Imperial College London
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DrCliveHoggart

Faculty of Medicine, Department of Infectious Disease

Honorary Research Officer
 
 
 
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Contact

 

+44 (0)20 7594 3915c.hoggart

 
 
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Location

 

231Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mobula:2018:10.4269/ajtmh.17-0090,
author = {Mobula, LM and MacDermott, NE and Hoggart, C and Brantly, K and Plyler, L and Brown, J and Kauffeldt, B and Eisenhut, D and Cooper, LA and Fankhauser, J},
doi = {10.4269/ajtmh.17-0090},
journal = {American Journal of Tropical Medicine and Hygiene},
pages = {1186--1193},
title = {Clinical manifestations and modes of death among Ebola Virus disease patients, Monrovia, Liberia, 2014},
url = {http://dx.doi.org/10.4269/ajtmh.17-0090},
volume = {98},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Although the high case fatality rate (CFR) associated with Ebola virus disease (EVD) is well documented, there are limited data on the actual modes of death. We conducted a retrospective, observational cohort study among patients with laboratory-confirmed EVD. The patients were all seen at the Eternal Love Winning Africa Ebola Treatment Unit in Monrovia, Liberia, from June to August 2014. Our primary objective was to describe the modes of death of our patients and to determine predictors of mortality. Data were available for 53 patients with laboratory-confirmed EVD, with a median age of 35 years. The most frequent presenting symptoms were weakness (91%), fever (81%), and diarrhea (78%). Visible hemorrhage was noted in 25% of the cases. The CFR was 79%. Odds of death were higher in patients with diarrhea (odds ratio = 26.1, P < 0.01). All patients with hemorrhagic signs died (P < 0.01). Among the 18 fatal cases for which clinical information was available, three distinct modes of death were observed: sudden death after a moderate disease process (44%), profuse hemorrhage (33%), and encephalopathy (22%). We found that these modes of death varied by age (P = 0.04), maximum temperature (P = 0.43), heart rate on admission (P = 0.04), time to death from symptom onset (P = 0.13), and duration of hospitalization (P = 0.04). Although further study is required, our findings provide a foundation for developing treatment strategies that factor in patients with specific disease phenotypes (which often require the use of aggressive hydration). These findings provide insights into underlying pathogenic mechanisms resulting in severe EVD and suggest direction for future research and development of effective treatment options.
AU  - Mobula,LM
AU  - MacDermott,NE
AU  - Hoggart,C
AU  - Brantly,K
AU  - Plyler,L
AU  - Brown,J
AU  - Kauffeldt,B
AU  - Eisenhut,D
AU  - Cooper,LA
AU  - Fankhauser,J
DO  - 10.4269/ajtmh.17-0090
EP  - 1193
PY  - 2018///
SN  - 0002-9637
SP  - 1186
TI  - Clinical manifestations and modes of death among Ebola Virus disease patients, Monrovia, Liberia, 2014
T2  - American Journal of Tropical Medicine and Hygiene
UR  - http://dx.doi.org/10.4269/ajtmh.17-0090
UR  - http://hdl.handle.net/10044/1/53725
VL  - 98
ER  -
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