The Contribution of Ebola Viral Load at Admission and Other Patient Characteristics to Mortality in a Medecins Sans Frontieres Ebola Case Management Centre, Kailahun, Sierra Leone, June-October 2014

被引：75

作者：

Fitzpatrick, Gabriel ^{[1
]}

Vogt, Florian ^{[2
]}

Gbabai, Osman B. Moi ^{[3
]}

Decroo, Tom ^{[4
]}

Keane, Marian ^{[5
]}

De Clerck, Hilde ^{[2
]}

Grolla, Allen ^{[6
]}

Brechard, Raphael ^{[2
]}

Stinson, Kathryn ^{[2
]}

Van Herp, Michel ^{[2
]}

机构：

[1] Medecins Sans Frontieres, Dublin, Ireland

[2] Medecins Sans Frontieres, Dept Operat Res, Brussels, Belgium

[3] Minist Hlth & Sanitat, Primary Hlth Care Unit Kailahun, Freetown, Sierra Leone

[4] Medecins Sans Frontieres, Dept Operat Res, Luxembourg, Luxembourg

[5] Dublin City Univ, Sch Math Sci, Dublin 9, Ireland

[6] Publ Hlth Agcy Canada, Natl Microbiol Lab, Special Pathogens Program, Winnipeg, MB, Canada

来源：

JOURNAL OF INFECTIOUS DISEASES | 2015年 / 212卷 / 11期

关键词：

Ebola virus; outbreak; Sierra Leone; viral load; mortality; REVERSE TRANSCRIPTION-PCR; HEMORRHAGIC-FEVER; TRANSMISSION; DIAGNOSIS; OUTBREAK; KIKWIT; CONGO;

D O I：

10.1093/infdis/jiv304

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

This paper describes patient characteristics, including Ebola viral load, associated with mortality in a Medecins Sans Frontieres Ebola case management centre (CMC). Out of 780 admissions between June and October 2014, 525 (67%) were positive for Ebola with a known outcome. The crude mortality rate was 51% (270/525). Ebola viral load (whole-blood sample) data were available on 76% (397/525) of patients. Univariate analysis indicated viral load at admission, age, symptom duration prior to admission, and distance traveled to the CMC were associated with mortality (P <.05). The multivariable model predicted mortality in those with a viral load at admission greater than 10 million copies per milliliter (P <.05, odds ratio >10), aged >= 50 years (P =.08, odds ratio = 2) and symptom duration prior to admission less than 5 days (P =.14). The presence of confusion, diarrhea, and conjunctivitis were significantly higher (P <.05) in Ebola patients who died. These findings highlight the importance viral load at admission has on mortality outcomes and could be used to cohort cases with viral loads greater than 10 million copies into dedicated wards with more intensive medical support to further reduce mortality.

引用

页码：1752 / 1758

页数：7