The impact of control strategies and behavioural changes on the elimination of Ebola from Lofa County, Liberia.
The impact of control strategies and behavioural changes on the elimination of Ebola from Lofa County, Liberia.
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DOI：
10.1098/rstb.2016.0302
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发表时间：
2017-05-26
期刊：
影响因子：
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通讯作者：
Reeder B
中科院分区：
文献类型：
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作者：
Funk S;Ciglenecki I;Tiffany A;Gignoux E;Camacho A;Eggo RM;Kucharski AJ;Edmunds WJ;Bolongei J;Azuma P;Clement P;Alpha TS;Sterk E;Telfer B;Engel G;Parker LA;Suzuki M;Heijenberg N;Reeder B
在当地社区以及国家和国际组织的巨大共同努力下，西非的埃博拉疫情得到了遏制。然而，尚不清楚受影响社区的公共卫生应对措施和行为改变分别对结束疫情有何贡献。在这里，我们分析了利比里亚洛法县从 2014 年 3 月到 11 月的疫情，报告了事件的全面时间线，并使用埃博拉传播的数学模型估计了随时间变化的传播强度。适合该流行病的模型显示传播高峰和低谷的交替，这与高度异质性传播一致。与此同时，自八月初以来，埃博拉病毒传播数量总体下降，同时当地埃博拉治疗中心也得到了扩建。我们估计，在疫情爆发期间寻求医疗保健的人数大约增加了一倍，而寻求医疗保健的人的隔离使他们的繁殖数量减少了 62%（平均估计，95% 可信区间 (CI) 59-66）。床位供应的扩大和医疗保健寻求的改善都有助于结束这一流行病，凸显了社区参与和临床干预的重要性。本文是“2013-2016 年西非埃博拉疫情：数据、决策和疾病控制”主题的一部分。
The Ebola epidemic in West Africa was stopped by an enormous concerted effort of local communities and national and international organizations. It is not clear, however, how much the public health response and behavioural changes in affected communities, respectively, contributed to ending the outbreak. Here, we analyse the epidemic in Lofa County, Liberia, lasting from March to November 2014, by reporting a comprehensive time line of events and estimating the time-varying transmission intensity using a mathematical model of Ebola transmission. Model fits to the epidemic show an alternation of peaks and troughs in transmission, consistent with highly heterogeneous spread. This is combined with an overall decline in the reproduction number of Ebola transmission from early August, coinciding with an expansion of the local Ebola treatment centre. We estimate that healthcare seeking approximately doubled over the course of the outbreak, and that isolation of those seeking healthcare reduced their reproduction number by 62% (mean estimate, 95% credible interval (CI) 59–66). Both expansion of bed availability and improved healthcare seeking contributed to ending the epidemic, highlighting the importance of community engagement alongside clinical intervention. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.