The Role of Social Mobilization in Controlling Ebola Virus in Lofa County, Liberia.
The Role of Social Mobilization in Controlling Ebola Virus in Lofa County, Liberia.
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DOI：
10.1371/currents.outbreaks.c3576278c66b22ab54a25e122fcdbec1
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发表时间：
2015-05-15
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影响因子：
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通讯作者：
Markuzon, Natasha
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作者：
Fast, Shannon M;Mekaru, Sumiko;Markuzon, Natasha
西非埃博拉病毒疫情似乎即将结束。在所提出的模型中，我们模拟人口行为的变化，有助于解释观察到的传输动态。我们引入了一个EVD传播模型，伴随着一个社会动员模型。使用美国疾病预防控制中心报告的每周新病例计数，该模型适用于利比里亚洛法县，直至2014年10月。在模拟研究中，我们分析了在有和没有人口行为变化的情况下疾病传播的动态，根据观察数据估计埃博拉治疗单位（ETU）的床位可用性。只有包括个人行为变化的模型情景与观察到的病例数吻合得很好。虽然洛法州紧急医疗队的能力在8月中旬大大增加，但我们的模拟表明，扩大不足以单独控制疫情。在不考虑行为变化的情况下对整个疫情进行建模，与数据拟合不佳，并且在不考虑行为变化的情况下从早期数据进行推断，导致预测爆发呈指数增长，而不是观察到的下降。教育和提高认识引起的民众行为改变有助于遏制洛法州的埃博拉疫情，并可能在完全阻止西非疫情方面发挥重要作用。
The West Africa Ebola virus epidemic now appears to be coming to an end. In the proposed model, we simulate changes in population behavior that help to explain the observed transmission dynamics. We introduce an EVD transmission model accompanied by a model of social mobilization. The model was fit to Lofa County, Liberia through October 2014, using weekly counts of new cases reported by the US CDC. In simulation studies, we analyze the dynamics of the disease transmission with and without population behavior change, given the availability of beds in Ebola treatment units (ETUs) estimated from observed data. Only the model scenario that included individuals' behavioral change achieved a good fit to the observed case counts. Although the capacity of the Lofa County ETUs greatly increased in mid-August, our simulations show that the expansion was insufficient to alone control the outbreak. Modeling the entire outbreak without considering behavior change fit the data poorly, and extrapolating from early data without taking behavioral changes into account led to a prediction of exponential outbreak growth, contrary to the observed decline. Education and awareness-induced behavior change in the population was instrumental in curtailing the Ebola outbreak in Lofa County and is likely playing an important role in stopping the West Africa epidemic altogether.