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About the Authors:
Benjamin D. Dalziel
Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, Writing - original draft, Writing - review & editing
* E-mail: [email protected]
Affiliations Department of Integrative Biology, Oregon State University, Corvallis, Oregon, United States of America, Department of Mathematics, Oregon State University, Corvallis, Oregon, United States of America
ORCID http://orcid.org/0000-0002-9674-2783
Max S. Y. Lau
Roles Formal analysis, Methodology, Writing - review & editing
Affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
Amanda Tiffany
Roles Data curation, Investigation, Resources, Writing - review & editing
Affiliation: Epidemiology and Population Health, Epicentre, Geneva, Switzerland
Amanda McClelland
Roles Data curation, Resources, Writing - review & editing
Affiliation: Emergency Health, International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
Jon Zelner
Roles Formal analysis, Methodology, Writing - review & editing
Affiliation: Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor Michigan, United States of America
Jessica R. Bliss
Roles Data curation, Formal analysis, Investigation, Writing - review & editing
Affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
Bryan T. Grenfell
Roles Funding acquisition, Project administration, Writing - review & editing
Affiliations Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America, The Woodrow Wilson School of Public and International Affairs Princeton University, Princeton, New Jersey, United States of AmericaAbstract
In the recent 2014-2016 Ebola epidemic in West Africa, non-hospitalized cases were an important component of the chain of transmission. However, non-hospitalized cases are at increased risk of going unreported because of barriers to access to healthcare. Furthermore, underreporting rates may fluctuate over space and time, biasing estimates of disease transmission rates, which are important for understanding spread and planning control measures. We performed a retrospective analysis on community deaths during the recent Ebola epidemic in Sierra Leone to estimate the number of unreported non-hospitalized cases, and to quantify how Ebola reporting rates varied across locations and over time. We then tested if variation in reporting rates affected the estimates of disease transmission rates that were used in surveillance and response. We found significant variation in reporting rates among districts,...