Roddy, Paul; Sara L Thomas; Benjamin Jeffs; Pascoal Nascimento Folo; Pedro Pablo Palma; Bengi Moco Henrique; Luis Villa; Fernando Paixao Damiao Machado; Oscar Bernal; Steven M. Jones; James E. Strong; Heinz Feldmann; Matthias Borchert
الوصف:
Background. Reliable on-site polymerase chain reaction (PCR) testing for Marburg hemorrhagic fever (MHF)
is not always available. Therefore, clinicians triage patients on the basis of presenting symptoms and contact history.
Using patient data collected in Uige, Angola, in 2005, we assessed the sensitivity and specificity of these factors
to evaluate the validity of World Health Organization (WHO)–recommended case definitions for MHF.
Methods. Multivariable logistic regression was used to identify independent predictors of PCR confirmation
of MHF. A data-derived algorithm was developed to obtain new MHF case definitions with improved sensitivity
and specificity.
Results. A MHF case definition comprising (1) an epidemiological link or (2) the combination of myalgia or
arthralgia and any hemorrhage could potentially serve as an alternative to current case definitions. Our dataderived
case definitions maintained the sensitivity and improved the specificity of current WHO-recommended
case definitions.
Conclusions. Continued efforts to improve clinical documentation during filovirus outbreaks would aid in
the refinement of case definitions and facilitate outbreak control.