ArticleThe Journal of infection2018
Enhanced case management can be delivered for patients with EVD in Africa: Experience from a UK military Ebola treatment centre in Sierra Leone.
Article in The Journal of infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Anti-Ebola therapy for patients with Ebola virus disease: a systematic review.BMC infectious diseases · 2019Pooled it
- Infections and Acute Kidney Injury: A Global Perspective.Seminars in nephrology · 2023Review
- Outcomes of hospitalised patients with hyperkalaemia at a South African tertiary healthcare centre.EClinicalMedicine · 2022Article
- Critical illness in the returning traveller.Journal of the Intensive Care Society · 2022Article
- Article
- Oxygen delivery systems for adults in Sub-Saharan Africa: A scoping review.Journal of global health · 2021Article
- Treatment of Ebola-related critical illness.Intensive care medicine · 2020Review
- Impact of intensive care unit supportive care on the physiology of Ebola virus disease in a universally lethal non-human primate model.Intensive care medicine experimental · 2019Article
- Caring for Critically Ill Patients in Humanitarian Settings.American journal of respiratory and critical care medicine · 2019Article
- Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance.Frontiers in physiology · 2019Review
- Caseload and Case Fatality of Lassa Fever in Nigeria, 2001-2018: A Specialist Center's Experience and Its Implications.Frontiers in public health · 2019Article
- The British Army's contribution to tropical medicine.Clinical medicine (London, England) · 2018Review
- Ebola Virus Causes Intestinal Tract Architectural Disruption and Bacterial Invasion in Non-Human Primates.Viruses · 2018Article
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32 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundLimited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with Ebola virus disease (EVD) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting.
methodsDemographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015.
resultsA total of 44 EVD patients were admitted (median age 37 years (range 17-63), 32/44 healthcare workers), and excluding those evacuated, the case fatality rate was 49% (95% CI 33%-65%). No pregnant women were admitted. At admission 9/44 had stage 1 disease (fever and constitutional symptoms only), 12/44 had stage 2 disease (presence of diarrhoea and/or vomiting) and 23/44 had stage 3 disease (presence of diarrhoea and/or vomiting with organ failure), with case fatality rates of 11% (95% CI 1%-58%), 27% (95% CI 6%-61%), and 70% (95% CI 47%-87%) respectively (p = 0.009). Haemorrhage occurred in 17/41 (41%) patients. The majority (21/40) of patients had hypokalaemia with hyperkalaemia occurring in 12/40 patients. Acute kidney injury (AKI) occurred in 20/40 patients, with 14/20 (70%, 95% CI 46%-88%) dying, compared to 5/20 (25%, 95% CI 9%-49%) dying who did not have AKI (p = 0.01). Ebola virus (EBOV) PCR cycle threshold value at baseline was mean 20.3 (SD 4.3) in fatal cases and 24.8 (SD 5.5) in survivors (p = 0.007). Mean national early warning score (NEWS) at admission was 5.5 (SD 4.4) in fatal cases and 3.0 (SD 1.9) in survivors (p = 0.02). Central venous catheters were placed in 37/41 patients and intravenous fluid administered to 40/41 patients (median duration of 5 days). Faecal management systems were inserted in 21/41 patients, urinary catheters placed in 27/41 and blood component therapy administered to 20/41 patients.
conclusionsEVD is commonly associated life-threatening electrolyte imbalance and organ dysfunction. We believe that the enhanced levels of protocolized care, scale and range of medical interventions we report, offer a blueprint for the future management of EVD in resource-limited settings.
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