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Surviving Ebola: A historical cohort study of Ebola mortality and survival in Sierra Leone 2014-2015.
- Source :
-
PloS one [PLoS One] 2018 Dec 27; Vol. 13 (12), pp. e0209655. Date of Electronic Publication: 2018 Dec 27 (Print Publication: 2018). - Publication Year :
- 2018
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Abstract
- Background: While a number of predictors for Ebola mortality have been identified, less is known about post-viral symptoms. The identification of acute-illness predictors for post-viral symptoms could allow the selection of patients for more active follow up in the future, and those in whom early interventions may be beneficial in the long term. Studying predictors of both mortality and post-viral symptoms within a single cohort of patients could also further our understanding of the pathophysiology of survivor sequelae.<br />Methods/principal Findings: We performed a historical cohort study using data collected as part of routine clinical care from an Ebola Treatment Centre (ETC) in Kerry Town, Sierra Leone, in order to identify predictors of mortality and of post-viral symptoms. Variables included as potential predictors were sex, age, date of admission, first recorded viral load at the ETC and symptoms (recorded upon presentation at the ETC). Multivariable logistic regression was used to identify predictors. Of 263 Ebola-confirmed patients admitted between November 2014 and March 2015, 151 (57%) survived to ETC discharge. Viral load was the strongest predictor of mortality (adjusted OR comparing high with low viral load: 84.97, 95% CI 30.87-345.94). We did not find evidence that a high viral load predicted post-viral symptoms (ocular: 1.17, 95% CI 0.35-3.97; musculoskeletal: 1.07, 95% CI 0.28-4.08). Ocular post-viral symptoms were more common in females (2.31, 95% CI 0.98-5.43) and in those who had experienced hiccups during the acute phase (4.73, 95% CI 0.90-24.73).<br />Conclusions/significance: These findings may add epidemiological support to the hypothesis that post-viral symptoms have an immune-mediated aspect and may not only be a consequence of high viral load and disease severity.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adolescent
Adult
Cohort Studies
Disease Outbreaks
Female
Hemorrhagic Fever, Ebola epidemiology
Hemorrhagic Fever, Ebola history
History, 21st Century
Humans
Male
Mortality
Population Surveillance
Risk Factors
Sierra Leone epidemiology
Survivors
Viral Load
Young Adult
Ebolavirus
Hemorrhagic Fever, Ebola mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 13
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 30589913
- Full Text :
- https://doi.org/10.1371/journal.pone.0209655