussions revealed three major themes: (1) deprivation and discrimination; (2) mistrust; and (3) epistemic dissonance with public health messages emphasizing risks posed by forest animals. In surveys, 98% of Bambuti were deprived using the multidimensional poverty index (versus 78% of Bantu controls, p < 0.0001) and 77% had no formal education (versus 29% of controls, p < 0.0001). Bambuti were more dependent on wild meat for survival (51% versus 32% of controls, p = 0.008) and more frequently opposed the implementation of a bushmeat ban (48% versus 19% of controls, p < 0.0001). Trust in government was similar among Bambuti and Bantu. Comprehensive EVD knowledge was poor overall, and lower among the Bambuti (2% versus 8% of controls, p = 0.041). Compliance with public health measures was associated with higher levels of education and trust in government but did not differ between Bambuti and Bantu survey respondents. Together, our findings point to a particular vulnerability of the Bambuti to the effects of EVD, attributable at least in part to multidimensional poverty.

摘要

2018-20 年，刚果民主共和国 (DRC) 发生了第二大埃博拉病毒病 (EVD) 流行病。班布提族是刚果民主共和国伊图里森林中的一个猎人族群，由于他们经常处理森林动物，他们可能容易受到埃博拉病毒病的人畜共患病传播。我们进行了五次焦点小组讨论，并调查了 113 名班布提人和 91 名班图人（对照组），以了解班布提人如何看待和应对 EVD。焦点小组讨论的主题分析揭示了三个主要主题：（1）剥夺和歧视；（二）不信任；(3) 与强调森林动物风险的公共卫生信息的认知不一致。在调查中，98% 的班布提人使用多维贫困指数（对比78% 的班图人对照组，p < 0.0001）和 77% 的人没有接受过正规教育（对照组为29%，p < 0.0001）。班布提更依赖野生肉类生存（51%对32% 的对照组，p = 0.008）并且更频繁地反对实施丛林肉禁令（48%对19% 的对照组，p < 0.0001）。班布提和班图人对政府的信任相似。总体而言，全面的 EVD 知识很差，而且在 Bambuti 中较低（2%对8% 的对照组，p = 0.041）。遵守公共卫生措施与更高水平的教育和对政府的信任有关，但在班布提和班图的调查受访者之间没有差异。总之，我们的研究结果表明，班布提人特别容易受到埃博拉病毒病的影响，至少部分归因于多维贫困。