Clinical presentation of pregnant women at isolation centers for Ebola Virus Disease in Sierra Leone, 2014
Objective: To examine EVD symptom prevalence and EVD status among pregnant women in EVD isolation units in Sierra Leone.
Methods: We abstracted data for pregnant women suspected of EVD in isolation units from July-December, 2014. Suspect cases were defined as pregnant women with fever (temperature>38ºC) and/or symptoms suggestive of EVD. We examined associations between EVD status and symptoms using chi-square tests and multivariate logistic regression.
Results: Of 192 pregnant women isolated, 36% (n=67) were EVD positive. Women testing EVD-positive were significantly more likely to have fever (89% vs 65% ), fatigue/weakness (84% vs 57% ), vomiting (69% vs 42% ), headache (69% vs 32%), muscle/joint pain (58% vs 32%), chest pain (41% vs 21%), vaginal bleeding (38% vs 14%), unexplained bleeding (19% vs 6%), sore throat (25% vs 3%) and cough (11% vs 2%) compared to EVD-negative women (p-value <0.05 for all comparisons). After adjusting for age and the above listed symptoms, only vomiting (OR:2.5 95%CI:1.0-6.0) , headache (OR:2.9 95%CI:1.2-6.8), vaginal bleeding (OR:2.9 95%CI:1.0-7.9), and sore throat (OR:11.7 95%CI:1.2-116.9) were associated with higher odds of positive EVD status.
Discussion: Our sample represents the largest collection of symptomology data from pregnant women with suspected EVD. Some symptoms were more common in EVD-positive than negative women. Our results highlight challenges associated with screening pregnant women for EVD.
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines
Public health or related research
Describe the symptomatology of EVD among a select group of pregnant women during the 2014-2015 EVD epidemic in Sierra Leone. Identify challenges associated with data collection, sampling, and logistics with a vulnerable population during an infectious disease epidemic.
Keyword(s): Vulnerable Populations, Maternal and Child Health
Qualified on the content I am responsible for because: I was involved in the design and collection of data for this study while working in Freetown, Sierra Leone for the Centers for Disease Control and Prevention (CDC) on the Infection Prevention and Control Team during the 2014-2015 Ebola outbreaks. I am an Epidemiologist in the Division of Reproductive Health at CDC. I am also a member of a multidisciplinary workgroup of clinicians and epidemiologists working on maternal health issues and Ebola at CDC.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.