Successful Implementation of a Multicountry Clinical Surveillance and Data Collection System for Ebola Virus Disease in West Africa: Findings and Lessons Learned
| Autor: | Kacey Pham, Sarah Cundy, Reshma Roshania, Erin Shedd, Nelson Dunbar, Anh-Minh A Tran, David Mansary, Adam C. Levine, Matthew Abad, Pranav Prathap Shetty, Michael Mallow, Taralyn Lyon |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Diarrhea Male Veterinary medicine Adolescent Databases Factual viruses 030231 tropical medicine Disease medicine.disease_cause West africa Sierra leone Disease Outbreaks Sierra Leone 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Lot Quality Assurance Sampling 030212 general & internal medicine Child health care economics and organizations Data collection system Retrospective Studies Ebolavirus Ebola virus business.industry Funeral Rites Data Collection Infant Newborn Outbreak Infant Retrospective cohort study General Medicine Hemorrhagic Fever Ebola Middle Aged medicine.disease Liberia Child Preschool Population Surveillance Female Original Article Medical emergency Health Facilities business |
| Zdroj: | Global Health: Science and Practice |
| ISSN: | 2169-575X |
| Popis: | Despite resource and logistical constraints, International Medical Corps cared for thousands at 5 Ebola treatment units in Liberia and Sierra Leone between 2014 and 2015 while collecting hundreds of data points on each patient. To facilitate data collection and global reporting in future humanitarian responses, standardized data forms and databases, with clear definitions of clinical and epidemiological variables, should be developed and adopted by the international community. 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. |
| Databáze: | OpenAIRE |
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