title: The Contribution of Ebola Viral Load at Admission and Other Patient Characteristics to Mortality in a Médecins Sans Frontières Ebola Case Management Centre, Kailahun, Sierra Leone, June-October 2014.
abstract: This paper describes patient characteristics, including Ebola viral load, associated with mortality in a Médecins Sans Frontières 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.
authors.affiliation: Médecins Sans Frontières, Dublin, Ireland.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Fitzpatrick
authors.affiliation: Médecins Sans Frontières, Operational Research Department, Brussels, Belgium.
authors.forename: Florian
authors.initials: F
authors.lastname: Vogt
authors.affiliation: Primary Health Care Unit Kailahun, Ministry of Health and Sanitation, Sierra Leone.
authors.forename: Osman B
authors.initials: OB
authors.lastname: Moi Gbabai
authors.affiliation: Médecins Sans Frontières, Operational Research Department, Luxembourg.
authors.forename: Tom
authors.initials: T
authors.lastname: Decroo
authors.affiliation: School of Mathematical Sciences, Dublin City University, Ireland.
authors.forename: Marian
authors.initials: M
authors.lastname: Keane
authors.affiliation: Médecins Sans Frontières, Operational Research Department, Brussels, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: De Clerck
authors.affiliation: Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba.
authors.forename: Allen
authors.initials: A
authors.lastname: Grolla
authors.affiliation: Médecins Sans Frontières, Operational Research Department, Brussels, Belgium.
authors.forename: Raphael
authors.initials: R
authors.lastname: Brechard
authors.affiliation: Médecins Sans Frontières, Operational Research Department, Brussels, Belgium.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Stinson
authors.affiliation: Médecins Sans Frontières, Operational Research Department, Brussels, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Van Herp
mesh_terms: D000293:Adolescent; D000328:Adult; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D029043:Ebolavirus / Q000235:genetics*; D005260:Female; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy / Q000821:virology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012807:Sierra Leone / Q000453:epidemiology; D019562:Viral Load / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Ebola virus; Sierra Leone; mortality; outbreak; viral load