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. 2022 Jun 3:49:101483.
doi: 10.1016/j.eclinm.2022.101483. eCollection 2022 Jul.

Ophthalmic sequelae and psychosocial impact in pediatric ebola survivors

Jessica G Shantha  1 , Dominick Canady  2 , Caleb Hartley  3 , Amy Cassedy  4 , Chris Miller  5 , Sheila T Angeles-Han  4 , Lloyd C M Harrison-Williams  6 , Matthew J Vandy  6 , Natalie Weil  7 , Gilberte Bastien  2 , Steven Yeh  8   9   10   11
Affiliations

Ophthalmic sequelae and psychosocial impact in pediatric ebola survivors

Jessica G Shantha et al. EClinicalMedicine. .

Abstract

Background: Ebola virus disease (EVD) outbreaks in West Africa (2013-2016) and the Democratic Republic of Congo (2018-2020) have resulted in thousands of EVD survivors who remain at-risk for survivor sequelae. While EVD survivorship has been broadly reported in adult populations, pediatric EVD survivors are under-represented. In this cross-sectional study, we investigated the prevalence of eye disease, health-related quality-of-life, vision-related quality-of-life, and the burden of mental illness among pediatric EVD survivors in Sierra Leone.

Methods: Twenty-three pediatric EVD survivors and 58 EVD close contacts were enrolled. Participants underwent a comprehensive ophthalmic examination and completed the following surveys: Pediatric Quality of Life Inventory Version 4.0, Effect of Youngsters Eyesight on Quality-of-Life, and the Revised Child Anxiety and Depression Scale.

Findings: A higher prevalence of uveitis was observed in EVD survivor eyes (10·8%) cohort compared to close contacts eyes (1·7%, p=0·03). Overall, 47·8% of EVD survivor eyes and 31·9% of close contact eyes presented with an eye disease at the time of our study (p=0·25). Individuals diagnosed with an ocular complication had poorer vision-related quality-of-life (p=0·02).

Interpretation: Both health related quality-of-life and vision-related quality-of-life were poor among EVD survivors and close contacts. The high prevalence of eye disease associated with reduced vision health, suggests that cross-disciplinary approaches are needed to address the unmet needs of EVD survivors.

Funding: National Institutes of Health R01 EY029594, K23 EY030158; National Eye Institute; Research to Prevent Blindness (Emory Eye Center); Marcus Foundation Combating Childhood Illness; Emory Global Health Institute; Stanley M. Truhlsen Family Foundation.

Keywords: Ebola; Ebola virus disease; Emerging infectious diseases; Mental health; Post-Ebola virus disease syndrome; Psychosocial stressors; Uveitis.

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Conflict of interest statement

The funding organizations highlighted above had no role in the design or conduct of this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The authors on this manuscript declare no financial conflicts of interest in relationship to the work presented.

Figures

Fig 1
Figure 1
Representative slit lamp photos of EVD survivors. (A) EVD survivor with vernal keratoconjunctivitis with diffuse conjunctival injection and characteristic Horner-Trantas dots, inflammatory aggregates in circumlimbal distribution (yellow arrows). (B) EVD survivor with dense white cataractous lens with surrounding posterior synechiae form the iris to the lens and pigment on the lens capsule. The patient is legally blind from the cataract associated with uveitis. (C) EVD close contact with a history of severe ocular trauma, dense adhesions from the iris to the cornea (green arrows), posterior synechiae and pigment on the lens capsule.
Fig 2
Figure 2
Relationship of ocular complications (presence or absence) to total vision score, visual function score, and vision related quality of life score. Box and whisker plots denote median with interquartile range (Q1, Q3; Box) and minimum and maximum values (Whiskers) for total vision score, visual function score, and vision related quality of life scores. EVD survivors and close contacts who showed at least one ocular complication showed reduced total vision score, visual function score, and vision related quality of score compared to individuals without an ocular complication. Note: ** indicates statistically significant difference between mean scores (p<0·05).
See this image and copyright information in PMC

References

    1. 2014-2016 Ebola Outbreak in West Africa [Internet]. Cdc.gov. 2020 [cited 2021 Dec 5]. Available from: https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html
    1. Ebola virus disease – Democratic Republic of the Congo [Internet]. Who.int. [cited 2021 Dec 5]. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/ebola-virus-d...
    1. Mattia JG, Vandy MJ, Chang JC, et al. Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study. Lancet Infect Dis. 2016;16(3):331–338. - PMC - PubMed
    1. Clark DV, Kibuuka H, Millard M, et al. Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study. Lancet Infect Dis. 2015;15(8):905–912. - PubMed
    1. Etard J-F, Sow MS, Leroy S, et al. Multidisciplinary assessment of post-Ebola sequelae in Guinea (Postebogui): an observational cohort study. Lancet Infect Dis. 2017;17(5):545–552. - PubMed

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