Post-Ebola Syndrome Among Ebola Virus Disease Survivors in Montserrado County, Liberia

ABSTRACT
Introduction 
An increased number of survivors have emerged from the 2014 West African Ebola Virus Disease outbreak. Fifty percent of survivors have reported a combination of physical and psychological symptoms termed Post-Ebola Syndrome. However, these physical and psychological symptoms reported by survivors during convalescence is not well understood. This is due to the high case fatality rates of previous outbreaks, fewer patients surviving and the existence of limited literature that has contributed to the phenomenon of Post-Ebola Syndrome. Also, 58% of survivors in Liberia resides in Montserrado County. A county of which the magnitude of Post-Ebola Syndrome among EVD survivors is unknown. Therefore, the study aim was to estimate the prevalence of Post-Ebola Syndrome among EVD survivors in Montserrado County. Method  An assessment was conducted to determine the prevalence, types, onset, duration and socio-economic challenges of Post-Ebola Syndrome among survivors .The study adopted a cross-sectional design. Quantitative data was collected using semi-structured questionnaire while, qualitative data was collected using an interview guide. A total of 300 respondents were stratified by the health districts and randomly selected from the seven health districts in Montserrado County. During the study data were collected for
the following variables; Ebola survivors demographic, prior and post- Ebola health history, and socio-economic status. Result Prevalence of Post-Ebola Syndrome among study participants was 91.3% (274/300). The commonest symptoms were reported from the following systems of the human body; Neurological System 35% (eyes problem 44%, headache 50.7%, sleep disorder 21.3%, unusual tiredness 25.7%) and Musculoskeletal System 34% (abdominal pain 22.8%, chest pain 21.6%, muscles pain 32.8% and joints pains 59%). The onset of Post Ebola Syndrome occurred more frequently between the first 1-12 weeks after discharged from a treatment unit.  Symptoms were intermittent and persist uP to 12 months after discharged from a treatment center. Fifty- five percent (165/300), of Ebola survivors, were unemployed and 72% (197/274) of those with Post-Ebola Syndrome had accessed health care. Of those accessing health care, 50% (99/197) have never improved with treatment due to inadequate drugs, limited health facilities and lack of hired specialists, while 11.6% (23/197) had somehow improved. Fifty- eight percent (173/300) of survivors had been stigmatized upon discharge from the ETU.  Conclusion: Prevalence of Post-Ebola Syndrome in Montserrado County, Liberia is high. Due to the newness of Post-Ebola Syndrome in Liberia, there is a need for the Ministry of Health, Liberia and its Partners to provide adequate drugs for appropriate health conditions, and hired specialists for the commonest reported symptoms at facilities rendering health services to EVD survivors.