Abstract
BackgroundThe last ebola virus disease (EVD) outbreak has been the most important since 1976. EVD cases decreased drastically in Sierra Leone at the beginning of 2015. We aim to determine the clinical findings and evolution of patients admitted to an Ebola treatment center (ETC) during the epidemic’s late phase.MethodsWe analyze retrospectively data of patients admitted to the Moyamba ETC (December 2014-March 2015). Patients were classified in EVD or non-EVD patients according to the results of Ebola virus real-time reverse transcription polymerase chain reaction (ZAIRE-RT-PCR).ResultsSeventy-five patients were included, 41.3 % were positive for ZAIRE-RT-PCR. More women (68 % vs 28 %, p = 0.001) were EVD-positive. More EVD patients had previous contact with an Ebola patient (74.2 % vs 36.3 %, p < 0.001). At admission, EVD patients were more likely to have fatigue (96.7 %, p < 0.001), diarrhea (67.7 %, p = 0.002), and muscle pain (61.3 %, p = 0.009); but only objective fevers in 35.5 % of EVD patients. The most reliable criteria for diagnosis were: contact with an Ebola patient plus three WHO symptoms (LR + =3.7, 95 % CI = 1.9–7.3), and positive contact (LR + =2.3, 95 % CI = 1.15–4.20). Only 45.2 % of EVD patients developed fevers during stay, but 75 % developed gastrointestinal symptoms. Non-EVD patients had gastrointestinal problems (33 %), respiratory conditions (26.6 %), and others such as malaria, HIV or tuberculosis with a mortality rate of 11.4 %. vs 58 % in EVD group (p < 0.001).ConclusionsMore non-EVD patients were admitted in the outbreak’s late phases. The low percentage of initial fever highlights the need to emphasize the epidemiological information. EVD patients presented new symptoms getting worse and requiring closer follow-up. Diagnoses of non-EVD patients were diverse with a remarkable mortality, presenting a challenge for the health system.
Highlights
The last ebola virus disease (EVD) outbreak has been the most important since 1976
Basic characteristics of Ebola virus disease (EVD) and non-EVD patients From December 2014 to March 2015, 92 patients were admitted to the Ebola treatment center (ETC) in Moyamba (Sierra Leone)
Individuals in this last group were RT-polymerase chain reaction (PCR) negative for EVD in two test and were excluded from our analysis because they did not complain of any symptoms during their stays or during the 21 days period of isolation after their admission (Fig. 1)
Summary
The last ebola virus disease (EVD) outbreak has been the most important since 1976. EVD cases decreased drastically in Sierra Leone at the beginning of 2015. A new Ebola treatment center (ETC) opened in the district of Moyamba (Sierra Leone) in December 2014. Since mid-August 2014, the district of Moyamba had only one Holding Center to manage patients with Ebola virus disease (EVD), and this center admitted 244 patients. The main aim of this ETC was to treat and manage EVD cases in response to the World Health Organization (WHO) declaration of EVD as public health emergency of international concern on 8 August 2014, demanding the need for “a coordinated international response to stop and reverse the international spread of Ebola because the Ebola outbreak in West Africa constitutes an extraordinary event” [1]. The creation of ETC facilities was one of the most important factors [2] that caused a significant decrease in the number of EVD cases during February and March 2015 throughout the country, including in the district of Moyamba, with fewer cases of confirmed EVD among suspected patients. On 7 November 2015, WHO declared Sierra Leone to be free of Ebola
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
