Post-Ebola Syndrome Presents With Multiple Overlapping Symptom Clusters: Evidence From an Ongoing Cohort Study in Eastern Sierra Leone
| Autor: | Nell G. Bond, Adaora Okoli, Robert J. Samuels, Michael Gbakie, William A. Fischer, Don Grant, Jeffrey G. Shaffer, Foday Alhasan, David A. Wohl, Robert F. Garry, Ibrahim Mustapha, Fatima Kamara, Emily J Engel, Lansana Kanneh, John S. Schieffelin, Sarah Talia Himmelfarb |
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| Rok vydání: | 2020 |
| Předmět: |
filovirus
Microbiology (medical) long-term sequelae Physical examination Survivorship Disease medicine.disease_cause Logistic regression Sierra leone Viral hemorrhagic fever Disease Outbreaks Sierra Leone Cohort Studies medicine Humans viral hemorrhagic fever Ebola virus medicine.diagnostic_test business.industry Outbreak Syndrome Hemorrhagic Fever Ebola medicine.disease Ebolavirus Major Articles and Commentaries AcademicSubjects/MED00290 Infectious Diseases survivor Ebola business Demography Cohort study |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 |
| Popis: | Background Following the 2013–2016 West African Ebola outbreak, distinct, persistent health complaints were recognized in Ebola virus disease (EVD) survivors. Here we provide an in-depth characterization of post-Ebola syndrome >2.5 years after resolution of disease. Additionally, we report subphenotypes of post-Ebola syndrome with overlapping symptom clusters in survivors from Eastern Sierra Leone. Methods Participants in Eastern Sierra Leone were identified by the Sierra Leone Association of Ebola survivors. Survivors and their contacts were administered a questionnaire assessing self-reported symptoms and a physical examination. Comparisons between survivors and contacts were conducted using conditional logistic regression. Symptom groupings were identified using hierarchical clustering approaches. Simplified presentation of incredibly complex evaluations (SPICE), correlation analysis, logistic regression, and principal component analysis (PCA) were performed to explore the relationships between symptom clusters. Results Three hundred seventy-five EVD survivors and 1040 contacts were enrolled into the study. At enrollment, EVD survivors reported significantly more symptoms than their contacts in all categories (P 2.5 years after disease. The interrelationship between symptom clusters indicates that post-Ebola syndrome is a heterogeneous disease. The distinct musculoskeletal and non-musculoskeletal phenotypes identified likely require targeted therapies to optimize long-term treatment for EVD survivors. This study explored the relationship between groups of symptoms in post-Ebola syndrome. We found that the presentation of post-Ebola syndrome is heterogeneous with distinct subphenotypes that likely require targeted interventions. |
| Databáze: | OpenAIRE |
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