title: A case-control study of the clinical diagnosis and course of Lassa fever.
abstract: A prospective case-control study of Lassa fever was established in Sierra Leone to measure the frequency and case-fatality ratio of Lassa fever among febrile hospital admissions and to better delineate the clinical diagnosis and course of this disease. Lassa fever was responsible for 10%-16% of all adult medical admissions and for approximately 30% of adult deaths in the two hospitals studied. The case-fatality ratio for 441 hospitalized patients was 16.5%. We found the best predictor of Lassa fever to be the combination of fever, pharyngitis, retrosternal pain, and proteinuria (predictive value together, .81); of outcome, the best predictor was the combination of fever, sore throat, and vomiting (relative risk of death, 5.5). Complications included mucosal bleeding (17%), bilateral or unilateral eighth-nerve deafness (4%), and pleural (3%) or pericardial (2%) effusion. Lassa fever is endemic in this area and is a more-common cause of hospital admission and death than has previously been described; this disease must be considered when diagnosing febrile illness in West Africa.
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007835:Lassa Fever / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D010612:Pharyngitis / Q000209:etiology; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology; D012807:Sierra Leone; D014839:Vomiting / Q000209:etiology