Abstract：
OBJECTIVE: Early isolation and care for Ebola disease patients at Ebola Treatment Units (ETU) curb outbreak spread. We evaluated time to ETU entry and associated factors during the 2022 Sudan virus disease (SVD) outbreak in Uganda.
METHODS: We included persons with RT-PCR-confirmed SVD with onset September 20-November 30, 2022. We categorized days from symptom onset to ETU entry (\"delays\") as short (≤2), moderate (3-5), and long (≥6); the latter two were \"delayed isolation.\" We categorized symptom onset timing as \"earlier\" or \"later,\" using October 15 as a cut-off. We assessed demographics, symptom onset timing, and awareness of contact status as predictors for delayed isolation. We explored reasons for early vs late isolation using key informant interviews.
RESULTS: Among 118 case-patients, 25 (21%) had short, 43 (36%) moderate, and 50 (43%) long delays. Seventy-five (64%) had symptom onset later in the outbreak. Earlier symptom onset increased risk of delayed isolation (crude risk ratio = 1.8, 95% confidence interval (1.2-2.8]). Awareness of contact status and SVD symptoms, and belief that early treatment-seeking was lifesaving facilitated early care-seeking. Patients with long delays reported fear of ETUs and lack of transport as contributors.
CONCLUSIONS: Delayed isolation was common early in the outbreak. Strong contact tracing and community engagement could expedite presentation to ETUs.
METHODS: We included persons with RT-PCR-confirmed SVD with onset September 20-November 30, 2022. We categorized days from symptom onset to ETU entry (\"delays\") as short (≤2), moderate (3-5), and long (≥6); the latter two were \"delayed isolation.\" We categorized symptom onset timing as \"earlier\" or \"later,\" using October 15 as a cut-off. We assessed demographics, symptom onset timing, and awareness of contact status as predictors for delayed isolation. We explored reasons for early vs late isolation using key informant interviews.
RESULTS: Among 118 case-patients, 25 (21%) had short, 43 (36%) moderate, and 50 (43%) long delays. Seventy-five (64%) had symptom onset later in the outbreak. Earlier symptom onset increased risk of delayed isolation (crude risk ratio = 1.8, 95% confidence interval (1.2-2.8]). Awareness of contact status and SVD symptoms, and belief that early treatment-seeking was lifesaving facilitated early care-seeking. Patients with long delays reported fear of ETUs and lack of transport as contributors.
CONCLUSIONS: Delayed isolation was common early in the outbreak. Strong contact tracing and community engagement could expedite presentation to ETUs.
摘要：
背景：埃博拉治疗单位（ETU）对埃博拉病患者的早期隔离和护理遏制了疫情的蔓延。我们评估了2022年乌干达苏丹病毒病（SVD）爆发期间ETU进入的时间和相关因素。
方法：我们纳入了2022年9月20日至11月30日发病的RT-PCR证实SVD患者。我们将从症状发作到ETU进入(\'延迟\')的天数归类为短(≤2)，中等（3-5），和长（≥6）；后两者是“延迟隔离”。我们将症状发作时间归类为\'更早\'或\'更晚，\'使用10月15日作为截止日期。我们评估了人口统计，症状发作时间，以及对接触状态的认识是延迟隔离的预测因素。我们使用关键的线人访谈探讨了早期和晚期隔离的原因。
结果：在118例患者中，25（21％）有短，43（36%）中度，和50（43％）长时间延迟。75人(64%)在疫情爆发后期出现症状。早期症状发作增加了延迟隔离的风险[cRR=1•8,95CI(1•2-2•8)]。对接触状态和SVD症状的认识，相信早期寻求治疗可以挽救生命，这促进了早期寻求护理。长期延误的患者报告担心ETU和缺乏运输作为贡献者。
结论：延迟隔离在爆发早期很常见。强大的联系人跟踪和社区参与可以加快向ETU的演示。
方法：我们纳入了2022年9月20日至11月30日发病的RT-PCR证实SVD患者。我们将从症状发作到ETU进入(\'延迟\')的天数归类为短(≤2)，中等（3-5），和长（≥6）；后两者是“延迟隔离”。我们将症状发作时间归类为\'更早\'或\'更晚，\'使用10月15日作为截止日期。我们评估了人口统计，症状发作时间，以及对接触状态的认识是延迟隔离的预测因素。我们使用关键的线人访谈探讨了早期和晚期隔离的原因。
结果：在118例患者中，25（21％）有短，43（36%）中度，和50（43％）长时间延迟。75人(64%)在疫情爆发后期出现症状。早期症状发作增加了延迟隔离的风险[cRR=1•8,95CI(1•2-2•8)]。对接触状态和SVD症状的认识，相信早期寻求治疗可以挽救生命，这促进了早期寻求护理。长期延误的患者报告担心ETU和缺乏运输作为贡献者。
结论：延迟隔离在爆发早期很常见。强大的联系人跟踪和社区参与可以加快向ETU的演示。
