Exposure Patterns Driving Ebola Transmission in West Africa:A Retrospective Observational Study

BackgroundThe ongoing West African Ebola epidemic began in December 2013 in Guinea, probably from a single zoonotic introduction. As a result of ineffective initial control efforts, an Ebola outbreak of unprecedented scale emerged. As of 4 May 2015, it had resulted in more than 19,000 probable and confirmed Ebola cases, mainly in Guinea (3,529), Liberia (5,343), and Sierra Leone (10,746). Here, we present analyses of data collected during the outbreak identifying drivers of transmission and highlighting areas where control could be improved.Methods and findingsOver 19,000 confirmed and probable Ebola cases were reported in West Africa by 4 May 2015. Individuals with confirmed or probable Ebola ("cases") were asked if they had exposure to other potential Ebola cases ("potential source contacts") in a funeral or non-funeral context prior to becoming ill. We performed retrospective analyses of a case line-list, collated from national databases of case investigation forms that have been reported to WHO. These analyses were initially performed to assist WHO's response during the epidemic, and have been updated for publication. We analysed data from 3,529 cases in Guinea, 5,343 in Liberia, and 10,746 in Sierra Leone; exposures were reported by 33% of cases. The proportion of cases reporting a funeral exposure decreased over time. We found a positive correlation (r = 0.35, p ConclusionsAchieving elimination of Ebola is challenging, partly because of super-spreading. Safe funeral practices and fast hospitalisation contributed to the containment of this Ebola epidemic. Continued real-time data capture, reporting, and analysis are vital to track transmission patterns, inform resource deployment, and thus hasten and maintain elimination of the virus from the human population

Total tooth loss and complete denture use in older adults with intellectual disabilities in Ireland: Older adults with intellectual disabilities

Objectives The objectives of this study were to describe the reported dentate status and complete denture use of older people with intellectual disability (ID) and compare with those of older people in the general population in Ireland. Methods The first wave of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) study provides opportunity to measure edentulism and complete denture use in a nationally representative sample of older people with ID in Ireland. Data drawn from the first wave of IDS-TILDA were matched using propensity score matching with data from The Irish Longitudinal Study on Ageing (TILDA), a study among older adults in Ireland. All IDS-TILDA variables showing significant association (P < 0.05) with edentulism were entered into a regression model to identify predictors of edentulism. Result The proportion of the 478 IDS-TILDA participants with no teeth was higher (34.1 percent) than the proportion of participants with no teeth in the 478 matched TILDA participants (14.9 percent). Only age was predictive of edentulism among older adults with ID. Edentulism was prevalent earlier for those with ID. Notably, 61.3 percent of edentulous older people with ID were without dentures. Conclusion Older people with ID are more likely to be edentulous than those without ID in Ireland and when they lose their teeth, they are unlikely to use dentures. This suggests a need for targeted measures to maintain the teeth of this group and, in the short term, the provision of replacement teeth in this population, where indicated