Re: Summary of Cases, Deaths, Discharges, and CFR
Re: Summary of Cases, Deaths, Discharges, and CFR
Opinion
Sierra Leone News: Ebola what is the true Case Fatality Rate CFR?
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In its web page of August 15, (
http://www.msf.org/article/international-response-west-africa-ebola-epidemic-dangerously-inadequate ), the organization breaks its statistics down by country. Finally here we get information that is almost complete.
For Sierra Leone:
204 confirmed cases
52 recovered
50 patients in center.
Therefore, assuming the patients who have not recovered and are not still in the center have all died (the only other option is that they left the hospital alive without being certified as recovered, which is unlikely) and discarding the 50 patients in the center whose eventual outcomes are not known, we have 102 deaths from 154 confirmed Ebola patients all of whose outcomes are known:
Sierra Leone MSF CFR = (102/154)*100 = 66.2%
For Guinea Conakry:
80 confirmed cases ***inconsistent with MSF August 8
50 recovered ***inconsistent with MSF August 8
4 patients in treatment center
Guinea Conakry MSF CFR = (26/76)*100 =34.2%
For Guinea Guekedou:
197 confirmed cases
45 recovered
11 in treatment center
Guinea Guekedou MSF CFR = (141/186)*100 = 75.8%
From the above we see that the Sierra Leone MSF CFR is not very different from the Guinea Guekedou MSF CFR. These numbers are also not very different from the maximum CFR given above from the Sierra Leone Ministry of Health figures, which also included patients not hospitalized.
We are told specifically that all the MSF cases were admitted at MSF facilities. The Guinea Conakry figure is much lower, but is based on a smaller sample and there are also inconsistencies with earlier figures.
The Sierra Leone Ministry of Health and Sanitation gives figures (
http://health.gov.sl/wp-content/uploads/2014/08/Ebola-Situation-Report_Vol-92.pdf ) for Ebola patients at the two Ebola facilities in Sierra Leone, at Kenema and Kailahun. The Kenema facility is run by Ministry of Health staff separately from the MSF Kailahun Case Management center, so it would be interesting to compare CFRs for these two different facilities.
For the Kenema facility:
Cumulative admission 390 (Note: the data does not indicate whether these were all lab confirmed with Ebola)
Cumulative discharged 175
Currently admitted 65
Cumulative deaths 162
The discharged, currently admitted and deaths exceed the admissions, which indicates a discrepancy in the data, albeit relatively small. Using the data as given, for this set of patients:
Kenema Ebola Center CFR = (162/325)*100 = 49.8%
For the Kailahun MSF facility, using the Ministry of Health data
Cumulative admissions 294
Cumulative discharged 69
Currently admitted Not indicated
Cumulative deaths 180
Assuming all admissions are accounted for, as they should be in a well run facility we can conclude that currently admitted are 294-69-180 = 45. This is close to the figure given by MSF itself above (50), although the dates are different. For this set of patients:
Kailahun MSF CFR = (180/249)*100 =72.3%
This is fairly close to the 66% figure obtained above using data from the organization’s web page of August 15.
Conclusions: Using all the available data from the two Ebola facilities in Sierra Leone we get CFRs that range between 50% and 72%. This is considerably higher than the 37.7% CFR that our Ministry of Health is reporting. The method used by MOH is mathematically incorrect and leads to an underestimation of CFR.
http://awoko.org/2014/09/02/sierra-leone-news-ebola-what-is-the-true-case-fatality-rate-cfr/
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