Available online 5 December 2022, 100558

The Democratic Republic of the Congo's (DRC) 10th known Ebola virus disease (EVD) outbreak was the largest in the country's history and occurred from August 1, 2018 to June 25, 2020. During this outbreak, the DRC Ministry of Health initiated traveler health screening at points of control (POC, locations not on the border) and points of entry (POE) to minimize disease translocation via ground and air travel. We sought to develop a model-based approach that could be applied in future outbreaks to inform decisions for optimizing POC and POE placement, and allocation of resources more broadly, to mitigate the risk of disease translocation associated with ground-level population mobility. We applied a parameter-free mobility model, the radiation model, to estimate likelihood of ground travel between selected origin locations (including Beni, DRC) and surrounding population centers, based on population size and drive-time. We then performed a road network route analysis and included estimated population movement results to estimate the proportionate volume of travelers who would move along each road segment; this reflects the proportion of travelers that could be screened at a POC or POE. For Beni, the road segments estimated to have the highest proportion of travelers that could be screened were part of routes into Uganda and Rwanda. Conversely, road segments that were part of routes to other population centers within DRC were estimated to have relatively lower proportions. We observed a posteriori that, in many instances, our results aligned with locations that were selected for actual POC or POE placement through more time-consuming methods. This study has demonstrated that mobility models and simple spatial techniques can help identify potential locations for health screening at newly placed POC or existing POE during public health emergencies based on expected movement patterns. Importantly, we have provided methods to estimate the proportionate volume of travelers that POC or POE screening measures would assess based on their location. This is critical information in outbreak situations when timely decisions must be made to implement public health interventions that reach the most individuals across a network.

Ebola virus disease

radiation model

road network analysis

resource allocation

population mobility

Democratic Republic of the Congo

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