Izudi · Journal of infection and public health 2024 · systematic review and meta-analysis · n=42 outbreaks

Case fatality rate for Ebola disease, 1976-2022: A meta-analysis of global data.

Cited 74 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational outbreak and surveillance data

PubMed 37992431 · doi:10.1016/j.jiph.2023.10.020 · record verified 2026-08-30

What was done

Authors conducted a meta-analysis of global Ebola disease (EBOD) data spanning 1976 to 2022 across 16 countries and 42 outbreaks to estimate pooled case fatality rates (CFR) globally, by ebolavirus species, by region, and over time.

What was found

The pooled global CFR for EBOD was 60.6% (95% CI 51.6–69.4; 95% prediction interval 12.9–99.1). Lethality differed across species: Zaire virus CFR was 66.6% (95% CI 55.9–76.8), Sudan virus was 48.5% (95% CI 38.6–58.4), Bundibugyo virus was 32.8% (95% CI 25.8–40.2), and Tai Forest virus was 0% (95% CI 0.0–97.5). The CFR was 61.3% (95% CI 52.8–69.6) in sub-Saharan Africa versus 24.5% (95% CI 0.0–67.9) in the rest of the world. CFR declined over time but remained at 61.0% (95% CI 52.0–69.0) between 2014 and 2022.

Why it matters

This paper establishes a comprehensive global baseline for Ebola mortality, demonstrating that despite advances in care, case fatality remains high and shows major disparities between sub-Saharan Africa and high-resource settings.

Limits

The total number of individual cases is not reported in the abstract. Statistical heterogeneity is high (prediction interval spans 12.9% to 99.1%), confidence intervals for rare species and non-African cases are extremely wide, and underlying drivers of outcome variation (such as supportive care quality or therapeutic access) cannot be determined from the abstract.

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