在不同家庭无法接触的情况下控制埃博拉流行病的疫苗接种战略
Vaccination strategies to control Ebola epidemics in the context of variable household inaccessibility levels
摘要：
在刚果民主共和国持续的埃博拉疫情背景下，积极的冲突和社区不信任正在破坏控制工作，包括疫苗接种战略。在本文中，我们采用了一个个人水平的随机结构化传播模型，以评估疫苗接种策略对流行病控制的影响，在可变水平的家庭不可访问的背景下。我们发现，密切接触者的环形疫苗接种策略将无法有效地控制疫情的情况下，即使是低水平的家庭无法接触接种疫苗的接触者的显着延迟，并评估补充社区疫苗接种策略的影响。对于较低水平的不可及性，随着时间的推移，流行病控制的概率会增加。对于更高程度的无法接触，即使结合了环形和社区疫苗接种战略，预计也无法控制这一流行病，尽管它们有助于降低发病率，从而挽救生命，使这一流行病更容易控制，并减少向其他社区的传播。我们发现，环形疫苗接种是有效的，直到不可访问的水平超过约10%，一个结合环和社区疫苗接种策略是有效的，直到不可访问的水平超过约50%。我们的研究结果强调了加强社区参与公共卫生干预措施的必要性。
英文摘要：
In the context of the ongoing Ebola epidemic in DRC, active conflict and community distrust are undermining control efforts, including vaccination strategies. In this paper, we employed an individual-level stochastic structured transmission model to assess the impact of vaccination strategies on epidemic control in the context of variable levels of household inaccessibility. We found that a ring vaccination strategy of close contacts would not be effective for containing the epidemic in the context of significant delays to vaccinating contacts even for low levels of household inaccessibility and evaluate the impact of a supplemental community vaccination strategy. For lower levels of inaccessibility, the probability of epidemic containment increases over time. For higher levels of inaccessibility, even the combined ring and community vaccination strategies are not expected to contain the epidemic even though they help lower incidence levels, which saves lives, makes the epidemic easier to contain and reduces spread to other communities. We found that ring vaccination is effective for containing an outbreak until the levels of inaccessibility exceeds approximately 10%, a combined ring and community vaccination strategy is effective until the levels of inaccessibility exceeds approximately 50%. Our findings underscore the need to enhance community engagement to public health interventions.
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