title: Factors associated with Marburg hemorrhagic fever: analysis of patient data from Uige, Angola.
abstract: BACKGROUND
  Reliable on-site polymerase chain reaction (PCR) testing for Marburg hemorrhagic fever (MHF) is not always available. Therefore, clinicians triage patients on the basis of presenting symptoms and contact history. Using patient data collected in Uige, Angola, in 2005, we assessed the sensitivity and specificity of these factors to evaluate the validity of World Health Organization (WHO)-recommended case definitions for MHF.
  
  
  METHODS
  Multivariable logistic regression was used to identify independent predictors of PCR confirmation of MHF. A data-derived algorithm was developed to obtain new MHF case definitions with improved sensitivity and specificity.
  
  
  RESULTS
  A MHF case definition comprising (1) an epidemiological link or (2) the combination of myalgia or arthralgia and any hemorrhage could potentially serve as an alternative to current case definitions. Our data-derived case definitions maintained the sensitivity and improved the specificity of current WHO-recommended case definitions.
  
  
  CONCLUSIONS
  Continued efforts to improve clinical documentation during filovirus outbreaks would aid in the refinement of case definitions and facilitate outbreak control.
authors.affiliation: Médecins Sans Frontières-Spain, Barcelona, Spain.
authors.forename: Paul
authors.initials: P
authors.lastname: Roddy
authors.forename: Sara L
authors.initials: SL
authors.lastname: Thomas
authors.forename: Benjamin
authors.initials: B
authors.lastname: Jeffs
authors.forename: Pascoal
authors.initials: P
authors.lastname: Nascimento Folo
authors.forename: Pedro
authors.initials: P
authors.lastname: Pablo Palma
authors.forename: Bengi
authors.initials: B
authors.lastname: Moco Henrique
authors.forename: Luis
authors.initials: L
authors.lastname: Villa
authors.forename: Fernando Paixao
authors.initials: FP
authors.lastname: Damiao Machado
authors.forename: Oscar
authors.initials: O
authors.lastname: Bernal
authors.forename: Steven M
authors.initials: SM
authors.lastname: Jones
authors.forename: James E
authors.initials: JE
authors.lastname: Strong
authors.forename: Heinz
authors.initials: H
authors.lastname: Feldmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Borchert
mesh_terms: D000293:Adolescent; D000328:Adult; D000810:Angola; D000818:Animals; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008379:Marburg Virus Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D029024:Marburgvirus / Q000235:genetics / Q000302:isolation & purification; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D055815:Young Adult