Disabilities persist in Ebola survivors 1 year after illness

Survivors of the West African Ebola virus epidemic demonstrated limitations in mobility, vision and cognition a year after recovering from their infection, study data showed.

“The scale of the [2014 to 2016] West African Ebola outbreak has resulted in an unprecedented number of survivors and the opportunity to vastly improve the understanding of the health challenges they face,” Soushieta Jagadesh, MBBS, of the Liverpool School of Tropical Medicine, and colleagues wrote. “In early convalescence from Ebola virus disease, ocular, musculoskeletal and neuropsychiatric sequelae are common. Reports from the Bundibuygo and Kikwit outbreaks suggest there are also long-term complications.”

The researchers performed a retrospective cohort study of 27 Ebola virus disease (EVD) survivors and 54 contacts (two contacts per survivor) who were recruited from a clinic in Freetown, Sierra Leone. Jagadesh and colleagues used the Washington Group-Disability Extended Questionnaire to measure participants’ self-reported physical and mental impairments. Survivors were mostly female (77.8%; n = 21) and aged older than 25 years (77.8%).

Significantly more EVD survivors than contacts reported disability in at least one of six categories (adjusted OR = 23.5; 95% CI, 6.5-85.7), the researchers reported. EVD survivors were more likely to have blurred vision (OR = 7.6; 95% CI, 2-27.9), and they had significantly higher mean pain scores (mean difference, 2.51; 95% CI, 1.33-3.69), as well as higher fatigue (2.23; 95% CI, 1.36-3.09), anxiety (1.89; 95% CI, 0.52-3.27) and depression scores (3.32; 95% CI, 1.95-2.59). Female survivors had significantly higher mean pain scores compared with male survivors (3.12; 95% CI, 0.88-5.36), although pain levels were similar between sexes among controls. Survivors of Ebola also had significantly greater subjective difficulties with memory or concentration (33.3% vs. 0%; P < .001).

“The magnitude of Ebola survivors reporting one or more disabilities was unprecedented,” Jagadesh told Infectious Disease News. “The disability study reflects the poor quality of life perceived by the survivors in comparison to their close contacts. The survivors continue to be in need of frequent visits to health care [providers] over a year following their discharge — such as needing frequent optometry visits, visits to physicians for pain medication, mental health counselling, etc. We believe that early management of Ebola sequelae and long-term sustainable rehabilitation are essential in post-EVD care.” – by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.