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Spatial variability in the reproduction number of Ebola virus disease, Democratic Republic of the Congo, January-September 2019.

ABSTRACT: The ongoing Ebola virus disease epidemic (August 2018?October 2019) in the Democratic Republic of the Congo, has been exacerbated by deliberate attacks on healthcare workers despite vaccination efforts. Using a mathematical/statistical modelling framework, we present the quantified effective reproduction number (R t) at national and regional levels as at 29 September. The weekly trend in R t displays fluctuations while our recent national-level R t falls slightly above 1.0 with substantial uncertainty, which suggests improvements in epidemic control.

SUBMITTER: Mizumoto K

PROVIDER: S-EPMC6807257 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Spatial variability in the reproduction number of Ebola virus disease, Democratic Republic of the Congo, January-September 2019.

Mizumoto Kenji K Tariq Amna A Roosa Kimberlyn K Kong Jun J Yan Ping P Chowell Gerardo G

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20191001 42

The ongoing Ebola virus disease epidemic (August 2018─October 2019) in the Democratic Republic of the Congo, has been exacerbated by deliberate attacks on healthcare workers despite vaccination efforts. Using a mathematical/statistical modelling framework, we present the quantified effective reproduction number (Rt) at national and regional levels as at 29 September. The weekly trend in Rt displays fluctuations while our recent national-level Rt</s ...[more]

PMID: 31640841

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Project description:BackgroundThe 2018-2019 Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo (DRC) is the largest ever recorded in the DRC. It has been declared a Public Health Emergency of International Concern. The outbreak emerged in a region of chronic conflict and insecurity, and directed attacks against health care workers may have interfered with disease response activities. Our study characterizes and quantifies the broader conflict dynamics over the course of the outbreak by pairing epidemiological and all available spatial conflict data.MethodsWe build a set of conflict variables by mapping the spatial locations of all conflict events and their associated deaths in each of the affected health zones in North Kivu and Ituri, eastern DRC, before and during the outbreak. Using these data, we compare patterns of conflict before and during the outbreak in affected health zones and those not affected. We then test whether conflict is correlated with increased EVD transmission at the health zone level.FindingsThe incidence of conflict events per capita is ~?600 times more likely in Ituri and North Kivu than for the rest of the DRC. We identified 15 time periods of substantial uninterrupted transmission across 11 health zones and a total of 120 bi-weeks. We do not find significant short-term associations between the bi-week reproduction numbers and the number of conflicts. However, we do find that the incidence of conflict per capita was correlated with the incidence of EVD per capita at the health zone level for the entire outbreak (Pearson's r?=?0.33, 95% CI 0.05-0.57). In the two provinces, the monthly number of conflict events also increased by a factor of 2.7 in Ebola-affected health zones (p value <?0.05) compared to 2.0 where no transmission was reported and 1.3 in the rest of the DRC, in the period between February 2019 and July 2019.ConclusionWe characterized the association between variables documenting broad conflict levels and EVD transmission. Such assessment is important to understand if and how such conflict variables could be used to inform the outbreak response. We found that while these variables can help characterize long-term challenges and susceptibilities of the different regions they provide little insight on the short-term dynamics of EVD transmission.

Dataset Information

Spatial variability in the reproduction number of Ebola virus disease, Democratic Republic of the Congo, January-September 2019.

Publications

Spatial variability in the reproduction number of Ebola virus disease, Democratic Republic of the Congo, January-September 2019.

Similar Datasets

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