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Title
The Impact of Different Types of Violence on Ebola Virus Transmission During the 2018-2020 Outbreak in the Democratic Republic of the Congo. |
Full text
https://escholarship.org/uc/item/08j5q087 |
Date
2020 |
Author(s)
Kelly, John Daniel; Wannier, Sarah Rae; Sinai, Cyrus; Moe, Caitlin A; Hoff, Nicole A; Blumberg, Seth; Selo, Bernice; Mossoko, Mathais; Chowell-Puente, Gerardo; Jones, James Holland; Okitolonda-Wemakoy, Emile; Rutherford, George W; Lietman, Thomas M; Muyembe-Tamfum, Jean Jacques; Rimoin, Anne W; Porco, Travis C; Richardson, Eugene T |
Abstract
BackgroundOur understanding of the different effects of targeted versus nontargeted violence on Ebola virus (EBOV) transmission in Democratic Republic of the Congo (DRC) is limited.MethodsWe 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.ResultsAverage 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 (Pā
=ā
.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.ConclusionsEbola-targeted violence, primarily driven by civilian-induced events, had the largest impact on EBOV transmission. |
Subject(s)
Humans; Hemorrhagic Fever; Ebola; Disease Outbreaks; Civil Disorders; Democratic Republic of the Congo; Ebolavirus; Geographic Mapping; Armed Conflicts; Africa; Ebola virus disease; transmission; violence; Mental Health; Violence Research; Microbiology; Biological Sciences; Medical and Health Sciences |
Coverage
2021 - 2029 |
Publisher
eScholarship, University of California |
Type of publication
article |
Format
application/pdf |
Source
The Journal of infectious diseases, vol 222, iss 12 |
Rights
public |
Identifier
qt08j5q087 |
Repository
Berkeley - University of California
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Added to C-A: 2022-06-22;10:49:08 |
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