Ebola vaccination in the Democratic Republic of the Congo
Ebola vaccination in the Democratic Republic of the Congo
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DOI：
10.1073/pnas.1817329116
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发表时间：
2019-05-14
影响因子：
11.1
通讯作者：
Galvani, Alison P.
中科院分区：
文献类型：
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作者：
Wells, Chad R.;Pandey, Abhishek;Galvani, Alison P.
2018年4月，埃博拉病毒在刚果（DRC）的一个农村地区重新出现后，该病毒于5月初蔓延到城市中心。在确诊首例病例后两周内，启动了疫苗接种运动，向病例接触者和一线医护人员接种了3，017剂疫苗。为了评估埃博拉病毒传播的空间动态并量化疫苗接种的影响，我们开发了一个地理上明确的模型，该模型结合了贫困和人口密度的高分辨率数据。我们发现，虽然埃博拉病毒的风险集中在最初报告感染的地点周围，但较长范围的传播也对人口密度高和贫困的地区构成了风险。我们估计，疫苗接种计划使埃博拉风险地区缩小了70.4%，并将该地区的风险水平降低了70.1%。尽早接种疫苗至关重要。即使延迟1周，这些影响也会分别降低至33.3%和44.8%。这些结果强调了在新出现的疫情期间迅速部署埃博拉疫苗对遏制传播和防止全球传播的重要性。这里开发的时空框架提供了一个工具，用于确定高风险地区，在这些地区可以加强监测，并在未来的疫情爆发期间实施先发制人的控制。
Following the April 2018 reemergence of Ebola in a rural region of the Democratic Republic of the Congo (DRC), the virus spread to an urban center by early May. Within 2 wk of the first case confirmation, a vaccination campaign was initiated in which 3,017 doses were administered to contacts of cases and frontline healthcare workers. To evaluate the spatial dynamics of Ebola transmission and quantify the impact of vaccination, we developed a geographically explicit model that incorporates high-resolution data on poverty and population density. We found that while Ebola risk was concentrated around sites initially reporting infections, longer-range dissemination also posed a risk to areas with high population density and poverty. We estimate that the vaccination program contracted the geographical area at risk for Ebola by up to 70.4% and reduced the level of risk within that region by up to 70.1%. The early implementation of vaccination was critical. A delay of even 1 wk would have reduced these effects to 33.3 and 44.8%, respectively. These results underscore the importance of the rapid deployment of Ebola vaccines during emerging outbreaks to containing transmission and preventing global spread. The spatiotemporal framework developed here provides a tool for identifying high-risk regions, in which surveillance can be intensified and preemptive control can be implemented during future outbreaks.