Fig 4. Mean trends and system losses due to Ebola virus disease (EVD) outbreak (June 2014–April 2015) for first pentavalent vaccinations in a census of 379 clinics providing services in Liberia from 2010–2016, excluding Montserrado County.

The black solid line represents the fitted mean from a linear mixed model using a segmented regression parameterization, random intercepts and slopes by facility, monthly indicator variables to adjust for seasonality, a fixed effect to adjust for clinic-level catchment area, and an AR(1) structure to account for autocorrelation in residual errors. Gray dashed lines are 95% confidence intervals around the fitted mean. Red lines are placed at the final month before the start (May 2014) and end (April 2015) of the EVD outbreak in Liberia.