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2017-05-01Zeitschriftenartikel DOI: 10.1371/journal.pone.0176692
Ebola management centre proximity associated with reduced delays of healthcare of Ebola Virus Disease (EVD) patients, Tonkolili, Sierra Leone, 2014–15
dc.contributor.authorTheocharopoulos, Georgios
dc.contributor.authorDanis, Kostas
dc.contributor.authorGreig, Jane
dc.contributor.authorHoffmann, Alexandra
dc.contributor.authorValk, Henriette De
dc.contributor.authorJimissa, Augustine
dc.contributor.authorTejan, Sumaila
dc.contributor.authorSankoh, Mohammed
dc.contributor.authorKleijer, Karline
dc.contributor.authorTurner, Will
dc.contributor.authorAchar, Jay
dc.contributor.authorDuncombe, Jennifer
dc.contributor.authorLokuge, Kamalini
dc.contributor.authorGayton, Ivan
dc.contributor.authorBroeder, Rob
dc.contributor.authorKremer, Ronald
dc.contributor.authorCaleo, Grazia
dc.date.accessioned2018-05-07T20:08:41Z
dc.date.available2018-05-07T20:08:41Z
dc.date.created2017-06-27
dc.date.issued2017-05-01none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/re8gxazTfL5pY/PDF/223I8Bhmdvgs.pdf
dc.identifier.urihttp://edoc.rki.de/176904/2680
dc.description.abstractBetween August-December 2014, Ebola Virus Disease (EVD) patients from Tonkolili District were referred for care to two Médecins Sans Frontières (MSF) Ebola Management Centres (EMCs) outside the district (distant EMCs). In December 2014, MSF opened an EMC in Tonkolili District (district EMC). We examined the effect of opening a district-based EMC on time to admission and number of suspect cases dead on arrival (DOA), and identified factors associated with fatality in EVD patients, residents in Tonkolili District. Residents of Tonkolili district who presented between 12 September 2014 and 23 February 2015 to the district EMC and the two distant EMCs were identified from EMC line-lists. EVD cases were confirmed by a positive Ebola PCR test. We calculated time to admission since the onset of symptoms, case-fatality and adjusted Risk Ratios (aRR) using Binomial regression. Of 249 confirmed Ebola cases, 206 (83%) were admitted to the distant EMCs and 43 (17%) to the district EMC. Of them 110 (45%) have died. Confirmed cases dead on arrival (n = 10) were observed only in the distant EMCs. The median time from symptom onset to admission was 6 days (IQR 4,8) in distant EMCs and 3 days (IQR 2,7) in the district EMC (p3 days after symptom onset) in the distant compared with the district EMC, but were less likely (aRR = 0.8; 95%CI 0.6–1.0) to have a high viral load (cycle threshold ≤22). A fatal outcome was associated with a high viral load (aRR 2.6; 95%CI 1.8–3.6) and vomiting at first presentation (aRR 1.4; 95%CI 1.0–2.0). The opening of a district EMC was associated with earlier admission of cases to appropriate care facilities, an essential component of reducing EVD transmission. High viral load and vomiting at admission predicted fatality. Healthcare providers should consider the location of EMCs to ensure equitable access during Ebola outbreaks.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionsepidemiologie
dc.subject.ddc610 Medizin
dc.titleEbola management centre proximity associated with reduced delays of healthcare of Ebola Virus Disease (EVD) patients, Tonkolili, Sierra Leone, 2014–15
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10053084
dc.identifier.doi10.1371/journal.pone.0176692
dc.identifier.doihttp://dx.doi.org/10.25646/2605
local.edoc.container-titlePLoS ONE
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176692
local.edoc.container-publisher-namePublic Library of Science
local.edoc.container-volume12
local.edoc.container-issue5
local.edoc.container-year2017

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