Evidence map›Paper›PMID 28256310›Full record

ArticleThe Lancet. Infectious diseases2017

Asymptomatic infection and unrecognised Ebola virus disease in Ebola-affected households in Sierra Leone: a cross-sectional study using a new non-invasive assay for antibodies to Ebola virus.

Judith R Glynn, Hilary Bower, Sembia Johnson, Catherine F Houlihan, Carla Montesano, Janet T Scott, Malcolm G Semple, Mohammed S Bangura, Alie Joshua Kamara, Osman Kamara and 9 more

Open access · hybridAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 2 pooled it
10.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 2 syntheses or guidelines pooled it, 114 citations in OpenAlex.

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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 8 institutions in 3 countries.

Judith R GlynnDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: judith.glynn@lshtm.ac.uk.
Hilary BowerDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Sembia JohnsonSave the Children, Freetown, Sierra Leone.
Catherine F HoulihanDivision of Infection and Immunity, University College London, London, UK.
Carla MontesanoDepartment of Biology, University of Rome "Tor Vergata", Rome, Italy; Department of Public Health, University of Makeni, Makeni, Sierra Leone; Holy Spirit Hospital, Makeni, Sierra Leone.
Janet T ScottInstitute of Translational Medicine and National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.
Malcolm G SempleInstitute of Translational Medicine and National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.
Mohammed S BanguraSave the Children, Freetown, Sierra Leone.
Alie Joshua KamaraSave the Children, Freetown, Sierra Leone.
Osman KamaraSave the Children, Freetown, Sierra Leone.
Saidu H MansaraySave the Children, Freetown, Sierra Leone.
Daniel SesaySave the Children, Freetown, Sierra Leone.
Cecilia TuraySave the Children, Freetown, Sierra Leone.
Steven DicksVirus Reference Department, Public Health England, London, UK.
Raoul E Guetiya WadoumDepartment of Biology, University of Rome "Tor Vergata", Rome, Italy; Department of Public Health, University of Makeni, Makeni, Sierra Leone; Holy Spirit Hospital, Makeni, Sierra Leone.
Vittorio ColizziDepartment of Biology, University of Rome "Tor Vergata", Rome, Italy; Department of Public Health, University of Makeni, Makeni, Sierra Leone; Holy Spirit Hospital, Makeni, Sierra Leone.
Francesco ChecchiSave the Children, London, UK.
Dhan SamuelVirus Reference Department, Public Health England, London, UK.
Richard S TedderVirus Reference Department, Public Health England, London, UK.
Sierra Leone Urban Research Centre · SLPublic Health England · GBUniversity of Makeni · SLLondon School of Hygiene & Tropical Medicine · GBHealth Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool · GBSave the Children · GBUniversity College London · GBUniversity of Liverpool · GB

Funding

Medical Research Council MC_UU_12014/8Wellcome Trust 107779
6 · The paper itself

Abstract

backgroundThe frequency of asymptomatic infection with Ebola virus is unclear: previous estimates vary and there is no standard test. Asymptomatic infection with Ebola virus could contribute to population immunity, reducing spread. If people with asymptomatic infection are infectious it could explain re-emergences of Ebola virus disease (EVD) without known contact.

methodsWe validated a new oral fluid anti-glycoprotein IgG capture assay among survivors from Kerry Town Ebola Treatment Centre and controls from communities unaffected by EVD in Sierra Leone. We then assessed the seroprevalence of antibodies to Ebola virus in a cross-sectional study of household contacts of the survivors. All household members were interviewed. Two reactive tests were required for a positive result, with a third test to resolve any discrepancies.

findingsThe assay had a specificity of 100% (95% CI 98·9-100; 339 of 339 controls tested negative) and sensitivity of 95·9% (89·8-98·9; 93 of 97 PCR-confirmed survivors tested positive). Of household contacts not diagnosed with EVD, 47·6% (229 of 481) had high level exposure (direct contact with a corpse, body fluids, or a case with diarrhoea, vomiting, or bleeding). Among the contacts, 12·0% (95% CI 6·1-20·4; 11 of 92) with symptoms at the time other household members had EVD, and 2·6% (1·2-4·7; 10 of 388) with no symptoms tested positive. Among asymptomatic contacts, seropositivity was weakly correlated with exposure level.

interpretationThis new highly specific and sensitive assay showed asymptomatic infection with Ebola virus was uncommon despite high exposure. The low prevalence suggests asymptomatic infection contributes little to herd immunity in Ebola, and even if infectious, would account for few transmissions.

fundingWellcome Trust ERAES Programme, Save the Children.

Indexed as

Family CharacteristicsSeroepidemiologic StudiesAdolescentAdultAgedAsymptomatic InfectionsChildChild, PreschoolCross-Sectional StudiesEbolavirusEnzyme-Linked Immunosorbent AssayFemaleGlycoproteinsHemorrhagic Fever, EbolaHumansInfantGlycoproteins

Identifiers

PMID28256310
PMCPMC6520246
OpenAlexW2592134271

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.