Peer-reviewed article
Community perceptions of yellow fever and its treatment practices in regions with reported outbreaks in Uganda: A qualitative study
Lena Huebl, Aloysious Nnyombi, Patricia Apoko, Denis Okello, Eddy Walakira et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study explored how communities in Uganda perceive yellow fever and treat it, focusing on vulnerable groups including older adults and pregnant women in six districts affected by outbreaks. Participants recognized jaundice as a symptom but could not distinguish yellow fever from other causes like malaria or hepatitis, and held multiple misconceptions about transmission routes. Many relied on traditional medicine rather than health facilities due to limited access and lack of specific treatment. The study found that without recognizing yellow fever as a distinct disease, prevention and diagnostic efforts may be ineffective.
Key points
- Communities recognized jaundice as a symptom but could not distinguish yellow fever from other causes of jaundice such as newborn jaundice, severe malaria, or hepatitis
- Participants believed yellow fever was transmitted through mosquito bites, airborne transmission, close contact, sexual intercourse, vertical transmission during pregnancy, poor hygiene, and certain foods
- Yellow fever survivors relied on traditional medicine due to limited access to health facilities, diagnostic options, and absence of specific treatment
- Awareness campaigns focused on symptoms, prevention, and mass vaccination but did not ensure participants understood the outbreak cause in remote areas
- Failure to diagnose yellow fever in clinical settings can hamper timely outbreak response
Limitations
This qualitative study captures community perceptions and practices but does not evaluate the effectiveness of any intervention or measure health outcomes. The study is descriptive rather than explanatory of causation, and findings are specific to the six districts studied in Uganda during reported outbreaks in 2010 and 2016.
Abstract
BACKGROUND: Yellow fever (YF), a mosquito-borne viral hemorrhagic fever, is endemic to Uganda and has caused numerous outbreaks in recent years. This study explored local perceptions of YF outbreaks among vulnerable groups in Uganda to inform future public health campaigns. METHODOLOGY: A qualitative study examined community perceptions of YF and its treatment practices. Data were collected in six districts where YF outbreaks were reported in 2010 and 2016. A total of 76 individuals participated, comprising 43 semi-structured interviews, 10 expert interviews, and 4 focus group discussions, including vulnerable groups of older adults ≥ 65 years and pregnant women. Data were analyzed using grounded theory. PRINCIPAL FINDINGS: Participants often recognized jaundice but did not distinguish YF from other causes of jaundice, such as newborn jaundice, severe malaria or hepatitis. Nevertheless, participants still considered YF a deadly disease. It was perceived to be transmitted through multiple pathways, including mosquito bites, airborne transmission, close contact with sick individuals, sexual intercourse, vertical transmission during pregnancy, poor hygiene, and certain foods. Treatments ranged from herbal remedies to visiting health centers. Several YF survivors shared first-hand experience, often relying on traditional medicine due to limited access to health facilities, diagnostic options, and no specific treatment for YF. In remote areas, participants often did not know the cause of the outbreak, as awareness campaigns focused on symptoms, prevention, and mass vaccination. CONCLUSIONS/SIGNIFICANCE: If YF is not seen as a distinct disease entity, implementing diagnostic and preventive measures may be impeded. Moreover, failure to diagnose YF in clinical settings can hamper timely outbreak response. We recommend strengthening health literacy through health education and public participation in vulnerable communities with programs tailored to local needs, given that other infectious diseases are prevalent in the region. Furthermore, we propose that access to diagnostic testing for YF may be enhanced.