Assessment of Yellow Fever Epidemic Risk: An Original Multi-criteria Modeling Approach

This article describes the use of an original modeling approach to assess the risk of yellow fever (YF) epidemics. YF is a viral hemorrhagic fever responsible in past centuries for devastating outbreaks. Since the 1930s, a vaccine has been available that protects the individual for at least 10 years, if not for life. However, immunization of populations in African countries was gradually discontinued after the 1960s. With the decrease in immunity against YF in African populations the disease reemerged in the 1980s. In 2005, WHO, UNICEF, and the GAVI Alliance decided to support preventive vaccination of at-risk populations in West African endemic countries in order to tackle the reemergence of YF and reduce the risk of urban YF outbreaks. Financial resources were made available to scale up a global YF vaccine stockpile and to support countries with limited resources in the management of preventive vaccination campaigns. This article describes the process we used to determine the most at-risk populations using a mathematical model to prioritize targeted immunization campaigns. We believe that this approach could be useful for other diseases for which decision making process is difficult because of limited data availability, complex risk variables, and a need for rapid decisions and implementation

Vulnerability map of all districts in Burkina Faso.

<p>Vulnerability map of all districts in Burkina Faso.</p

Yellow fever vulnerability profiles of districts identified with the quantitative assessment.

<p>Yellow fever vulnerability profiles of districts identified with the quantitative assessment.</p

District situated in the ecological risk zone 15°N–10°S, wet savannah or dry forest (Source: FAO).

<p>District situated in the ecological risk zone 15°N–10°S, wet savannah or dry forest (Source: FAO).</p

Yellow fever cases reported in Burkina Faso from 1950 to 2004.

<p>Yellow fever cases reported in Burkina Faso from 1950 to 2004.</p

Yellow fever vulnerability of rural districts in Burkina Faso.

<p>Yellow fever vulnerability of rural districts in Burkina Faso.</p

Yellow fever vulnerability model for decision making.

<p>Yellow fever vulnerability model for decision making.</p