Risk factors for Ebola virus disease among household care providers, Sierra Leone, 2015
Author:
Duffy Nadezhda1ORCID, Bruden Dana2, Thomas Harold3, Nichols Erin4, Knust Barbara5, Hennessy Thomas2, Reichler Mary R6, Bangura James, Keimbe Charles, Jambai Amara, Morgan Oliver, Farmar Ismail, Davies Francis, Dumbuya Mohamed Sima, Kamara Hannah, Kallon Mohamed, Kpukumu Joseph, Abu Sheku, Bangura Fatmata, Bangura Saidu Rahim, Bangura Tomeh, Benya Hassan, Blango Sandi, Conteh Imurana, Conteh Peter, Jabbie Bintu, Jabbie Sheku, Kamara Luseni, Lansana Francis, Rogers Maada, Sewa Sahr Brima, Yamba Matthew, Bessler P, Washburn Faith, Ervin E, Campbell S, Chung W, Hersey S,
Affiliation:
1. Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention , Atlanta, GA, USA 2. Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic diseases, Centers for Disease Control and Prevention , Anchorage, AK, USA 3. Directorate of Health Security and Emergencies, Ministry of Health and Sanitation , Freetown, Sierra Leone 4. National Center for Health Statistics, Centers for Disease Control and Prevention , Hyattsville, MD, USA 5. Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention , Atlanta, GA, USA 6. Division of Tuberculosis Elimination, National Center for HIV/AIDS, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, GA, USA
Abstract
Abstract
Background
Household contacts who provide care to an Ebola virus disease (EVD) case have a 3-fold higher risk of EVD compared with contacts who do not provide care.
Methods
We enrolled persons with confirmed EVD from December 2014 to April 2015 in Freetown, Sierra Leone, and their household contacts. Index cases and contacts were interviewed, and contacts were followed for 21 days to identify secondary cases. Epidemiological data were analysed to describe household care and to identify risk factors for developing EVD.
Results
Of 838 contacts in 147 households, 156 (17%) self-reported providing care to the index case; 56 households had no care provider, 52 a single care provider and 39 multiple care providers. The median care provider age was 29 years, 68% were female and 32% were the index case’s spouse. Care providers were more likely to report physical contact, contact with body fluids or sharing clothing, bed linens or utensils with an index case, compared with non-care providers (P <0.01). EVD risk among non-care providers was greater when the number of care providers in the household increased (odds ratio: 1.61; 95% confidence interval: 1.1, 2.4). In multivariable analysis, factors associated with care provider EVD risk included no piped water access and absence of index case fever, and protective factors included age <20 years and avoiding the index case.
Conclusions
Limiting the number of care providers in a household could reduce the risk of EVD transmission to both care providers and non-care providers. Strategies to protect care providers from EVD exposure are needed.
Funder
Centers for Disease Control and Prevention and by the CDC Foundation
Publisher
Oxford University Press (OUP)
Subject
General Medicine,Epidemiology
Cited by
2 articles.
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