ArticlePLoS neglected tropical diseases2016
Heterogeneity in District-Level Transmission of Ebola Virus Disease during the 2013-2015 Epidemic in West Africa.
Article in PLoS neglected tropical diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- Mpox: A case study for a one health approach to infectious disease prevention.One health (Amsterdam, Netherlands) · 2025Review
- Characterizing tuberculosis transmission dynamics in high-burden urban and rural settings.Scientific reports · 2022Article
- The socio-economic distribution of exposure to Ebola: Survey evidence from Liberia and Sierra Leone.SSM - population health · 2020Article
- Article
- Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2019Article
- Adequacy of SEIR models when epidemics have spatial structure: Ebola in Sierra Leone.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2019Article
- Quantifying heterogeneous contact patterns in Japan: a social contact survey.Theoretical biology & medical modelling · 2019Article
- Article
- Assessing the relationship between epidemic growth scaling and epidemic size: The 2014-16 Ebola epidemic in West Africa.Epidemiology and infection · 2018Article
- The Response to and Impact of the Ebola Epidemic: Towards an Agenda for Interdisciplinary Research.International journal of health policy and management · 2018Article
- Noise Is Not Error: Detecting Parametric Heterogeneity Between Epidemiologic Time Series.Frontiers in microbiology · 2018Article
- Herd Immunity to Ebolaviruses Is Not a Realistic Target for Current Vaccination Strategies.Frontiers in immunology · 2018Article
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Authors and funding
5 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Ebola virus disease (EVD) epidemic in West Africa in 2013-2015 spread heterogeneously across the three hardest-hit countries Guinea, Liberia and Sierra Leone and the estimation of national transmission of EVD provides little information about local dynamics. To investigate district-level transmissibility of EVD, we applied a statistical modelling approach to estimate the basic reproduction number (R0) for each affected district and each country using weekly incident case numbers. We estimated growth rates during the early exponential phase of the outbreak using exponential regression of the case counts on the first eight weeks since onset. To take into account the heterogeneity between and within countries, we fitted a mixed effects model and calculated R0 based on the predicted individual growth rates and the reported serial interval distribution. At district level, R0 ranged from 0.36 (Dubréka) to 1.72 (Beyla) in Guinea, from 0.53 (Maryland) to 3.37 (Margibi) in Liberia and from 1.14 (Koinadugu) to 2.73 (Western Rural) in Sierra Leone. At national level, we estimated an R0 of 0.97 (95% CI 0.77-1.18) for Guinea, 1.26 (95% CI 0.98-1.55) for Liberia and 1.66 (95% CI 1.32-2.00) for Sierra Leone. Socio-demographic variables related to urbanisation such as high population density and high wealth index were found positively associated with R0 suggesting that the consequences of fast urban growth in West Africa may have contributed to the increased spread of EVD.
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