Depressive symptoms among survivors of Ebola virus disease in Conakry (Guinea): preliminary results of the PostEboGui cohort

Abstract

BackgroundThe 2013–2016 West African Ebola outbreak infected 28,616 people and caused 11,310 deaths by 11 May 2016, across six countries. The outbreak has also resulted in the largest number of EVD survivors in history—over 17,000. Guinea was declared Ebola-free on 1 June 2016. Reports from the outbreak documented 3814 cases resulting in 2544 deaths and 1270 survivors. EVD survivors face various neuropsychological and psycho-affective alterations that have not been fully identified yet. This study aims to document the depressive symptoms among adult survivors in Guinea.MethodsDepressive symptoms were investigated using the French version of the Center for Epidemiologic Studies-Depression Scale (CES-D) administered to all adult survivors (≥ 20 years) participating in the PostEboGui study and receiving care in Conakry. The study was combined with a clinical consultation by a psychiatrist at the Donka National Hospital in Conakry that ensured adapted care was provided when needed.ResultsOverall, 256 adult participants receiving care in Conakry participated in this study: 55% were women, median age 31 years [IQR: 26–40]. The median time since the Ebola Treatment Center (ETC) discharge was 8.1 months [IQR: 4.1–11.7]. 15% had a score above the threshold values indicating psychological suffering (15% for men and 14% for women). 33 people (16 women and 17 men) met with the psychiatrist, which resulted in the diagnosis of 3 cases of post-traumatic stress disorder (PTSD), 3 cases of mild depression, 13 cases of moderate depression, and 11 cases of severe depression, including 1 with kinesthetic hallucinations and another with visual hallucinations, and 1 with suicidal ideation and 3 with attempted suicide. Severe depression was diagnosed between 1 and 19 months after ETC discharge. The various identified forms of depression responded favorably to conventional drug therapies and cognitive behavioral therapy.ConclusionLong-term follow-up for EVD survivors will be necessary to understand the evolution of these pathologies. In the current post-epidemic context, these cases underscore the need to strengthen mental health diagnostic systems and treatment on a national scale.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1280-8) contains supplementary material, which is available to authorized users.

Post‐Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review

“…and receiving constant stares from the public after being discharged from the ETC. In similar studies conducted in Uganda, Sierra Leone and Guinea, EVD survivors reported feelings of frustration, anger, sadness and worthlessness due to a decline in quality of life and community neglect . Another Sierra Leonean study by Ji and colleagues reported that symptoms of obsession‐compulsion (83.3%), anxiety (83.3%), hostility (94.4%), phobic anxiety (94.4%) and paranoid ideation (72.2%) were more common among EVD survivors compared to medical staff, logistic staff, medical students and a Chinese medical team .…”

“…The remaining three were cohort studies. Eighteen studies were from the 2013 to 2016 outbreak in West Africa the remaining six are from 1995 to 2012 outbreaks in Eastern Africa . Of the 24 papers, 23 were published in English and one published in French .…”

“…The outcomes of the quality assessment of the included articles are presented in Tables and . Appraisal of the 17 quantitative studies ( n = 17: 11 quantitative cross‐sectional, three mixed methods and three cohorts studies) shows that half (9/17, 52.9%) of the articles adequately addressed the study purpose, literature review, study design, study sample, outcome measures, intervention, data analysis, result, dropouts or exclusions, clinical importance, conclusion and limitations . Poorly reported components were research design , sample size and description , outcome measures (valid and reliable) , results and statistical significance , dropouts/exclusions and limitations .…”

“…In a Guinean cross‐sectional study conducted in the capital Conakry Guinea by Keita et al ., a psychiatrist assessed 33 of the 256 EVD survivors. The 33 EVD survivors reported either mild ( n = 3), moderate ( n = 13) or severe ( n = 11) depression . A cross‐sectional study conducted in Nigeria and which used a General Health Questionnaire to evaluate psychological distress among EVD survivors, seronegative contacts and relatives of survivors, reported that two of the four participating EVD survivors felt unhappy or depressed .…”

High risk of infection caused Posttraumatic Stress symptoms in individuals with poor sleep quality: A study on influence of Coronavirus disease (COVID-19) in China

“…Another study showed that chronic post-SARS symptoms were characterized by sleep-related problems (Moldofsky and Patcai, 2011). Survivors of EVD also reported various sleep quality problems (Keita et al, 2017 In early December 2019, the first pneumonia case was identified in Wuhan, the capital city of Hubei province (Huang et al, 2020). With the spreading of the epidemic, Wuhan became the worst influenced area, where the mortality and incidence rate of COVID-19 were above the national level according to the National Health Commission of China (2020).…”