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. 2015 Dec 1;212(11):1752-8.
doi: 10.1093/infdis/jiv304. Epub 2015 May 22.

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

Gabriel Fitzpatrick  1 , Florian Vogt  2 , Osman B Moi Gbabai  3 , Tom Decroo  4 , Marian Keane  5 , Hilde De Clerck  2 , Allen Grolla  6 , Raphael Brechard  2 , Kathryn Stinson  2 , Michel Van Herp  2
Affiliations

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

Gabriel Fitzpatrick et al. J Infect Dis. .

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.

Keywords: Ebola virus; Sierra Leone; mortality; outbreak; viral load.

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Figures

Figure 1.
Figure 1.
Fluctuation of crude fatality rate by week of admission (26–42), Kailahun Ebola Case Management Centre, Sierra Leone, 2014.
Figure 2.
Figure 2.
Mortality rate and interval (days) between symptom onset and admission by distance traveled to Kailahun CMC. Abbreviation: CMC, case management centre.
Figure 3.
Figure 3.
Kaplan–Meier curve of the probability of survival among patients with EVD according to CT value. Abbreviations: CT, cycle threshold; EVD, Ebola virus disease.
Figure 4.
Figure 4.
Kaplan–Meier curve of the probability of survival among patients with EVD according to age. Abbreviation: EVD, Ebola virus disease.
See this image and copyright information in PMC

Comment in

  • Monitoring of Prognostic Laboratory Markers in Ebola Virus Disease.
    Janvier F, Foissaud V, Cotte J; Healthcare Workers Ebola Treatment Center Medical Team; Aletti M, Savini H, Cordier PY, Maugey N, Duron S, Koulibaly F, Granier H, Carmoi T, Sagui E. Janvier F, et al. J Infect Dis. 2016 Mar 15;213(6):1049. doi: 10.1093/infdis/jiv546. Epub 2015 Nov 17. J Infect Dis. 2016. PMID: 26582958 No abstract available.

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