Systematic Review and Meta-Analysis of Female Reproductive Health Following Ebola Virus Disease

The viral hemorrhagic fevers Lassa fever (LF) and Ebola virus disease (EVD) have been documented to cause long-term health problems in survivors. Limited studies have noted the presence of adverse reproductive health outcomes, including menstrual irregularities and pregnancy loss, after recovery from infection. The objective of this systematic review and meta-analysis is to summarize existing knowledge surrounding reproductive health in female survivors of LF and EVD. Literature was gathered from PubMed, Embase, Ovid Medline, Cumulative Index of Nursing and Allied Health (CINAHL) Complete, Web of Science, and Global Health databases and subsequently reviewed in Covidence. Included studies described at least one reproductive health outcome in women after recovery from EVD or LF. Thirteen studies were identified in the systematic review, all of which only discussed reproductive health in EVD survivors. No studies of reproductive health among survivors of LF were identified. The included studies were conducted in Guinea, Sierra Leone, and Liberia, and they reported irregular menstruation, pregnancy loss, decreased libido, pelvic inflammatory disease, sexual dysfunction, female reproductive odor, and genital problems/infections among survivors. In a meta-analysis of nine studies, 14.0% of female EVD survivors experienced any adverse reproductive health outcome. However, there was significant heterogeneity among the included studies. This study highlights the health problems faced by female EVD survivors and underscores the need for more research surrounding the effects of viral hemorrhagic fevers on women's health.