Prognostic and Predictive Factors of Ebola Virus Disease Outcome in Elderly People during the 2014 Outbreak in Guinea

Mahamoud Sama Cherif Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;
Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan;

Search for other papers by Mahamoud Sama Cherif in
Current site
Google Scholar
PubMed
Close
,
Shyam Prakash Dumre Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan;

Search for other papers by Shyam Prakash Dumre in
Current site
Google Scholar
PubMed
Close
,
Diénaba Kassé Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;

Search for other papers by Diénaba Kassé in
Current site
Google Scholar
PubMed
Close
,
Fatoumata Cherif Ministry of Health and Public Hygiene, Conakry, Guinea;

Search for other papers by Fatoumata Cherif in
Current site
Google Scholar
PubMed
Close
,
Facely Camara Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;

Search for other papers by Facely Camara in
Current site
Google Scholar
PubMed
Close
,
Alpha Koné Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;

Search for other papers by Alpha Koné in
Current site
Google Scholar
PubMed
Close
,
Mandiou Diakité Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;

Search for other papers by Mandiou Diakité in
Current site
Google Scholar
PubMed
Close
,
Mohamed Cissé Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;

Search for other papers by Mohamed Cissé in
Current site
Google Scholar
PubMed
Close
,
Mamadou Pathé Diallo Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;

Search for other papers by Mamadou Pathé Diallo in
Current site
Google Scholar
PubMed
Close
,
Edouard Le Gall Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea;
Pôle Régional de Cancérologie Bretagne, Rennes, France

Search for other papers by Edouard Le Gall in
Current site
Google Scholar
PubMed
Close
,
Juntra Karbwang Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan;

Search for other papers by Juntra Karbwang in
Current site
Google Scholar
PubMed
Close
, and
Kenji Hirayama Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan;

Search for other papers by Kenji Hirayama in
Current site
Google Scholar
PubMed
Close
Restricted access

Elderly people occupy a prominent position in African societies; however, their potential linkage to high case fatality rate (CFR) in Ebola virus disease (EVD) was often overlooked. We describe the predictive factors for EVD lethality in the elderly. A total of 2,004 adults and 309 elderly patients with confirmed EVD were included in the analysis. The median age (interquartile range) was 35 years (23–44) in adults and 65 years (60–70) in the elderly. The proportion of funeral participation was significantly higher in the elderly group than in the adult group. Duration (in days) between the onset of symptoms and admission was significantly longer in elderly. CFR in the elderly people was also significantly higher (80.6%) than in the adult group (66.2%). Funeral participation constituted a risk factor for the transmission of EVD in elderly people.

Author Notes

Address correspondence to Mahamoud Sama Cherif, Faculty of Medicine Pharmacy and Odontostomatology, Gamal Abdel Nasser university of Conakry, Guinea, BP 1147, E-mail: msamafr@gmail.com and Kenji Hirayama, Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan, E-mail: hiraken@nagasaki-u.ac.jp.

Authors’ addresses: Mahamoud Sama Cherif, Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, and Department of Medecine, Universite Gamal Abdel Nasser de Conakry, Commune de Dixinn, Conakry, Guinea, E-mail: msamafr@gmail.com. Shyam Prakash Dumre and Kenji Hirayama, Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, E-mails: sp.dumre@gmail.com and hiraken@nagasaki-u.ac.jp. Diénaba Kassé, Facely Camara, Alpha Koné, Mandiou Diakité, Mohamed Cissé, and Mamadou Pathé Diallo, Department of Medecine, Universite Gamal Abdel Nasser de Conakry, Conakry, Guinea, E-mails: dienabak@yahoo.fr, facelyfr@yahoo.fr, alafekone@gmail.com, mandioud@yahoo.fr, cissebibi1@gmail.com, and bapathediallo@yahoo.fr. Fatoumata Cherif, Ministry of Health and Public Hygiene, Agence Nationale de Sécurité Sanitaire, Conakry, Guinea, E-mail: fatoumatacherif82@yahoo.fr. Edouard Le Gall, Pôle Régional de Cancérologie Bretagne, Rennes, Rennes, France, and Department of Medecine, Universite Gamal Abdel Nasser de Conakry, Conakry, Guinea, E-mail: edouard.le.gall@chu-rennes.fr. Juntra karbwang, Department of Product Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, E-mail: karbwangj@nagasaki-u.ac.jp.

  • 1.

    Elston JW, Moosa AJ, Moses F, Walker G, Dotta N, Waldman RJ, Wright J, 2016. Impact of the Ebola outbreak on health systems and population health in Sierra Leone. J Public Health (Oxf) 38: 673678.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Brainard J, Hooper L, Pond K, Edmunds K, Hunter PR, 2016. Risk factors for transmission of Ebola or Marburg virus disease: a systematic review and meta-analysis. Int J Epidemiol 45: 102116.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Pellecchia U, 2015. Do Traditions Spread Ebola? Available at: http://www.ebola-anthropology.net/case_studies/do-traditions-spread-ebola/. Accessed January 4, 2017.

    • PubMed
    • Export Citation
  • 4.

    Thomas LV, 1986. La vieillesse en Afrique noire: transmission orale et rarete individuelle. Quebec: Universite du Quebec a Chicoutimi, Departement des sciences humaines.

    • PubMed
    • Export Citation
  • 5.

    Fairhead JRP, 2014. Ebola and Older People in Sierra Leone, Liberia and Guinea. Available at: http://www.ebola-anthropology.net/key_messages/ebola-and-older-people-in-sierra-leone-liberia-and-guinea/. Accessed June 30, 2017.

    • PubMed
    • Export Citation
  • 6.

    WHO, 2014. Case Definition Recommendations for Ebola or Marburg Virus Diseases. Geneva, Switzerland: World Health Organization.

    • PubMed
    • Export Citation
  • 7.

    Rico A et al. 2016. Epidemiology of epidemic Ebola virus disease in Conakry and surrounding prefectures, Guinea, 2014–2015. Emerg Infect Dis 22: 178183.

  • 8.

    WHO, 2002. Definition of an Older or Elderly Person: Proposed Working Definition of an Older Person in Africa for the MDS Project. WHO Health statistics and information systems. Geneva, Switzerland: World Health Organization.

    • PubMed
    • Export Citation
  • 9.

    Bower H, Johnson S, Bangura MS, Kamara AJ, Kamara O, Mansaray SH, Sesay D, Turay C, Checchi F, Glynn JR, 2016. Exposure-specific and age-specific attack rates for Ebola virus disease in Ebola-affected households, Sierra Leone. Emerg Infect Dis 22: 14031411.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Hartley MA, Young A, Tran AM, Okoni-Williams HH, Suma M, Mancuso B, Al-Dikhari A, Faouzi M, 2017. Predicting Ebola severity: a clinical prioritization score for Ebola virus disease. PLoS Negl Trop Dis 11: e0005265.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Pisani MA, 2009. Considerations in caring for the critically ill older patient. J Intensive Care Med 24: 8395.

  • 12.

    Marik PE, 2006. Management of the critically ill geriatric patient. Crit Care Med 34: S176S182.

  • 13.

    Leligdowicz A et al. 2016. Ebola virus disease and critical illness. Crit Care 20: 217.

  • 14.

    Fitzpatrick G, Vogt F, Moi Gbabai OB, Decroo T, Keane M, De Clerck H, Grolla A, Brechard R, Stinson K, Van Herp M, 2015. The contribution of Ebola viral load at admission and other patient characteristics to mortality in a Medecins Sans Frontieres Ebola Case Management Centre, Kailahun, Sierra Leone, June–October 2014. J Infect Dis 212: 17521758.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    WHO, 2015. Guinea: The Ebola Virus Shows Its Tenacity: One Year into the Ebola Epidemic. Emergencies preparedness, response. Geneva, Switzerland: World Health Organization.

    • PubMed
    • Export Citation
  • 16.

    Wilkinson A, Fairhead J, 2017. Comparison of social resistance to Ebola response in Sierra Leone and Guinea suggests explanations lie in political configurations not culture. Crit Public Health 27: 1427.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Carrion Martin AI, Derrough T, Honomou P, Kolie N, Diallo B, Kone M, Rodier G, Kpoghomou C, Jansa JM, 2016. Social and cultural factors behind community resistance during an Ebola outbreak in a village of the Guinean Forest region, February 2015: a field experience. Int Health 8: 227229.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Manguvo A, Mafuvadze B, 2015. The impact of traditional and religious practices on the spread of Ebola in West Africa: time for a strategic shift. Pan Afr Med J 22 (Suppl 1): 9.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Ji YJ et al. 2016. Clinical presentations and outcomes of patients with Ebola virus disease in Freetown, Sierra Leone. Infect Dis Poverty 5: 101.

  • 20.

    Yan T et al. 2015. Clinical characteristics of 154 patients suspected of having Ebola virus disease in the Ebola holding center of Jui Government Hospital in Sierra Leone during the 2014 Ebola outbreak. Eur J Clin Microbiol Infect Dis 34: 20892095.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Cherif MS, Koonrungsesomboon N, Diallo MP, Le Gall E, Kasse D, Cherif F, Kone A, Diakite M, Camara F, Magassouba N, 2017. The predictor of mortality outcome in adult patients with Ebola virus disease during the 2014–2015 outbreak in Guinea. Eur J Clin Microbiol Infect Dis 36: 689695.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 866 659 16
Full Text Views 613 10 4
PDF Downloads 124 7 2
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save