1. Risk Factors for Ebola Exposure in Health Care Workers in Boende, Tshuapa Province, Democratic Republic of the Congo
- Author
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Anna Bratcher, Benoit Ilunga-Kebela, Adva Gadoth, Matthew S. Bramble, Vivian H. Alfonso, Cyrus Sinai, Jean-Jacques Muyembe-Tamfum, Anne W. Rimoin, Alexis Mwanza, Bradly P. Nicholson, Nicole A. Hoff, Rupal Shah, Matthias Mossoko, Patrick Mukadi, Daniel Mukadi, Reena H. Doshi, Emile Okitolonda-Wemakoy, Joseph Wasiswa, and Russell A. Williams
- Subjects
Health Personnel ,030231 tropical medicine ,Population ,Disease ,medicine.disease_cause ,Logistic regression ,Asymptomatic ,Medical and Health Sciences ,Microbiology ,health care workers ,Disease Outbreaks ,Vaccine Related ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Clinical Research ,Environmental health ,Biodefense ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,education ,Subclinical infection ,education.field_of_study ,Ebola virus ,business.industry ,Transmission (medicine) ,Prevention ,Outbreak ,Hemorrhagic Fever, Ebola ,Biological Sciences ,Ebolavirus ,Emerging Infectious Diseases ,Infectious Diseases ,Good Health and Well Being ,Immunoglobulin G ,Ebola ,Democratic Republic of the Congo ,Hemorrhagic Fever ,medicine.symptom ,business ,Infection - Abstract
Background Health care workers (HCW) are more likely to be exposed to Ebola virus (EBOV) during an outbreak compared to people in the general population due to close physical contact with patients and potential exposure to infectious fluids. However, not all will fall ill. Despite evidence of subclinical and paucisymptomatic Ebola virus disease (EVD), prevalence and associated risk factors remain unknown. Methods We conducted a serosurvey among HCW in Boende, Tshuapa Province, Democratic Republic of Congo. Human anti-EBOV glycoprotein IgG titers were measured using a commercially available ELISA kit. We assessed associations between anti-EBOV IgG seroreactivity, defined as ≥2.5 units/mL, and risk factors using univariable and multivariable logistic regression. Sensitivity analyses explored a more conservative cutoff, >5 units/mL. Results Overall, 22.5% of HCWs were seroreactive for EBOV. In multivariable analyses, using any form of personal protective equipment when interacting with a confirmed, probable, or suspect EVD case was negatively associated with seroreactivity (adjusted odds ratio, 0.23; 95% confidence interval, .07–.73). Discussion Our results suggest high exposure to EBOV among HCWs and provide additional evidence for asymptomatic or minimally symptomatic EVD. Further studies should be conducted to determine the probability of onward transmission and if seroreactivity is associated with immunity.
- Published
- 2022