不同类型暴力活动对 2018-2020 年刚果民主共和国埃博拉疫情传播的影响。
The Impact of Different Types of Violence on Ebola Virus Transmission During the 2018-2020 Outbreak in the Democratic Republic of the Congo.
机构信息
Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA.
F. I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
出版信息
J Infect Dis. 2020 Nov 13;222(12):2021-2029. doi: 10.1093/infdis/jiaa163.
BACKGROUND
Our understanding of the different effects of targeted versus nontargeted violence on Ebola virus (EBOV) transmission in Democratic Republic of the Congo (DRC) is limited.
METHODS
We used time-series data of case counts to compare individuals in Ebola-affected health zones in DRC, April 2018-August 2019. Exposure was number of violent events per health zone, categorized into Ebola-targeted or Ebola-untargeted, and into civilian-induced, (para)military/political, or protests. Outcome was estimated daily reproduction number (Rt) by health zone. We fit linear time-series regression to model the relationship.
RESULTS
Average Rt was 1.06 (95% confidence interval [CI], 1.02-1.11). A mean of 2.92 violent events resulted in cumulative absolute increase in Rt of 0.10 (95% CI, .05-.15). More violent events increased EBOV transmission (P = .03). Considering violent events in the 95th percentile over a 21-day interval and its relative impact on Rt, Ebola-targeted events corresponded to Rt of 1.52 (95% CI, 1.30-1.74), while civilian-induced events corresponded to Rt of 1.43 (95% CI, 1.21-1.35). Untargeted events corresponded to Rt of 1.18 (95% CI, 1.02-1.35); among these, militia/political or ville morte events increased transmission.
CONCLUSIONS
Ebola-targeted violence, primarily driven by civilian-induced events, had the largest impact on EBOV transmission.
背景
我们对靶向和非靶向暴力对刚果民主共和国（刚果（金））埃博拉病毒（EBOV）传播的不同影响的理解有限。
方法
我们使用 2018 年 4 月至 2019 年 8 月刚果（金）埃博拉疫区的病例数时间序列数据进行比较。暴露是每个卫生区的暴力事件数量，分为针对埃博拉的或非针对埃博拉的，以及平民引发的、（准）军事/政治的或抗议的。结果是按卫生区估计的每日繁殖数（Rt）。我们拟合线性时间序列回归模型来模拟这种关系。
结果
平均 Rt 为 1.06（95%置信区间[CI]，1.02-1.11）。平均 2.92 起暴力事件导致 Rt 累计绝对增加 0.10（95%CI，0.05-.15）。更多的暴力事件增加了埃博拉病毒的传播（P = 0.03）。考虑到 21 天间隔内第 95 百分位的暴力事件及其对 Rt 的相对影响，针对埃博拉的事件对应于 Rt 为 1.52（95%CI，1.30-1.74），而平民引发的事件对应于 Rt 为 1.43（95%CI，1.21-1.35）。非靶向事件对应于 Rt 为 1.18（95%CI，1.02-1.35）；其中，民兵/政治或 Ville morte 事件增加了传播。
结论
针对埃博拉的暴力事件，主要由平民引发，对埃博拉病毒的传播影响最大。
Zotero 插件