Lassa fever survivors: long-term health effects and chronic sequelae - a scoping review.

introductionLassa fever is a viral haemorrhagic disease endemic to West Africa. While most infections are mild, severe cases have high morbidity and mortality, with case fatality rates ranging from 15% in mild cases to 60% in severe cases. Survivors often experience chronic health complications, but these long-term effects remain understudied despite their public health significance.

objectivesThis scoping review synthesises evidence on the long-term health sequelae of Lassa fever, maps key findings from existing studies, and identifies critical gaps to guide future research and clinical care.

methodsA systematic literature search was conducted in PubMed/MEDLINE, Embase, and Google Scholar (up to September 2024) for English-language studies reporting physical, psychological, and functional outcomes ≥ 4 weeks post-recovery. Studies were selected using PCC framework (Population: Lassa survivors; Concept: Long-term sequelae; Context: Endemic regions globally). PRISMA-ScR guidelines were followed.

resultsNine (9) studies from Nigeria, Sierra Leone and Germany were included, comprising three cross-sectional studies, two case-control studies, two case reports, one retrospective descriptive study and one retrospective cohort study. Hearing loss was the most prevalent sequela (16–35% of survivors), often bilateral and sensorineural with associated balance disorders (55%) and social isolation. Neurological sequelae included delayed-onset paraparesis, seizures (37% in on cohort) and cognitive impairment (8.8%). 42% of survivors in one study had ophthalmic manifestations such as cataract and retinal hemorrhage. Depression and delirium were frequently reported.

conclusionLassa fever has significant long-term health consequences requiring multidisciplinary care. More research, particularly longitudinal and interventional studies is needed to improve post-recovery outcomes, survivor rehabilitation, inform evidence-based policies and guide resource allocation in endemic regions.