The Impact of Different Types of Violence on Ebola Virus Transmission During the 2018-2020 Outbreak in the Democratic Republic of the Congo.

Armed Conflicts / classification Civil Disorders / classification Democratic Republic of the Congo / epidemiology Disease Outbreaks Ebolavirus Geographic Mapping Hemorrhagic Fever, Ebola / epidemiology Humans
Africa Democratic Republic of the Congo Ebola virus disease transmission violence

Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
13 11 2020
Historique:
received: 01 12 2019
accepted: 05 04 2020
pubmed: 8 4 2020
medline: 2 4 2021
entrez: 8 4 2020
Statut: ppublish

Résumé

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. 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. 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 (P = .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. Ebola-targeted violence, primarily driven by civilian-induced events, had the largest impact on EBOV transmission.

Sections du résumé

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 (P = .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.

Identifiants

DOI: 10.1093/infdis/jiaa163 PMID: 32255180 PMC: PMC7661768
pubmed: 32255180
pii: 5816846
doi: 10.1093/infdis/jiaa163
pmc: PMC7661768
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

2021-2029

Subventions

Organisme : NIAID NIH HHS
ID : K08 AI139361
Pays : United States
Organisme : NIAID NIH HHS
ID : K23 AI146268
Pays : United States
Organisme : NIGMS NIH HHS
ID : R01 GM130900
Pays : United States

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

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Auteurs

John Daniel Kelly (JD)

Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.
F. I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Institute of Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.

Sarah Rae Wannier (SR)

Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.
F. I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.

Cyrus Sinai (C)

Department of Geography, University of North Carolina, Chapel Hill, North Carolina, USA.

Caitlin A Moe (CA)

Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA.
Firearm Injury Policy and Research Program, Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.

Nicole A Hoff (NA)

School of Public Health, University of California Los Angeles, Los Angeles, California, USA.

Seth Blumberg (S)

F. I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.

Bernice Selo (B)

Ministry of Health, Kinshasa, Democratic Republic of Congo.

Mathais Mossoko (M)

Ministry of Health, Kinshasa, Democratic Republic of Congo.

Gerardo Chowell-Puente (G)

Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA.

James Holland Jones (JH)

Department of Earth Systems Science, Stanford University, Stanford, California, USA.

Emile Okitolonda-Wemakoy (E)

School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

George W Rutherford (GW)

Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.
Institute of Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.

Thomas M Lietman (TM)

Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.

Jean Jacques Muyembe-Tamfum (JJ)

National Institute of Biomedical Research, Kinshasa, Democratic Republic of Congo.

Anne W Rimoin (AW)

School of Public Health, University of California Los Angeles, Los Angeles, California, USA.

Travis C Porco (TC)

Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.
F. I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.

Eugene T Richardson (ET)

Harvard Medical School, Boston, Massachusetts, USA.
Brigham and Women's Hospital, Boston, Massachusetts, USA.

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Classifications MeSH

questionsmedicales.fr › Sciences sociales › Sociologie › Problèmes sociaux › Guerre et conflits armés › Conflits armés › The Impact of Different Types of Violence on...
questionsmedicales.fr › Sciences sociales › Sociologie › Problèmes sociaux › Désordres civils › The Impact of Different Types of Violence on...
questionsmedicales.fr › Régions géographiques › Afrique › Afrique subsaharienne › Afrique centrale › République démocratique du Congo › The Impact of Different Types of Violence on...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Épidémies de maladies › The Impact of Different Types of Violence on...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN de polarité négative › Mononegavirales › Filoviridae › Ebolavirus › The Impact of Different Types of Violence on...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse spatiale › Cartographie géographique › The Impact of Different Types of Violence on...
questionsmedicales.fr › Infection › Maladies virales › Infections à virus à ARN › Infections à Mononegavirales › Infections à Filoviridae › Fièvre hémorragique à virus Ebola › The Impact of Different Types of Violence on...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Impact of Different Types of Violence on...