@article{oai:jrckicn.repo.nii.ac.jp:00000250,
 author = {KUNII, Osamu and 國井, 修 and KITA, Etsuko and 喜多, 悦子 and SHIBUYA, Kenji and 渋谷, 健司},
 issue = {10},
 journal = {日本公衆衛生雑誌, Japanese journal of public health},
 month = {Oct},
 note = {http://ci.nii.ac.jp/naid/10008645514, application/pdf, 【目的】　1994～97年に3度のエボラ出血熱（以下EHF）流行が発生したガボン共和国において，流行状況とその対策，また背景にあると考えられる文化的要因について検討した。
【方法】　1997年1月3度目のEHF流行期間中，米国およびガボンにおいて関係機関を訪問し情報を収集した。また，EHFが流行中のガボンのBooue村において，20歳以上男女計20人に対しEHFに関する知識および意識について，伝統治療士2人に対し患者の治療方法について，それぞれ訪問面接調査を実施した。
【結果】　3回の流行はすべてチンパンジーやゴリラとの関連が疑われ，特に第二の流行では12人の死亡例が村の祭りのため死んだチンパンジーの皮を剥いで調理し食していた。スーダンやザイールでEHF流行を悪化させた要因である病院での汚染注射針の利用は早期に予防されていたが，家庭内における家族の患者との濃厚な接触，葬式における遺体への抱擁などの伝統的風習が本流行での重要な伝播要因となっていたと考えられる。
　訪問面接調査の結果は，流行地の村でありながら3割以上はその疾病の名前さえ知らず，知っていてもそれがどのような病気でどのように伝播するかを回答できない者が多かった。住民の伝統治療士に対する信頼度は高いが，患者の両腕にナイフで傷をつけ血液を皮膚に擦りつけるなどの伝統的治療が感染伝播に寄与していることも推測された。
【結論】　EHF流行の背景には文化的要因が強く関連している可能性が示唆された。今後国際的な感染症対策において，人類学・社会学など保健医療以外の分野との協力体制が重要になってくると思われる。, 【Objective】The Republic of Gabon experienced epidemics of Ebola hemorrhagic fever (EHF) three times between 1994 and 1997. This study aimed at exploring cultural factors related to the outbreaks.
【Methods】We collected information about EHF epidemics from the Gabon Ministry of Health, district hospitals and other facilities and conducted in-depth interviews with 20 villagers and 2 traditional healers in the village where the third epidemic occurred.
【Results】All three epidemics were supposed to have direct or indirect relationship with great apes, the victims having cooked or eaten chimpanzees meat. Although the reuse of syringes and needles in hospitals which had worsened past EHF outbreaks in Sudan and Zaire did not contribute to the outbreak in Gabon, traditional practices as family members remaining close to the patient to nurse him/her, and hugging and touching the dead at funerals were suspected to be crucial sources of infection. Interviews with traditional healers revealed that traditional treatment methods as cutting a patient' skin with an unsterilized knife and appkling blood to the skin were risky and might have been contributory factors in the deaths of one traditionals healer and his assistant in the thir EHF outbreak.
 In one village where EHF had reached epidemic proportions, in-depth interviews were conducted with 2 traditional healers and 20 persons of mean age 33 (20～46) years with a sampling method of selecting every tenth household form the entrance. Even though they lived in a village suffering an EHF outbreak, only two thirds of them knew the name of the disease and about half of them could not explain what kind of thought it had been due to evil spirits; others responded the mosquitoes or patient's sweat/saliva were the cause.
【Conclusions】This study showed that cultural factors might  be very crucial to EHF outbreaks in developing counties. Quick intervention with health education is needed to disseminate appropriate knowledge and persuade people that traditional practices could carry a high risk of infection.},
 pages = {853--859},
 title = {ガボン共和国におけるエボラ出血熱流行と関連する文化的要因},
 volume = {48},
 year = {2001},
 yomi = {クニイ, オサム and キタ, エツコ and シブヤ, ケンジ}
}