Lassa fever in post-conflict sierra leone.

Area of Science:

• Infectious Diseases
• Public Health
• Virology

Background:

• Lassa fever (LF) is a deadly hemorrhagic disease caused by Lassa virus (LASV), posing a major threat in West Africa.
• Following Sierra Leone's civil conflict, the LF program at Kenema Government Hospital (KGH), in a high-incidence area, was restored.

Purpose of the Study:

• To analyze Lassa fever trends and outcomes in the post-conflict era at KGH.
• To assess the impact of the restored LF program on disease management and patient outcomes.

Main Methods:

• Electronic organization of clinical and laboratory records for suspected LF patients.
• Utilized recombinant antigen-based immunoassays to detect LASV antigenemia and antibodies.
• Reviewed patient demographics, case fatality rates (CFRs), and treatment responses.

Main Results:

• KGH now manages over 500 suspected LF cases annually, with higher observed CFRs compared to pre-conflict studies.
• LF incidence peaked during the dry season, extending beyond traditional endemic zones across ten districts.
• LASV antigenemia was associated with higher mortality in patients under 29 and pregnant women; ribavirin showed a lower CFR when administered early.

Conclusions:

• Lassa fever continues to be a critical public health issue in Sierra Leone.
• Increased geographic spread suggests a need for expanded outreach and surveillance.
• Urgent improvements in case finding, diagnosis, and treatment are vital to reduce LF mortality, highlighting the need for novel therapies.