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Cuts in aid are linked to Ebola crisis, say MPs

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5975 (Published 02 October 2014) Cite this as: BMJ 2014;349:g5975

Ebola, Twitter, and Misinformation: A dangerous combination?

Dear Editor,

The recent Ebola outbreak in West Africa has so far affected countries that are deeply in need of foreign aid (1). There is also a strong need to give people correct information about what can be done to prevent and treat Ebola. Despite the poverty affecting much of the region, there is an increasing spread of computers, tablets, and smartphones in West Africa that creates an opportunity for the rapid dissemination of information through the Internet and social media. Unfortunately, these technological advancements do not guarantee that the disseminated information is correct from a medical viewpoint. As there have been reports of misinformation spread by text messages leading to deaths (2,3), we wanted to check the quality of information related to Ebola prevention and treatment in the increasingly important microblogging service Twitter.

By making use of the Twitter search engine, we collected all tweets including the terms Ebola and prevention or cure, in English, respectively emitted from the West African countries of Guinea, Liberia and Nigeria during the period Sept 1- Sept 7. We then categorized all unique tweets (n=564) into three categories; a) medically correct information, b) medical misinformation, and c) other (this latter group also included tweets of a religious or spiritual nature).

We found 203 tweets (36%) in category a, 313 (55.5%) in category b, and 48 (8.5%) in category c. Tweets in category a were potentially read by 5,596,153 Twitter users, while the tweets in category b potentially reached 15,039,097 Twitter users. Among these tweets, 248 (44%) were at least retweeted once; 95 of the retweeted messages contained scientifically correct information (38.3%) vs 146 of retweets contained medical misinformation (58.9%, p less than 0.001). Two of these tweets were retweeted 23 and 24 times, respectively: ““Take Ewedu Daily To Prevent & Cure Ebola” – LUTH Doctor Urges Nigerians”; and “Herbal healers’ claim to cure Ebola false”.

The most common misinformation was that the plant Ewedu might cure Ebola, followed by the statement that blood transfusions (unqualified, ie not mentioning from Ebola survivors) might do so. Drinking and washing in salty water was also mentioned by several. While most erroneous tweets were left undisputed, we found some cases where a Nigerian State government via a newspaper had corrected wrong information, and where this correction was spread on Twitter three days later.

We believe our findings suggest that public health and government agencies in West Africa should be more active on Twitter, in order to spread correct information on how to deal with this emergency and in order to correct misinformation.

References
1. Gulland A. Cuts in aid are linked to Ebola crisis, say MPs. BMJ 2014;349:g5975
2. Wagner M. Phony Ebola cures spread online; 2 Nigerians die from drinking salt water to ward off virus, UN says. New York Daily News [Internet]. 2014 Aug 16. Cited 2014 Sep 21. Available at: http://www.nydailynews.com/life-style/health/phony-ebola-cures-spread-on...
3. Nanlong M-T. Nigeria: Ebola - Two Die After Drinking Salt Water in Jos. Vanguard [Internet]. 2014 Aug 8. Cited 2014 Sep 21. Available at: http://allafrica.com/stories/201408111640.html

Sunday Oluwafemi Oyeyemi, MD
State Specialist Hospital, Akure, Nigeria

Elia Gabarron, Psych
Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway

Rolf Wynn, MD, PhD
Department of Clinical Medicine, The Arctic University of Norway

Competing interests: No competing interests

07 October 2014
Sunday Oluwafemi Oyeyemi
MD
Elia Gabarron, Rolf Wynn
State Specialist Hospital, Akure, Nigeria
State Specialist Hospital, Akure, Nigeria