P6 Comparison of children testing negative and positive for Ebola virus disease in Ebola holding units, Sierra Leone

Background The West African Ebola virus disease (EVD) outbreak decimated fragile health systems. The paediatric case definition of EVD is broad, and the symptoms non-specific meaning many children are admitted to Ebola Holding Units (EHUs) as suspect cases who subsequently test negative. Little is known about the characteristics or outcome of these children and caregivers, or their risk of nosocomial EVD infection. Aim To compare features at presentation in children testing negative and positive for EVD To describe outcomes of children admitted to EHUs who test negative for EVD Method All children admitted to 11 EHUs in the Western Area, Sierra Leone from 8/14–3/15 aged Results 1059 children were admitted, 309 (29%) testing positive and 750 (71%) negative for EVD, with outcomes available for 91% and 99% respectively. Children testing negative were younger (Median 3 years IQR 1–7 years, versus 4 years, IQR 1.25–8 years, crude OR for each additional year 1.16, 95% CI 1.13–1.21) with a lower case fatality rate (12% vs. 58%, p Conclusion Clinically distinguishing between children with and without EVD at admission is extremely challenging. There is urgent need for evaluation of sensitive and specific point of care tests for EVD in children. Furthermore, in a spacious and well designed Red Zone alongside handwashing advice, the risks of nosocomial transmission of EVD can be low to caregivers admitted with children who test negative.