Abstract Details

Title Long-term Neurologic, Cognitive and Psychiatric Sequelae of Ebola in Liberian Pediatric Survivors

Topic Infectious Disease

Presentation(s) S9 - Neuroinfectious Disease: Associations and Outcomes (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

Objective To characterize the neurologic, cognitive and psychiatric sequelae following Ebola Virus Disease (EVD) in children at ten years or greater following infection.

Background The 2014 West Africa EVD epidemic infected over 28,000 people, mostly in the countries of Liberia, Guinea, and Sierra Leone. Pediatric Liberian survivors seen at about 18 months after EVD had significantly more physical disability and executive function issues and reported neurologic symptoms including limb weakness, fecal incontinence, and motivation issues significantly more than controls. The long-term impact of EVD on the developing brain, however, was largely unknown.

Design/Methods This cross-sectional observational study enrolled EVD survivors (cases) and their close contacts (controls) in Monrovia, Liberia between February and September 2025. A single visit included neurologic history and symptom questionnaire, depression screening (PHQ-9), neurologic exam, and cognitive testing via NIH Toolbox Cognition Battery (NIHTB-CB) and International Cognitive Assessment-Pediatrics (ICA-P). Symptom prevalence was compared using Fisher’s exact test. Comparisons adjusting for age, sex and education for test scores used multiple linear regression and for PHQ-9 used Poisson regression (statistical significance= p<0.05).

Results One-hundred fifty-three cases and 175 controls were seen with median age 20 years (range 9-27) and 55% female. Sixty-two percent reported difficulty finding food and 91% reported less than 3 meals daily. The prevalence of memory problems (p<0.001), confusion (p=0.0012), and vision problems (p=0.0288) were significantly higher in cases than controls. On NIHTB-CB, attention was found to be significantly worse for cases than controls (p=0.01) with no significant difference in other cognitive domains but the overall fluid composite score bordering on significance (p=0.051). Scores did not differ significantly between groups on PHQ-9 (β=0.08, p=0.65) nor ICA-P (p=0.468).

Conclusions At 10 years following infection, pediatric EVD survivors have significantly higher prevalence of memory problems, confusion and visual problems and were found to have significantly worse attention when compared with controls.

Authors/Disclosures
Hanalise Huff, MD (National Institute of Health) PRESENTER	Dr. Huff has nothing to disclose.
Princess Lobbo, RN	Miss Lobbo has nothing to disclose.
Victor D. Taryor, RN	Mr. Taryor has nothing to disclose.
joseph s. dorbor, RN	Mr. dorbor has nothing to disclose.
Rebecca A. Slewion, RN	Mrs. Slewion has nothing to disclose.
Gina Norato	Gina Norato has nothing to disclose.
Richa Dugirrala (National Institute of Health)	No disclosure on file
Leroy Yankae, MD	Leroy Yankae has nothing to disclose.
Avindra Nath, MD, MBBS, FAAN (National Institutes of Health)	The institution of Dr. Nath has received research support from National Institutes of Health. The institution of Dr. Nath has received research support from Target ALS. Dr. Nath has received intellectual property interests from a discovery or technology relating to health care.
Dehkontee L. Dennis, MD	Dr. Dennis has nothing to disclose.
Kumblytee M. Johnson, MD	Dr. Johnson has nothing to disclose.
Bridgette J. Billioux, MD	Dr. Billioux has nothing to disclose.

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