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Spread of Yellow Fever Virus outbreak in Angola and the Democratic Republic Congo 2015-2016: a modelling study

2017-03Journal article Open access
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dc.contributor.authorKraemer, Moritz U. G.
dc.contributor.authorFaria, Nuno R.
dc.contributor.authorReiner Jr, Robert C.
dc.contributor.authorGolding, Nick
dc.contributor.authorNikolay, Birgit
dc.contributor.authorStasse, Stephanie
dc.contributor.authorJohansson, Michael A.
dc.contributor.authorSalje, Henrik
dc.contributor.authorFaye, Ousmane
dc.contributor.authorWint, G. R. William
dc.contributor.authorNiedrig, Matthias
dc.contributor.authorShearer, Freya M.
dc.contributor.authorHill, Sarah C.
dc.contributor.authorThompson, Robin N.
dc.contributor.authorBisanzio, Donal
dc.contributor.authorTaveira, Nuno
dc.contributor.authorNax, Heinrich H.
dc.contributor.authorPradelski, Bary S. R.
dc.contributor.authorNsoesie, Elaine O.
dc.contributor.authorMurphy, Nicholas R.
dc.contributor.authorBogoch, Isaac I.
dc.contributor.authorKhan, Kamran
dc.contributor.authorBrownstein, John S.
dc.contributor.authorTatem, Andrew J.
dc.contributor.authorOliveira, Tulio de
dc.contributor.authorSmith, David L.
dc.contributor.authorSall, Amadou A.
dc.contributor.authorPybus, Oliver G. Pybus
dc.contributor.authorHay, Simon I.
dc.contributor.authorCauchemez, Simon
dc.date.accessioned2019-12-13T10:13:50Z
dc.date.available2019-12-13T10:13:50Z
dc.date.issued2017-03
dc.descriptionThis is an Open Access article under the CC BY license.pt_PT
dc.description.abstractBACKGROUND: Since late 2015, an epidemic of yellow fever has caused more than 7334 suspected cases in Angola and the Democratic Republic of the Congo, including 393 deaths. We sought to understand the spatial spread of this outbreak to optimise the use of the limited available vaccine stock. METHODS: We jointly analysed datasets describing the epidemic of yellow fever, vector suitability, human demography, and mobility in central Africa to understand and predict the spread of yellow fever virus. We used a standard logistic model to infer the district-specific yellow fever virus infection risk during the course of the epidemic in the region. FINDINGS: The early spread of yellow fever virus was characterised by fast exponential growth (doubling time of 5-7 days) and fast spatial expansion (49 districts reported cases after only 3 months) from Luanda, the capital of Angola. Early invasion was positively correlated with high population density (Pearson's r 0·52, 95% CI 0·34-0·66). The further away locations were from Luanda, the later the date of invasion (Pearson's r 0·60, 95% CI 0·52-0·66). In a Cox model, we noted that districts with higher population densities also had higher risks of sustained transmission (the hazard ratio for cases ceasing was 0·74, 95% CI 0·13-0·92 per log-unit increase in the population size of a district). A model that captured human mobility and vector suitability successfully discriminated districts with high risk of invasion from others with a lower risk (area under the curve 0·94, 95% CI 0·92-0·97). If at the start of the epidemic, sufficient vaccines had been available to target 50 out of 313 districts in the area, our model would have correctly identified 27 (84%) of the 32 districts that were eventually affected. INTERPRETATION: Our findings show the contributions of ecological and demographic factors to the ongoing spread of the yellow fever outbreak and provide estimates of the areas that could be prioritised for vaccination, although other constraints such as vaccine supply and delivery need to be accounted for before such insights can be translated into policy.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLancet Infect Dis. 2017 Mar;17(3):330-338. doi: 10.1016/S1473-3099(16)30513-8pt_PT
dc.identifier.doi10.1016/S1473-3099(16)30513-8pt_PT
dc.identifier.issn1473-3099
dc.identifier.urihttp://hdl.handle.net/10400.26/30473
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://doi.org/10.1016/S1473-3099(16)30513-8pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectYellow fever viruspt_PT
dc.subjectAngolapt_PT
dc.subjectDemocratic Republic of Congopt_PT
dc.titleSpread of Yellow Fever Virus outbreak in Angola and the Democratic Republic Congo 2015-2016: a modelling studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage338pt_PT
oaire.citation.startPage330pt_PT
oaire.citation.titleThe Lancet Infectious Diseasespt_PT
oaire.citation.volume17(3)pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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