Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children.
BACKGROUND:Young children who contract Ebola Virus Disease (EVD) have a high case fatality rate, but their sources of infection and the role of breastfeeding are unclear. METHODS/PRINCIPAL FINDINGS:Household members of EVD survivors from the Kerry Town Ebola Treatment Centre in Sierra Leone were int...
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ftdoajarticles:oai:doaj.org/article:44381af93a6a4a4aaf3f778aa5f58013 2023-05-15T15:18:14+02:00 Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. Hilary Bower Sembia Johnson Mohamed S Bangura Alie Joshua Kamara Osman Kamara Saidu H Mansaray Daniel Sesay Cecilia Turay Francesco Checchi Judith R Glynn 2016-04-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0004622 https://doaj.org/article/44381af93a6a4a4aaf3f778aa5f58013 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4825998?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004622 https://doaj.org/article/44381af93a6a4a4aaf3f778aa5f58013 PLoS Neglected Tropical Diseases, Vol 10, Iss 4, p e0004622 (2016) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2016 ftdoajarticles https://doi.org/10.1371/journal.pntd.0004622 2022-12-31T01:28:59Z BACKGROUND:Young children who contract Ebola Virus Disease (EVD) have a high case fatality rate, but their sources of infection and the role of breastfeeding are unclear. METHODS/PRINCIPAL FINDINGS:Household members of EVD survivors from the Kerry Town Ebola Treatment Centre in Sierra Leone were interviewed four to 10 months after discharge to establish exposure levels for all members of the household, whether or not they became ill, and including those who died. We analysed a cohort of children under three years to examine associations between maternal illness, survival and breastfeeding, and the child's outcome. Of 77 children aged zero to two years in the households we surveyed, 43% contracted EVD. 64 children and mothers could be linked: 25/40 (63%) of those whose mother had EVD developed EVD, compared to 2/24 (8%) whose mother did not have EVD, relative risk adjusted for age, sex and other exposures (aRR) 7·6, 95%CI 2·0-29·1. Among those with mothers with EVD, the risk of EVD in the child was higher if the mother died (aRR 1·5, 0·99-2·4), but there was no increased risk associated with breast-feeding (aRR 0·75, 0·46-1·2). Excluding those breastfed by infected mothers, half (11/22) of the children with direct contact with EVD cases with wet symptoms (diarrhoea, vomiting or haemorrhage) remained well. CONCLUSION/SIGNIFICANCE:This is the largest study of mother-child pairs with EVD to date, and the first attempt at assessing excess risk from breastfeeding. For young children the key exposure associated with contracting EVD was mother's illness with EVD, with a higher risk if the mother died. Breast feeding did not confer any additional risk in this study but high risk from proximity to a sick mother supports WHO recommendations for separation. This study also found that many children did not become ill despite high exposures. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 10 4 e0004622 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Hilary Bower Sembia Johnson Mohamed S Bangura Alie Joshua Kamara Osman Kamara Saidu H Mansaray Daniel Sesay Cecilia Turay Francesco Checchi Judith R Glynn Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Young children who contract Ebola Virus Disease (EVD) have a high case fatality rate, but their sources of infection and the role of breastfeeding are unclear. METHODS/PRINCIPAL FINDINGS:Household members of EVD survivors from the Kerry Town Ebola Treatment Centre in Sierra Leone were interviewed four to 10 months after discharge to establish exposure levels for all members of the household, whether or not they became ill, and including those who died. We analysed a cohort of children under three years to examine associations between maternal illness, survival and breastfeeding, and the child's outcome. Of 77 children aged zero to two years in the households we surveyed, 43% contracted EVD. 64 children and mothers could be linked: 25/40 (63%) of those whose mother had EVD developed EVD, compared to 2/24 (8%) whose mother did not have EVD, relative risk adjusted for age, sex and other exposures (aRR) 7·6, 95%CI 2·0-29·1. Among those with mothers with EVD, the risk of EVD in the child was higher if the mother died (aRR 1·5, 0·99-2·4), but there was no increased risk associated with breast-feeding (aRR 0·75, 0·46-1·2). Excluding those breastfed by infected mothers, half (11/22) of the children with direct contact with EVD cases with wet symptoms (diarrhoea, vomiting or haemorrhage) remained well. CONCLUSION/SIGNIFICANCE:This is the largest study of mother-child pairs with EVD to date, and the first attempt at assessing excess risk from breastfeeding. For young children the key exposure associated with contracting EVD was mother's illness with EVD, with a higher risk if the mother died. Breast feeding did not confer any additional risk in this study but high risk from proximity to a sick mother supports WHO recommendations for separation. This study also found that many children did not become ill despite high exposures. |
format |
Article in Journal/Newspaper |
author |
Hilary Bower Sembia Johnson Mohamed S Bangura Alie Joshua Kamara Osman Kamara Saidu H Mansaray Daniel Sesay Cecilia Turay Francesco Checchi Judith R Glynn |
author_facet |
Hilary Bower Sembia Johnson Mohamed S Bangura Alie Joshua Kamara Osman Kamara Saidu H Mansaray Daniel Sesay Cecilia Turay Francesco Checchi Judith R Glynn |
author_sort |
Hilary Bower |
title |
Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. |
title_short |
Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. |
title_full |
Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. |
title_fullStr |
Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. |
title_full_unstemmed |
Effects of Mother's Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. |
title_sort |
effects of mother's illness and breastfeeding on risk of ebola virus disease in a cohort of very young children. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pntd.0004622 https://doaj.org/article/44381af93a6a4a4aaf3f778aa5f58013 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 10, Iss 4, p e0004622 (2016) |
op_relation |
http://europepmc.org/articles/PMC4825998?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004622 https://doaj.org/article/44381af93a6a4a4aaf3f778aa5f58013 |
op_doi |
https://doi.org/10.1371/journal.pntd.0004622 |
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PLOS Neglected Tropical Diseases |
container_volume |
10 |
container_issue |
4 |
container_start_page |
e0004622 |
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1766348446775640064 |