Clinical illness and outcomes in patients with Ebola in Sierra Leone.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Schieffelin John S, Shaffer Jeffrey G, Goba Augustine, Gbakie Michael, Gire Stephen K, Colubri Andres, Sealfon Rachel S G, Kanneh Lansana, Moigboi Alex, Momoh Mambu, Fullah Mohammed, Moses Lina M, Brown Bethany L, Andersen Kristian G, Winnicki Sarah, Schaffner Stephen F, Park Daniel J, Yozwiak Nathan L, Jiang Pan-Pan, Kargbo David, Jalloh Simbirie, Fonnie Mbalu, Sinnah Vandi, French Issa, Kovoma Alice, Kamara Fatima K, Tucker Veronica, Konuwa Edwin, Sellu Josephine, Mustapha Ibrahim, Foday Momoh, Yillah Mohamed, Kanneh Franklyn, Saffa Sidiki, Massally James L B, Boisen Matt L, Branco Luis M, Vandi Mohamed A, Grant Donald S, Happi Christian, Gevao Sahr M, Fletcher Thomas E, Fowler Robert A, Bausch Daniel G, Sabeti Pardis C, Khan S Humarr, Garry Robert F, KGH Lassa Fever Program, Viral Hemorrhagic Fever Consortium, WHO Clinical Response Team
Аннотация
METHODS: We reviewed available epidemiologic, clinical, and laboratory records of patients in whom EVD was diagnosed between May 25 and June 18, 2014. We used quantitative reverse-transcriptase-polymerase-chain-reaction assays to assess the load of Ebola virus (EBOV, Zaire species) in a subgroup of patients.
RESULTS: Of 106 patients in whom EVD was diagnosed, 87 had a known outcome, and 44 had detailed clinical information available. The incubation period was estimated to be 6 to 12 days, and the case fatality rate was 74%. Common findings at presentation included fever (in 89% of the patients), headache (in 80%), weakness (in 66%), dizziness (in 60%), diarrhea (in 51%), abdominal pain (in 40%), and vomiting (in 34%). Clinical and laboratory factors at presentation that were associated with a fatal outcome included fever, weakness, dizziness, diarrhea, and elevated levels of blood urea nitrogen, aspartate aminotransferase, and creatinine. Exploratory analyses indicated that patients under the age of 21 years had a lower case fatality rate than those over the age of 45 years (57% vs. 94%, P=0.03), and patients presenting with fewer than 100,000 EBOV copies per milliliter had a lower case fatality rate than those with 10 million EBOV copies per milliliter or more (33% vs. 94%, P=0.003). Bleeding occurred in only 1 patient.
CONCLUSIONS: The incubation period and case fatality rate among patients with EVD in Sierra Leone are similar to those observed elsewhere in the 2014 outbreak and in previous outbreaks. Although bleeding was an infrequent finding, diarrhea and other gastrointestinal manifestations were common. (Funded by the National Institutes of Health and others.).