Evaluation of Management Strategies for Maximizing Supportive Care for Patients with Ebola Virus Disease

评估埃博拉病毒病患者最大限度支持护理的管理策略

基本信息

批准号：
9369313
负责人：
Adam Carl Levine
金额：
$ 10.34万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-06-08 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9369313
关键词：
Africa Africa South of the Sahara Antibiotics Antimalarials Ascorbic Acid Caring Cessation of life Clinical Clinical Treatment Country Coupled Data Data Quality Data Set Databases Diagnosis Disease Disease Management Disease Outbreaks Dose Ebola Hemorrhagic Fever Ebola virus Epidemic Epidemiology Evaluation Fluid Therapy Future Geography Goals Guidelines Guinea IV Fluid Individual Infection International Intervention Intravenous Laboratories Legal patent Liberia Liquid substance Literature Malaria Medical Methodology Micronutrients Modality Morbidity - disease rate Multivitamin Oral Oral Rehydration Therapy Outcome Patient Care Patient-Focused Outcomes Patients Pharmaceutical Preparations Population Population Heterogeneity Process Recovery Rehydrations Reporting Research Role Sierra Leone Site Stratification Supplementation Supportive care Survivors Symptoms Therapeutic Intervention Time United States Vitamin A Work Zinc supplementation antimicrobial base clinical care co-infection control trial evidence base global health improved mortality primary outcome psychosocial response secondary outcome treatment center treatment effect

项目摘要

PROJECT SUMMARY Since 1976, there have been nearly 20 confirmed outbreaks of Ebola Virus Disease (EVD), all originating in sub-Saharan Africa. The most recent outbreak in West Africa was by far the largest, leading to nearly 30,000 suspected and confirmed cases of EVD and 12,000 deaths. Although Guinea, Liberia, and Sierra Leone accounted for the vast majority of cases, infections imported from these countries were identified in seven additional countries, including the United States. The magnitude and geographic breadth of the recent epidemic, coupled with its high overall mortality, highlights the global health dangers posed by future EVD outbreaks and the associated need for better management strategies in order to improve disease survival. However, there remains a lack of high-quality data on the efficacy of various clinical interventions for EVD, and to date no multisite studies exist evaluating the impacts of commonly utilized supportive care and treatment modalities on patient-centered outcomes. Between September 2014 and December 2015, the humanitarian organization International Medical Corps (IMC) managed five Ebola Treatment Units (ETUs) in Liberia and Sierra Leone, which cared for over 2,500 patients, including 470 with confirmed EVD. From these sites, IMC collected over 25,000 pages of clinical, laboratory, and operational data. Prior to the closure of the ETUs, IMC underwent the painstaking work of extracting, digitizing, aggregating, and quality checking this data. This extensive process yielded a unique database that can now be used to evaluate the impacts of specific clinical interventions on patient-centered outcomes among EVD infected individuals. Using advanced statistical methodologies, the impacts of various supportive care interventions, including rehydration therapies, micronutrient supplementation, and antimicrobials, on mortality and duration of symptoms in EVD-infected patients will be evaluated. This research has the potential to improve the evidence-base for international EVD guidelines, identify potentially high-yield interventions for future study in controlled trials, and improve the quality of the overall response to future EVD epidemics.

项目摘要自1976年以来，已有近20次确认的埃博拉病毒疾病爆发（EVD），均起源于撒哈拉以南非洲。西非最近一次爆发是迄今为止最大的爆发，导致近30,000 怀疑并确认的EVD案件和12,000例死亡。虽然几内亚，利比里亚和塞拉利昂在绝大多数情况下，从这些国家进口进口的感染是在七个国家中发现的包括美国在内的其他国家。最近的大小和地理广度流行病，再加上其总体死亡率很高，强调了未来EVD构成的全球健康危险爆发和相关的需要更好的管理策略，以改善疾病的生存。但是，仍然缺乏有关各种临床干预措施功效的高质量数据 evd，迄今为止，尚无多个网站研究来评估普遍使用的支持性的影响以患者为中心的结果的护理和治疗方式。在2014年9月至12月之间 2015年，人道主义组织国际医疗团（IMC）管理五个埃博拉治疗单位（ETUS）在利比里亚和塞拉利昂（Sierra Leone），该塞拉利昂（Sierra Leone）照顾了2500多名患者，其中470例已确认EVD。从这些站点中，IMC收集了超过25,000页的临床，实验室和操作数据。之前 ETU的关闭，IMC经历了提取，数字化，汇总和质量的艰苦工作检查此数据。这个广泛的过程产生了一个独特的数据库，现在可以用来评估特定的临床干预对EVD感染的以患者为中心的结果的影响个人。使用先进的统计方法，各种支持性护理干预措施的影响，包括补液疗法，补充微量营养素和抗菌剂，关于死亡率和持续时间将评估感染EVD感染患者的症状。这项研究有可能改善国际EVD指南的证据库，确定未来的潜在高收益干预措施在对照试验中进行的研究，并提高对未来EVD流行病的总体反应的质量。