Determinants of Transmission Risk During the Late Stage of the West African Ebola Epidemic.
Ebola
Guinea
multiple imputation
regression analysis
risk factors
Journal
American journal of epidemiology
ISSN: 1476-6256
Titre abrégé: Am J Epidemiol
Pays: United States
ID NLM: 7910653
Informations de publication
Date de publication:
01 07 2019
01 07 2019
Historique:
received:
05
09
2018
revised:
26
03
2019
accepted:
27
03
2019
pubmed:
4
4
2019
medline:
26
3
2020
entrez:
4
4
2019
Statut:
ppublish
Résumé
Understanding risk factors for Ebola transmission is key for effective prediction and design of interventions. We used data on 860 cases in 129 chains of transmission from the latter half of the 2013-2016 Ebola epidemic in Guinea. Using negative binomial regression, we determined characteristics associated with the number of secondary cases resulting from each infected individual. We found that attending an Ebola treatment unit was associated with a 38% decrease in secondary cases (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI): 0.38, 0.99) among individuals that did not survive. Unsafe burial was associated with a higher number of secondary cases (IRR = 1.82, 95% CI: 1.10, 3.02). The average number of secondary cases was higher for the first generation of a transmission chain (mean = 1.77) compared with subsequent generations (mean = 0.70). Children were least likely to transmit (IRR = 0.35, 95% CI: 0.21, 0.57) compared with adults, whereas older adults were associated with higher numbers of secondary cases. Men were less likely to transmit than women (IRR = 0.71, 95% CI: 0.55, 0.93). This detailed surveillance data set provided an invaluable insight into transmission routes and risks. Our analysis highlights the key role that age, receiving treatment, and safe burial played in the spread of EVD.
Identifiants
pubmed: 30941398
pii: 5426492
doi: 10.1093/aje/kwz090
pmc: PMC6601535
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1319-1327Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Medical Research Council
ID : MR/S003975/1
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 206250/Z/17/Z
Pays : United Kingdom
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
Références
Emerg Infect Dis. 2003 Nov;9(11):1430-7
pubmed: 14718087
Nature. 2005 Nov 17;438(7066):355-9
pubmed: 16292310
PLoS One. 2007 Feb 14;2(2):e180
pubmed: 17299582
Am J Epidemiol. 2008 Aug 15;168(4):355-7
pubmed: 18591202
BMJ. 2009 Jun 29;338:b2393
pubmed: 19564179
Science. 2014 Sep 12;345(6202):1369-72
pubmed: 25214632
N Engl J Med. 2014 Oct 16;371(16):1481-95
pubmed: 25244186
Lancet Infect Dis. 2015 Mar;15(3):320-6
pubmed: 25619149
N Engl J Med. 2015 Mar 26;372(13):1274-7
pubmed: 25806936
Lancet Infect Dis. 2015 May;15(5):507-8
pubmed: 25932579
BMJ. 2015 Jul 27;351:h3740
pubmed: 26215666
Lancet. 2015 Aug 29;386(9996):857-66
pubmed: 26248676
Lancet. 2015 Aug 1;386(9992):432
pubmed: 26251391
Lancet Infect Dis. 2015 Nov;15(11):1292-9
pubmed: 26271406
Emerg Infect Dis. 2015 Oct;21(10):1800-7
pubmed: 26402477
Elife. 2015 Nov 03;4:null
pubmed: 26525597
Int J Epidemiol. 2016 Feb;45(1):102-16
pubmed: 26589246
BMC Med. 2015 Nov 26;13:281
pubmed: 26607790
Proc Natl Acad Sci U S A. 2016 Apr 19;113(16):4488-93
pubmed: 27035948
Int Health. 2016 May;8(3):227-9
pubmed: 27059272
Emerg Infect Dis. 2016 Aug;22(8):1403-11
pubmed: 27144428
Emerg Infect Dis. 2016 Sep;22(9):1653-5
pubmed: 27268508
N Engl J Med. 2016 Aug 11;375(6):587-96
pubmed: 27509108
PLoS Med. 2016 Nov 15;13(11):e1002170
pubmed: 27846234
Proc Natl Acad Sci U S A. 2017 Feb 28;114(9):2337-2342
pubmed: 28193880
Philos Trans R Soc Lond B Biol Sci. 2017 May 26;372(1721):null
pubmed: 28396469
Nature. 2017 Apr 20;544(7650):309-315
pubmed: 28405027
PLoS Negl Trop Dis. 2017 Jun 22;11(6):e0005491
pubmed: 28640823
Front Public Health. 2017 Jul 10;5:160
pubmed: 28740846
BMJ. 2018 May 30;361:k2388
pubmed: 29848617
Lancet. 2018 Jul 21;392(10143):213-221
pubmed: 30047375
Pediatr Infect Dis J. 1996 Mar;15(3):189-91
pubmed: 8852904
J Infect Dis. 1999 Feb;179 Suppl 1:S87-91
pubmed: 9988169