Analysis of Diagnostic Findings From the European Mobile Laboratory in Guéckédou, Guinea, March 2014 Through March 2015

J Infect Dis. 2016 Oct 15;214(suppl 3):S250-S257. doi: 10.1093/infdis/jiw269. Epub 2016 Sep 16.


Background: A unit of the European Mobile Laboratory (EMLab) consortium was deployed to the Ebola virus disease (EVD) treatment unit in Guéckédou, Guinea, from March 2014 through March 2015.

Methods: The unit diagnosed EVD and malaria, using the RealStar Filovirus Screen reverse transcription-polymerase chain reaction (RT-PCR) kit and a malaria rapid diagnostic test, respectively.

Results: The cleaned EMLab database comprised 4719 samples from 2741 cases of suspected EVD from Guinea. EVD was diagnosed in 1231 of 2178 hospitalized patients (57%) and in 281 of 563 who died in the community (50%). Children aged <15 years had the highest proportion of Ebola virus-malaria parasite coinfections. The case-fatality ratio was high in patients aged <5 years (80%) and those aged >74 years (90%) and low in patients aged 10-19 years (40%). On admission, RT-PCR analysis of blood specimens from patients who died in the hospital yielded a lower median cycle threshold (Ct) than analysis of blood specimens from survivors (18.1 vs 23.2). Individuals who died in the community had a median Ct of 21.5 for throat swabs. Multivariate logistic regression on 1047 data sets revealed that low Ct values, ages of <5 and ≥45 years, and, among children aged 5-14 years, malaria parasite coinfection were independent determinants of a poor EVD outcome.

Conclusions: Virus load, age, and malaria parasite coinfection play a role in the outcome of EVD.

Keywords: Ebola virus disease; Filovirus; Guinea; epidemic; malaria; mobile laboratory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Clinical Laboratory Services
  • Ebolavirus / genetics
  • Ebolavirus / isolation & purification*
  • Epidemics*
  • Female
  • Filoviridae
  • Filoviridae Infections / complications
  • Filoviridae Infections / diagnosis*
  • Filoviridae Infections / virology
  • Guinea
  • Hemorrhagic Fever, Ebola / complications
  • Hemorrhagic Fever, Ebola / diagnosis*
  • Hemorrhagic Fever, Ebola / virology
  • Humans
  • Infant
  • Malaria / complications*
  • Malaria / parasitology
  • Male
  • Middle Aged
  • Mobile Health Units*
  • RNA, Viral / blood
  • Viral Load
  • Young Adult


  • RNA, Viral