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Published on: September 27, 2014
Ebola Virus Disease in Children, Sierra Leone, 2014-2015
Insights
This study found that Ebola virus disease in children has a high fatality rate, with most deaths occurring early. Limited data prevented identification of modifiable factors to improve outcomes for pediatric Ebola patients.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of viral hemorrhagic fevers
Background:
- Ebola virus disease (EVD) poses a significant threat to children, yet modifiable factors influencing outcomes remain poorly understood.
- Understanding pediatric EVD is critical for developing effective interventions during outbreaks.
Purpose of the Study:
- To identify factors affecting the outcomes of children under 13 years old admitted to Ebola holding units.
- To investigate potential modifiable factors influencing mortality in pediatric EVD cases.
Main Methods:
- Retrospective cohort study of 309 Ebola virus-positive children (2 days–12 years) admitted to 11 Ebola holding units in Sierra Leone (2014–2015).
- Primary outcome: death or discharge after transfer to Ebola treatment centers. Data collected from multiple sources.
- Outcomes were available for 282 children (91% follow-up).
Main Results:
- Overall case-fatality rate was 57%, with 55% of deaths occurring in holding units.
- Deaths were swift (median 3 days post-admission) and associated with younger age and diarrhea.
- Laboratory findings included hypoglycemia and hepatic/renal dysfunction; no modifiable factors significantly impacting death were identified due to data limitations.
Conclusions:
- Pediatric Ebola virus disease has a high mortality, often occurring rapidly and early in the disease course.
- Limited data availability hindered the identification of specific modifiable factors for improving outcomes in children.
- Robust and rapid data collection strategies are essential for future EVD epidemics to evaluate interventions in pediatric populations.
Abstract:
Little is known about potentially modifiable factors in Ebola virus disease in children. We undertook a retrospective cohort study of children <13 years old admitted to 11 Ebola holding units in the Western Area, Sierra Leone, during 2014-2015 to identify factors affecting outcome. Primary outcome was death or discharge after transfer to Ebola treatment centers. All 309 Ebola virus-positive children 2 days-12 years old were included; outcomes were available for 282 (91%). Case-fatality was 57%, and 55% of deaths occurred in Ebola holding units. Blood test results showed hypoglycemia and hepatic/renal dysfunction. Death occurred swiftly (median 3 days after admission) and was associated with younger age and diarrhea. Despite triangulation of information from multiple sources, data availability was limited, and we identified no modifiable factors substantially affecting death. In future Ebola virus disease epidemics, robust, rapid data collection is vital to determine effectiveness of interventions for children.
