title: [The register of activity at the Ebola treatment center in Forecariah (Guinea) from april 23 to june 5, 2015: analysis and thoughts].
abstract: The register of activity at the Ebola Treatment Center (ETC) in Forecariah (Guinea), from April 23 to June 5, 2015 is presented for analysis. The viral load of each patient is evaluated by the cycle threshold (Ct). One hundred and thirty patients were seen in Triage at the ETC, of which 24 (18.5%) patients who failed to meet theWHO case criteria for viral hemorrhagic fever were excluded from admission to the ETC. Of the 106 patients admitted in the ETC, 72 (67.9%) were declared non-cases after the results of their two PCR (drawn 48 hours apart) tests were negative. Thirty-four patients were tested positive for Ebola virus disease (EVD): 19 women and 15 men (sex ratio: male/female = 0.78), mean age of 33.51 ± 20.1 years (extremes of 42 days to 70 years), of which six children were aged below 8 years. The median initial Ct value was 21.6 ± 6.3 cycles in this group. Enquiry into patient contacts was only able to identify actual contacts in 20 of these patients (58.8%). Thirteen patients were ultimately cured of EVD (six men and seven women) - with a median age of 31.8 years (extremes of 4 to 54 years). These patients presented on admission with a median Ct value of 21.88 ± 6.2 cycles (extremes of 17.6 to 31.7). Of the six children aged below 8 years, only one survived. Twenty-one patients (61.76%) with EVD died (9 men and 12 women) - median age, 34 ± 21 years (extremes of 42 days to 70 years). They presented on admission with a median Ct value of 18 ± 7 cycles (extremes of 12 to 24). The single most important factor associated with lethality was the Ct value at the time of admission to the ETC (P = 0.0004), i.e., the lower the Ct value, the higher the lethality rate or simply stated, the higher the viral load, the greater the lethality. Age, sex, identification of contact, and delay between the onset of symptoms and admission did not prove to be predictive of death outcome in our series.
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France. bernard.gauzere@chu-reunion.fr.|Service de réanimation polyvalente, CHU de La Réunion, site centre hospitalier Félix-Guyon, 97400 Saint-Denis, La Réunion, France. bernard.gauzere@chu-reunion.fr.|Centre René-Labusquière, université de Bordeaux, 33000, Bordeaux, France. bernard.gauzere@chu-reunion.fr.
authors.forename: B-A
authors.initials: BA
authors.lastname: Gaüzère
authors.affiliation: Croix-Rouge canadienne, 170 rue Metcalfe, Ottawa, Ontario, K2P 2P2, Canada.|Département de médecine de famille et de médecine d'urgence, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke et Service d'urgence, CHU Sherbrooke, 3001, 12e av. Nord, Sherbrooke, Qc, Canada, J1H 5N4 T.
authors.forename: I
authors.initials: I
authors.lastname: Ouellet
authors.affiliation: Croix-Rouge canadienne, 170 rue Metcalfe, Ottawa, Ontario, K2P 2P2, Canada.|UBC Department of Family Medicine, Kelowna General Hospital, Kelowna, 2268 Pandosy street, BC, VTY 1T2, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Nottebrock
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Nied
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Beya-Kadiebwe
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: A K
authors.initials: AK
authors.lastname: Camara
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Camara
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: M L M
authors.initials: ML
authors.lastname: Camara
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Camara
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Soumah
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: M K
authors.initials: MK
authors.lastname: Tounkara
authors.affiliation: Expertise France, 73 rue de Vaugirard, 75006, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Monteil
authors.affiliation: Expertise France, 73 rue de Vaugirard, 75006, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Camara
authors.affiliation: Expertise France, 73 rue de Vaugirard, 75006, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Bauffe
authors.affiliation: Expertise France, 73 rue de Vaugirard, 75006, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Camara
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: I B
authors.initials: IB
authors.lastname: Camara
authors.affiliation: Centre René-Labusquière, université de Bordeaux, 33000, Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Sissoko
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Simon
authors.affiliation: Service de maladies infectieuses et tropicales, hôpital de La Pitié-Salpêtrière, 75013, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Jaspard
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Tran-Minh
authors.affiliation: Croix-Rouge française, 98 rue Didot, 75014, Paris, France.|Centre de coordination de la lutte contre les infections nosocomiales (CCLIN) de l'interrégion Paris-Nord, 8, rue Maria-Helena-Vieira-da-Silva, 75014, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: L'Hériteau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D016701:Guinea / Q000453:epidemiology; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000628:therapy*; D017052:Hospital Mortality; D006782:Hospitals, Special / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Case fatality rates; Ebola; Forecariah; French Red Cross; Guinea; RT–PCR; Sub-Saharan Africa