Ebola survivors commonly show joint pain, vision problems and hearing problems that underscore the urgent need to provide follow-up care in West Africa, researchers say.

At a clinic in Port Loko, Sierra Leone, about 45 kilometers east of Freetown, Dr. Sharmistha Mishra and her team treated more than 600 survivors of Ebola in March and April.

In Tuesday's online issue of the journal Lancet Infectious Diseases, they document commonly reported complications such as vision, hearing and joint pain problems among 227 survivors.

The researchers found:

  • 76 per cent of the survivors reported joint pain, some limiting their ability to do work.
  • 60 per cent reported new vision problems.
  • 18 per cent had an eye inflammation (some potentially sight-threatening).
  • 24 per cent had self-reported hearing or ear problems.  

"This is one of the first opportunities that we've had to systematically count how many people develop these lingering effects," Mishra said. "These numbers are much more staggering than anecdotes would suggest."

One of the limitations of the study is the researchers didn't have a comparison group to see how the rates compare to hearing, eye and joint problems in the general population. But the complication rates were much higher than what's seen in the literature for similar parts of the world, Mishra said.

Ebola eye exam

Study co-author and ophthalmic nurse Amadu Kamara, left, conducts an eye exam at the Port Loko Ebola Survivor Clinic in Sierra Leone. About 18 per cent of Ebola survivors had eye inflammation. (Dr. Sharmistha Mishra)

Starting with the basics of strengthening the health-care system could probably go far, particularly when so much effort when into helping these people to survive in the first place, she said.

"Last Christmas we were at the height of the outbreak in Sierra Leone, and even though there's not as much attention put on Ebola now, the health system aspect needs just as much urgent attention to strengthen and to rebuild."

Sierra Leone has only two ophthalmologists, who were the lead authors of the paper. Dr. Matthew Vandy and Dr. John Mattia were able to provide eye exams, there was a lack of objective hearing measurements.

Dr. Allison McGeer is an infectious disease consultant at Toronto's Mount Sinai Hospital who travelled several times to Liberia throughout 2014 to help control the outbreak. She was not involved in the study.

Ebola has "been incomprehensibly devastating for these countries. It's not just the health-care system. It's also the entire economy," McGeer said.

The outbreak added to the unemployment, trouble with pediatric vaccinations and contributed other consequences that also need to be addressed to help the countries to recover, McGeer said.

It's not yet clear if the long-term complications of Ebola infections will resolve on their own. A previous study of an Ebola outbreak in Uganda pointed to joint symptoms that lingered for two years.

The study was funded by the Canadian Institutes of Health Research.

With files from CBC's Marijka Hurko