This cross-sectional survey evaluated the psychosocial impact of the 2024 Marburg virus disease (MVD) outbreak on both individuals who recovered from MVD and frontline health workers (FHWs) in Kigali, Rwanda. The study focused on symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), and examined relationships with perceived stigma and social support following outbreak containment.
The investigation took place in Kigali, the capital city of Rwanda, where two treatment centres managed MVD cases during the outbreak period from 24 September to 24 October 2024. The study attempted to include all eligible cases: 51 recovered individuals from MVD and 98 FHWs who met eligibility criteria. The analyzed sample comprised 115 participants: 29 recovered people and 86 frontline health workers.
Psychological outcomes were assessed using validated instruments. Depression was measured by the Patient Health Questionnaire (PHQ-9), anxiety by the Generalised Anxiety Disorder scale (GAD-7), and PTSD symptoms by the PTSD Checklist for DSM-5 (PCL-5). Perceived stigma was assessed using an adapted Ebola stigma and discrimination questionnaire. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MPSS).
Non-parametric tests were used to examine group differences in symptom scores: Wilcoxon rank-sum and Kruskal–Wallis tests assessed differences by sex and profession. Spearman correlation coefficients evaluated relationships between continuous variables such as symptom scores, stigma, and social support. Regression analyses produced beta coefficients with 95% confidence intervals to quantify associations between demographic variables and symptom levels.
Among frontline health workers, 11.8% had moderate-to-severe depression. For recovered individuals, 20.7% had mild-to-moderate depression. Regarding anxiety, 9.4% of FHWs exhibited moderate-to-severe symptoms, while 17.2% of recovered people reported mild anxiety.
For PTSD screening using the PCL-5 threshold of 33, 9.3% of frontline health workers and one recovered individual exceeded this cutoff, indicating levels consistent with probable PTSD in a subset of participants.
Among recovered people, a significant negative correlation was observed between anxiety and social support (Spearman r = −0.36, p = 0.05), indicating higher perceived social support was associated with lower anxiety symptom scores in this group. Recovered individuals also showed a significant difference in PTSD symptom levels between sexes (p = 0.01), though the source did not report directionality or effect sizes by sex beyond the statistical significance.
Among frontline health workers, MVD-related stigma correlated positively with PTSD symptoms (Spearman r = +0.23, p = 0.05), suggesting perceived stigma was associated with higher PTSD symptom burden.
Regression results among FHWs indicated that age was inversely associated with symptoms: depressive symptoms decreased with increasing age (β = −0.19, 95% CI −0.32 to −0.05), and anxiety symptoms also decreased with age (β = −0.16, 95% CI −0.26 to −0.06).
Marital status related to symptom levels in FHWs: married frontline workers reported lower levels of depression (β = −2.72, 95% CI −4.96 to −0.49) and lower anxiety (β = −2.35, 95% CI −4.07 to −0.62) compared with single colleagues.
Six months after containment of the 2024 MVD outbreak in Rwanda, a proportion of frontline health workers continued to experience depression, anxiety, and PTSD. The study authors recommend integration of contextualised and culturally adapted mental health and psychosocial support interventions into infectious disease response plans to address persistent psychological effects among responders and survivors.
The source summary does not provide detailed information on sampling procedures, response rates from the invited pool, or other methodological limitations. Those details were not reported in the provided source text and therefore cannot be described here.