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BackgroundA unit of the European Mobile Laboratory (EMLab) consortium was deployed to the Ebola virus disease (EVD) treatment unit in Guéckédou, Guinea, from March 2014 through March 2015.MethodsThe unit diagnosed EVD and malaria, using the RealStar Filovirus Screen reverse transcription-polymerase chain reaction (RT-PCR) kit and a malaria rapid diagnostic test, respectively.ResultsThe cleaned EMLab database comprised 4719 samples from 2741 cases of suspected EVD from Guinea. EVD was diagnosed in 1231 of 2178 hospitalized patients (57%) and in 281 of 563 who died in the community (50%). Children aged <15 years had the highest proportion of Ebola virus-malaria parasite coinfections. The case-fatality ratio was high in patients aged <5 years (80%) and those aged >74 years (90%) and low in patients aged 10-19 years (40%). On admission, RT-PCR analysis of blood specimens from patients who died in the hospital yielded a lower median cycle threshold (Ct) than analysis of blood specimens from survivors (18.1 vs 23.2). Individuals who died in the community had a median Ct of 21.5 for throat swabs. Multivariate logistic regression on 1047 data sets revealed that low Ct values, ages of <5 and ≥45 years, and, among children aged 5-14 years, malaria parasite coinfection were independent determinants of a poor EVD outcome.ConclusionsVirus load, age, and malaria parasite coinfection play a role in the outcome of EVD.

Original publication

DOI

10.1093/infdis/jiw269

Type

Journal article

Journal

The Journal of infectious diseases

Publication Date

10/2016

Volume

214

Pages

S250 - S257

Addresses

Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.

Keywords

Humans, Filoviridae, Hemorrhagic Fever, Ebola, Filoviridae Infections, Malaria, RNA, Viral, Viral Load, Adolescent, Adult, Aged, Middle Aged, Child, Child, Preschool, Infant, Mobile Health Units, Guinea, Female, Male, Ebolavirus, Young Adult, Epidemics, Clinical Laboratory Services