Lassa Fever Induced Hearing Loss: The Neglected Disability of Hemorrhagic Fever

Ficenec, Samuel C.; Percak, Jeffrey; Arguello, Sara L; Bays, Alison M.; Goba, Augustine; Gbakie, Michael; Shaffer, Jeffrey G.; Emmett, Susan D.; Schieffelin, John S.; Bausch, Daniel G.

doi:10.1016/j.ijid.2020.08.021

Cited by 18 publications

(12 citation statements)

References 54 publications

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“…The more common viral etiologies include CMV, rubella, mumps, and tropical pathogens such as chikungunya, Zika, and Lassa fever viruses [ 16 , 33 , 42 – 49 ]. Although previous studies have suggested that direct viral damage to structures of the inner ear such as the stria vascularis, cochlea, and neuronal damage may be responsible in mumps and rubella, a host immune response to viral antigens in CMV, or the development of a vasculitis or autoimmune disease as in Lassa fever have been hypothesized [ 16 , 45 ]. However, definitive evidence of any mechanism of pathogenesis is limited.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of Post-Ebola Syndrome hearing loss, Sierra Leone

Ficenec

Grant

Sumah³

et al. 2022

BMC Infect Dis

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Background Globally, hearing loss is the second leading cause of disability, affecting approximately 18.7% of the world’s population. However, the burden of hearing loss is unequally distributed, with the majority of affected individuals located in Asia or Sub-Saharan Africa. Following the 2014 West African Ebola Outbreak, disease survivors began to describe hearing loss as part of the constellation of symptoms known as Post-Ebola Syndrome. The goal of this study was to more fully characterize hearing loss among Ebola Virus Disease (EVD) survivors. Methodology and principal findings EVD survivors and their household contacts were recruited (n = 1,12) from Eastern Sierra Leone. Each individual completed a symptom questionnaire, physical exam, and a two-step audiometry process measuring both air and bone conduction thresholds. In comparison to contacts, EVD survivors were more likely to have complaints or abnormal findings affecting every organ system. A significantly greater percentage of EVD survivors were found to have hearing loss in comparison to contacts (23% vs. 9%, p < 0.001). Additionally, survivors were more likely to have bilateral hearing loss of a mixed etiology. Logistic regression revealed that the presence of any symptoms of middle or inner ear (p < 0.001), eye (p = 0.005), psychiatric (p = 0.019), and nervous system (p = 0.037) increased the odds of developing hearing loss. Conclusions and significance This study is the first to use an objective and standardized measurement to report hearing loss among EVD survivors in a clinically meaningful manner. In this study it was found that greater than 1/5th of EVD survivors develop hearing loss. The association between hearing impairment and symptoms affecting the eye and nervous system may indicate a similar mechanism of pathogenesis, which should be investigated further. Due to the quality of life and socioeconomic detriments associated with untreated hearing loss, a greater emphasis must be placed on understanding and mitigating hearing loss following survival to aid in economic recovery following infectious disease epidemics.

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Section: Discussionmentioning

confidence: 99%

The prevalence of Post-Ebola Syndrome hearing loss, Sierra Leone

Ficenec

Grant

Sumah³

et al. 2022

BMC Infect Dis

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“…There were both unilateral and bilateral cases of hearing loss. Ficenec et al [15] reported 30% cases of bilateral hearing loss, while Cummins et al [13] reported 50% cases of bilateral hearing loss.…”

Section: Hearing Loss Among Lassa Fever Patientsmentioning

confidence: 99%

“…Mertens et al reported an incidence of 30% in Liberia [11]. Ibekwe reported an incidence of 13.5% in Nigeria [14] and Ficenec et al reported an incidence of 17% in Sierra Leone [15]. All these countries are in Lassa fever endemic region in West Africa.…”

Section: Open Journal Of Preventive Medicinementioning

confidence: 99%

Hearing Loss in Lassa Fever: A Systematic Review

Chime¹,

Chime²,

Nwosu³

2022

OJPM

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Background: Lassa fever is a viral haemorrhagic fever associated with several complications which include hearing loss. Hearing loss in Lassa fever may become residual with its negative impact on the quality of life. Purpose: This paper is a review of various studies on Lassa fever related hearing loss. Methods: Systematic literature review was done on articles on Lassa fever patients and Lassa fever survivors. Relevant articles published in English between 1969 and 2021 were searched for using Google Scholar and PubMed databases. Eight studies which met the inclusion criteria were finally selected and included in the review. The variables of interest were extracted from the full-text articles. Results: Lassa fever related hearing loss occurs in both sexes and in all age groups. The incidence of self-reported hearing loss ranged from 12.5% to 30% with a mean of 17.6%. The incidence of audiometrically determined sensorineural hearing loss ranged from 13.5% to 29% with a mean of 22.1%. Hearing loss persisted in 64% of those that were followed up. Cases of hearing loss varied in severity, ranging from mild to profound. No successful specific treatment for Lassa fever related hearing loss was reported apart from hearing rehabilitation. Conclusion: Hearing loss among Lassa fever patients remains a major challenge. Lack of effective treatment for Lassa fever related hearing loss is a serious gap in the management of Lassa fever patients which should be addressed in future research.

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“…Four of the 22 imported Lassa fever cases (18.2%) had hearing loss. Hearing loss is a common finding among Lassa fever patients in the endemic region, especially when assessed by pure tone audiometry rather than by self-reported hearing loss [43]. Because Lassa fever related hearing loss is not among the early symptoms of Lassa fever, it may not be a very helpful diagnostic symptom if an early diagnosis of Lassa fever is desired.…”

Section: Findings Of Clinical Features Of Lassa Fever Cases Inmentioning

confidence: 99%

Clinical Presentations of Lassa Fever in Non-Endemic Parts of the World: A Systematic Review

Chime¹,

Chime²,

Ezeanolue³

2022

IJCM

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Background: Lassa fever cases outside Africa are seen as imported cases of Lassa fever. Timely diagnosis of imported Lassa fever is important for timely intervention necessary to reduce the morbidity and mortality associated with Lassa fever, and this requires the knowledge of the clinical manifestations of Lassa fever. Purpose: This review was done to see how clinical diagnosis of imported Lassa fever can be facilitated based on the clinical presentations of imported cases of Lassa fever in Lassa fever non-endemic region. Methods:The relevant articles for the review were obtained from the databases of PubMed and Google Scholar. Results: The clinical presentations of the imported Lassa fever cases consisted of multisystem involvement and were similar to those of Lassa fever patients who were treated in the Lassa fever endemic region. Conclusions: History of recent travel to, or residence in, Lassa fever endemic region is an important clue for clinical diagnosis of Lassa fever. The 2011 CDC surveillance case definition and the modified Khan case definition for Lassa fever may aid clinical diagnosis of Lassa fever. Any clinically suspected case of Lassa fever should have a laboratory confirmation.

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Lassa Fever Induced Hearing Loss: The Neglected Disability of Hemorrhagic Fever

Cited by 18 publications

References 54 publications

The prevalence of Post-Ebola Syndrome hearing loss, Sierra Leone

The prevalence of Post-Ebola Syndrome hearing loss, Sierra Leone

Hearing Loss in Lassa Fever: A Systematic Review

Clinical Presentations of Lassa Fever in Non-Endemic Parts of the World: A Systematic Review

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