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Prevalence of infection among asymptomatic and paucisymptomatic contact persons exposed to Ebola virus in Guinea: a retrospective, cross-sectional observational study

2019; Elsevier BV; Volume: 19; Issue: 3 Linguagem: Inglês

10.1016/s1473-3099(18)30649-2

1474-4457

Mamadou Saliou Kalifa Diallo, Muriel Rabilloud, Ahidjo Ayouba, Abdoulaye Touré, Guillaume Thaurignac, Alpha Kabinet Keïta, Christelle Butel, Cécé Kpamou, Thierno Alimou Barry, Mariama Djouldé Sall, Ibrahima Camara, Sandrine Leroy, Philippe Msellati, René Écochard, Martine Peeters, Mamadou Sow, Éric Delaporte, Jean-François Étard, Diaby ABOUBACAR, Alseny BALDE, I Baldé, Amara Bamba, Amadou CAMARA, Aboubacar Mamy CONTE, Jean‐François Delfraissy, Amadou Diallo, Saran DOUMBOUYA, Emile Souro KAMANO, Joel Balle KOIVOGUI, Charlotte Lanièce Delaunay, Yves Lévy, Jean Louis Monemou, Moriba Povogui, Maou SAKOUVOGUI, Abdoul Karim Soumah, Fabien Subtil, Aboubacar Hawa SYLLA, Bernard Taverne, Yazdan Yazdanpanah,

COVID-19 epidemiological studies

Summary Background The prevalence of Ebola virus infection among people who have been in contact with patients with Ebola virus disease remains unclear, but is essential to understand the dynamics of transmission. This study aimed to identify risk factors for seropositivity and to estimate the prevalence of Ebola virus infection in unvaccinated contact persons. Methods In this retrospective, cross-sectional observational study, we recruited individuals between May 12, 2016, and Sept 8, 2017, who had been in physical contact with a patient with Ebola virus disease, from four medical centres in Guinea (Conakry, Macenta, N'zérékoré, and Forécariah). Contact persons had to be 7 years or older and not diagnosed with Ebola virus disease. Participants were selected through the Postebogui survivors' cohort. We collected self-reported information on exposure and occurrence of symptoms after exposure using a questionnaire, and tested antibody response against glycoprotein, nucleoprotein, and 40-kDa viral protein of Zaire Ebola virus by taking a blood sample. The prevalence of Ebola virus infection was estimated with a latent class model. Findings 1721 contact persons were interviewed and given blood tests, 331 of whom reported a history of vaccination so were excluded, resulting in a study population of 1390. Symptoms were reported by 216 (16%) contact persons. The median age of participants was 26 years (range 7–88) and 682 (49%) were male. Seropositivity was identified in 18 (8·33%, 95% CI 5·01–12·80) of 216 paucisymptomatic contact persons and 39 (3·32%, 5·01–12·80) of 1174 (2–4) asymptomatic individuals (p=0·0021). Seropositivity increased with participation in burial rituals (adjusted odds ratio [aOR] 2·30, 95% CI 1·21–4·17; p=0·0079) and exposure to blood or vomit (aOR 2·15, 1·23–3·91; p=0·0090). Frequency of Ebola virus infection varied from 3·06% (95% CI 1·84–5·05) in asymptomatic contact persons who did not participate in burial rituals to 5·98% (2·81–8·18) in those who did, and from 7·17% (3·94–9·09) in paucisymptomatic contact persons who did not participate in burial rituals to 17·16% (12·42–22·31) among those who did. Interpretation This study provides a new assessment of the prevalence of Ebola virus infection among contact persons according to exposure, provides evidence for the occurrence of paucisymptomatic cases, and reinforces the importance of closely monitoring at-risk contact persons. Funding Institut National de la Santé et de la Recherche Médicale, Reacting, the French Ebola Task Force, Institut de Recherche pour le Développement, and Montpellier University Of Excellence-University of Montpellier.