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Determinants of patient survival during the 2014 Ebola Virus Disease outbreak in Bong county,Liberia

Global Health Research and Policy 2016年第1期1卷 34-43页

作者： Thomas A.Weppelmann Bangure Donewell Ubydul Haque Wenbiao Hu Ricardo J.Soares Magalhaes Mutaawe Lubogo Lucas Godbless Sasita Shabani Justin Maeda Herilinda Temba theophil c.malibiche Naod Berhanu Wenyi Zhang Luke Bawo Department of Environmental and Global Health University of FloridaGainesvilleFLUSA Emerging Pathogens Institute University of Florida2055 Mowry RdGainesvilleFLUSA African Union Support to Ebola Outbreak in West Africa(ASEOWA) MonroviaLiberia Department of Geography University of FloridaGainesvilleFLUSA School of Public Health and Social Work Queensland University of TechnologyBrisbaneAustralia School of Veterinary Science The University of QueenslandBrisbaneAustralia children’s Health Research centre The University of QueenslandSt LuciaAustralia Institute of Disease control and Prevention Academy of Military Medical ScienceBeijingPeople’s Republic of China Liberian Ministry of Health and Social Work(MOHSW) MonroviaLiberia.

Background:The unprecedented size of the 2014 Ebola Virus Disease(EVD)outbreak in West Africa has allowed for a more extensive characterization of the clinical presentation and management of this *** this study,we report the trends in morbidity,mortality,and determinants of patient survival as EVD spread into Bong county,***:An analysis of suspected,probable,or confirmed cases of EVD(n=607)reported to the Liberian Ministry of Health and Social Welfare(MOHSW)between March 23rd and December 31st 2014 was *** likelihood of infection given exposure factors was determined using logistic regression in individuals with a definitive diagnosis by RT-PcR(n=321).The risk of short-term mortality(30 days)given demographic factors,clinical symptoms,and highest level of treatment received was assessed with cox regression and survival analyses(n=391).Results:The overall mortality rate was 53.5%(95%cI:49%,58%)and decreased as access to medical treatment *** who reported contact with another EVD case were more likely to be infected(OR:5.7),as were those who attended a funeral(OR:3.9).Mortality increased with age(Pcompared to females(P=0.006).Fever(HR:6.63),vomiting(HR:1.93),diarrhea(HR:1.99),and unexplained bleeding(HR:2.17)were associated with increased *** adjusting for age,hospitalized patients had a 74%reduction in the risk of short term mortality(PcI AHR:0.18,0.37),compared to those not given medical ***:Even treatment with only basic supportive care such as intravenous rehydration therapy was able to significantly improve patient survival in suspected,probable,or confirmed EVD cases.

关键词： Ebola diagnosis treatment

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Ebola Response in Liberia;Field Experiences, challenges and Lessons Learnt during the Response, 2014-2015

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Open Journal of Epidemiology 2016年第1期6卷 88-94页

作者： Mutaawe Lubogo Donewell Bangure Justin Maeda Sasita Shabani theophile c. malibiche Herilinda Temba Lucas Godbless Naod Bruhan Oketta Julius Uganda Field Epidemiology Programme Kampala Uganda Zimbabwe Field Epidemiology Programme Harare Zimbabwe Tanzania Field Epidemiology Programme Dar es Salam Tanzania Ethiopia Field Epidemiology Programme Addis Ababa Ethiopia ASEOWA Head of Mission Kampala Uganda

The 2014-2015 Ebola Virus Disease (EVD) outbreaks which began in Guinea and later spread to Liberia, Sierra Leona and other countries have been responsible for a number of infections and deaths among the communities including health workers. The natural host of the EVD virus has not been identified even when scientific evidence points to bats as the natural reservoirs to similar strains of EVD virus. EVD male survivors have also been identified as a potential source of infection among the populations. Some of the reasons attributed to this rapid spread of EVD to other countries have been weak early warning systems to identify and notify health authorities of such diseases of high epidemic potential. Liberia has been one of the countries to be declared EVD free on two different occasions in 2015 each with a different epicenter. Despite a number of international organizations coming together to support control efforts in Liberia, the coordination of response activities by the Ministry of Health and Social Welfare and replicated at all levels of the surveillance systems was the key in suppressing the outbreak. Adoption of the Integrated Disease Surveillance and Response (IDSR) guidelines as recommended by World Health Organization (WHO/AFRO) was a positive step towards the structuring of response activities. capacity building of health workers in infection control and prevention and surveillance was important to improve skills of health workers to triage EVD cases as recommended by WHO. Training community health volunteers in contact tracing and active case search was important in strengthening the Early Warning Disease surveillance system. Decentralization of response activities in addition to establishing Ebola Treatment units and community care centers in all counties was vital in containing the spread of infection. Even when EVD was associated to high levels of stigma, community and individual counseling sessions led by community leaders enabled building community

关键词： Ebola Liberia Field Experiences challenges

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