Measuring the impact of Ebola control measures in Sierra Leone
Measuring the impact of Ebola control measures in Sierra Leone
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DOI：
10.1073/pnas.1508814112
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发表时间：
2015-11-17
影响因子：
11.1
通讯作者：
Funk, Sebastian
中科院分区：
文献类型：
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作者：
Kucharski, Adam J.;Camacho, Anton;Funk, Sebastian
2014年9月至2015年2月期间，塞拉利昂许多地区报告的埃博拉病毒病（EVD）病例数量有所下降。在此期间，国际社会作出了重大反应，在采取其他感染控制措施的同时，还设立了数千张治疗床位。然而，评估应对措施的影响具有挑战性，因为有几个因素可能影响了感染率的下降，包括行为变化和其他社区干预措施。我们开发了EVD传播的数学模型，并测量了塞拉利昂12个地区的传播如何随时间变化，并在2014年6月至2015年2月期间持续传播。我们使用该模型来估计由于在每个地区引入额外的治疗床位而避免了多少病例。通过检查地区一级的疫情动态，我们估计，截至2015年2月2日，由于引入了额外的治疗床位，塞拉利昂避免了56，600例（95%可信区间：48，300 - 84，500例）埃博拉病例（包括报告和未报告）。我们还发现，如果早一个月引入床位，还可以避免12，500例病例。我们的研究结果表明，前所未有的本地和国际反应导致2014-2015年期间EVD传播大幅下降。特别是，床位的引入对减少塞拉利昂的EVD病例产生了直接影响，尽管不同地区的效果差异很大。
Between September 2014 and February 2015, the number of Ebola virus disease (EVD) cases reported in Sierra Leone declined in many districts. During this period, a major international response was put in place, with thousands of treatment beds introduced alongside other infection control measures. However, assessing the impact of the response is challenging, as several factors could have influenced the decline in infections, including behavior changes and other community interventions. We developed a mathematical model of EVD transmission, and measured how transmission changed over time in the 12 districts of Sierra Leone with sustained transmission between June 2014 and February 2015. We used the model to estimate how many cases were averted as a result of the introduction of additional treatment beds in each area. Examining epidemic dynamics at the district level, we estimated that 56,600 (95% credible interval: 48,300-84,500) Ebola cases (both reported and unreported) were averted in Sierra Leone up to February 2, 2015 as a direct result of additional treatment beds being introduced. We also found that if beds had been introduced 1 month earlier, a further 12,500 cases could have been averted. Our results suggest the unprecedented local and international response led to a substantial decline in EVD transmission during 2014-2015. In particular, the introduction of beds had a direct impact on reducing EVD cases in Sierra Leone, although the effect varied considerably between districts.