Journal Article > ResearchFull Text
Trop Med Int Health. 2015 January 7; Volume 20 (Issue 4); DOI:10.1111/tmi.12454
Dallatomasinas S, Crestani R, Squire JS, Declerck H, Caleo GNC, et al.
Trop Med Int Health. 2015 January 7; Volume 20 (Issue 4); DOI:10.1111/tmi.12454
To describe Ebola cases in the district Ebola Management Centre of in Kailahun, a remote rural district of Sierra Leone, in terms of geographic origin, patient and hospitalization characteristics, treatment outcomes and time from symptom onset to admission.
Journal Article > Short ReportFull Text
Euro Surveill. 2014 December 11
Baggi FM, Taybi A, Kurth A, Van Herp M, Di Caro A, et al.
Euro Surveill. 2014 December 11
Journal Article > ResearchFull Text
Emerg Med (Los Angel). 2015 October 13; Volume 05 (Issue 06); DOI:10.4172/2165-7548.1000285
Hugo M, Declerck H, Fitzpatrick G, Severy N, Gbabai O, et al.
Emerg Med (Los Angel). 2015 October 13; Volume 05 (Issue 06); DOI:10.4172/2165-7548.1000285
Journal Article > ResearchFull Text
Euro Surveill. 2015 December 17; Volume 20 (Issue 50); DOI:10.2807/1560-7917.ES.2015.20.50.30097
Vogt F, Fitzpatrick G, Patten GE, Van der Bergh R, Stinson K, et al.
Euro Surveill. 2015 December 17; Volume 20 (Issue 50); DOI:10.2807/1560-7917.ES.2015.20.50.30097
Prevention of nosocomial Ebola virus (EBOV) infection among patients admitted to an Ebola management centre (EMC) is paramount. Current Médecins Sans Frontières (MSF) guidelines recommend classifying admitted patients at triage into suspect and highly-suspect categories pending laboratory confirmation. We investigated the performance of the MSF triage system to separate patients with subsequent EBOV-positive laboratory test (true-positive admissions) from patients who were initially admitted on clinical grounds but subsequently tested EBOV-negative (false-positive admissions). We calculated standard diagnostic test statistics for triage allocation into suspect or highly-suspect wards (index test) and subsequent positive or negative laboratory results (reference test) among 433 patients admitted into the MSF EMC Kailahun, Sierra Leone, between 1 July and 30 September 2014. 254 (59%) of admissions were classified as highly-suspect, the remaining 179 (41%) as suspect. 276 (64%) were true-positive admissions, leaving 157 (36.3%) false-positive admissions exposed to the risk of nosocomial EBOV infection. The positive predictive value for receiving a positive laboratory result after being allocated to the highly-suspect ward was 76%. The corresponding negative predictive value was 54%. Sensitivity and specificity were 70% and 61%, respectively. Results for accurate patient classification were unconvincing. The current triage system should be changed. Whenever possible, patients should be accommodated in single compartments pending laboratory confirmation. Furthermore, the initial triage step on whether or not to admit a patient in the first place must be improved. What is ultimately needed is a point-of-care EBOV diagnostic test that is reliable, accurate, robust, mobile, affordable, easy to use outside strict biosafety protocols, providing results with quick turnaround time.