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Evaluation of convalescent whole blood for treating Ebola Virus Disease in Freetown, Sierra Leone.
J Infect. 2017 03; 74(3):302-309.JI

Abstract

BACKGROUND

Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), but less attention has been focused on it for treatment.

METHOD

We assessed the effectiveness of convalescent whole blood (CWB) in the treatment of consented EVD patients. We recruited 69 subjects in December 2014 up to April 2015, at the 34 Military Hospital in Wilberforce and the PTS 1 Ebola Treatment Unit in Hastings, Freetown. Forty-four were given CWB, and 25 who consented but preferred to be exempted from the CWB treatment were used to compare clinical outcomes. All were given routine treatment used at the Ebola Treatment Unit.

RESULTS

One of 44 subjects treated with CWB dropped out of the study and 31 recovered while 12 succumbed to the disease with a case fatality rate of 27.9%. For the group that was given routine treatment without CWB, 11 died with a case fatality rate of 44%. There was a significant difference between admission viral load and viral load after the first 24 h of treatment with convalescent whole blood (P < 0.01). The odds ratio for survival with CWB was 2.3 (95% CI, 0.8-6.5).

CONCLUSION

CWB is promising for treating EVD in resource-poor settings, especially in the early phases of outbreaks when resource-mobilization is done. Even though our sample size was small and the evaluation was not randomised, our results contribute to existing evidence that convalescent whole blood could be considered as a useful candidate for treating EVD. Further studies that are randomised will be required to further assess the efficacy of CWB as treatment option during any EVD outbreak.

Authors+Show Affiliations

34 Military Hospital, Wilberforce, Freetown, Sierra Leone; College of Medicine and Allied Health Sciences, Freetown, Sierra Leone.Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone; Njala University, Bo, Sierra Leone. Electronic address: rashidansumana@gmail.com.34 Military Hospital, Wilberforce, Freetown, Sierra Leone.34 Military Hospital, Wilberforce, Freetown, Sierra Leone; College of Medicine and Allied Health Sciences, Freetown, Sierra Leone.34 Military Hospital, Wilberforce, Freetown, Sierra Leone.Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone; Njala University, Bo, Sierra Leone.Ministry of Health and Sanitation, Sierra Leone.Davidson Nicol Memorial Hospital, Freetown, Sierra Leone.Physio - Fitness and Rehabilitation Centre, Freetown, Sierra Leone.College of Medicine and Allied Health Sciences, Freetown, Sierra Leone; Ministry of Health and Sanitation, Sierra Leone.College of Medicine and Allied Health Sciences, Freetown, Sierra Leone; Ministry of Health and Sanitation, Sierra Leone.Ministry of Health and Sanitation, Sierra Leone.Ministry of Health and Sanitation, Sierra Leone.Lassa Fever Laboratory, Kenema Government Hospital, Sierra Leone.College of Medicine and Allied Health Sciences, Freetown, Sierra Leone; Ministry of Health and Sanitation, Sierra Leone.College of Medicine and Allied Health Sciences, Freetown, Sierra Leone; Ministry of Health and Sanitation, Sierra Leone.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

27867062

Citation

Sahr, F, et al. "Evaluation of Convalescent Whole Blood for Treating Ebola Virus Disease in Freetown, Sierra Leone." The Journal of Infection, vol. 74, no. 3, 2017, pp. 302-309.
Sahr F, Ansumana R, Massaquoi TA, et al. Evaluation of convalescent whole blood for treating Ebola Virus Disease in Freetown, Sierra Leone. J Infect. 2017;74(3):302-309.
Sahr, F., Ansumana, R., Massaquoi, T. A., Idriss, B. R., Sesay, F. R., Lamin, J. M., Baker, S., Nicol, S., Conton, B., Johnson, W., Abiri, O. T., Kargbo, O., Kamara, P., Goba, A., Russell, J. B., & Gevao, S. M. (2017). Evaluation of convalescent whole blood for treating Ebola Virus Disease in Freetown, Sierra Leone. The Journal of Infection, 74(3), 302-309. https://doi.org/10.1016/j.jinf.2016.11.009
Sahr F, et al. Evaluation of Convalescent Whole Blood for Treating Ebola Virus Disease in Freetown, Sierra Leone. J Infect. 2017;74(3):302-309. PubMed PMID: 27867062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of convalescent whole blood for treating Ebola Virus Disease in Freetown, Sierra Leone. AU - Sahr,F, AU - Ansumana,R, AU - Massaquoi,T A, AU - Idriss,B R, AU - Sesay,F R, AU - Lamin,J M, AU - Baker,S, AU - Nicol,S, AU - Conton,B, AU - Johnson,W, AU - Abiri,O T, AU - Kargbo,O, AU - Kamara,P, AU - Goba,A, AU - Russell,J B W, AU - Gevao,S M, Y1 - 2016/11/17/ PY - 2016/06/19/received PY - 2016/09/20/revised PY - 2016/11/11/accepted PY - 2016/11/22/pubmed PY - 2017/10/17/medline PY - 2016/11/22/entrez KW - Convalescent whole blood KW - EVD KW - Sierra Leone KW - Treatment SP - 302 EP - 309 JF - The Journal of infection JO - J Infect VL - 74 IS - 3 N2 - BACKGROUND: Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), but less attention has been focused on it for treatment. METHOD: We assessed the effectiveness of convalescent whole blood (CWB) in the treatment of consented EVD patients. We recruited 69 subjects in December 2014 up to April 2015, at the 34 Military Hospital in Wilberforce and the PTS 1 Ebola Treatment Unit in Hastings, Freetown. Forty-four were given CWB, and 25 who consented but preferred to be exempted from the CWB treatment were used to compare clinical outcomes. All were given routine treatment used at the Ebola Treatment Unit. RESULTS: One of 44 subjects treated with CWB dropped out of the study and 31 recovered while 12 succumbed to the disease with a case fatality rate of 27.9%. For the group that was given routine treatment without CWB, 11 died with a case fatality rate of 44%. There was a significant difference between admission viral load and viral load after the first 24 h of treatment with convalescent whole blood (P < 0.01). The odds ratio for survival with CWB was 2.3 (95% CI, 0.8-6.5). CONCLUSION: CWB is promising for treating EVD in resource-poor settings, especially in the early phases of outbreaks when resource-mobilization is done. Even though our sample size was small and the evaluation was not randomised, our results contribute to existing evidence that convalescent whole blood could be considered as a useful candidate for treating EVD. Further studies that are randomised will be required to further assess the efficacy of CWB as treatment option during any EVD outbreak. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/27867062/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(16)30291-2 DB - PRIME DP - Unbound Medicine ER -