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

项目总结 自1976年以来，已确认近20起埃博拉病毒病(EVD)疫情，均源于 撒哈拉以南非洲。西非最近的疫情是迄今为止规模最大的，导致近30,000人死亡 埃博拉病毒病疑似和确诊病例及12,000例死亡病例。尽管几内亚、利比里亚和塞拉利昂 在绝大多数病例中，从这些国家输入的感染病例有7例 其他国家，包括美国。最近地震的规模和地理广度 埃博拉病毒的流行，加上其高死亡率，突显了未来埃博拉病毒对全球健康构成的危险 疾病暴发和相关的需要更好的管理战略，以提高疾病存活率。 然而，仍然缺乏关于各种临床干预措施的疗效的高质量数据。 EVD，到目前为止还没有多点研究评估常用的支持性药物的影响 以病人为中心的护理和治疗模式。2014年9月至12月 2015年，人道主义组织国际医疗队(IMC)管理了五个埃博拉治疗单位 利比里亚和塞拉利昂的紧急救援小组照顾了2500多名患者，包括470名确诊的埃博拉病毒携带者。 从这些网站上，IMC收集了超过25,000页的临床、实验室和操作数据。在此之前 关闭ETU后，IMC经历了提取、数字化、聚合和质量的艰苦工作 正在检查这些数据。这一广泛的过程产生了一个独特的数据库，现在可以用来评估 特定临床干预措施对埃博拉病毒感染者以患者为中心结局的影响 个人。利用先进的统计方法，各种支持性护理干预措施的影响， 包括补液疗法、微量营养素补充剂和抗菌剂，对死亡率和持续时间的影响 将对埃博拉病毒感染者的症状进行评估。这项研究有可能改善 国际EVD指南的证据基础，确定未来潜在的高收益干预措施 在对照试验中进行研究，提高对未来埃博拉疫情的总体反应质量。

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.