{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T09:29:06Z","timestamp":1780824546779,"version":"3.54.1"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:00:00Z","timestamp":1587427200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:00:00Z","timestamp":1587427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 2013\u20132016 West Africa Ebola Virus Disease (EVD) outbreak recorded the highest incidence and mortality since the discovery of the virus in Zaire in 1976; with more than 28,000 probable and confirmed EVD cases and 11,000 deaths. 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed the anonymized medical records of 938 laboratory-confirmed EVD patients 15\u2009years old and above who 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age of the EVD cases was 33\u2009years (interquartile range\u2009=\u200925 to 40\u2009years). The majority of the EVD cases were male (59.0%) and had secondary level education (79.3%). We reported a low overall in-facility case fatality rate of 26.4%. The associations between case fatality rates and EVD patients who reported fever, abdominal pain, cough, diarrhoea, vomiting, fatigue, haemorrhage, dysphagia, conjunctival injection, dyspnea, and skin rash at the time of admission were all statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009\u00a00.05). Our preferred model with the age group 65\u2009years and above alongside the following clinical symptoms; diarrhoea, vomiting, fatigue, dysphagia, conjunctival injection, dyspnea and cough produced a receiver operating characteristic (ROC) curve with an AUC (area under the curve) value of 0.93.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We constructed a simple model that can be optimally used alongside other rapid EVD diagnostic tools to identify EVD in-facility treatment mortality predictors based on the sociodemographic characteristics and clinical symptoms of adult EVD patients. We also reported low EVD cases among patients with secondary and tertiary education. These subpopulations of our patients who are generally informed about the signs and symptoms of EVD, alongside our treatment regimen may have been responsible for our comparatively lower case fatality rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-020-04994-9","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:14:43Z","timestamp":1587428083000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Sociodemographic and clinical determinants of in-facility case fatality rate for 938 adult Ebola patients treated at Sierra Leone Ebola treatment center"],"prefix":"10.1186","volume":"20","author":[{"given":"Jia Bainga","family":"Kangbai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Heumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hoelscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foday","family":"Sahr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guenter","family":"Froeschl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,21]]},"reference":[{"key":"4994_CR1","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1056\/NEJMsr1513109","volume":"375","author":"Team WER","year":"2016","unstructured":"Team WER. After Ebola in West Africa \u2014 unpredictable risks, preventable epidemics. N Engl J Med. 2016;375:587\u201396.","journal-title":"N Engl J Med"},{"key":"4994_CR2","unstructured":"WHO. 2016. Ebola situation reports: archive.\nhttp:\/\/www.who.int\/csr\/disease\/ebola\/situation-reports\/archive\/en\/. Accessed 22 Dec 2019."},{"issue":"15","key":"4994_CR3","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.1056\/NEJMoa1404505","volume":"371","author":"S Blaize","year":"2014","unstructured":"Blaize S, Pannetier D, LO, et al. Emergence of Zaire Ebola virus disease in Guinea. N Engl J Med. 2014;371(15):1418\u201325.","journal-title":"N Engl J Med"},{"key":"4994_CR4","unstructured":"World Health Organization (2017) Ebola Virus Disease, fact sheet. Available at www.who.int\/mediacentre\/factsheets\/fs103\/en. Accessed 8 Jan 2020."},{"key":"4994_CR5","unstructured":"WHO (2014) Sierra Leone: a traditional healer and a funeral. https:\/\/www.who.int\/csr\/disease\/ebola\/ebola-6-months\/sierra-leone\/en\/.Accessed 28 May  2019."},{"key":"4994_CR6","doi-asserted-by":"publisher","unstructured":"World Health Organization Ebola Response Team Ebola virus disease in West Africa\u2014the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481\u201395. https:\/\/doi.org\/10.1056\/NEJMoa1411100.","DOI":"10.1056\/NEJMoa1411100"},{"key":"4994_CR7","doi-asserted-by":"publisher","unstructured":"Breman JG, Johnson KM. Ebola then and now. N Engl J Med. 2014;371(18):1663\u20136. https:\/\/doi.org\/10.1056\/NEJMp1410540.","DOI":"10.1056\/NEJMp1410540"},{"key":"4994_CR8","doi-asserted-by":"crossref","unstructured":"Barry M, et al. Ebola outbreak in Conakry, Guinea: Epidemiological,clinical and outcome features. Med Mal Infect. 2014.","DOI":"10.1016\/j.medmal.2014.09.009"},{"issue":"9","key":"4994_CR9","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.3201\/eid2209.151621","volume":"22","author":"Y Haaskjold","year":"2016","unstructured":"Haaskjold Y, Bolkan H, KK, et al. Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014\u2013February 2015. Emerg Infect Dis. 2016;22(9):1537\u201344.","journal-title":"Emerg Infect Dis"},{"key":"4994_CR10","doi-asserted-by":"crossref","unstructured":"Forna, Alpha and Nouvellet, Pierre and Dorigatti, Ilaria and Donnelly, Christl A; Case Fatality Ratio Estimates for the 2013 - 2016 West African Ebola Epidemic. Application of Boosted Regression Trees for Imputation, 2018. Available at SSRN: https:\/\/ssrn.com\/abstract=3220099. Accessed 23 Feb 2019.","DOI":"10.1016\/j.ijid.2018.11.313"},{"issue":"16","key":"4994_CR11","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1056\/NEJMoa1411100","volume":"371","author":"Team WER","year":"2014","unstructured":"Team WER. Ebola virus disease in West Africa\u2013the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481\u201395.","journal-title":"N Engl J Med"},{"key":"4994_CR12","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.1056\/NEJMoa1411680","volume":"371","author":"JS Schieffelin","year":"2014","unstructured":"Schieffelin JS, Shaffer JG, Goba A, Gbakie M, Gire SK, Colubri A, et al. Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone. N Engl J Med. 2014;371:2092\u2013100.","journal-title":"N Engl J Med"},{"key":"4994_CR13","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1093\/infdis\/jiv304","volume":"212","author":"G Fitzpatrick","year":"2015","unstructured":"Fitzpatrick G, Vogt F, Moi Gbabai OB, et al. The contribution of Ebola viral load at admission and other patient characteristics to mortality in a M\u00e9decins Sans Fronti\u00e8res Ebola case management Centre, Kailahun, Sierra Leone, June\u2013October 2014. J Infect Dis. 2015;212:1752\u20138.","journal-title":"J Infect Dis"},{"issue":"3","key":"4994_CR14","doi-asserted-by":"publisher","first-page":"100","DOI":"10.15585\/mmwr.su6503a2","volume":"65","author":"BP Bell","year":"2016","unstructured":"Bell BP, Damon IK, Jernigan DB, et al. CDC\u2019s response to the 2014\u20132016 Ebola epidemic \u2014West Africa and United States. MMWR Supplement. 2016;65(3):100\u20136.","journal-title":"MMWR Supplement"},{"key":"4994_CR15","doi-asserted-by":"publisher","first-page":"2923","DOI":"10.1016\/j.ijid.2016.08.011","volume":"53","author":"C Ohuabunwo","year":"2016","unstructured":"Ohuabunwo C, et al. Clinical profile and containment of the Ebola virus disease outbreak in two large west African cities, Nigeria, July\u2013September 2014. Int J Infect Dis. 2016;53:2923\u20136.","journal-title":"Int J Infect Dis"},{"key":"4994_CR16","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.1056\/NEJMc1415318","volume":"372","author":"Team WER","year":"2015","unstructured":"Team WER. Ebola virus disease among children in West Africa. N Engl J Med. 2015;372:1274\u20137.","journal-title":"N Engl J Med"},{"issue":"4","key":"4994_CR17","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1111\/tmi.12454","volume":"20","author":"S Dallatomasina","year":"2015","unstructured":"Dallatomasina S, Crestani R, Sylvester Squire J, Declerk H, Caleo GM, Wolz A, et al. Ebola outbreak in rural West Africa: epidemiology, clinical features and outcomes. Trop Med Int Health. 2015;20(4):448\u201354.","journal-title":"Trop Med Int Health"},{"key":"4994_CR18","doi-asserted-by":"crossref","unstructured":"Roddy P, Howard N, Kerkhove V, et al. Clinical Manifestations and Case Management of Ebola Haemorrhagic Fever Caused by a Newly Identified Virus Strain, Bundibugyo, Uganda, 2007\u20132008. PLoS One. 2012;7(12).","DOI":"10.1371\/journal.pone.0052986"},{"issue":"4","key":"4994_CR19","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1093\/cid\/civ319","volume":"61","author":"E Qin","year":"2015","unstructured":"Qin E, et al. Clinical features of patients with Ebola virus disease in Sierra Leone. Clinical Infect Dis. 2015;61(4):491\u20135.","journal-title":"Clinical Infect Dis"},{"key":"4994_CR20","volume-title":"Microsoft Word","author":"Microsoft","year":"2018","unstructured":"Microsoft. Microsoft Word. Redmond: Microsoft; 2018."},{"key":"4994_CR21","volume-title":"World Health Organization WHO statement on the meeting of the International Health Regulations Emergency Committee regarding the 2014 ebola outbreak in West Africa","author":"WHO","year":"2014","unstructured":"WHO. World Health Organization WHO statement on the meeting of the International Health Regulations Emergency Committee regarding the 2014 ebola outbreak in West Africa. Geneva: WHO; 2014."},{"key":"4994_CR22","volume-title":"Clinical management of patients with viral haemorrhagic fever: a pocket guide for the front-line health workers","author":"World Health Organization","year":"2014","unstructured":"World Health Organization. Clinical management of patients with viral haemorrhagic fever: a pocket guide for the front-line health workers. 2014."},{"key":"4994_CR23","volume-title":"R: A language and environment for statistical computing. R Foundation for Statistical Computing","author":"Team RC","year":"2017","unstructured":"Team RC. R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna: R Core Team; 2017."},{"key":"4994_CR24","volume-title":"An introduction to statistical learning: with applications in R","author":"G James","year":"2014","unstructured":"James G, Witten D, Hastie T, Tibshirani R. An introduction to statistical learning: with applications in R. Incorporated: Springer Publishing Company; 2014."},{"key":"4994_CR25","doi-asserted-by":"publisher","unstructured":"Garske T, Cori A, Ariyarajah A, Blake IM, Dorigatti I, Eckmanns T, Fraser C, Hinsley W, Jombart T, Mills HL, Nedjati-Gilani G, Newton E, Nouvellet P, Perkins D, Riley S, Schumacher D, Shah A, Van Kerkhove MD, Dye C, Ferguson NM, Donnelly CA. Heterogeneities in the case fatality ratio in the West African Ebola outbreak 2013\u20132016372. Philos Transact R Soc B Biol Sci. https:\/\/doi.org\/10.1098\/rstb.2016.0308.","DOI":"10.1098\/rstb.2016.0308"},{"issue":"7","key":"4994_CR26","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1017\/S0950268815003003","volume":"144","author":"JY Wong","year":"2016","unstructured":"Wong JY, Zhang W, Kargbo D, Haque U, Hu W, Wu P, et al. Assessment of the severity of Ebola virus disease in Sierra Leone in 2014-2015. Epidemiol Infect. 2016;144(7):1473\u201381. https:\/\/doi.org\/10.1017\/S0950268815003003.","journal-title":"Epidemiol Infect"},{"key":"4994_CR27","unstructured":"World Health Organisation. Ebola Fact Sheet. February 2018. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ebola-virus-disease Accessed 13 Jan 2019."},{"key":"4994_CR28","unstructured":"MSF International. How does MSF care for patients suffering from Ebola? (2015) https:\/\/www.msf.org\/ebola-how-does-msf-care-patients-suffering-ebola. Accessed 23 Feb 019."},{"key":"4994_CR29","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1172\/JCI100966","volume":"17","author":"MD Altschule","year":"1938","unstructured":"Altschule MD, Gilligan DR. The effects on the cardiovascular system of fluids administered intravenously in man. II. The dynamics of the circulation. J. Clin. Invest. 1938;17:401.","journal-title":"J. Clin. Invest"},{"key":"4994_CR30","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1172\/JCI100930","volume":"17","author":"DR Gilligan","year":"1938","unstructured":"Gilligan DR, Altschule MD, Volk MC. The effects on the cardiovascular system of fluids administered intravenously in man. I. Studies of the amount and duration of changes in blood volume. J. Clin. Invest. 1938;17:7.","journal-title":"J. Clin. Invest"},{"key":"4994_CR31","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1001\/archinte.1939.00190030098007","volume":"64","author":"DR Gilligan","year":"1939","unstructured":"Gilligan DR, Altschule MD, Linenthal AJ. Effects on the cardiovascular system of fluids administered intravenously in man. III Studies of the glomerular filtration rate as measured by the urea clearance. Arch Int Med. 1939;64:505.","journal-title":"Arch Int Med"},{"key":"4994_CR32","doi-asserted-by":"crossref","unstructured":"Rosenke K, Adjemian J, Munster VJ, et al. Plasmodium parasitemia associated with increased survival in Ebola virus-infected patients. Clin Infect Dis. 2016;63:1026\u20133.","DOI":"10.1093\/cid\/ciw452"},{"key":"4994_CR33","doi-asserted-by":"crossref","unstructured":"Kerber R, Krumkamp R, Diallo B, et al. Analysis of diagnostic findings from the European mobile laboratory in Gueckedou, Guinea, March 2014 through March 2015. J Infect Dis. 2016;214:S250\u20137.","DOI":"10.1093\/infdis\/jiw269"},{"key":"4994_CR34","doi-asserted-by":"crossref","unstructured":"Smit MA, Michelow IC, Glavis-Bloom J, Wolfman V, Levine AC. Characteristics and outcomes of pediatric patients with Ebola virus disease admitted to treatment units in Liberia and Sierra Leone: a retrospective cohort study. Clin Infect Dis. 2017;64:243\u20139.","DOI":"10.1093\/cid\/ciw725"},{"key":"4994_CR35","doi-asserted-by":"crossref","unstructured":"Vernet MA, Reynard S, Fizet A, et al. Clinical, virological, and biological parameters associated with outcomes of Ebola virus infection in Macenta, Guinea. JCI Insight. 2017;2:e88864.","DOI":"10.1172\/jci.insight.88864"},{"key":"4994_CR36","doi-asserted-by":"crossref","unstructured":"Waxman M, Aluisio AR, Rege S, Levine AC. Characteristics and survival of patients with Ebola virus infection, malaria, or both in Sierra Leone: a retrospective cohort study. Lancet Infect Dis. 2017;17:654\u201360.","DOI":"10.1016\/S1473-3099(17)30112-3"},{"key":"4994_CR37","doi-asserted-by":"publisher","unstructured":"Carroll MW, Haldenby S, Rickett NY, et al. Deep sequencing of RNA from blood and oral swab samples reveals the presence of nucleic acid from a number of pathogens in patients with acute Ebola virus disease and is consistent with bacterial translocation across the Gut. mSphere. 2017;2. https:\/\/doi.org\/10.1128\/mSphereDirect.00325-17.","DOI":"10.1128\/mSphereDirect.00325-17"},{"key":"4994_CR38","unstructured":"Ebola haemorrhagic fever in Zaire, 1976. Bull World Health Organ. 1978;56(2):271\u201393."},{"key":"4994_CR39","doi-asserted-by":"crossref","unstructured":"Sadek RF, Khan AS, Stevens G, Peters CJ, Ksiazek TG. Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995: determinants of survival. J Infect Dis. 1999;179(suppl 1):S24\u20137.","DOI":"10.1086\/514311"},{"key":"4994_CR40","doi-asserted-by":"crossref","unstructured":"Okware SI, Omaswa FG, Zaramba S, et al. An outbreak of Ebola in Uganda. Trop Med Int Health. 2002;7(12):1068\u201375.","DOI":"10.1046\/j.1365-3156.2002.00944.x"},{"key":"4994_CR41","doi-asserted-by":"crossref","unstructured":"MacNeil A, Farnon EC, Wamala J, et al. Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda. Emerg Infect Dis. 2010;16(12):1969\u201372.","DOI":"10.3201\/eid1612.100627"},{"key":"4994_CR42","doi-asserted-by":"publisher","first-page":"g7348","DOI":"10.1136\/bmj.g7348","volume":"349","author":"NJ Beeching","year":"2014","unstructured":"Beeching NJ, Fenech M, Houlihan CF. Ebola virus disease. BMJ. 2014;349:g7348. https:\/\/doi.org\/10.1136\/bmj.g7348.","journal-title":"BMJ"},{"key":"4994_CR43","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1056\/NEJMoa1411249","volume":"372","author":"EI Bah","year":"2015","unstructured":"Bah EI, Lama MC, Fletcher T, et al. Clinical presentation of patients with Ebola virus disease in Conakry, Guinea. N Engl J Med. 2015;372:40\u20137.","journal-title":"N Engl J Med"},{"key":"4994_CR44","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1016\/S1473-3099(15)00144-9","volume":"15","author":"L Hunt","year":"2015","unstructured":"Hunt L, Gupta-Wright A, Simms V, Tamba F, VK, Tamba K, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015;15:1292\u20139.","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"4994_CR45","first-page":"323","volume":"2","author":"B Levy","year":"2017","unstructured":"Levy B, Edholm C, et al. Modeling the role of public health education in Ebola virus disease outbreaks in Sudan. Infect Dis Model. 2017;2(3):323\u201340.","journal-title":"Infect Dis Model"},{"issue":"7","key":"4994_CR46","doi-asserted-by":"publisher","first-page":"e495","DOI":"10.1016\/S2214-109X(16)30097-3","volume":"4","author":"T Shah","year":"2016","unstructured":"Shah T, Greig J, van der Plas LM, Achar J, Caleo G, Squire JS, et al. Inpatient signs and symptoms and factors associated with death in children aged 5 years and younger admitted to two Ebola management centres in Sierra Leone, 2014: a retrospective cohort study. Lancet Glob Health. 2016;4(7):e495\u2013501.","journal-title":"Lancet Glob Health"},{"issue":"2","key":"4994_CR47","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1016\/S0031-3955(16)36878-X","volume":"37","author":"ED Brewer","year":"1990","unstructured":"Brewer ED. Disorders of Acid-Base balance. Pediatr Clin N Am. 1990;37(2):429\u201347.","journal-title":"Pediatr Clin N Am"},{"issue":"2","key":"4994_CR48","first-page":"60","volume":"1","author":"E Mupere","year":"2001","unstructured":"Mupere E, Kaducu OF, ZY. Ebola haemorrhagic fever among hospitalised children and adolescents in northern Uganda: epidemiologic and clinical observations. Afr Health Sci. 2001;1(2):60\u20135.","journal-title":"Afr Health Sci"},{"key":"4994_CR49","doi-asserted-by":"publisher","unstructured":"Theocharopoulos G, Danis K, Greig J, Hoffmann A, De Valk H, Jimissa A, et al. Ebola management centre proximity associated with reduced delays of healthcare of Ebola Virus Disease (EVD) patients, Tonkolili, Sierra Leone, 2014\u201315. PLoS ONE. 2017;12(5):e0176692. https:\/\/doi.org\/10.1371\/journal.pone.0176692.","DOI":"10.1371\/journal.pone.0176692"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-04994-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-020-04994-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-04994-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T19:55:50Z","timestamp":1618948550000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-020-04994-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,21]]},"references-count":49,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["4994"],"URL":"https:\/\/doi.org\/10.1186\/s12879-020-04994-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.10746\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,21]]},"assertion":[{"value":"11 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The Sierra Leone Ethics and Scientific Review Committee (Opinion date 29 March 2017) and the Institutional Review Board at the Ludwig-Maximillian\u2019s Universidad Munched, Germany (Opinion No. LMU 17\u2013582) provided ethical clearance and approved this study. The Sierra Leone Ethics and Scientific Review Committee granted us ethical clearance and waivered the requirement to obtain individual informed consent from EVD patients on confidentiality purpose since we were analyzing facility-specific aggregated medical records. All data used in this study were anonymized before they were used. Administrative clearances were obtained from the Sierra Leone Ethics and Scientific Review Committee and The 34 Military Hospital in Sierra Leone which was managing the ETCs at The 34 Military Hospital and The Police Training School prior to the use of the said datasets.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"293"}}