Grant: Operating Grant: Innovative Ebola Research Grants: Health system impacts

With over 27000 cases reported, and an estimated case fatality rate of 50-70%, there are about 10000 to 15000 survivors of the current Ebola Virus Disease outbreak. There is an unprecedented and urgent need to better understand the health effects and future health systems needs of these patients, some of whom are losing their sight and hearing, and are unable to access appropriate care. For the first year of the outbreak, health systems and international partners were completely overwhelmed and the response was reactive, struggling to provide essential services for the acutely infected with little attention paid to Ebola survivors. It has now become apparent that those surviving acute infection are suffering disabling complications ranging from blindness and hearing loss, to pain syndromes and post-traumatic stress. Similar health problems have been described anecdotally or in small studies from prior outbreaks and demonstrate persistence for as long as 2 years after acute infection. We propose to examine the clinical features of post-Ebola syndrome through a prospective cohort study in Sierra Leone, that will among other things, systematically describe the clinical course and complications in a group of adults and children who have recovered from acute Ebola infection. We will look at the effects of post-Ebola syndrome on mental health, health related quality of life and functional status, as well as socioeconomic impacts. Our team is uniquely placed to combine extensive frontline experience delivering clinical care to Ebola patients with acute infection and post-Ebola syndrome, with technical expertise in conducting clinical and public health research in sub-Saharan Africa. Our research collaborators include government decision makers and international partners in Sierra Leone and at the World Health Organization, who will rapidly use results to inform programs for Ebola survivors as well as influence planning for future outbreaks.