Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved]
Background The 2013-2016 West African Ebola Virus Disease (EVD) outbreak resulted in 28,600 cases and 11,300 deaths officially reported to the World Health Organization. Previous studies investigating factors associated with death had conflicting findings, interventions showing promising outcomes ha...
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2025-03-01
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| author | Ralph W. Jetoh Ajay M.V. Kumar Alexandre Delamou Laura Merson Prabin Dahal Gomathi Ramaswamy Ibrahima Kaba Benjamin T. Vonhm Trokon Omarley Yeabah Anthony D. Harries Pryanka Relan Adam C. Levine |
| author_facet | Ralph W. Jetoh Ajay M.V. Kumar Alexandre Delamou Laura Merson Prabin Dahal Gomathi Ramaswamy Ibrahima Kaba Benjamin T. Vonhm Trokon Omarley Yeabah Anthony D. Harries Pryanka Relan Adam C. Levine |
| author_sort | Ralph W. Jetoh |
| collection | DOAJ |
| description | Background The 2013-2016 West African Ebola Virus Disease (EVD) outbreak resulted in 28,600 cases and 11,300 deaths officially reported to the World Health Organization. Previous studies investigating factors associated with death had conflicting findings, interventions showing promising outcomes had small sample sizes, studies were often single- or dual-country based and most focused on laboratory-confirmed EVD and not on clinically-suspected EVD. We used the Ebola data platform of the Infectious Disease Data Observatory (IDDO) to review individual patient records to assess factors associated with death, and particularly whether there were differences between laboratory-confirmed and clinically-suspected cases. Methods This was a cohort study involving analysis of secondary data in the IDDO database. The study population included all patients classified as having either clinically-suspected or laboratory-confirmed EVD, admitted to 22 Ebola Treatment Units (ETU) in Guinea, Liberia and Sierra Leone between December 2013 and March 2016. Baseline characteristics and treatments were documented along with ETU exit outcomes. Factors associated with death were investigated by multivariable modified Poisson regression. Results There were 14,163 patients, of whom 6,208 (43.8%) were laboratory-confirmed and 7,955 (56.2%) were clinically-suspected. Outcomes were not recorded in 2,889 (20.4%) patients. Of the 11,274 patients with known outcomes, 4,090 (36.3%) died: 2,956 (43.6%) with laboratory-confirmed EVD and 1,134 (18.8%) with clinically-suspected EVD. The strongest risk factor for death was confirmed disease status. Patients with laboratory-confirmed disease had 2.9 times higher risk of death compared to clinically-suspected patients, after adjusting for other co-variables. Other factors significantly associated with death included a higher risk for patients aged ≥60 years and a lower risk for patients in Sierra Leone. Conclusions Although laboratory-confirmed patients admitted to ETUs fared worse than clinically-suspected patients, the latter still had a substantial risk of death and more attention needs to be paid to this group in future EVD outbreaks. |
| format | Article |
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| institution | OA Journals |
| issn | 2046-1402 |
| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-b9bf5bf28b824de6b312eead412db7d42025-08-20T02:02:21ZengF1000 Research LtdF1000Research2046-14022025-03-011310.12688/f1000research.149612.2178279Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved]Ralph W. Jetoh0Ajay M.V. Kumar1Alexandre Delamou2Laura Merson3https://orcid.org/0000-0002-4168-1960Prabin Dahal4Gomathi Ramaswamy5Ibrahima Kaba6Benjamin T. Vonhm7Trokon Omarley Yeabah8https://orcid.org/0000-0002-3790-8042Anthony D. Harries9https://orcid.org/0000-0001-6113-9741Pryanka Relan10https://orcid.org/0000-0002-9543-7891Adam C. Levine11Department of Technical Services, National Public Health Institute of Liberia, Monrovia, Montserrado, 1000, LiberiaInternational Union Against Tuberculosis and Lung Disease, The Union, 2 Rue Jean Lantier, Paris, 75001, FranceCentre national de formation et de recherche en santé rurale de Maferinyah, University Gamal Abdel Nasser, Forécariah, Conakry, 1017, GuineaISARIC, Pandemic Sciences Institute, University of Oxford, Old Road Campus, Headington, Oxfordshire, OX3 7LG, UKInfectious Diseases Data Observatory, Centre for Tropical Medicine & Global Health, University of Oxford, Headington, Oxfordshire, OX3 7LG, UKAll India Institute of Medical Sciences, Bibinagar, Hyderabad, 508126, IndiaAfrican Center of Excellence for the Prevention and Control of Transmissible Diseases, University Gamal Abdel Nasser, Conakry, Guinea, 1017, GuineaDepartment of Technical Services, National Public Health Institute of Liberia, Monrovia, Montserrado, 1000, LiberiaDepartment of Technical Services, National Public Health Institute of Liberia, Monrovia, Montserrado, 1000, LiberiaDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UKHealth Emergencies Programme, World Health Organization, Avenue Appia 20, Geneva, 1203, SwitzerlandWarren Alpert Medical School, Brown University, Providence, Rhode Island, 02903, USABackground The 2013-2016 West African Ebola Virus Disease (EVD) outbreak resulted in 28,600 cases and 11,300 deaths officially reported to the World Health Organization. Previous studies investigating factors associated with death had conflicting findings, interventions showing promising outcomes had small sample sizes, studies were often single- or dual-country based and most focused on laboratory-confirmed EVD and not on clinically-suspected EVD. We used the Ebola data platform of the Infectious Disease Data Observatory (IDDO) to review individual patient records to assess factors associated with death, and particularly whether there were differences between laboratory-confirmed and clinically-suspected cases. Methods This was a cohort study involving analysis of secondary data in the IDDO database. The study population included all patients classified as having either clinically-suspected or laboratory-confirmed EVD, admitted to 22 Ebola Treatment Units (ETU) in Guinea, Liberia and Sierra Leone between December 2013 and March 2016. Baseline characteristics and treatments were documented along with ETU exit outcomes. Factors associated with death were investigated by multivariable modified Poisson regression. Results There were 14,163 patients, of whom 6,208 (43.8%) were laboratory-confirmed and 7,955 (56.2%) were clinically-suspected. Outcomes were not recorded in 2,889 (20.4%) patients. Of the 11,274 patients with known outcomes, 4,090 (36.3%) died: 2,956 (43.6%) with laboratory-confirmed EVD and 1,134 (18.8%) with clinically-suspected EVD. The strongest risk factor for death was confirmed disease status. Patients with laboratory-confirmed disease had 2.9 times higher risk of death compared to clinically-suspected patients, after adjusting for other co-variables. Other factors significantly associated with death included a higher risk for patients aged ≥60 years and a lower risk for patients in Sierra Leone. Conclusions Although laboratory-confirmed patients admitted to ETUs fared worse than clinically-suspected patients, the latter still had a substantial risk of death and more attention needs to be paid to this group in future EVD outbreaks.https://f1000research.com/articles/13-672/v2West Africa Ebola mortality viral haemorrhagic fever filovirus SORT ITeng |
| spellingShingle | Ralph W. Jetoh Ajay M.V. Kumar Alexandre Delamou Laura Merson Prabin Dahal Gomathi Ramaswamy Ibrahima Kaba Benjamin T. Vonhm Trokon Omarley Yeabah Anthony D. Harries Pryanka Relan Adam C. Levine Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved] F1000Research West Africa Ebola mortality viral haemorrhagic fever filovirus SORT IT eng |
| title | Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved] |
| title_full | Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved] |
| title_fullStr | Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved] |
| title_full_unstemmed | Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved] |
| title_short | Factors associated with death in patients admitted with Ebola virus disease to Ebola Treatment Units in Guinea, Sierra Leone, and Liberia – December 2013 to March 2016 [version 2; peer review: 2 approved] |
| title_sort | factors associated with death in patients admitted with ebola virus disease to ebola treatment units in guinea sierra leone and liberia december 2013 to march 2016 version 2 peer review 2 approved |
| topic | West Africa Ebola mortality viral haemorrhagic fever filovirus SORT IT eng |
| url | https://f1000research.com/articles/13-672/v2 |
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