Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec 31;9(12):e0004260.
doi: 10.1371/journal.pntd.0004260. eCollection 2015 Dec.

Quantifying Poverty as a Driver of Ebola Transmission

Mosoka P Fallah  1   2   3   4 , Laura A Skrip  4 , Shai Gertler  4 , Dan Yamin  4   5 , Alison P Galvani  3   4
Affiliations

Quantifying Poverty as a Driver of Ebola Transmission

Mosoka P Fallah et al. PLoS Negl Trop Dis. .

Abstract

Background: Poverty has been implicated as a challenge in the control of the current Ebola outbreak in West Africa. Although disparities between affected countries have been appreciated, disparities within West African countries have not been investigated as drivers of Ebola transmission. To quantify the role that poverty plays in the transmission of Ebola, we analyzed heterogeneity of Ebola incidence and transmission factors among over 300 communities, categorized by socioeconomic status (SES), within Montserrado County, Liberia.

Methodology/principal findings: We evaluated 4,437 Ebola cases reported between February 28, 2014 and December 1, 2014 for Montserrado County to determine SES-stratified temporal trends and drivers of Ebola transmission. A dataset including dates of symptom onset, hospitalization, and death, and specified community of residence was used to stratify cases into high, middle and low SES. Additionally, information about 9,129 contacts was provided for a subset of 1,585 traced individuals. To evaluate transmission within and across socioeconomic subpopulations, as well as over the trajectory of the outbreak, we analyzed these data with a time-dependent stochastic model. Cases in the most impoverished communities reported three more contacts on average than cases in high SES communities (p<0.001). Our transmission model shows that infected individuals from middle and low SES communities were associated with 1.5 (95% CI: 1.4-1.6) and 3.5 (95% CI: 3.1-3.9) times as many secondary cases as those from high SES communities, respectively. Furthermore, most of the spread of Ebola across Montserrado County originated from areas of lower SES.

Conclusions/significance: Individuals from areas of poverty were associated with high rates of transmission and spread of Ebola to other regions. Thus, Ebola could most effectively be prevented or contained if disease interventions were targeted to areas of extreme poverty and funding was dedicated to development projects that meet basic needs.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. World Health Organization. Ebola Situation Report—14 October 2015 (2015) http://apps.who.int/ebola/current-situation/ebola-situation-report-14-oc.... Accessed 18 October 2015.
    1. Organization WH. Elimination soil-transmitted helminthiases as a public health problem in children: Progress report 2001–2010 and strategic plan 2011–2020. 2012.
    1. United Nations Children's Fund (UNICEF). At a glance: Liberia. http://www.unicef.org/infobycountry/liberia_statistics.html. Accessed 15 July 2015.
    1. Slum population as percentage of urban, percentage. Millennium Development Goals Database, United Nations Statistics Division, 2009. http://data.un.org/Data.aspx?d=MDG&f=seriesRowID%3A710. Accessed 15 July 2015.
    1. Cole H (2009) Monrovia City Corporation’s Slum Initiative: Preparation of Monrovia Slum Upgrading Initiative. Cities Alliance: Cities without Slums. http://www.citiesalliance.org/sites/citiesalliance.org/files/CAFiles/Pro.... Accessed 14 July 2015

Publication types