Female reproductive health outcomes associated with survival of Ebola virus disease and Lassa fever in a Sierra Leonean cohort
Description
Ebola Virus Disease (EVD) and Lassa Fever (LF) are viral hemorrhagic fevers with both acute and longitudinal impacts in West Africa. Previous published literature indicates that female Ebola survivors may experience adverse reproductive health outcomes following disease survival. However, the pathophysiological mechanisms facilitating these phenomena are not well established. This study aims to conduct a systematic literature review to synthesize the existing knowledge of reproductive health outcomes in female EVD and LF survivors. Moreover, this study will analyze data from the EVD and LF Survivor Study in Kenema, Sierra Leone to determine the prevalence of reproductive health makers in a cohort of EVD/LF survivors and. Finally, this study includes a laboratory analysis to explore possible pathophysiological mechanism facilitating reproductive health changes in VHF survivors. The present study found that EVD survivors were at a significantly higher risk of experiencing missed periods compared with controls. However, no significant differences were found between menstrual irregularities in LF survivors in controls, indicating this phenomenon might be attributed to a specific aspect of EVD. Further, EVD survivors who reported missed periods were significantly more likely to experience weight loss, depression, and anxiety. Laboratory analysis found an increased trend of hyperthyroidism in EVD survivors reporting missed periods compared to contacts as well as significantly lower Albumin levels in EVD survivors reporting missed periods compared to those without missed periods. The analysis did not support Premature Ovarian Failure or reduced ovarian reserve as facilitating mechanisms in missed periods among EVD survivors.