Abstract
Situated in southeastern Sierra Leone, Kenema Government Hospital (KGH) maintains one of the world’s only Lassa fever isolation wards and was a strategic Ebola virus disease (EVD) treatment facility during the 2014 EVD outbreak. Since 2006, the Viral Hemorrhagic Fever Consortium (VHFC) has carried out research activities at KGH, capturing clinical and laboratory data for suspected cases of Lassa fever. Here we describe the approach, progress, and challenges in designing and maintaining a data capture and management system (DCMS) at KGH to assist infectious disease researchers in building and sustaining DCMS in low-resource environments. Results on screening patterns and case-fatality rates are provided to illustrate the context and scope of the DCMS covered in this study. A medical records system and DCMS was designed and implemented between 2010 and 2016 linking historical and prospective Lassa fever data sources across KGH Lassa fever units and its peripheral health units. Data were captured using a case report form (CRF) system, enzyme-linked immunosorbent assay (ELISA) plate readers, polymerase chain reaction (PCR) machines, blood chemistry analyzers, and data auditing procedures. Between 2008 and 2016, blood samples for 4,229 suspected Lassa fever cases were screened at KGH, ranging from 219 samples in 2008 to a peak of 760 samples in 2011. Lassa fever case-fatality rates before and following the Ebola outbreak were 65.5% (148/226) and 89.5% (17/19), respectively, suggesting that fewer, but more seriously ill subjects with Lassa fever presented to KGH following the 2014 EVD outbreak (p = .040). DCMS challenges included weak specificity of the Lassa fever suspected case definition, limited capture of patient survival outcome data, internet costs, lapses in internet connectivity, low bandwidth, equipment and software maintenance, lack of computer teaching laboratories, and workload fluctuations due to variable screening activity. DCMS are the backbone of international research efforts and additional literature is needed on the topic for establishing benchmarks and driving goal-based approaches for its advancement in developing countries.
Highlights
Lassa fever is a hemorrhagic illness that is transmitted to humans primarily through contact with rodent excreta
The largest proportion of samples was observed for subjects testing negative for Lassa fever, which may be a result of the weak specificity of the Lassa fever suspected case definition or variable triaging practices from Kenema Government Hospital (KGH) peripheral health units
We developed a data capture and management system (DCMS) for Lassa fever supporting both research and hospital activities in a limited resource hospital setting
Summary
Lassa fever ( referred to here as Lassa) is a hemorrhagic illness that is transmitted to humans primarily through contact with rodent excreta. The disease was first detected in 1969 in Lassa, Nigeria, and stems from an Old World arenavirus known as Lassa virus [1, 2]. Lassa is currently found in sub-Saharan West Africa and is endemic to parts of Sierra Leone, Liberia, Guinea, and Nigeria. There is currently no vaccine available for Lassa, and it accounts for between 100,000 and 300,000 infections and 5,000 deaths annually [6, 7]. Lassa infections most commonly arise in poor, rural areas, partly due to insufficient food storage practices and increased interaction between humans and animals found in such areas. Some of the world’s highest observed Lassa fever infection rates are found in Sierra Leone’s Kenema District that is located in its Eastern Province near its south Liberian border (Fig 1; [8, 9])
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
