TY  - JOUR
PY  - 2020//
TI  - The impact of different types of violence on Ebola virus disease transmission during the 2018-2020 outbreak in the Democratic Republic of the Congo
JO  - Journal of infectious diseases
A1  - Kelly, John Daniel
A1  - Wannier, Sarah Rae
A1  - Sinai, Cyrus
A1  - Moe, Caitlin A.
A1  - Hoff, Nicole A.
A1  - Blumberg, Seth
A1  - Selo, Bernice
A1  - Mossoko, Mathais
A1  - Chowell-Puente, Gerardo
A1  - Jones, James Holland
A1  - Okitolonda-Wemakoy, Emile
A1  - Rutherford, George W.
A1  - Lietman, Thomas M.
A1  - Muyembe-Tamfum, Jean Jacques
A1  - Rimoin, Anne W.
A1  - Porco, Travis C.
A1  - Richardson, Eugene T.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND:  Our understanding of the different effects of targeted versus non-targeted violence on subsequent EVD transmission in the current outbreak in the eastern Democratic Republic of the Congo (DRC) is limited. <br><br>METHODS: We used time-series data of case counts to compare individuals who lived in Ebola-affected health zones in DRC from April 2018 to August 2019. Exposure was number of violent events per health zone, categorized into "Ebola-targeted" or "Ebola-untargeted," and into "civilian-involvement," "militia/political," or "protests." The outcome was estimated daily reproduction number (Rt) by health zone. We fit a linear time-series regression to model the relationship. <br><br>RESULTS: The average Rt was 1.06 (95% confidence interval [CI]: 1.02-1.11). A mean of 2.92 violent events resulted in a cumulative absolute increase in Rt of 0.10 (95%CI: 0.05-0.15). More violent events increased EVD transmission (p=0.03). 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 these civilian-involved 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. <br><br>CONCLUSION: Ebola-targeted violence, primarily driven by civilian-involved events, had the largest impact on EVD transmission.<br><br>© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-1899
UR  - http://dx.doi.org/10.1093/infdis/jiaa163
ID  - ref1
ER  -