Household demographic determinants of Ebola epidemic risk
Household demographic determinants of Ebola epidemic risk
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DOI：
10.1016/j.jtbi.2015.11.025
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发表时间：
2016-03-07
影响因子：
2
通讯作者：
Adams, Ben
中科院分区：
文献类型：
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作者：
Adams, Ben
埃博拉以及其他一些传染病（如结核病）的一个显著特征是在少数同居人群中强烈传播，而在更广泛的人群中无差别传播相对有限。在此，我们考虑一个针对人口按同等规模的家庭进行结构划分的埃博拉疫情的数学模型。我们表明，家庭规模这一基本人口单位是决定一个社区对疫情的脆弱性以及控制疫情所需努力的关键因素。我们的分析基于家庭再生数，但我们也考虑了基本再生数、内在增长率和最终疫情规模。我们表明，当其他流行病学参数保持不变时，家庭规模越大以及家庭内传播越强烈，所有这些对疫情增长和规模的量化指标都会增加。我们接着通过病例检测与隔离以及随后的家庭隔离来对疫情控制进行建模。我们表明，如果家庭隔离无效，为阻止疫情而必须检测出病例的临界概率会随着家庭规模的每次增加而显著提高，对于由大家庭组成的社区来说，这可能是一个极具挑战性的目标。然而，有效的隔离可能会减轻大家庭规模的不利影响。我们得出结论，由大家庭组成的社区从根本上更容易受到主要通过密切接触传播的传染病疫情的影响，并且对这些疫情的控制策略的任何评估都应考虑人口的人口结构。（C）2015爱思唯尔有限公司。保留所有权利。
A salient characteristic of Ebola, and some other infectious diseases such as Tuberculosis, is intense transmission among small groups of cohabitants and relatively limited indiscriminate transmission in the wider population. Here we consider a mathematical model for an Ebola epidemic in a population structured into households of equal size. We show that household size, a fundamental demographic unit, is a critical factor that determines the vulnerability of a community to epidemics, and the effort required to control them. Our analysis is based on the household reproduction number, but we also consider the basic reproduction number, intrinsic growth rate and final epidemic size. We show that, when other epidemiological parameters are kept the same, all of these quantifications of epidemic growth and size are increased by larger households and more intense within-household transmission. We go on to model epidemic control by case detection and isolation followed by household quarantine. We show that, if household quarantine is ineffective, the critical probability with which cases must be detected to halt an epidemic increases significantly with each increment in household size and may be a very challenging target for communities composed of large households. Effective quarantine may, however, mitigate the detrimental impact of large household sizes. We conclude that communities composed of large households are fundamentally more vulnerable to epidemics of infectious diseases primarily transmitted by close contact, and any assessment of control strategies for these epidemics should take into account the demographic structure of the population. (C) 2015 Elsevier Ltd. All rights reserved.