Geographic correlates of Yellow Fever Virus emergence and spread in the Democratic Republic of the Congo

Authors: Corinna Keeler*, University of North Carolina - Chapel Hill
Topics: Medical and Health Geography, Spatial Analysis & Modeling, Africa
Keywords: health geography, medical geography, yellow fever virus, spatiotemporal modeling
Session Type: Paper
Day: 4/6/2020
Start / End Time: 3:05 PM / 4:20 PM
Room: Governors Square 16, Sheraton, Concourse Level
Presentation File: No File Uploaded

The twenty-first century has brought increased attention to the public health consequences of
Arboviruses such as Dengue virus, West Nile virus, Chikungunya virus, Zika virus, and Yellow Fever virus (YFV). Of these viruses, YFV has the highest case fatality rate at 20-50%, but also is the only disease in this group that can be prevented with a safe, low-cost, and highly effective vaccine; however, in recent years, vaccination rates have dropped in endemic countries, with estimated coverage rates below 30% in many age groups in countries across Sub-Saharan Africa. As such, understanding the geographic determinants of YFV emergence can facilitate earlier identification of outbreaks and improve targeting of vaccination campaigns to the most relevant communities. We use spatiotemporal data of weekly YFV incidence across all health zones (N=515) in the Democratic Republic of Congo (DRC) to identify geographic correlates of YFV emergence and spread from 2005-2017. We analyze relationships between YFV incidence in the DRC and geographic variables relating to environmental context, such as precipitation and temperature; political-economic context, such as major livelihoods and infrastructure development; and demographic context, such as migration patterns and population density. Additionally, we are able to leverage the fine spatial and temporal resolution of our case data to characterize the different geographic correlates of two distinct YFV transmission cycles, examining differences between sylvatic or “jungle” transmission of YFV and the urban transmission cycle that is associated with epidemic YFV. The implications of this research for public health intervention planning and health care delivery are discussed.

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