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Development of a Pediatric Ebola Predictive Score, Sierra Leone1

Felicity Fitzgerald et al. Emerg Infect Dis. 2018 Feb.

Abstract

We compared children who were positive for Ebola virus disease (EVD) with those who were negative to derive a pediatric EVD predictor (PEP) score. We collected data on all children <13 years of age admitted to 11 Ebola holding units in Sierra Leone during August 2014-March 2015 and performed multivariable logistic regression. Among 1,054 children, 309 (29%) were EVD positive and 697 (66%) EVD negative, with 48 (5%) missing. Contact history, conjunctivitis, and age were the strongest positive predictors for EVD. The PEP score had an area under receiver operating characteristics curve of 0.80. A PEP score of 7/10 was 92% specific and 44% sensitive; 3/10 was 30% specific, 94% sensitive. The PEP score could correctly classify 79%-90% of children and could be used to facilitate triage into risk categories, depending on the sensitivity or specificity required.

Keywords: Ebola virus; Ebola virus disease; Sierra Leone; case definition; child mortality; children; pediatrics; prediction; viral hemorrhagic fever; viruses.

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Figures

Figure 1
Figure 1
World Health Organization screening flowchart for Ebola virus disease used during outbreak in Sierra Leone (late-2014 case definition). Adapted from (9).
Figure 2
Figure 2
Frequency of clinical features in children positive and negative for Ebola virus disease (unadjusted) at an Ebola holding unit, Sierra Leone, August 14, 2014–March 31, 2015.
Figure 3
Figure 3
Receiver operating characteristics curve for final pediatric Ebola predictive score model based on a cohort of children who attended an Ebola holding unit and had Ebola virus disease test results recorded, Sierra Leone, August 14, 2014–March 31, 2015.
See this image and copyright information in PMC

References

    1. World Health Organization. Ebola data and statistics. 2016. http://apps.who.int/gho/data/node.ebola-sitrep.quick-downloads?lang=en
    1. Johnson O, Youkee D, Brown CS, Lado M, Wurie A, Bash-Taqi D, et al. Ebola Holding Units at government hospitals in Sierra Leone: evidence for a flexible and effective model for safe isolation, early treatment initiation, hospital safety and health system functioning. BMJ Glob Health. 2016;1:e000030. 10.1136/bmjgh-2016-000030 - DOI - PMC - PubMed
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    1. Fitzgerald F, Naveed A, Wing K, Gbessay M, Ross JC, Checchi F, et al. Ebola virus disease in children, Sierra Leone, 2014–2015. Emerg Infect Dis. 2016;22:1769–77. 10.3201/eid2210.160579 - DOI - PMC - PubMed
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