Successful Implementation of a Multicountry Clinical Surveillance and Data Collection System for Ebola Virus Disease in West Africa: Findings and Lessons Learned.
Glob Health Sci Pract
; 4(3): 394-409, 2016 09 28.
Article
em En
| MEDLINE
| ID: mdl-27688716
ABSTRACT
BACKGROUND:
The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest ever recorded. Starting in September 2014, International Medical Corps (IMC) managed 5 Ebola treatment units (ETUs) in Liberia and Sierra Leone, which cumulatively cared for about 2,500 patients. We conducted a retrospective cohort study of patient data collected at the 5 ETUs over 1 year of operations.METHODS:
To collect clinical and epidemiological data from the patient care areas, each chart was either manually copied across the fence between the high-risk zone and low-risk zone, imaged across the fence, or imaged in the high-risk zone. Each ETU's data were entered into a separate electronic database, and these were later combined into a single relational database. Lot quality assurance sampling was used to ensure data quality, with reentry of data with high error rates from imaged records.RESULTS:
The IMC database contains records on 2,768 patient presentations, including 2,351 patient admissions with full follow-up data. Of the patients admitted, 470 (20.0%) tested positive for EVD, with an overall case fatality ratio (CFR) of 57.0% for EVD-positive patients and 8.1% for EVD-negative patients. Although more men were admitted than women (53.4% vs. 46.6%), a larger proportion of women were diagnosed EVD positive (25.6% vs. 15.2%). Diarrhea, red eyes, contact with an ill person, and funeral attendance were significantly more common in patients with EVD than in those with other diagnoses. Among EVD-positive patients, age was a significant predictor of mortality the highest CFRs were among children under 5 (89.1%) and adults over 55 (71.4%).DISCUSSION:
While several prior reports have documented the experiences of individual ETUs, this study is the first to present data from multiple ETUs across 2 countries run by the same organization with similar clinical protocols. Our experience demonstrates that even in austere settings under difficult conditions, it is possible for humanitarian organizations to collect high-quality clinical and epidemiologic data during a major infectious disease outbreak.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Surtos de Doenças
/
Coleta de Dados
/
Bases de Dados Factuais
/
Doença pelo Vírus Ebola
/
Ebolavirus
/
Instalações de Saúde
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adolescent
/
Adult
/
Child
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Child, preschool
/
Female
/
Humans
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Infant
/
Male
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Middle aged
/
Newborn
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article