Ebola Reduces Visual Quality of Life in Pediatric Patients

Ebola virus particles
String-like Ebola virus particles are shedding from an infected cell in this electron micrograph. (Photo by: NIH/NAID/IMAGE.FR/BSIP/Universal Images Group via Getty Images)
Both children infected and their parents or caretakers demonstrated a significantly lowered emotional functioning, researchers report.

Among children who survived ebola virus disease (EVD), both health- and vision-related quality of life are poor, according to findings published in eClinical Medicine.

This cross-sectional observational study was performed at the Lowell and Ruth Gess Kissy Eye Hospital in Sierra Leone in 2018. Survivors of pediatric EVD (n=23) and their close contacts (n=58) were evaluated by the Pediatric Quality of Life Inventory Version 4.0 (PedsQL), Effect of Youngsters Eyesight on Quality-of-Life (Eye-Q), and Revised Child Anxiety and Depression Scale (RCADS).

The survivors and close contact cohorts comprised 60.9% and 44.8% boys, aged a mean 11.5±3.8 and 9.1±4.3 years, respectively.

Ocular characteristics were similar between the survivors and close contacts, except that more of the survivors had uveitis (10.8% vs 1.72%; P =.03).

The survivors had numerically lower parent-reported EYE-Q total scores (mean, 49.14 vs 58.56; P =.15), visual function (mean, 48.27 vs 57.56; P =.18), uveitis-related quality of life (mean, 45.78 vs 55.32; P =.15), and PedsQL total scores (mean, 60.73 vs 66.18; P =.17) and higher RCADS total scores (mean, 62.00 vs 58.63; P =.33) and lower child-reported EYE-Q total scores (mean, 60.10 vs 63.21; P =.34), visual function (mean, 59.33 vs 63.80; P =.58), uveitis-related quality of life (mean, 54.98 vs 58.61; P =.34), PedsQL (mean, 67.32 vs 71.61; P =.14), and significantly higher RCADS total scores (mean, 49.36 vs 45.15; P =.045).

For the individual components of the PedsQL score, the parents reported significantly lower emotional functioning for the survivors (mean, 57.68 vs 68.40; P =.02) and the children tended to report lower emotional functioning (mean, 63.20 vs 69.14; P =.06). No other group differences were observed, except that the survivors tended to report poorer school functioning (mean, 57.97 vs 65.36; P =.07).

Among all children, stratifying individuals by the presence of 1 or more ocular complication revealed significant detriments to total vision, visual function, and quality of life (all P <.05).

The major limitation of this study was the small sample sizes. Additional, larger trials are needed to evaluate the long-term visual and quality of life outcomes after surviving EVD.

Survivors of EVD and their close contacts were found to have poor health- and vision-related quality of life, especially among children with one or more ocular complications.

Reference

Shantha JG, Canady D, Hartley C, et al. Ophthalmic sequelae and psychosocial impact in pediatric ebola survivors. EClinicalMedicine. 2022;49:101483. doi:10.1016/j.eclinm.2022.101483