Asymptomatic infection and family contact patterns in households of Ebola Virus Disease survivors, Sierra Leone 2015

Glynn, JR, Bower, H, Houlihan, C, Oza, S, Checchi, F, Johnson, S, Turay, C, Sesay, D, Mansaray, SH, Kamara, O, Kamara, JA, Bangura, MS, Montesano, C, Dicks, S, Samuel, D, Tedder, R and Sebba, C. 2017. Asymptomatic infection and family contact patterns in households of Ebola Virus Disease survivors, Sierra Leone 2015. [Online]. London School of Hygiene & Tropical Medicine, London, United Kingdom. Available from: https://doi.org/10.17037/DATA.41.

Glynn, JR, Bower, H, Houlihan, C, Oza, S, Checchi, F, Johnson, S, Turay, C, Sesay, D, Mansaray, SH, Kamara, O, Kamara, JA, Bangura, MS, Montesano, C, Dicks, S, Samuel, D, Tedder, R and Sebba, C. Asymptomatic infection and family contact patterns in households of Ebola Virus Disease survivors, Sierra Leone 2015. [Internet] LSHTM Data Compass. London, United Kingdom: London School of Hygiene & Tropical Medicine; 2017. Available from: https://doi.org/10.17037/DATA.41.

Glynn, JR, Bower, H, Houlihan, C, Oza, S, Checchi, F, Johnson, S, Turay, C, Sesay, D, Mansaray, SH, Kamara, O, Kamara, JA, Bangura, MS, Montesano, C, Dicks, S, Samuel, D, Tedder, R and Sebba, C (2017). Asymptomatic infection and family contact patterns in households of Ebola Virus Disease survivors, Sierra Leone 2015. [Data Collection]. London School of Hygiene & Tropical Medicine, London, United Kingdom. https://doi.org/10.17037/DATA.41.

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Description of data capture The study used qualitative interview methods to obtain quantitative data. All survivors discharged from Kerry Town Ebola Treatment Centre (ETC), Sierra Leone between November 2014 and March 2015 and living in the Western Area (or their parents/guardians) were contacted by the study team during July-August 2015 and invited to bring all household members who were present at the time Ebola was affecting their household to an interview. Households were defined as people eating from the same ‘pot’ at the time Ebola was in the household, regardless of the time they had spent in the household, and including people who joined the household during the Ebola period. Each household was interviewed separately. Individual written informed consent was requested from all members, with parents/guardians providing consent for those under 18 years. At the interview we first drew up an inventory of all household members, noting their age, sex, and whether or not they had had or had died of Ebola virus disease. A member of the study team then demonstrated the oral swab and self-administered oral swabs were collected from all consenting participants (with parents helping young children). These were stored at -20◦C for later testing for Ebola IgG in the Immunology and Applied Biotechnology Research Laboratory of University of Makeni, Sierra Leone, in January 2016. As a group, household members were then asked to describe what had happened in the household in their own words. For each person reported by the family as having had Ebola we asked about symptoms while at home, who had helped them while they were ill, shared a bed or had other contact with them, and who had contact with their body if they died. Adults spoke for young children and corroborated information from older children. In this way, using probing questions, we assigned a maximum exposure for each household member using predefined levels, which we had developed based on the literature and discussion with staff from the Ebola Treatment Centre. (see Additional Information section below for detail of exposure measurement). We also asked about exposures outside the home and classified them on the same scale. For those not reported to have had Ebola we asked about symptoms at the time others in the household had Ebola. EVD cases were defined as laboratory-confirmed survivors and deaths from Kerry Town or other ETCs, and all those whom the family reported as having died of Ebola. Deaths for which the family was unsure of the cause, and, for some analyses, symptomatic individuals who were not tested or diagnosed with Ebola at the time, were classified as probable EVD if they fitted the Sierra Leone case definition of probable cases. The most likely primary or co-primary cases were identified for each household, and order of illness among other cases recorded if mentioned. To avoid overburdening participants, we did not collect time sequences or dates. We also did not directly ask family members who they thought transmitted to whom to avoid stimulating blame or ill-feeling among already traumatised families. All interviews were done in the participants’ language by multi-lingual study teams, and key outcomes were recorded in English on household inventory and individual forms. During the interview, one team member was the focal point, maintaining eye contact with the participants and guiding the discussion. A minimum of two other study team members listened and made notes, asking questions only if an issue was overlooked. This avoided multiple conversations taking place at the same time as well as ‘tick-box’ questioning. Study members were trained extensively so as not to need to use a paper interview guide to avoid loss of connection with the family group. Immediately after the family departed, the team sat together to discuss the story to make sure all elements were understood and data, including each person’s maximum level of exposure, were finalised. Oral fluid samples were tested for Ebola virus glycoprotein IgG using an IgG Capture assay based on the EBOV Mayinga GP antigen (rGPδTM, IBT Bioservices Inc. USA cat.0501-016). Two positive controls and four negative controls were included in each plate. The cut-off for a reactive result was defined per plate as the mean optical density (OD) of the negative controls plus a fixed OD measure (0.1). Data are given as “normalised ODs”, i.e. the ratio of the test OD to the cut-off, so results >1 are reactive. Tests were repeated for positive samples and some negative samples, including those with unexpected results and samples nearer the cut-off.
Data capture method Interview: Face-to-face, Lab observation: Participant
Data Collection Period
FromTo
20 July 201527 August 2015
Date (Completed) 4 January 2017
Geographical area covered
North LatitudeEast LongitudeSouth LatitudeWest Longitude
8.33267-12.92348.25725-13.0524
Language(s) of written materials English
Data Creators Glynn, JR, Bower, H, Houlihan, C, Oza, S, Checchi, F, Johnson, S, Turay, C, Sesay, D, Mansaray, SH, Kamara, O, Kamara, JA, Bangura, MS, Montesano, C, Dicks, S, Samuel, D, Tedder, R and Sebba, C
LSHTM Faculty/Department Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Participating Institutions London School of Hygiene & Tropical Medicine, Save the Children (SCI), University of Rome
Funders
ProjectFunderGrant NumberFunder URI
Asymptomatic infection and family contact patterns in households of Ebola Virus Disease survivors, Sierra Leone 2015Wellcome Trust107779/Z/15/Z (ER1502)UNSPECIFIED
UNSPECIFIEDSave the ChildrenUNSPECIFIEDUNSPECIFIED
Depositor LSHTM Library & Archives Service
Date Deposited 05 Jan 2017 13:22
Last Modified 20 Feb 2018 17:13
Publisher London School of Hygiene & Tropical Medicine

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Filename: sl_ebola_repos_ALL_VAR.zip

Description: Dataset contains individual and household characteristics, exposure levels, symptoms, outcomes & possible sources of transmission, and laboratory results from ELISA antibody testing for Ebola IgG for EVD survivors households

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Filename: sl_ebola_repos_NO_LAB.zip

Description: Dataset of 46 variables comprising individual and household characteristics, exposure levels, symptoms, outcomes and possible sources of transmission for 937 members of the households of 123 EVD survivors from the Kerry Town Ebola Treatment Centre

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Documentation

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Filename: sl_ebola_repos_NO_LAB_Codebook.pdf

Description: Codebook for Ebola Response dataset that doesn’t contain serological variables

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Filename: sl_ebola_repos_ALL_VAR_Codebook.pdf

Description: Codebook for Ebola Response dataset with serological variables

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Filename: Participant_Consent_Form.pdf

Description: Participant consent form used in study

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Filename: Participant_Information_Sheet.pdf

Description: Information sheet for participants

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Filename: Study_Protocol.pdf

Description: Protocol for study on sub-clinical infection, household transmission and long-term sequelae among Ebola Virus Disease survivors, their households and neighbours in Sierra Leone

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Study Instrument

Filename: Survivor_Household_Questionnaire.pdf

Description: Forms used to produce the member inventory of survivor households and perform questionnaires of each person

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