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Lassa Fever in Post-Conflict Sierra Leone
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نویسنده
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shaffer j.g. ,grant d.s. ,schieffelin j.s. ,boisen m.l. ,goba a. ,hartnett j.n. ,levy d.c. ,yenni r.e. ,moses l.m. ,fullah m. ,momoh m. ,fonnie m. ,fonnie r. ,kanneh l. ,koroma v.j. ,kargbo k. ,ottomassathien d. ,muncy i.j. ,jones a.b. ,illick m.m. ,kulakosky p.c. ,haislip a.m. ,bishop c.m. ,elliot d.h. ,brown b.l. ,zhu h. ,hastie k.m. ,andersen k.g. ,gire s.k. ,tabrizi s. ,tariyal r. ,stremlau m. ,matschiner a. ,sampey d.b. ,spence j.s. ,cross r.w. ,geisbert j.b. ,folarin o.a. ,happi c.t. ,pitts k.r. ,geske f.j. ,geisbert t.w. ,saphire e.o. ,robinson j.e. ,wilson r.b. ,sabeti p.c. ,henderson l.a. ,khan s.h. ,bausch d.g. ,branco l.m. ,garry r.f.
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منبع
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plos neglected tropical diseases - 2014 - دوره : 8 - شماره : 3
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چکیده
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Background:lassa fever (lf),an often-fatal hemorrhagic disease caused by lassa virus (lasv),is a major public health threat in west africa. when the violent civil conflict in sierra leone (1991 to 2002) ended,an international consortium assisted in restoration of the lf program at kenema government hospital (kgh) in an area with the world's highest incidence of the disease.methodology/principal findings:clinical and laboratory records of patients presenting to the kgh lassa ward in the post-conflict period were organized electronically. recombinant antigen-based lf immunoassays were used to assess lasv antigenemia and lasv-specific antibodies in patients who met criteria for suspected lf. kgh has been reestablished as a center for lf treatment and research,with over 500 suspected cases now presenting yearly. higher case fatality rates (cfrs) in lf patients were observed compared to studies conducted prior to the civil conflict. different criteria for defining lf stages and differences in sensitivity of assays likely account for these differences. the highest incidence of lf in sierra leone was observed during the dry season. lf cases were observed in ten of sierra leone's thirteen districts,with numerous cases from outside the traditional endemic zone. deaths in patients presenting with lasv antigenemia were skewed towards individuals less than 29 years of age. women self-reporting as pregnant were significantly overrepresented among lasv antigenemic patients. the cfr of ribavirin-treated patients presenting early in acute infection was lower than in untreated subjects.conclusions/significance:lassa fever remains a major public health threat in sierra leone. outreach activities should expand because lf may be more widespread in sierra leone than previously recognized. enhanced case finding to ensure rapid diagnosis and treatment is imperative to reduce mortality. even with ribavirin treatment,there was a high rate of fatalities underscoring the need to develop more effective and/or supplemental treatments for lf. © 2014 shaffer et al.
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آدرس
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department of biostatistics and bioinformatics,tulane school of public health and tropical medicine,new orleans,la, United States, lassa fever program,kenema government hospital,kenema, Sierra Leone, sections of infectious disease,departments of pediatrics and internal medicine,school of medicine,tulane university,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la,united states,corgenix,inc.,broomfield,co, United States, lassa fever program,kenema government hospital,kenema, Sierra Leone, department of microbiology and immunology,tulane university,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la,united states,department of tropical medicine,tulane school of public health and tropical medicine,new orleans,la, United States, lassa fever program,kenema government hospital,kenema, Sierra Leone, lassa fever program,kenema government hospital,kenema, Sierra Leone, lassa fever program,kenema government hospital,kenema, Sierra Leone, lassa fever program,kenema government hospital,kenema, Sierra Leone, lassa fever program,kenema government hospital,kenema, Sierra Leone, lassa fever program,kenema government hospital,kenema, Sierra Leone, lassa fever program,kenema government hospital,kenema, Sierra Leone, corgenix,inc.,broomfield,co, United States, corgenix,inc.,broomfield,co, United States, corgenix,inc.,broomfield,co, United States, biofactura inc.,rockville,md, United States, autoimmune technologies,llc,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la, United States, sections of infectious disease,departments of pediatrics and internal medicine,school of medicine,tulane university,new orleans,la, United States, corgenix,inc.,broomfield,co, United States, vybion inc.,ithaca,ny, United States, department of immunology and microbial science,the scripps research institute,la jolla,ca, United States, fas center for systems biology,department of organismic and evolutionary biology,harvard university,cambridge,ma,united states,broad institute,cambridge,ma, United States, fas center for systems biology,department of organismic and evolutionary biology,harvard university,cambridge,ma,united states,broad institute,cambridge,ma, United States, fas center for systems biology,department of organismic and evolutionary biology,harvard university,cambridge,ma,united states,broad institute,cambridge,ma, United States, broad institute,cambridge,ma, United States, fas center for systems biology,department of organismic and evolutionary biology,harvard university,cambridge,ma,united states,broad institute,cambridge,ma, United States, biofactura inc.,rockville,md, United States, biofactura inc.,rockville,md, United States, department of microbiology and immunology,tulane university,new orleans,la, United States, department of microbiology and immunology,tulane university,new orleans,la,united states,department of microbiology and immunology,university of texas medical branch at galveston,galveston,tx, United States, department of microbiology and immunology,university of texas medical branch at galveston,galveston,tx, United States, department of biological sciences,college of natural sciences,redeemers university,redemption city,ogun state, Nigeria, department of biological sciences,college of natural sciences,redeemers university,redemption city,ogun state, Nigeria, corgenix,inc.,broomfield,co, United States, corgenix,inc.,broomfield,co, United States, department of microbiology and immunology,university of texas medical branch at galveston,galveston,tx, United States, vybion inc.,ithaca,ny,united states,the skaggs institute for chemical biology,the scripps research institute,la jolla,ca, United States, sections of infectious disease,departments of pediatrics and internal medicine,school of medicine,tulane university,new orleans,la, United States, autoimmune technologies,llc,new orleans,la, United States, department of immunology and microbial science,the scripps research institute,la jolla,ca,united states,fas center for systems biology,department of organismic and evolutionary biology,harvard university,cambridge,ma,united states,department of immunology and infectious disease,harvard school of public health,boston,ma, United States, autoimmune technologies,llc,new orleans,la, United States, lassa fever program,kenema government hospital,kenema, Sierra Leone, department of tropical medicine,tulane school of public health and tropical medicine,new orleans,la, United States, autoimmune technologies,llc,new orleans,la,united states,zalgen labs,llc,germantown,md, United States, department of microbiology and immunology,tulane university,new orleans,la,united states,broad institute,cambridge,ma,united states,zalgen labs,llc,germantown,md, United States
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Authors
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