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Lassa fever outcomes and prognostic factors in Nigeria (LASCOPE): a prospective cohort study

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDUVIGNAUD, Alexandre
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorJASPARD, Marie
dc.contributor.authorETAFO, Ijeoma Chukwudumebi
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGABILLARD, Delphine
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorSERRA, Beatrice
dc.contributor.authorABEJEGAH, Chukwuyem
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorLE GAL, Camille
dc.contributor.authorABIDOYE, Abiodun Tolani
dc.contributor.authorDOUTCHI, Mahamadou
dc.contributor.authorOWHIN, Sampson
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorSERI, Benjamin
dc.contributor.authorVIHUNDIRA, Jackson Katembo
dc.contributor.authorBERERD-CAMARA, Marion
dc.contributor.authorSCHAEFFER, Justine
dc.contributor.authorDANET, Nicolas
dc.contributor.authorAUGIER, Augustin
dc.contributor.authorOGBAINI-EMOVON, Ephraim
dc.contributor.authorSALAM, Alex Paddy
dc.contributor.authorAHMED, Liasu Adeagbo
dc.contributor.authorDURAFFOUR, Sophie
dc.contributor.authorHORBY, Peter
dc.contributor.authorGUNTHER, Stephan
dc.contributor.authorADEDOSU, Akinola Nelson
dc.contributor.authorAYODEJI, Oladele Oluwafemi
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorANGLARET, Xavier
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorMALVY, Denis
dc.date.accessioned2021-06-24T09:09:55Z
dc.date.available2021-06-24T09:09:55Z
dc.date.issued2021-04
dc.identifier.issn2214-109xen_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/79285
dc.description.abstractEnBACKGROUND: Lassa fever is a viral haemorrhagic fever endemic in parts of west Africa. New treatments are needed to decrease mortality, but pretrial reference data on the disease characteristics are scarce. We aimed to document baseline characteristics and outcomes for patients hospitalised with Lassa fever in Nigeria. METHODS: We did a prospective cohort study (LASCOPE) at the Federal Medical Centre in Owo, Nigeria. All patients admitted with confirmed Lassa fever were invited to participate and asked to give informed consent. Patients of all ages, including newborn infants, were eligible for inclusion, as were pregnant women. All participants received standard supportive care and intravenous ribavirin according to Nigeria Centre for Disease Control guidelines and underwent systematic biological monitoring for 30 days. Patients' characteristics, care received, mortality, and associated factors were recorded using standard WHO forms. We used univariable and multivariable logistic regression models to investigate an association between baseline characteristics and mortality at day 30. FINDINGS: Between April 5, 2018, and March 15, 2020, 534 patients with confirmed Lassa fever were admitted to hospital, of whom 510 (96%) gave consent and were included in the analysis. The cohort included 258 (51%) male patients, 252 (49%) female patients, 426 (84%) adults, and 84 (16%) children (younger than 18 years). The median time between first symptoms and hospital admission was 8 days (IQR 7-13). At baseline, 176 (38%) of 466 patients had a Lassa fever RT-PCR cycle threshold (Ct) lower than 30. From admission to end of follow-up, 120 (25%) of 484 reached a National Early Warning Score (second version; NEWS2) of 7 or higher, 67 (14%) of 495 reached a Kidney Disease-Improving Global Outcome (KDIGO) stage of 2 or higher, and 41 (8%) of 510 underwent dialysis. All patients received ribavirin for a median of 10 days (IQR 9-13). 62 (12%) patients died (57 [13%] adults and five [6%] children). The median time to death was 3 days (1-6). The baseline factors independently associated with mortality were the following: age 45 years or older (adjusted odds ratio 16·30, 95% CI 5·31-50·30), NEWS2 of 7 or higher (4·79, 1·75-13·10), KDIGO grade 2 or higher (7·52, 2·66-21·20), plasma alanine aminotransferase 3 or more times the upper limit of normal (4·96, 1·69-14·60), and Lassa fever RT-PCR Ct value lower than 30 (4·65, 1·50-14·50). INTERPRETATION: Our findings comprehensively document clinical and biological characteristics of patients with Lassa fever and their relationship with mortality, providing prospective estimates that could be useful for designing future therapeutic trials. Such trials comparing new Lassa fever treatments to a standard of care should take no more than 15% as the reference mortality rate and consider adopting a combination of mortality and need for dialysis as the primary endpoint. FUNDING: Institut National de la Santé et de la Recherche Médicale, University of Oxford, EU, UK Department for International Development, Wellcome Trust, French Ministry of Foreign Affairs, Agence Nationale de Recherches sur le SIDA et les hépatites virales, French National Research Institute for Sustainable Development.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.title.enLassa fever outcomes and prognostic factors in Nigeria (LASCOPE): a prospective cohort study
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/s2214-109x(20)30518-0en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
bordeaux.journalThe Lancet global healthen_US
bordeaux.pagee469-e478en_US
bordeaux.volume9en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue4en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamIDLICen_US
bordeaux.teamPACCIen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut National de la Santé et de la Recherche Médicaleen_US
bordeaux.identifier.funderIDWellcome Trusten_US
bordeaux.identifier.funderIDMinistère des Affaires Etrangèresen_US
bordeaux.identifier.funderIDAgence Nationale de Recherches sur le Sida et les Hépatites Viralesen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
hal.identifierhal-03269674
hal.version1
hal.date.transferred2021-06-24T09:10:00Z
hal.exporttrue
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