Sequelae and Other Conditions in Ebola Virus Disease Survivors, Sierra Leone, 2015

Abstract

We rapidly assessed the health of Ebola virus disease (EVD) survivors in Kenema, Sierra Leone, by reviewing medical charts of all patients attending the Survivor Clinic of Kenema Government Hospital. Data were abstracted on signs and symptoms at every attendance. As of November 2015, a total of 621 attendances by 115 survivors with laboratory-confirmed EVD were made to the Survivor Clinic. Most (60.9%) survivors were women. Survivors' median age was 28 years (range 0.25-70 years). Survivors attended the clinic a median of 5 times (range 1-21 times) each, and the median time from EVD discharge to attendance was 261 days (range 4-504 days). The most commonly reported signs and symptoms among the 621 attendances were headache (63.1%), fever (61.7%), and myalgia (43.3%). Because health needs of EVD survivors are complex, rapid chart reviews at survivor clinics should be repeated regularly to assess the extent of illness and prioritize service delivery.

Keywords: Ebola virus disease; Sierra Leone; sequelae; survivors; viruses.

Figure 1

Hospital discharge and attendances for 115 survivors of laboratory-confirmed Ebola virus disease (EVD) attending the Survivor Clinic at Kenema Government Hospital (KGH), Kenema, Sierra Leone), 2014–2015. A) Discharge from KGH after initial EVD diagnosis for the 88 (76.5%) survivors for whom data were available on date of EVD discharge. B) Dates of the 621 attendances at KGH during convalescence by the 115 EVD survivors.

Figure 2

Frequency of symptoms reported without fever at 238 attendances of survivors of laboratory-confirmed Ebola virus disease (EVD) at the Survivor Clinic, Kenema Government Hospital (KGH), Kenema, Sierra Leone, 2014–2015. A) Overall; B) 4–144 days from KGH discharge after initial EVD diagnosis to Survivor Clinic attendance; C) 145–254 days from discharge to attendance; D) 255–358 days from discharge to attendance; and E) 359–504 days from discharge to attendance. Eye problems comprise eye irritation, eye pain, eye discharge, itchy eye, poor vision, or blurred vision. Amenorrhea was recorded only for women (age range 15–40 years) and erectile dysfunction only for men (age range 24–35 years). Chest burn is a local term for heartburn.

Figure 3

Frequency of symptoms reported at 621 attendances with and without reported fever by 115 survivors of laboratory-confirmed Ebola virus disease at the Survivor Clinic, Kenema Government Hospital, Kenema, Sierra Leone, 2014–2015. Fever was recorded for 61.7% total attendances. Amenorrhea was recorded only for women (age range 15–40 years) and erectile dysfunction only for men (age range 24–35 years). Chest burn is a local term for heartburn. p values are from univariate generalized estimating equations logistic regression analysis. *p<0.01; †p<0.05.

Figure 4

Frequency of symptoms reported by 115 survivors of laboratory-confirmed Ebola virus disease attending the Survivor Clinic, Kenema Government Hospital, Sierra Leone, 2014–2015. Eye problems comprise eye irritation, eye pain, eye discharge, itchy eye, poor vision, or blurred vision. Amenorrhea was recorded only for women (age range 15–40 years) and erectile dysfunction only for men (age range 24–35 years). Chest burn is a local term for heartburn.

Figure 5

Diseases and conditions with at least a 5% frequency diagnosed at 621 attendances by 115 survivors of laboratory-confirmed Ebola virus disease at the Survivor Clinic at Kenema Government Hospital, Kenema, Sierra Leone, 2014–2015. MSP, musculoskeletal pain; PID, pelvic inflammatory disease (women only); RTI, respiratory tract infection.