scholarly journals Understanding the long-term evolution and predictors of sequelae of Ebola virus disease survivors in Guinea: A 48-month prospective, longitudinal cohort study (PostEboGui)

2021 ◽  
Author(s):  
Mamadou Saliou Kalifa Diallo ◽  
Abdoulaye Toure ◽  
Mamadou Saliou Sow ◽  
Cécé Kpamou ◽  
Alpha Kabinet Keita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Phase ◽  
Ebola Virus ◽  
Virus Disease ◽  
Cox Model ◽  
Ebola Virus Disease ◽  
Post Discharge ◽  
Factors Associated ◽  
Prospective Longitudinal

Abstract Background Longitudinal analyses are needed to better understand long-term Ebola virus disease (EVD) sequelae. We aimed to estimate the prevalence, incidence and duration of sequelae and identify risk factors associated with symptom occurrence among EVD survivors in Guinea. Methods We followed 802 EVD survivors over 48 months and recorded clinical symptoms with their start/end dates. Prevalence, incidence and duration of sequelae were calculated. Risk factors associated with symptom occurrence were assessed using an extended Cox model for recurrent events. Results Overall, the prevalence and incidence of all symptoms decreased significantly over time, but sequelae remained present 48 months after Ebola treatment center discharge with a prevalence of 30.68% (95% confidence interval [CI] 21.40-39.96) for abdominal, 30.55% (95% CI 20.68-40.41) for neurologic, 5.80% (95% CI 1.96-9.65) for musculoskeletal and 4.24% (95% CI 2.26-6.23) for ocular sequelae. Half of all patients (50.70%; 95% CI 47.26-54.14) complained of general symptoms 2 years’ post-discharge and 25.35% (95% CI 23.63-27.07) 4 years’ post-discharge. Hemorrhage (hazard ratio [HR], 2.70; P = .007), neurologic (HR 2.63; P = .021) and general symptoms (HR 0.34; P = .003) in the EVD acute phase were significantly associated with the further occurrence of ocular sequelae, whereas hemorrhage (HR 1.91; P =.046) and abdominal (HR 2.21; P = .033) symptoms were significantly associated with musculoskeletal sequelae. Conclusion Our findings provide new insight into the long-term clinical complications of EVD and their significant association with symptoms in the acute phase, thus reinforcing the importance of regular, long-term follow-up for EVD survivors.

Ebola virus disease in children in Conakry and Coyah Ebola treatment centers and risk factors associated with death

2020 ◽  
Vol 50 (7) ◽  
pp. 562-566 ◽  
Author(s):  
M.S. Sow ◽  
D.C. Sow ◽  
M.L. Diallo ◽  
D. Kassé ◽  
K. Sylla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Factors Associated

scholarly journals Zoonotic risk factors associated with seroprevalence of Ebola virus GP antibodies in the absence of diagnosed Ebola virus disease in the Democratic Republic of Congo

2021 ◽  
Vol 15 (8) ◽  
pp. e0009566
Author(s):  
Anna Bratcher ◽  
Nicole A. Hoff ◽  
Reena H. Doshi ◽  
Adva Gadoth ◽  
Megan Halbrook ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ebola Virus ◽  
Democratic Republic Of Congo ◽  
Virus Disease ◽  
Severe Disease ◽  
Asymptomatic Infection ◽  
Ebola Virus Disease ◽  
Factors Associated ◽  
Bodily Fluids ◽  
Zoonotic Risk

Background Ebola virus (EBOV) is a zoonotic filovirus spread through exposure to infected bodily fluids of a human or animal. Though EBOV is capable of causing severe disease, referred to as Ebola Virus Disease (EVD), individuals who have never been diagnosed with confirmed, probable or suspected EVD can have detectable EBOV antigen-specific antibodies in their blood. This study aims to identify risk factors associated with detectable antibody levels in the absence of an EVD diagnosis. Methodology Data was collected from September 2015 to August 2017 from 1,366 consenting individuals across four study sites in the DRC (Boende, Kabondo-Dianda, Kikwit, and Yambuku). Seroreactivity was determined to EBOV GP IgG using Zaire Ebola Virus Glycoprotein (EBOV GP antigen) ELISA kits (Alpha Diagnostic International, Inc.) in Kinshasa, DRC; any result above 4.7 units/mL was considered seroreactive. Among the respondents, 113 (8.3%) were considered seroreactive. Several zoonotic exposures were associated with EBOV seroreactivity after controlling for age, sex, healthcare worker status, location, and history of contact with an EVD case, namely: ever having contact with bats, ever having contact with rodents, and ever eating non-human primate meat. Contact with monkeys or non-human primates was not associated with seroreactivity. Conclusions This analysis suggests that some zoonotic exposures that have been linked to EVD outbreaks can also be associated with EBOV GP seroreactivity in the absence of diagnosed EVD. Future investigations should seek to clarify the relationships between zoonotic exposures, seroreactivity, asymptomatic infection, and EVD.

scholarly journals Correction to ‘Long-term wildlife mortality surveillance in northern Congo: a model for the detection of Ebola virus disease epizootics’

2019 ◽  
Vol 374 (1786) ◽  
pp. 20190658
Author(s):  
Eeva Kuisma ◽  
Sarah H. Olson ◽  
Kenneth N. Cameron ◽  
Patricia E. Reed ◽  
William B. Karesh ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Mortality Surveillance ◽  
Wildlife Mortality

Translating Professional Obligations to Care for Patients With Ebola Virus Disease Into Practice in Nonepidemic Settings

2015 ◽  
Vol 9 (5) ◽  
pp. 527-530 ◽  
Author(s):  
Jeremy Sugarman ◽  
Nancy Kass ◽  
Cynda H. Rushton ◽  
Mark T. Hughes ◽  
Thomas D. Kirsch
Keyword(s):  
Health Care Professionals ◽  
Policy Making ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Clinical Environment ◽  
Professional Obligations ◽  
Factors Associated ◽  
Implementing Strategies ◽  
And Training

AbstractDetermining how clinicians should meet their professional obligations to treat patients with Ebola virus disease in nonepidemic settings necessitates considering measures to minimize risks to clinicians, the context of care, and fairness. Minimizing risks includes providing appropriate equipment and training, implementing strategies for reducing exposure to infectious material, identifying a small number of centers to provide care, and determining which risky procedures should be used when they pose minimal likelihood of appreciable clinical benefit. Factors associated with the clinical environment, such as the local prevalence of the disease, the nature of the setting, and the availability of effective treatment, are also relevant to obligations to treat. Fairness demands that the best possible medical care be provided for health care professionals who become infected and that the rights and interests of relevant stakeholders be addressed through policy-making processes. Going forward it will be essential to learn from current approaches and to modify them based on data. (Disaster Med Public Health Preparedness. 2015;9:527–530)

scholarly journals Risk Factors for Long-Term Vancomycin-Resistant Enterococci Persistence—A Prospective Longitudinal Study

2019 ◽  
Vol 7 (10) ◽  
pp. 400 ◽  
Author(s):  
Correa-Martinez ◽  
Stollenwerk ◽  
Kossow ◽  
Schaumburg ◽  
Mellmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Control ◽  
Control Measures ◽  
Factors Associated ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
History Of ◽  
Vancomycin Resistant ◽  
Prospective Longitudinal

Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens that require effective infection control measures, representing a challenge for healthcare systems. This study aimed at identifying risk factors associated with prolonged VRE carriage and determining the rate of clearance that allows the discontinuation of contact precautions. During a 2-year study, screening was performed in patients with a history of VRE or at risk of becoming colonized. After bacterial identification and antibiotic susceptibility testing, glycopeptide resistance was confirmed by PCR. Isolates were compared via whole genome sequence-based typing. Risk factors were recorded, and follow-up screening was performed upon readmission, defining patients as long-term carriers if still colonized ≥10 weeks after first detection. Of 1059 patients positive for VRE, carriage status was assessed upon readmission in 463 patients. VRE was cleared in 56.4% of the cases. Risk factors associated with long-term persistence were hospital stays (frequency, length), hemato-oncological disease, systemic treatment with steroids, and use of antibiotics. No specific genotypic clustering was observed in patients with VRE clearance or persistence. VRE clearance is possibly underestimated. The identification of risk factors favoring long-term carriage may contribute to a targeted implementation of infection control measures upon readmission of patients with history of VRE.

Doctors’ Knowledge of Viral Haemorrhagic Fevers

2015 ◽  
Vol 14 (2) ◽  
pp. 47-52
Author(s):  
Clifford Lisk ◽  
◽  
Luke Snell ◽  
Michael Haji-Coll ◽  
Jayne Ellis ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
At Risk ◽  
West Africa ◽  
Ebola Virus ◽  
Healthcare Professionals ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Poor Knowledge ◽  
Online Study

Viral Haemorrhagic Fevers (VHF) such as Ebola Virus Disease (EVD) are of increasing concern of increasing concern to clinicians and public heath bodies across Europe and America due to the on-going epidemic in West Africa. We conducted an online study to assess clinicians’ knowledge of VHF across six hospital sites in London. This showed suboptimal knowledge of Public Health England guidance, EVD epidemiology and the risk factors for acquiring VHF. Knowledge about VHF was dependent on seniority of grade with the most junior grade of doctors performing worse in several areas of the survey. Poor knowledge raises concerns that those at risk of VHF will be inappropriately risk stratified and managed. Education of doctors and other healthcare professionals about VHF is necessary to address these knowledge gaps.

scholarly journals Deep Sequencing of RNA from Blood and Oral Swab Samples Reveals the Presence of Nucleic Acid from a Number of Pathogens in Patients with Acute Ebola Virus Disease and Is Consistent with Bacterial Translocation across the Gut

mSphere ◽  
2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Miles W. Carroll ◽  
Sam Haldenby ◽  
Natasha Y. Rickett ◽  
Bernadett Pályi ◽  
Isabel Garcia-Dorival ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Acute Phase ◽  
Bacterial Translocation ◽  
Ebola Virus ◽  
Virus Disease ◽  
Adverse Outcomes ◽  
Ebola Virus Disease ◽  
Resource Poor Setting ◽  
Rna Seq ◽  
Blood Samples

ABSTRACT In this study, samples from the 2013–2016 West African Ebola virus outbreak from patients in Guinea with Ebola virus disease (EVD) were analyzed to discover and classify what other pathogens were present. Throat swabs were taken from deceased EVD patients, and peripheral blood samples were analyzed that had been taken from patients when they presented at the treatment center with acute illness. High-throughput RNA sequencing (RNA-seq) and bioinformatics were used to identify the potential microorganisms. This approach confirmed Ebola virus (EBOV) in all samples from patients diagnosed as acute positive for the virus by quantitative reverse transcription-PCR in deployed field laboratories. Nucleic acid mapping to Plasmodium was also used on the patient samples, confirming results obtained with an antigen-based rapid diagnostic test (RDT) conducted in the field laboratories. The data suggested that a high Plasmodium load, as determined by sequence read depth, was associated with mortality and influenced the host response, whereas a lower parasite load did not appear to affect outcome. The identifications of selected bacteria from throat swabs via RNA-seq were confirmed by culture. The data indicated that the potential pathogens identified in the blood samples were associated with translocation from the gut, suggesting the presence of bacteremia, which transcriptome data suggested may induce or aggravate the acute-phase response observed during EVD. Transcripts mapping to different viruses were also identified, including those indicative of lytic infections. The development of high-resolution analysis of samples from patients with EVD will help inform care pathways and the most appropriate general antimicrobial therapy to be used in a resource-poor setting. IMPORTANCE Our results highlight the identification of an array of pathogens in the blood of patients with Ebola virus disease (EVD). This has not been done before, and the data have important implications for the treatment of patients with EVD, particularly considering antibiotic stewardship. We show that EVD patients who were also infected with Plasmodium, particularly at higher loads, had more adverse outcomes than patients with lower levels of Plasmodium. However, the presence of Plasmodium did not influence the innate immune response, and it is likely that the presence of EBOV dominated this response. Several viruses other than EBOV were identified, and bacteria associated with sepsis were also identified. These findings were indicative of bacterial translocation across the gut during the acute phase of EVD.

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