Sociodemographic and clinical determinants of in-facility case fatality rate for 938 Ebola patients treated in Sierra Leone

Abstract Background The 2013 – 2016 West Africa Ebola Virus Disease (EVD) outbreak recorded the highest incidence and mortality since the discovery of the virus in Zaire in 1976. Studies relating to previous outbreaks usually involved small sample sizes. In this study we are set to identify those sociodemographic and clinical features that predict in-facility mortality among EVD patients using a large sample size. Methods We analysed the anonymized medical records of 938 laboratory-confirmed EVD patients 15 years old and above that received treatment at the 34 Military Hospital and the Police Training School EVD Treatment Centers in Sierra Leone in the period June 2014 to April 2015. We used both univariable and multivariable logistic regression to determine the predictors for in-facility mortality of these patients based on their sociodemographic and clinical characteristics. Results The median age of the EVD cases was 33 years (interquartile range = 25 to 40 years). The majority of the EVD cases were male (59.0%) and had secondary level education (79.3%). A low overall in-facility case fatality rate of 26.4% was shown. The associations between case fatality rates and EVD patients who reported fever, abdominal pain, cough, diarrhoea, vomiting, fatigue, haemorrhage, dysphagia, conjunctival injection, dyspnoea, and skin rash at the time of admission were statistically significant (p < 0.05). Our preferred model with age group of EVD patients and the presence of the symptoms diarrhoea, vomiting, fatigue, dysphagia, conjunctival injection, dyspnoea and muscle pain produced a receiver operating characteristic (ROC) curve with an AUC (area under the curve) value of 0.94. Conclusions The age of EVD patients, as well those patients who reported vomiting, diarrhoea, fatigue, dysphagia, conjunctival injection, dyspnoea and muscle pain have increased odds of dying during treatment and hence will require prompt and intensive treatment at the time of admission. We argue that the high proportion of individuals with higher educational levels may have been a critical determinant for the low case fatality rate.

Download Full-text

Managing older adults’ fear of coronavirus disease: A new role for social work practice

Qualitative Social Work ◽

10.1177/1473325020973295 ◽

2020 ◽

pp. 147332502097329

Author(s):

Hamed Mortazavi

Keyword(s):

Older Adults ◽

Case Fatality Rate ◽

Severe Disease ◽

Case Fatality ◽

Social Work Practice ◽

World Health ◽

National Committee ◽

Fatality Rate ◽

Number Of Patients ◽

Incidence And Mortality

As the number of patients infected with the 2019 novel coronavirus disease (nCOVID-19) increases, the number of deaths has also been increasing. According to World Health Organization (WHO), as of 4 October 2020, 34,804,348 cases had tested positive for nCOVID-19 globally, which among them, 1,030,738 confirmed deaths had occurred, equivalent to a case-fatality rate of 2.96%. However, in comparison with global statistics, the incidence and mortality of the nCOVID-19 infection are higher in Iran. As reported by the National Committee on COVID-19 Epidemiology of Ministry of Health of Iran, the total number of patients with confirmed COVID-19 infection has reached 468,119, of which 26,746 have died, equivalent to a case-fatality rate of 5.71%. Currently, there is solid evidence that older adults are at a higher risk of severe disease following infection from COVID-19.

Download Full-text

Age-Dependent Serotype-Associated Case-Fatality Rate in Invasive Pneumococcal Disease in the Autonomous Community of Madrid between 2007 and 2020

Microorganisms ◽

10.3390/microorganisms9112286 ◽

2021 ◽

Vol 9 (11) ◽

pp. 2286

Author(s):

Sara De Miguel ◽

Pello Latasa ◽

José Yuste ◽

Luis García ◽

María Ordobás ◽

...

Keyword(s):

Invasive Pneumococcal Disease ◽

Case Fatality Rate ◽

Pneumococcal Disease ◽

Case Fatality ◽

Fatality Rate ◽

Incidence And Mortality ◽

High Incidence ◽

Common Serotypes ◽

Low Levels ◽

Quellung Reaction

The aim of this study was to investigate the serotype-associated fatality rate in cases of invasive pneumococcal disease (IPD) in the Spanish region of Madrid between 2007 and 2020. Serotyping was performed by Pneumotest Latex and the Quellung reaction using commercial antisera. Case-fatality rate was estimated as the ratio between the number of deaths at hospital discharge and the number of cases attributable to each serotype. To evaluate the association measures, the odds ratios with a 95% confidence interval were calculated. Twenty five pneumococcal serotypes were associated to mortality and comprised 87.8% of the total number of isolates characterized. Serotypes 8, 3, 19A, 1, 7F, 22F, 12F, and 11A were the most prevalent (≥3% each). Serotypes 31, 11A, and 19F were significantly associated to high case-fatality rates (>20% each). The lower significantly associated case-fatality rate (<10% each) was found in serotypes 5, 1, 12B, 7F, 12F, 8, 33, and 10A. The serotypes with higher mortality levels (≥0.04 per 100,000 population) were 11A (fatality 24.0%), 3 (fatality 18.7%), 19A (fatality 12.5%), and 8 (fatality 7.2%). Serotype 3 was worrisome because it is associated with important fatality levels combined with very high incidence and mortality rates. Serotype 11A also showed a high fatality with marked incidence and mortality levels. Some few frequent serotypes as 31, 19F, and 15A despite its high fatality had low levels of mortality. By contrast other serotypes as 8 showing low fatality had high mortality ranges because it shows a wide extended distribution. Finally, common serotypes, such as 1 and 5, presented small mortality length, due to their low case-fatality rates.

Download Full-text

Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis

10.21203/rs.3.rs-39404/v1 ◽

2020 ◽

Cited By ~ 4

Author(s):

Vanessa Vasquez-Apestegui ◽

Enrique Parras-Garrido ◽

Vilma Tapia ◽

Valeria M. Paz-Aparicio ◽

Jhojan P. Rojas ◽

...

Keyword(s):

Air Pollution ◽

Case Fatality Rate ◽

Virus Disease ◽

National Level ◽

Case Fatality ◽

Fatality Rate ◽

Food Markets ◽

Early Implementation ◽

Incidence And Mortality ◽

Post Hoc

Abstract Background Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America and it is also one of the cities with highest levels of air pollution in the Region. Methods This study investigated the association of the levels of PM2.5 exposure in the previous years (2010–2016) in 24 districts of Lima with the cases, deaths and case-fatality rates of COVID-19. Results Until June 12, 2020, there were 6,308 deaths and 220,749 SARS-CoV-2 positive cases in Peru. In Lima, the total number of COVID-19 deaths in all metropolitan areas was 2,382. The case-fatality rate at the national level was 2.58% and 1.93% in Lima. Higher PM2.5 levels are associated with higher number of cases and deaths of COVID-19. The case-fatality rate (Deaths/cases*100) did not increase with the increase in PM2.5 levels. A higher number of food markets was associated with higher incidence and mortality of COVID-19 (p < 0.01 for both); these associations persisted when cases (r = 0.49; p < 0.01) and deaths (r = 0.58; p < 0.01) were adjusted by the population density. The association of PM2.5 with cases of COVID-19 was maintained after controlling analysis by age, sex and number of food markers. Conclusions the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long term perspective, and social distancing are needed to prevent spreads of virus outbreak.

Download Full-text

Protective role of intravesical BCG in COVID-19 severity

BMC Urology ◽

10.1186/s12894-021-00823-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Héctor Gallegos ◽

Pablo A. Rojas ◽

Francisca Sepúlveda ◽

Álvaro Zúñiga ◽

Ignacio F. San Francisco

Keyword(s):

Cumulative Incidence ◽

Case Fatality Rate ◽

Case Fatality ◽

National Registry ◽

Categorical Variables ◽

Control Group ◽

Fatality Rate ◽

Incidence And Mortality ◽

Intravesical Bcg

Abstract Objectives To establish the role of BCG instillations in the incidence and mortality of COVID-19. Patients and methods NMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables. Results 175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70–79 years = 6.3%. Chilean fatality rate 70–79 years = 14%. Conclusions According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.

Download Full-text

Mortality in Digestive Cancers, 2012: International Data and Data from Romania

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.244.rom ◽

2015 ◽

Vol 24 (4) ◽

pp. 507-514 ◽

Cited By ~ 1

Author(s):

Simona Valean ◽

Monica Acalovschi ◽

Mircea Diculescu ◽

Mircea Manuc ◽

Adrian Goldis ◽

...

Keyword(s):

Colorectal Cancer ◽

Human Development ◽

Human Development Index ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate ◽

Development Index ◽

Incidence And Mortality ◽

Digestive Cancers ◽

The Difference

We aimed to compare the difference in case fatality rate between more developed and very high Human Development Index (HDI) regions, less developed and low HDI regions, and Romania. The incidence and mortality rates for digestive cancers were obtained from the IARC/WHO 2012 database. World mean mortality-to-incidence ratios registered the highest values in pancreatic cancer (0.97/0.94), and liver cancer (0.93/0.96) in males/females, respectively. The lowest values were recorded in colorectal cancer (0.48 in both sexes). Mortality-to-incidence ratios were generally higher in less developed areas, low HDI populations, and in Romania. The difference in case fatality rate between different areas showed higher variations for colorectal, gastric and gallbladder cancers, and smaller variations for esophageal, liver, and pancreatic cancers. In summary, mortality-to-incidence ratios of digestive cancers were high in 2012; higher values were registered in less developed and low HDI regions, and in Romania. Mortality-to-incidence ratios were similar in both sexes, even though the incidence was generally higher in men. Digestive cancer mortality variation suggests the necessity of finding better strategies for prevention, early diagnosis and treatment of digestive cancers. Abbreviations: ASRWs: age-standardized rate (World Standard Population) per 100,000 population; CRC: colorectal cancer; GC: gastric cancer; HDI: Human Development Index; HCC: hepatocellular carcinoma; IARC: International

Download Full-text

Sociodemographic and clinical determinants of in-facility case fatality rate for 938 adult Ebola patients treated at Sierra Leone Ebola treatment center

BMC Infectious Diseases ◽

10.1186/s12879-020-04994-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jia Bainga Kangbai ◽

Christian Heumann ◽

Michael Hoelscher ◽

Foday Sahr ◽

Guenter Froeschl

Keyword(s):

Sierra Leone ◽

Case Fatality Rate ◽

Case Fatality ◽

Treatment Center ◽

Fatality Rate

Download Full-text

Malaria incidence and mortality in Italy in 1999-2000

Eurosurveillance ◽

10.2807/esm.06.10.00378-en ◽

2001 ◽

Vol 6 (10) ◽

pp. 143-147 ◽

Cited By ~ 12

Author(s):

R Romi ◽

D Boccolini ◽

G Majori

Keyword(s):

Latin American ◽

Case Fatality Rate ◽

Malaria Incidence ◽

Case Fatality ◽

Infection Risk ◽

Fatality Rate ◽

African Origin ◽

Asian Countries ◽

Incidence And Mortality ◽

Permanent Residents

In 1999-2000, a total of 2060 malaria cases were reported by the ISS. Most of the patients took inappropriate treatments or did not have any prophylaxis. Ninety-three per cent became infected in African malarious countries, 4% in Asian countries, and 3% in Latin America. P. falciparum accounted for 84% of the cases, followed by P. vivax (8%), P. ovale (5%), and P. malariae (2%). Deaths corresponded to an annual case fatality rate of 0.3% in 1999 and 0.5% in 2000. In general, imported malaria cases reflect the number of Italian travellers who underestimate the infection risk in Asian and Latin American malarious countries and permanent residents of African origin who visit their relatives in their native countries.

Download Full-text

Preliminary Estimate of COVID-19 Case Fatality Rate in the Philippines using Linear Regression Analysis

SSRN Electronic Journal ◽

10.2139/ssrn.3569248 ◽

2020 ◽

Author(s):

Michael Arieh Medina

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Case Fatality Rate ◽

Linear Regression Analysis ◽

Case Fatality ◽

The Philippines ◽

Fatality Rate ◽

Preliminary Estimate

Download Full-text

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

10.2196/preprints.20886 ◽

2020 ◽

Author(s):

Ahmed Youssef Kada

Keyword(s):

Case Fatality Rate ◽

Doubling Time ◽

Case Fatality ◽

World Health ◽

Fatality Rate ◽

Therapeutic Protocol ◽

First Case ◽

The World ◽

The Impact ◽

At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

Download Full-text