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Heterogeneities in the case fatality ratio in the West African Ebola outbreak 2013 – 2016
- Publication Year :
- 2016
- Publisher :
- Royal Society, The, 2016.
-
Abstract
- The 2013–2016 Ebola outbreak in West Africa is the largest on record with 28 616 confirmed, probable and suspected cases and 11 310 deaths officially recorded by 10 June 2016, the true burden probably considerably higher. The case fatality ratio (CFR: proportion of cases that are fatal) is a key indicator of disease severity useful for gauging the appropriate public health response and for evaluating treatment benefits, if estimated accurately. We analysed individual-level clinical outcome data from Guinea, Liberia and Sierra Leone officially reported to the World Health Organization. The overall mean CFR was 62.9% (95% CI: 61.9% to 64.0%) among confirmed cases with recorded clinical outcomes. Age was the most important modifier of survival probabilities, but country, stage of the epidemic and whether patients were hospitalized also played roles. We developed a statistical analysis to detect outliers in CFR between districts of residence and treatment centres (TCs), adjusting for known factors influencing survival and identified eight districts and three TCs with a CFR significantly different from the average. From the current dataset, we cannot determine whether the observed variation in CFR seen by district or treatment centre reflects real differences in survival, related to the quality of care or other factors or was caused by differences in reporting practices or case ascertainment.
- Subjects :
- Life Sciences & Biomedicine - Other Topics
OUTCOMES
Evolutionary Biology
Science & Technology
FEATURES
CONAKRY
spatial heterogeneity
Ebola virus disease
case fatality ratio
severity
11 Medical And Health Sciences
outlier detection
PERFORMANCE
06 Biological Sciences
mortality
SIERRA-LEONE
SURVIVAL
GUINEA
EPIDEMIOLOGY
Life Sciences & Biomedicine
Biology
VIRUS DISEASE
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.od......1032..2846a475a8460b7a518db8053b0f8724