Abstract

As of June 16, 2019, an Ebola virus disease (EVD) outbreak has led to 2136 reported cases in the northeastern region of the Democratic Republic of the Congo (DRC). As this outbreak continues to threaten the lives and livelihoods of people already suffering from civil strife and armed conflict, relatively simple mathematical models and their short-term predictions have the potential to inform Ebola response efforts in real time. We applied recently developed non-parametrically estimated Hawkes point processes to model the expected cumulative case count using daily case counts from May 3, 2018, to June 16, 2019, initially reported by the Ministry of Health of DRC and later confirmed in World Health Organization situation reports. We generated probabilistic estimates of the ongoing EVD outbreak in DRC extending both before and after June 16, 2019, and evaluated their accuracy by comparing forecasted vs. actual outbreak sizes, out-of-sample log-likelihood scores and the error per day in the median forecast. The median estimated outbreak sizes for the prospective thee-, six-, and nine-week projections made using data up to June 16, 2019, were, respectively, 2317 (95% PI: 2222, 2464); 2440 (95% PI: 2250, 2790); and 2544 (95% PI: 2273, 3205). The nine-week projection experienced some degradation with a daily error in the median forecast of 6.73 cases, while the six- and three-week projections were more reliable, with corresponding errors of 4.96 and 4.85 cases per day, respectively. Our findings suggest the Hawkes point process may serve as an easily-applied statistical model to predict EVD outbreak trajectories in near real-time to better inform decision-making and resource allocation during Ebola response efforts.

Highlights

  • As of June 16, 2019, 2136 confirmed and probable cases of Ebola virus disease (EVD) were reported in North Kivu and Ituri Provinces of the Democratic Republic of the Congo (DRC) (WHO, 2019)

  • Data were collected from the Ministry of Health and World Health Organization (WHO) situation reports on EVD case counts occurring in the northeastern region of DRC

  • Our dataset included probable and confirmed EVD cases that occurred from the start of the outbreak on May 3, 2018, until June 16, 2019 (Supplement 1)

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Summary

Introduction

As of June 16, 2019, 2136 confirmed and probable cases of Ebola virus disease (EVD) were reported in North Kivu and Ituri Provinces of the Democratic Republic of the Congo (DRC) (WHO, 2019). The use of case counts from previous EVD outbreaks reported in the literature have proven unreliable in their ability to forecast an outbreak’s size (Worden et al, 2018; Asher, 2018). The Hawkes point process model, offers the Ebola modeling community a novel, rapid option to forecast outbreak size and spread (Meyer et al, 2012). Hawkes point process models have been used to forecast the spatial and temporal spread of infectious disease outbreaks (Schoenberg et al, 2018; Meyer and Leonard, 2014; Meyer et al, 2012), including the 2013–2016 EVD outbreak in West Africa (Park et al, 2018)

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