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Volume 30, Number 11—November 2024
Online Report

Rapid Decision Algorithm for Patient Triage during Ebola Outbreaks

Denis-Luc Ardiet1Comments to Author , Justus Nsio1, Gaston Komanda, Rebecca M. Coulborn, Emmanuel Grellety, Francesco Grandesso, Richard Kitenge, Dolla L. Ngwanga, Bibiche Matady, Guyguy Manangama, Mathias Mossoko, John K. Ngwama, Placide Mbala, Francisco Luquero, Klaudia Porten, and Steve Ahuka-Mundeke
Author affiliation: Epicentre, Paris, France (D.-L. Ardiet, G. Komanda, R.M. Coulborn, E. Grellety, F. Grandesso, F. Luquero, K. Porten); Ministry of Health, Kinshasa, Democratic Republic of the Congo (J. Nsio, R. Kitenge, D.L. Ngwanga, B. Matady, M. Mossoko, J.K. Ngwama); Médecins Sans Frontières France, Paris (G. Manangama); Institut National de la Recherche Biomédicale, Kinshasa (P. Mbala, S. Ahuka-Mundeke); University of Kinshasa, Kinshasa (S. Ahuka-Mundeke)

Main Article

Table 1

Diagnostic performance statistics when applying the EVD-prediction score of a rapid decision algorithm for patient triage during Ebola outbreaks to a testing population derived from EVD-suspected patients, Democratic Republic of the Congo, during epidemics in 2018–2019*

Parameter Threshold
≥−2 ≥−1 ≥0 ≥1 ≥2 ≥3 ≥4 ≥5
Sensitivity, % (95% CI) 100 (98.8–100) 97.5 (95.1–98.9) 88.1 (84.0–91.4) 55.1 (49.5–60.7) 30.4 (25.4–35.8) 13.8 (10.2–18.1) 6.3 (3.9–9.5) 1.3 (0.3–3.29)
Specificity, % (95% CI) 1.6 (1.4–1.7) 10.8 (10.3–11.3) 33.0 (32.2–33.7) 70.4 (69.6–71.1) 89.9 (89.4–90.4) 97.7 (97.4–97.9) 99.6 (99.5–99.7) 100 (99.9–100)
PPV, % (95% CI) 2.3 (2.0–2.5) 2.4 (2.2–2.7) 2.9 (2.6–3.3) 4.1 (3.5–4.7) 6.4 (5.2–7.8) 11.9 (8.8–15.7) 27.4 (17.6–39.1) 36.4 (10.9–69.2)
NPV, % (95% CI) 100 (98.3–100) 99.5 (99.0–99.8) 99.2 (98.9–99.4) 98.6 (98.3–98.8) 98.3 (98.0–98.5) 98.0 (97.8–98.3) 97.9 (97.7–98.1) 97.8 (97.5–98.0)
LR+ (95% CI) 1.0 (1.0–1.0) 1.1 (1.1–1.1) 1.3 (1.3–1.4) 1.9 (1.7–2.1) 3.0 (2.5–3.6) 6.0 (4.4–8.0) 16.6 (10.0–27.4) 25.1 (7.4–85.4)
LR− (95% CI) 0.0 (0.0–0.0) 0.23 (0.12–0.46) 0.36 (0.27–0.49) 0.64 (0.56–0.72) 0.77 (0.72–0.83) 0.88 (0.84–0.92) 0.94 (0.91–0.97) 0.99 (0.98–1.0)

*The algorithm (version 4.2) considered all times-to-presentation (time from symptom onset to seeking care). EVD, Ebola virus disease; LR−, likelihood ratio of negative; LR+, likelihood ratio of positive; NPV, negative predictive value; PPV, positive predictive value.

Main Article

1These authors are co–principal investigators and contributed equally to this article.

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