Characterizing Musculoskeletal Sequelae in Ebola Virus Survivors During the 7 Years Since Hospital Discharge in Eastern Sierra Leone - Report - MDSpire
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Characterizing Musculoskeletal Sequelae in Ebola Virus Survivors During the 7 Years Since Hospital Discharge in Eastern Sierra Leone
Musculoskeletal Complications in Ebola Survivors Seven Years Post-Discharge
Overview
Ebola virus disease survivors in Eastern Sierra Leone exhibited persistent musculoskeletal sequelae, primarily joint pain and tenderness, up to seven years after hospital discharge. These sequelae generally decreased over time but showed fluctuations, with the highest rates observed in survivors aged 15–40 years.
Background
Ebola virus disease (EVD) survivors often experience post-Ebola syndrome (PES), characterized by heterogeneous symptoms including musculoskeletal (MSK) complaints such as joint and muscle pain. Understanding the long-term trajectory of these sequelae is critical as the number of survivors increases with ongoing outbreaks. Previous studies have been limited to short-term follow-up or lacked physical examination data, underscoring the need for longitudinal analyses to guide management.
Data Highlights
Parameter
Survivors
Household Contacts
P-value
Median Age (years)
29
19
<.001
MSK Signs at Enrollment (%)
23.8
7.5
<.001
MSK Symptoms at Enrollment (%)
38.9
9.0
<.001
Joint Pain Reported (%)
38.4
NA
NA
Muscle Pain Reported (%)
23.8
NA
NA
Joint Tenderness to Palpation (%)
17.0
NA
NA
Abdominal Tenderness (%)
11.1
NA
NA
Decreased Joint Range of Motion (%)
10.6
NA
NA
Joint Edema/Effusion (%)
2.1
NA
NA
Key Findings
At enrollment, 23.8% of survivors exhibited MSK signs on physical exam versus 7.5% of household contacts (P < .001).
38.9% of survivors reported current MSK symptoms compared to 9.0% of contacts (P < .001).
Joint pain (38.4%) and joint tenderness to palpation (17%) were the most common MSK sequelae among survivors.
Survivors aged 15–40 years had the highest rates of MSK sequelae, with 3.1 times higher odds of MSK signs compared to those under 15 years (P = .02).
MSK sequelae generally decreased over the 7-year follow-up but showed fluctuations.
Shorter time from ETU discharge was associated with higher likelihood of MSK signs and symptoms.
Clinical Implications
Clinicians should be aware that musculoskeletal complications can persist for many years in Ebola survivors, particularly in those aged 15–40 years. Regular monitoring and targeted management of joint pain and tenderness may improve quality of life. Recognizing the fluctuating nature of these sequelae is important for long-term care planning.
Conclusion
Musculoskeletal sequelae remain a significant component of post-Ebola syndrome up to seven years post-discharge, with the highest burden in young to middle-aged adult survivors. Longitudinal follow-up is essential to optimize management strategies for these chronic complications.
References
Author/Source/Year -- Evaluating Musculoskeletal Complications in Ebola Virus Survivors Seven Years Post-Hospital Discharge in Eastern Sierra Leone
by Anna C Sanford, Nell G Bond, Emily J Engel, Foday Alhasan, Michael Gbakie, Fatima Kamara, Lansana Kanneh, Ibrahim Mustapha, Mohamed Yillah, Donald Grant, Robert Samuels, John S Schieffelin
