The Impact of Different Types of Violence on Ebola Virus Transmission During the 2018-2020 Outbreak in the Democratic Republic of the Congo.
J Infect Dis
; 222(12): 2021-2029, 2020 11 13.
Article
em En
| MEDLINE
| ID: mdl-32255180
ABSTRACT
BACKGROUND:
Our understanding of the different effects of targeted versus nontargeted violence on Ebola virus (EBOV) transmission in Democratic Republic of the Congo (DRC) is limited.METHODS:
We used time-series data of case counts to compare individuals in Ebola-affected health zones in DRC, April 2018-August 2019. Exposure was number of violent events per health zone, categorized into Ebola-targeted or Ebola-untargeted, and into civilian-induced, (para)military/political, or protests. Outcome was estimated daily reproduction number (Rt) by health zone. We fit linear time-series regression to model the relationship.RESULTS:
Average Rt was 1.06 (95% confidence interval [CI], 1.02-1.11). A mean of 2.92 violent events resulted in cumulative absolute increase in Rt of 0.10 (95% CI, .05-.15). More violent events increased EBOV transmission (Pâ =â .03). Considering violent events in the 95th percentile over a 21-day interval and its relative impact on Rt, Ebola-targeted events corresponded to Rt of 1.52 (95% CI, 1.30-1.74), while civilian-induced events corresponded to Rt of 1.43 (95% CI, 1.21-1.35). Untargeted events corresponded to Rt of 1.18 (95% CI, 1.02-1.35); among these, militia/political or ville morte events increased transmission.CONCLUSIONS:
Ebola-targeted violence, primarily driven by civilian-induced events, had the largest impact on EBOV transmission.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Surtos de Doenças
/
Distúrbios Civis
/
Doença pelo Vírus Ebola
/
Conflitos Armados
/
Mapeamento Geográfico
Limite:
Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
J Infect Dis
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos