Despite the notoriety of Ebola virus disease (EVD) as one of the world's most deadly infectio... more Despite the notoriety of Ebola virus disease (EVD) as one of the world's most deadly infections, EVD has a wide range of outcomes, where asymptomatic infection may be almost as common as fatality. With increasingly sensitive EVD diagnosis, there is a need for more accurate prognostic tools that objectively stratify clinical severity to better allocate limited resources and identify those most in need of intensive treatment. This retrospective cohort study analyses the clinical characteristics of 158 EVD(+) patients at the GOAL-Mathaska Ebola Treatment Centre, Sierra Leone. The prognostic potential of each characteristic was assessed and incorporated into a statistically weighted disease score. The mortality rate among EVD(+) patients was 60.8% and highest in those aged <5 or >25 years (p<0.05). Death was significantly associated with malaria co-infection (OR = 2.5, p = 0.01). However, this observation was abrogated after adjustment to Ebola viral load (p = 0.1), potenti...
Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "liv... more Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "live alert" system to refer suspect cases from the community to specialized Ebola treatment centers. As EVD case burden declined in Port Loko District, Sierra Leone so did the number of reported alerts. Because EVD presents similarly to malaria, the number of alerts should remain consistent with malaria prevalence in malaria-endemic areas, irrespective of the reduction in true EVD cases. A community-based EVD surveillance system with improved symptom recording and follow-up of malaria-confirmed patients at PHUs was implemented in order to strengthen the sensitivity of EVD reporting.
Port Loko district in Sierra Leone had over 1,400 confirmed Ebola cases since the start of the ou... more Port Loko district in Sierra Leone had over 1,400 confirmed Ebola cases since the start of the outbreak. Stronger surveillance systems were critical for the early detection of potential EVD cases, thus containing further spread of the epidemic. Community structures such as clinics, village/section chiefs, community Ebola responders, religious institutions and community social mobilization teams were critical to developing robust integrated surveillance systems that could report significant EVD events to the District Ebola Response Center. This ensured that all significant events were investigated. Continuous engagement of community and section structures proved critical in stopping the spread of EVD in Port Loko
Despite the notoriety of Ebola virus disease (EVD) as one of the world's most deadly infectio... more Despite the notoriety of Ebola virus disease (EVD) as one of the world's most deadly infections, EVD has a wide range of outcomes, where asymptomatic infection may be almost as common as fatality. With increasingly sensitive EVD diagnosis, there is a need for more accurate prognostic tools that objectively stratify clinical severity to better allocate limited resources and identify those most in need of intensive treatment. This retrospective cohort study analyses the clinical characteristics of 158 EVD(+) patients at the GOAL-Mathaska Ebola Treatment Centre, Sierra Leone. The prognostic potential of each characteristic was assessed and incorporated into a statistically weighted disease score. The mortality rate among EVD(+) patients was 60.8% and highest in those aged <5 or >25 years (p<0.05). Death was significantly associated with malaria co-infection (OR = 2.5, p = 0.01). However, this observation was abrogated after adjustment to Ebola viral load (p = 0.1), potenti...
Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "liv... more Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "live alert" system to refer suspect cases from the community to specialized Ebola treatment centers. As EVD case burden declined in Port Loko District, Sierra Leone so did the number of reported alerts. Because EVD presents similarly to malaria, the number of alerts should remain consistent with malaria prevalence in malaria-endemic areas, irrespective of the reduction in true EVD cases. A community-based EVD surveillance system with improved symptom recording and follow-up of malaria-confirmed patients at PHUs was implemented in order to strengthen the sensitivity of EVD reporting.
Port Loko district in Sierra Leone had over 1,400 confirmed Ebola cases since the start of the ou... more Port Loko district in Sierra Leone had over 1,400 confirmed Ebola cases since the start of the outbreak. Stronger surveillance systems were critical for the early detection of potential EVD cases, thus containing further spread of the epidemic. Community structures such as clinics, village/section chiefs, community Ebola responders, religious institutions and community social mobilization teams were critical to developing robust integrated surveillance systems that could report significant EVD events to the District Ebola Response Center. This ensured that all significant events were investigated. Continuous engagement of community and section structures proved critical in stopping the spread of EVD in Port Loko
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Papers by Brooke Mancuso