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Majority of ebola survivors ‘need long-term rehabilitation’

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Eight out of 10 ebola survivors suffer disabilities one year after discharge, highlighting a need for long-term rehabilitation, according to UK researchers.

New research, conducted by the University of Liverpool and Liverpool School of Tropical Medicine, found survivors had major limitations in mobility, cognition and vision.

“Survivors continue to have a higher chance of disability in mobility, cognition and vision”

Soushieta Jagadesh

They noted that the scale of the 2014-16 West African ebola outbreak had resulted in an unprecedented number of survivors.

The researchers compared disability among a cohort of survivors 12 months after discharge from the Ebola Survivors Clinic, 34 Military Hospital (MH34) in Freetown, Sierra Leone, with close contacts.

In total, 27 ebola survivors and 54 unaffected contacts were recruited for the study. The MH34 clinic itself continues to care for over 500 ebola survivors.

Disability was measured using the Washington Group-Disability Extended Questionnaire (WG ES-F). It measured self-reported physical and mental impairments present at the time of the interview.

The questionnaire assessed six domains – vision, hearing, mobility, self-care, communication and cognition – with functionality scores calculated from the severity and frequency of anxiety, depression, pain and fatigability.

Disability in at least one of the six domains was reported by 78% of ebola survivors, compared to 11% controls, said the researchers in the journal Clinical Infectious Diseases.

Differences in physical disability were most marked, with the survivors’ cohort being much more likely to experience difficulty in walking 100m and 500m, climbing 12 stairs or overall moderate difficulty with mobility.

University of Liverpool

Ebola survivor and nedical team

Source: MG Semple

An ebola survivor and medical team at her discharge ceremony from the Ebola Treat Unit 34th Regiment Military Hospital Freetown, Sierra Leone on 5 February 2016

In addition, relative to the controls, the ebola survivors had significantly increased mean pain scores, fatigue scores, anxiety scores and depression scores.

The study also showed that survivors had significantly higher subjective difficulties remembering or concentrating and were eight times more likely than controls to suffer from blurred vision.

Lead researcher Dr Soushieta Jagadesh, said: “We have demonstrated that a year following acute disease, survivors of the West African ebola virus disease outbreak continue to have a higher chance of disability in mobility, cognition and vision than their close-contacts.

“Issues such as anxiety and depression persist in ebola virus disease D survivors and must not be neglected,” she said.

Dr Janet Scott, clinical lecturer at the University of Liverpool, said: “This study highlights that ebola virus disease results in long-term substantial disability.

“Understanding post ebola syndrome could improve our future care of ebola virus disease patients and patients suffering the sequelae of other severe viral infections,” she noted.



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