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Volume 22, Number 9—September 2016
Synopsis

Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015

Yngvar Lunde Haaskjold, Håkon Angell Bolkan, Kurt Østhuus Krogh, James Jongopi, Karen Marie Lundeby, Sindre Mellesmo, Pedro San José Garcés, Ola Jøsendal, Åsmund Øpstad, Erling Svensen, Luis Matias Zabala Fuentes, Alfred Sandy Kamara, Melchor Riera, Javier Arranz, David P. Roberts, Paul D. Stamper, Paula Austin, Alfredo J. Moosa, Dennis Marke, Shoaib Hassan, Geir Egil Eide, Åse Berg, and Bjørn BlombergComments to Author 
Author affiliations: Haukeland University Hospital, Bergen, Norway (Y.L. Haaskjold, O. Jøsendal, E. Svensen, G.E. Eide, B. Blomberg); St. Olav Hospital, Trondheim, Norway (H.A. Bolkan, K.Ø. Krogh, S. Mellesmo); Moyamba District Hospital, Moyamba, Sierra Leone (J. Jongopi, A.S. Kamara, A.J. Moosa, D. Marke); Oslo University Hospital, Oslo, Norway (K.M. Lundeby); Médicos del Mundo, Madrid, Spain (P. San José Garcés, L.M. Zabala Fuentes, J. Arranz); Haraldsplass Diaconal Hospital, Bergen (Å. Øpstad); University of Bergen, Bergen (E. Svensen, G.E. Eide, B. Blomberg); Hospital Son Espases, Palma de Mallorca, Spain (M. Riera); Instituto de Investigacion de Palma (IDISPA), Madrid (J. Arranz); MRIGlobal, Rockville, Maryland, USA (D.P. Roberts, P.D. Stamper); Sandia National Laboratories, Albuquerque, New Mexico, USA (P. Austin); FELTP Public Health, Islamabad, Pakistan (S. Hassan); Stavanger University Hospital, Stavanger, Norway (Å. Berg)

Main Article

Table 1

Characteristics of patients with confirmed Ebola virus disease admitted to the treatment center in Moyamba District, Sierra Leone, December 19, 2014–February 17, 2015*

Characteristic Patients†
 OR (95% CI) p value‡
Total, N = 31 Died, n = 18 Survived, n = 13
Demographic characteristics
Sex
M 14 (45) 12 (67) 2 (15) 11.0 (2.1–57.0) 0.007
F 17 (55) 6 (35) 11 (65) 0.009 (0.02–0.5)
Age group, y
<15 6 (19) 4 (22) 2 (15) 2.0 (0.25–16.3) 0.565§
15–44 19 (61) 11 (61) 8 (62) 1.4 (0.26–7.1) NA
>45 6 (19) 3 (17) 3 (23) 1 NA
Healthcare workers
 0 (0)
 0
 0
 NA
 NA
Length of incubation, median d (range)¶
 8 (1–17)
 7 (1–10)
 8.5 (5–17)
 NA
 0.059#
Time from symptom onset to admission, median d (range)**
 3 (0–23)
 2 (0–17)
 4.5 (1–23)
 NA
 0.006#
Time from symptom onset to death/discharge, median d (range)**
 10 (2–45)
 6 (2–18)
 19.5 (12–45)
 NA
 <0.001#
Signs and symptoms
Weakness 30 (97) 18 (100) 12 (92) NA 0.210
Diarrhea 21 (68) 15 (83) 6 (46) 5.8 (1.2–25.0) 0.036
Fever 19 (61) 12 (67) 7 (54) 1.7 (0.42–7.4) 0.597
Loss of appetite 19 (61) 12 (67) 7 (54) 1.7 (0.42–7.4) 0.597
Vomiting 18 (58) 12 (67) 6 (46) 2.3 (0.60–11.0) 0.216
Red eyes 13 (42) 9 (50) 4 (31) 2.3 (0.55–8.3) 0.378
Nausea 8 (26) 4 (22) 4 (31) 0.64 (0.16–2.7) 0.551
Dysphagia 8 (26) 5 (28) 3 (23) 1.3 (0.22–5.7) 0.845
Hiccups 2 (6) 2 (11) 0 NA 0.332
Pain
Overall 29 (94) 18 (100) 11 (85) NA 0.084
Muscle pain 19 (61) 10 (56) 9 (69) 0.56 (0.15–2.2) 0.373
Joint pain 17 (55) 10 (56) 7 (54) 1.1 (0.27–4.1) 0.858
Headache 17 (55) 11 (61) 6 (46) 1.8 (0.48–7.7) 0.378
Abdominal pain 14 (45) 9 (50) 5 (38) 1.6 (0.42–7.3) 0.599
Chest pain 7 (23) 3 (17) 4 (31) 0.45 (0.10–2.1) 0.302
Pain requiring opiates 19 (61) 16 (89) 3 (23) 27 (3.9–144.0) <0.001
Bleeding manifestations
At admission 11 (35) 8 (44) 3 (23) 2.7 (0.61–11.0) 0.202
In feces 5 (16) 5 (28) 0 NA 0.033
From mouth 2 (6) 1 (6) 1 (8) 0.71 (0.04–14.0) 0.748
From eyes 1 (3) 0 1 (8) 0.0 (0–6.5) 0.210
From genitals 3 (10) 1 (6) 2 (15) 0.32 (0.02–3.2) 0.401
From puncture sites 1 (3) 1 (6) 0 NA 0.710
Any time during hospitalization 17 (55) 14 (78) 3 (23) 12 (2.3–50.0) 0.002
In feces 13 (42) 13 (72) 0 NA <0.001
From mouth 9 (29) 8 (44) 1 (8) 9.6 (1.2–114.0) 0.031
From eyes 4 (13) 3 (17) 1 (8) 2.4 (0.31–33.0) 0.452
From genitals 6 (19) 4 (22) 2 (15) 1.6 (0.29–9.3) 0.838
From puncture sites
 7 (23)
 7 (39)
 0
 NA
 0.019
Cycle threshold, median (range)†† 22 (15.0–36.5) 20.5 (15–23) 26.5 (22.0–36.5) NA <0.001#

*NA, not applicable; OR, odds ratio.
†Data are no. (%) except as indicated.
‡By Fisher 2-tailed exact mid-p test, except for ordered groups and continuous variables.
§By nonparametric test for trend across ordered groups (i.e., age groups).
¶Incubation time was unknown for 8 patients with fatal and 3 with nonfatal disease.
#By 2-sample Fligner-Policello robust rank order test for continuous variables (i.e., time variables, PCR values).
**Time was unknown for 1 patient with nonfatal disease.
††Determined by real-time reverse transcription PCR; value was unknown for 1 patient with fatal disease.

Main Article

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Page created: August 16, 2016
Page updated: August 16, 2016
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