Evaluation of the Efficacy of Ribavirin Therapy on Survival of Crimean-Congo Hemorrhagic Fever Patients: a Case-Control Study

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  • Izadi Shahrokh
    Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Chabahar International Branch, I. R. Iran
  • Salehi Masoud
    Research Center for Infectious Diseases and Tropical Medicine, Zahedan University of Medical Sciences, I. R. Iran

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<p>The mortality rate resulting from Crimean-Congo hemorrhagic fever (CCHF) has been reported in different epidemics to range from 5% to more than 70%. While ribavirin has been recommended as the drug of choice in the treatment of CCHF, no consistent study has unequivocally demonstrated its effectiveness. Using the case-control method, we attempted to evaluate the efficacy of ribavirin in reducing mortality among CCHF cases admitted to Boo-Ali Educational Hospital in Zahedan, Iran, during the years 2000 to 2006. Sixteen deaths among CCHF cases were compared with 47 cases of survival. All patients had a definitive diagnosis based on the results of IgG and IgM capture ELISA tests recorded in their files. Ribavirin therapy for patients who survived had begun on average approximately 24 h earlier than the initiation of ribavirin therapy in the cases of death (P = 0.033), and about 2 days earlier in non-bleeding survivors than in bleeding survivors (P = 0.013). Based on the results of a multivariable analysis, the most important variables found to enhance survival were the time interval between the disease onset and ribavirin prescription (P = 0.004), the time interval between bleeding onset and ribavirin prescription (P = 0.037), and the time interval between disease onset and bleeding onset (P = 0.014). Based on our findings, ribavirin appears to exert a marked effect on disease outcome, especially when it is prescribed within the first 4 days of the disease.<tt> </tt></p>

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