{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:06:33Z","timestamp":1792789593376,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Longitudinal analyses are needed to better understand long-term Ebola virus disease (EVD) sequelae. We aimed to estimate the prevalence, incidence, and duration of sequelae and to identify risk factors associated with symptom occurrence among EVD survivors in Guinea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We followed 802 EVD survivors over 48 months and recorded clinical symptoms with their start\/end dates. Prevalence, incidence, and duration of sequelae were calculated. Risk factors associated with symptom occurrence were assessed using an extended Cox model for recurrent events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, the prevalence and incidence of all symptoms decreased significantly over time, but sequelae remained present 48 months after Ebola treatment center discharge with a prevalence of 30.68% (95% confidence interval [CI] 21.40\u201339.96) for abdominal, 30.55% (95% CI 20.68\u201340.41) for neurologic, 5.80% (95% CI 1.96\u20139.65) for musculoskeletal, and 4.24% (95% CI 2.26\u20136.23) for ocular sequelae. Half of all patients (50.70%; 95% CI 47.26\u201354.14) complained of general symptoms 2 years\u2019 postdischarge and 25.35% (95% CI 23.63\u201327.07) 4 years\u2019 post-discharge. Hemorrhage (hazard ratio [HR], 2.70; P = .007), neurologic (HR 2.63; P = .021), and general symptoms (HR 0.34; P = .003) in the EVD acute phase were significantly associated with the further occurrence of ocular sequelae, whereas hemorrhage (HR 1.91; P = .046) and abdominal (HR 2.21; P = .033) symptoms were significantly associated with musculoskeletal sequelae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings provide new insight into the long-term clinical complications of EVD and their significant association with symptoms in the acute phase, thus reinforcing the importance of regular, long-term follow-up for EVD survivors.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciab168","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T12:49:19Z","timestamp":1613998159000},"page":"2166-2174","source":"Crossref","is-referenced-by-count":26,"title":["Understanding Long-term Evolution and Predictors of Sequelae of Ebola Virus Disease Survivors in Guinea: A 48-Month Prospective, Longitudinal Cohort Study (PostEboGui)"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9742-8702","authenticated-orcid":false,"given":"Mamadou Saliou Kalifa","family":"Diallo","sequence":"first","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"},{"name":"Centre de Recherche et de Formation en Infectiologie de Guin\u00e9e, Universit\u00e9 Gamal Abdel Nasser de Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdoulaye","family":"Toure","sequence":"additional","affiliation":[{"name":"Centre de Recherche et de Formation en Infectiologie de Guin\u00e9e, Universit\u00e9 Gamal Abdel Nasser de Conakry, Conakry, Guinea"},{"name":"Institut National de Sant\u00e9 Publique, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou Saliou","family":"Sow","sequence":"additional","affiliation":[{"name":"Donka National Hospital, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9c\u00e9","family":"Kpamou","sequence":"additional","affiliation":[{"name":"Centre de Recherche et de Formation en Infectiologie de Guin\u00e9e, Universit\u00e9 Gamal Abdel Nasser de Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpha Kabinet","family":"Keita","sequence":"additional","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"},{"name":"Centre de Recherche et de Formation en Infectiologie de Guin\u00e9e, Universit\u00e9 Gamal Abdel Nasser de Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Taverne","sequence":"additional","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6738-8730","authenticated-orcid":false,"given":"Martine","family":"Peeters","sequence":"additional","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Msellati","sequence":"additional","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierno Alimou","family":"Barry","sequence":"additional","affiliation":[{"name":"Centre de Recherche et de Formation en Infectiologie de Guin\u00e9e, Universit\u00e9 Gamal Abdel Nasser de Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Francois","family":"Etard","sequence":"additional","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Ecochard","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Service de Biostatistique, Lyon, France"},{"name":"CNRS UMR 5558 Laboratoire de Biom\u00e9trie et Biologie \u00c9volutive, \u00c9quipe Biostatistique-Sant\u00e9, Villeurbanne, France"},{"name":"Universit\u00e9 de Lyon, Lyon, France"},{"name":"Universit\u00e9 Lyon 1, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Delaporte","sequence":"additional","affiliation":[{"name":"IRD\/INSERM\/Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PostEboGui Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahidjo","family":"Ayouba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Baize","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaba","family":"Bangoura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alimou","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moumi\u00e9","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoudou","family":"Ciss\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Ciss\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Delaporte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Delfraissy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Delmas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Desclaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saliou","family":"Bella Diallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Safiatou Diallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariama","family":"Sadjo Diallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"\u00c9tard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Etienne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ousmane","family":"Faye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahima","family":"Fofana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Granouillac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Izard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djenaba","family":"Kass\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpha","family":"Kabinet Keita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakoba","family":"Keita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamine","family":"Koivogui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9c\u00e9","family":"Kpamou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Lacarabaratz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Levy Marchal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u2019Fally","family":"Magassouba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"March","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Mendiboure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Msellati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harissatou","family":"Niane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Peeters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves-Marie","family":"Pers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Raoul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidi","family":"Lamine Sacko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahima","family":"Savan\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Saliou Sow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Taverne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdoulaye","family":"Tour\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fod\u00e9","family":"Amara Traor\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falaye","family":"Traor\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamoussa","family":"Youla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazdan","family":"Yazdanpanah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"2021121701511401400_CIT0001","first-page":"1","article-title":"WHO Strategic Response Plan: West Africa Ebola Outbreak","volume-title":"World Health Organisation","author":"WHO","year":"2015"},{"key":"2021121701511401400_CIT0002","author":"WHO","year":"2016"},{"key":"2021121701511401400_CIT0003","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1001\/jamaophthalmol.2020.0173","article-title":"Evolving longitudinal retinal observations in a cohort of survivors of Ebola virus disease","volume":"138","author":"Steptoe","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"2021121701511401400_CIT0004","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1080\/09273948.2018.1484493","article-title":"Clinical manifestations and pathogenesis of uveitis in Ebola virus disease survivors","volume":"26","author":"Yeh","year":"2018","journal-title":"Ocul Immunol Inflamm"},{"key":"2021121701511401400_CIT0005","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3201\/eid2204.151302","article-title":"Post-Ebola syndrome, Sierra Leone","volume":"22","author":"Scott","year":"2016","journal-title":"Emerg Infect Dis"},{"key":"2021121701511401400_CIT0006","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1093\/cid\/civ453","article-title":"Study of Ebola virus disease survivors in Guinea","volume":"61","author":"Qureshi","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2021121701511401400_CIT0007","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3201\/eid2301.160631","article-title":"Sequelae and other conditions in Ebola virus disease survivors, Sierra Leone, 2015","volume":"23","author":"Mohammed","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2021121701511401400_CIT0008","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/cid\/civ795","article-title":"Sequelae of Ebola virus disease, Kenema District, Sierra Leone","volume":"62","author":"Nanyonga","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2021121701511401400_CIT0009","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1093\/cid\/ciw158","article-title":"Ebola virus disease complications as experienced by survivors in Sierra Leone","volume":"62","author":"Tiffany","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2021121701511401400_CIT0010","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S1473-3099(15)00489-2","article-title":"Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study","volume":"16","author":"Mattia","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"2021121701511401400_CIT0011","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(16)30516-3","article-title":"Multidisciplinary assessment of post-Ebola sequelae in Guinea (Postebogui): an observational cohort study","volume":"17","author":"Etard","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2021121701511401400_CIT0012","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007654","article-title":"Serological analysis of Ebola virus survivors and close contacts in Sierra Leone: A cross-sectional study","volume":"13","author":"Halfmann","year":"2019","journal-title":"PLoS Neg Trop Dis"},{"key":"2021121701511401400_CIT0013","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofy239","article-title":"Care of Ebola survivors and factors associated with clinical sequelae-Monrovia, Liberia","volume":"5","author":"de St Maurice","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2021121701511401400_CIT0014","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.tmaid.2017.05.001","article-title":"Neuropsychological long-term sequelae of Ebola virus disease survivors - A systematic review","volume":"18","author":"L\u00f6tsch","year":"2017","journal-title":"Travel Med Infect Dis"},{"key":"2021121701511401400_CIT0015","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1056\/NEJMoa1805435","article-title":"A longitudinal study of Ebola sequelae in Liberia","volume":"380","author":"Sneller","year":"2019","journal-title":"New Engl J Med"},{"key":"2021121701511401400_CIT0016","author":"Ji","year":"2017"},{"key":"2021121701511401400_CIT0017","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1093\/rheumatology\/kex074","article-title":"Characteristics of the musculoskeletal symptoms observed among survivors of Ebola virus disease in the Postebogui cohort in Guinea","volume":"56","author":"Pers","year":"2017","journal-title":"Rheumatology (Oxford)"},{"key":"2021121701511401400_CIT0018","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ophtha.2016.10.011","article-title":"Ophthalmic manifestations and causes of vision impairment in Ebola virus disease survivors in Monrovia, Liberia","volume":"124","author":"Shantha","year":"2017","journal-title":"Ophthalmology"},{"key":"2021121701511401400_CIT0019","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/S1473-3099(15)70152-0","article-title":"Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study","volume":"15","author":"Clark","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"2021121701511401400_CIT0020","article-title":"Long-term complications of Ebola virus disease: prevalence and predictors of major symptoms and the role of inflammation","author":"Tozay","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021121701511401400_CIT0021","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.ajo.2017.05.029","article-title":"Ocular complications in survivors of the Ebola outbreak in Guinea","volume":"181","author":"Steptoe","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"2021121701511401400_CIT0022","article-title":"Depressive symptoms among survivors of Ebola virus disease in Conakry (Guinea): Preliminary results of the PostEboGui cohort","volume":"17","author":"Keita","year":"2017","journal-title":"BMC Psych"},{"key":"2021121701511401400_CIT0023","article-title":"A 40-month follow-up of Ebola virus disease survivors in Guinea (Postebogui) reveals long-term detection of Ebola viral ribonucleic acid in semen and breast milk","volume":"6","author":"Keita","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"2021121701511401400_CIT0024","doi-asserted-by":"crossref","DOI":"10.1111\/j.2517-6161.1976.tb01597.x","article-title":"The empirical distribution function with arbitrarily grouped, censored and truncated data","author":"Turnbull","year":"1976","journal-title":"J Royal Stat Soc: Series B (Methodological)"},{"key":"2021121701511401400_CIT0025","article-title":"Multiple imputation for nonresponse in surveys","author":"Campion","year":"1989","journal-title":"J Market Res"},{"key":"2021121701511401400_CIT0026","doi-asserted-by":"crossref","DOI":"10.1214\/aos\/1176345976","article-title":"Cox\u2019s regression model for counting processes: a large sample study","volume":"10","author":"Andersen","year":"1982","journal-title":"Ann Stat"},{"key":"2021121701511401400_CIT0027","doi-asserted-by":"crossref","DOI":"10.1093\/biomet\/81.3.515","article-title":"Proportional hazards tests and diagnostics based on weighted residuals","volume":"81","author":"Grambsch","year":"1994","journal-title":"Biometrika"},{"key":"2021121701511401400_CIT0028","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/tmi.13226","article-title":"Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review","volume":"24","author":"James","year":"2019","journal-title":"Trop Med Int Health"},{"key":"2021121701511401400_CIT0029","doi-asserted-by":"crossref","first-page":"e82","DOI":"10.1016\/S1473-3099(16)00077-3","article-title":"Sequelae of Ebola virus disease: the emergency within the emergency","volume":"16","author":"Vetter","year":"2016","journal-title":"Lancet Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciab168\/39112347\/ciab168.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/73\/12\/2166\/41793485\/ciab168.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/73\/12\/2166\/41793485\/ciab168.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T17:06:13Z","timestamp":1724519173000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/73\/12\/2166\/6148739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,23]]},"references-count":29,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,2,23]]},"published-print":{"date-parts":[[2021,12,16]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciab168","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,12,15]]},"published":{"date-parts":[[2021,2,23]]}}}