Health Outcomes, Sequelae, and Physiological Profile of Ebola Survivors with Post-Recovery Syndrome in Sierra Leone: A Retrospective Cross-Sectional Study

Authors

  • Raoul Emeric Guetiya Wadoum Department of Public Health, EBK University of Science and Technology, Makeni, Sierra Leone
  • Stephen Sevalie 34th Regimental Military Hospital, Freetown, Sierra Leone
  • Andrew Clarke Global Health Division, Save the Children UK, London, UK
  • Hawa Mariama Sesay Department of Microbiology and Immunology, EBK University of Science and Technology, Makeni, Sierra Leone
  • Hassan Rogers Department of Public Health, EBK University of Science and Technology, Makeni, Sierra Leone
  • Sherryl Bangura Sierra Leone Association of Ebola Survivors Port Loko Branch (SLAESPL), Port Loko, Sierra Leone
  • Mariatu Kargbo Sierra Leone Association of Ebola Survivors Port Loko Branch (SLAESPL), Port Loko, Sierra Leone
  • Joseph Marah 34th Regimental Military Hospital, Freetown, Sierra Leone
  • Gbassay Caulker 34th Regimental Military Hospital, Freetown, Sierra Leone
  • Abdul H. Kamara Sierra Leone Association of Ebola Survivors Port Loko Branch (SLAESPL), Port Loko, Sierra Leone
  • Jamil Bangura Sierra Leone Association of Ebola Survivors Port Loko Branch (SLAESPL), Port Loko, Sierra Leone
  • Alie F. Kamara Sierra Leone Association of Ebola Survivors Port Loko Branch (SLAESPL), Port Loko, Sierra Leone
  • Christiana S. Sesay Department of Public Health, EBK University of Science and Technology, Makeni, Sierra Leone
  • Maurizio Mattei Department of Biology, University of Rome Tor Vergata, Rome, Italy
  • Carla Montesano Department of Biology, University of Rome Tor Vergata, Rome, Italy
  • Vittorio Colizzi Faculty of Science and Technology, Evangelical University of Cameroon, Bandjoun, Cameroun
  • Maurice B. Kargbo Department of Agriculture and Food Security; EBK University of Science and Technology, Makeni, Sierra Leone
  • Alhaji B. Gogra Department of Basic Sciences; EBK University of Science and Technology, Makeni, Sierra Leone
  • Edwin J. J. Momoh Department of Agriculture and Food Security; EBK University of Science and Technology, Makeni, Sierra Leone

DOI:

https://doi.org/10.4314.3.9

Abstract

Background: Towards the end of the 2014 – 2016 Ebola Virus Disease outbreak in Sierra Leone, the government and its partners established specialized clinics to provide integrated primary healthcare services for survivors. These services aimed to address the complex health challenges faced by survivors after discharge from the Ebola Treatment Units (ETU), many of whom developed post-Ebola syndrome. These survivors continue to suffer a range of physiological and physical problems that directly affect their general well-being. This study describes the health outcomes and physiological profiles of Ebola Virus Disease survivors, focusing on nutritional parameters as proxies for physiological status.

Materials and Methods: Data was collected from medical records and questionnaires at two clinics, the 34th Regimental Military Hospital Ebola Survivors Clinic in Freetown and a Mobile Health Clinic (MHC) operating in Bombali and Port Loko districts. This study period was from February, 2015 to December 2016 and included 166 EVD survivors (49 men and 117 women), aged 19 – 65 paired with a control group of 113 household contacts (69 men and 44 women). The data collected covered self-reported health statuses, anthropometric measurements and physiological parameters recorded from baseline visits. Body Mass Index (BMI) was used as a measure of overall physical status to capture both the health outcomes and broader physiological profiles of survivors.

Results: Sequelae were significantly more frequent among survivors than household contacts (p < .05). The most common nutritional sequelae included diarrhoea (43.4%), loss of appetite (41.6%), and nausea/vomiting (37.9%). Survivors had a significantly higher mean BMI than household contacts (p = .004), with the opposite pattern observed for height (p < .001) and weight (p = .023). Among survivors, the mean BMI was 24.73±4.9 Kg/m² (range, 14.7 – 53.4 Kg/m²), with 51.8% having a normal BMI, 4.8% being underweight, 30.7% overweight, and 12.7% obese. Significant differences were observed between gender and BMI categories (x² = 16.420; df = 3; p = .001), with female EVD survivors more likely to be obese (17.1%). While there was a low positive non-significant association between survivors' BMI and duration at the ETU (r = .107, p = .25), a significant low positive association was found between survivors' age and ETU duration (r = .31, p = .001). The regression model was not significant in predicting most nutritional sequelae; but, it did

 

significantly predict nausea/vomiting as nutritional sequelae (χ² [5] = 11.69, p = .039), with female survivors at greater odds.

Conclusion: This study highlights the importance of addressing complex health challenges faced by EVD survivors with post – Ebola syndrome. To improve access to necessary care and enhance health outcomes, we recommend exempting EVD survivors from premium payments under the Sierra Leone Social Health Insurance (SLeSHI) scheme to facilitate better access to healthcare services, particularly interventions supporting their recovery and long-term well-being.

Keywords: Ebola Survivors, Post – Ebola Syndrome, Health Outcomes, Physiological Profile, Nutritional Sequelae

 

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Published

2026-06-12

Issue

Vol. 16 No. 3 (2026): May 2026

Section

Original Articles

License

Submission of manuscripts to the Sierra Leone Journal of Biomedical Research is of the understanding that the article either in part or whole is not under consideration for publication in any other Journal. Accepted papers become the permanent property of Sierra Leone Journal of Biomedical Research but unrestricted use, distribution, and reproduction in any medium is permitted, provided the original work is properly cited.