TY - JOUR
T1 - Determinants of patient survival during the 2014 Ebola Virus Disease outbreak in Bong County, Liberia
AU - Weppelmann, Thomas A.
AU - Donewell, Bangure
AU - Haque, Ubydul
AU - Hu, Wenbiao
AU - Magalhaes, Ricardo J.Soares
AU - Lubogo, Mutaawe
AU - Godbless, Lucas
AU - Shabani, Sasita
AU - Maeda, Justin
AU - Temba, Herilinda
AU - Malibiche, Theophil C.
AU - Berhanu, Naod
AU - Zhang, Wenyi
AU - Bawo, Luke
N1 - Funding Information:
The data collection efforts were funded in part by the Ministry of Health and Social Welfare (MOHSW) and the African Union Support to Ebola Outbreak in West Africa (ASEOWA) in Liberia. Additional funding for this study was provided by the National Natural Science Foundation of China (grant #81550001) and the University of Florida pre-eminence initiative.
Publisher Copyright:
© 2016, The Author(s).
PY - 2016/12
Y1 - 2016/12
N2 - Background: The unprecedented size of the 2014 Ebola Virus Disease (EVD) outbreak in West Africa has allowed for a more extensive characterization of the clinical presentation and management of this disease. In this study, we report the trends in morbidity, mortality, and determinants of patient survival as EVD spread into Bong County, Liberia. Methods: An analysis of suspected, probable, or confirmed cases of EVD (n = 607) reported to the Liberian Ministry of Health and Social Welfare (MOHSW) between March 23rd and December 31st 2014 was conducted. The likelihood of infection given exposure factors was determined using logistic regression in individuals with a definitive diagnosis by RT-PCR (n = 321). The risk of short-term mortality (30 days) given demographic factors, clinical symptoms, and highest level of treatment received was assessed with Cox regression and survival analyses (n = 391). Results: The overall mortality rate was 53.5 % (95 % CI: 49 %, 58 %) and decreased as access to medical treatment increased. Those who reported contact with another EVD case were more likely to be infected (OR: 5.7), as were those who attended a funeral (OR: 3.9). Mortality increased with age (P < 0.001) and was higher in males compared to females (P =0.006). Fever (HR: 6.63), vomiting (HR: 1.93), diarrhea (HR: 1.99), and unexplained bleeding (HR: 2.17) were associated with increased mortality. After adjusting for age, hospitalized patients had a 74 % reduction in the risk of short term mortality (P < 0.001 AHR: 0.26; 95 % CI AHR: 0.18, 0.37), compared to those not given medical intervention. Conclusion: Even treatment with only basic supportive care such as intravenous rehydration therapy was able to significantly improve patient survival in suspected, probable, or confirmed EVD cases.
AB - Background: The unprecedented size of the 2014 Ebola Virus Disease (EVD) outbreak in West Africa has allowed for a more extensive characterization of the clinical presentation and management of this disease. In this study, we report the trends in morbidity, mortality, and determinants of patient survival as EVD spread into Bong County, Liberia. Methods: An analysis of suspected, probable, or confirmed cases of EVD (n = 607) reported to the Liberian Ministry of Health and Social Welfare (MOHSW) between March 23rd and December 31st 2014 was conducted. The likelihood of infection given exposure factors was determined using logistic regression in individuals with a definitive diagnosis by RT-PCR (n = 321). The risk of short-term mortality (30 days) given demographic factors, clinical symptoms, and highest level of treatment received was assessed with Cox regression and survival analyses (n = 391). Results: The overall mortality rate was 53.5 % (95 % CI: 49 %, 58 %) and decreased as access to medical treatment increased. Those who reported contact with another EVD case were more likely to be infected (OR: 5.7), as were those who attended a funeral (OR: 3.9). Mortality increased with age (P < 0.001) and was higher in males compared to females (P =0.006). Fever (HR: 6.63), vomiting (HR: 1.93), diarrhea (HR: 1.99), and unexplained bleeding (HR: 2.17) were associated with increased mortality. After adjusting for age, hospitalized patients had a 74 % reduction in the risk of short term mortality (P < 0.001 AHR: 0.26; 95 % CI AHR: 0.18, 0.37), compared to those not given medical intervention. Conclusion: Even treatment with only basic supportive care such as intravenous rehydration therapy was able to significantly improve patient survival in suspected, probable, or confirmed EVD cases.
KW - Detailed Epidemiological Data
KW - Oral Rehydration Salt
KW - Reverse Transcriptase Polymerase Chain Reaction
KW - Short Term Mortality
KW - Unexplained Bleeding
UR - http://www.scopus.com/inward/record.url?scp=85084514650&partnerID=8YFLogxK
U2 - 10.1186/s41256-016-0005-8
DO - 10.1186/s41256-016-0005-8
M3 - Article
AN - SCOPUS:85084514650
SN - 2397-0642
VL - 1
JO - Global Health Research and Policy
JF - Global Health Research and Policy
IS - 1
M1 - 5
ER -