[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]
Analysis of Diagnostic Findings From the European Mobile Laboratory in Guéckédou, Guinea, March 2014 Through March 2015
Romy Kerber1,2,4,a, Ralf Krumkamp1,4,a, Boubacar Diallo9, Anna Jaeger1,4, Martin Rudolf1,2,4, Simone Lanini2,13, Joseph Akoi Bore2,10, Fara Raymond Koundouno2,10, Beate Becker-Ziaja1,2,4, Erna Fleischmann2,4,5, Kilian Stoecker2,4,5, Silvia Meschi2,13, Stéphane Mély2,14,15, Edmund N. C. Newman2,17, Fabrizio Carletti2,13, Jasmine Portmann2,19, Misa Korva2,22, Svenja Wolff2,4,6, Peter Molkenthin2,4,5, Zoltan Kis2,23, Anne Kelterbaum2,4,6, Anne Bocquin2,14,15, Thomas Strecker2,4,6, Alexandra Fizet2,14,16, Concetta Castilletti2,13, Gordian Schudt2,4,6, Lisa Ottowell2,17, Andreas Kurth2,7, Barry Atkinson2,17, Marlis Badusche1,2,4, Angela Cannas2,13, Elisa Pallasch1,2,4, Andrew Bosworth2,17, Constanze Yue2,7, Bernadett Pályi2,23, Heinz Ellerbrok2,7, Claudia Kohl2,7, Lisa Oestereich1,2,4, Christopher H. Logue2,17, Anja Lüdtke2,3,4, Martin Richter2,7, Didier Ngabo2,17, Benny Borremans2,24, Dirk Becker2,4,6, Sophie Gryseels2,24, Saïd Abdellati2,25, Tine Vermoesen2,25, Eeva Kuisma2,17, Annette Kraus2,28, Britta Liedigk1,2,4, Piet Maes2,26, Ruth Thom2,17, Sophie Duraffour2,26, Sandra Diederich2,4,8, Julia Hinzmann2,7, Babak Afrough2,17, Johanna Repits2,29, Marc Mertens2,4,8, Inês Vitoriano2,17, Amadou Bah2,20, Andreas Sachse2,7, Jan Peter Boettcher2,7, Stephanie Wurr1,2,4, Sabrina Bockholt1,2,4, Andreas Nitsche2,7, Tatjana Avšič Županc2,22, Marc Strasser2,19, Giuseppe Ippolito2,13, Stephan Becker2,4,6, Herve Raoul2,15, Miles W. Carroll2,17,18, Hilde De Clerck27, Michel Van Herp27, Armand Sprecher27, Lamine Koivogui11, N’Faly Magassouba12, Sakoba Keïta10, Patrick Drury21, Cèline Gurry21, Pierre Formenty21, Jürgen May1,4, Martin Gabriel1,2,4,b, Roman Wölfel2,4,5,b, Stephan Günther1,2,4,b and Antonino Di Caro2,13,b
Author Affiliations: 1Bernhard Nocht Institute for Tropical Medicine; 2European Mobile Laboratory Consortium; 3Heinrich Pette Institute–Leibniz Institute for Experimental Virology, Hamburg; 4German Center for Infection Research, Hamburg–Munich–Marburg–Riems; 5Bundeswehr Institute of Microbiology, Munich; 6Institute of Virology, Philipps University Marburg; 7Robert Koch Institute, Berlin; 8Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany; 9World Health Organization; 10Ministry of Health Guinea; 11Institut National de Santé Publique; 12Université Gamal Abdel Nasser de Conakry, Laboratoire des Fièvres Hémorragiques en Guinée, Guinea; 13National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy; 14National Reference Center for Viral Hemorrhagic Fevers; 15Laboratoire P4 Inserm-Jean Mérieux; 16Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France; 17Public Health England, Porton Down; 18South General Hospital, University of Southampton, United Kingdom; 19Spiez Laboratory, Federal Office for Civil Protection; 20Swiss Tropical and Public Health Institute, Basel; 21World Health Organization, Geneva, Switzerland; 22Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia; 23National Biosafety Laboratory, National Center for Epidemiology, Budapest, Hungary; 24Evolutionary Ecology Group, Department of Biology, University of Antwerp; 25Institute of Tropical Medicine, Antwerp; 26Department of Microbiology and Immunology, Rega Institute, KU Leuven; 27Médecins Sans Frontières, Brussels, Belgium; 28Public Health Agency of Sweden, Solna; 29Janssen-Cilag, Stockholm, Sweden
Correspondence: S. Günther, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany (firstname.lastname@example.org).
a R. K. and R. K. contributed equally to this work.
b M. G., R. W., S. G., and A. D. C. are co–senior authors and contributed equally to this work.
A 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.
The 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.
The 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.
Virus load, age, and malaria parasite coinfection play a role in the outcome of EVD.
Key words: Filovirus – Ebola virus disease – malaria – Guinea – epidemic – mobile laboratory
© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.
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Keywords: Research; Abstracts; Ebola; Malaria; Guinea.