Lassa fever-induced hearing loss: The neglected disability of hemorrhagic fever

OBJECTIVE: Lassa fever (LF), a hemorrhagic fever endemic to West Africa, has an incidence of approximately 500,000 cases per year. This study evaluated hearing loss and other sequelae following LF. METHODS: This case–control study enrolled laboratory-confirmed LF survivors, non-LF febrile controls and matched-community controls with no history of LF or recent hospitalization for a febrile illness. Study participants completed a symptom questionnaire. Pure-tone audiometry was completed by a subset of participants. RESULTS: A total of 147 subjects aged 3–66 years (mean, 23.3) were enrolled. LF survivors were significantly more likely to report balance difficulties (55% vs. 20%, p < 0.001), hair loss (32% vs. 7%, p < 0.001), difficulty speaking (19% vs. 1%, p < 0.001), social isolation (50% vs. 0%, p < 0.001), and hearing loss (17% vs. 1%, p = 0.002) in comparison with matched-community controls. Similar trends were noted in comparison with febrile controls, although these findings were non-significant. Fifty subjects completed audiometry. Audiometry found that LF survivors had significantly more bilateral hearing loss in comparison with matched-community controls (30% vs. 4%, p = 0.029). CONCLUSION: This study characterized the sequelae of LF and highlighted the need for increased access to hearing care in West Africa.