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Lancet Infect Dis. 2015 Aug;15(8):905-12. doi: 10.1016/S1473-3099(15)70152-0. Epub 2015 Apr 21.

Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study.

Author information

1
Walter Reed Army Institute of Research, Silver Spring, MD, USA; Naval Medical Research Center, Biological Defense Research Directorate, Fort Detrick, MD, USA. Electronic address: dclark@aceso-sepsis.org.
2
Makerere University Walter Reed Project, Kampala, Uganda.
3
Ministry of Health, Kampala, Uganda.
4
US Military HIV Research Program, Bethesda, MD, USA.
5
Walter Reed Army Institute of Research, Silver Spring, MD, USA; US Military HIV Research Program, Bethesda, MD, USA.
6
Virology Division, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA; Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, MD, USA.
7
Diagnostic Systems Division, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
8
Medical Division, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.

Abstract

BACKGROUND:

The limited data available for long-term Ebola virus disease health outcomes suggest that sequelae persist for longer than 1 year after infection. The magnitude of the present outbreak in west Africa necessitates a more complete understanding of the health effects and future medical needs of these patients.

METHODS:

We invited adult survivors of the 2007 Bundibugyo Ebola virus outbreak in Uganda and their contacts to take part in an observational study roughly 29 months after the outbreak. We collected information about health status, functional limitations, and demographics. We collected blood samples for clinical chemistry, haematology, and filovirus antibodies using ELISA. Analyses were restricted to probable and confirmed survivors and their seronegative contacts.

FINDINGS:

We recruited 70 survivors of the 2007 Bundibugyo Ebola virus and 223 contacts. We did analyses for 49 probable and confirmed survivors and 157 seronegative contacts. Survivors of the Bundibugyo Ebola virus were at significantly increased risk of ocular deficits (retro-orbital pain [RR 4·3, 95% CI 1·9-9·6; p<0·0001], blurred vision [1·9, 1·1-3·2; p=0·018]), hearing loss (2·3, 1·2-4·5; p=0·010), difficulty swallowing (2·1, 1·1-3·9; p=0·017), difficulty sleeping (1·9, 1·3-2·8; p=0·001), arthralgias (2·0, 1·1-3·6; p=0·020), and various constitutional symptoms controlling for age and sex. Chronic health problems (prevalence ratio [PR] 2·1, 95% CI 1·2-3·6; p=0·008) and limitations due to memory loss or confusion (PR 5·8, 1·5-22·4; p=0·010) were also reported more frequently by survivors of Bundibugyo Ebola virus.

INTERPRETATION:

Long-term sequelae persist for more than 2 years after Ebola virus disease. Definition of health consequences related to Ebola virus disease could improve patient care for survivors and contribute to understanding of disease pathogenesis.

FUNDING:

Chemical Biological Technologies Directorate, Defense Threat Reduction Agency.

PMID:
25910637
DOI:
10.1016/S1473-3099(15)70152-0
[Indexed for MEDLINE]

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