Drogy Madison, Glezer Celia, Engel Emily, Bond Nell, Pickett Keith, Shaffer Jeffrey, Schieffelin John, Zheng Crystal
School of Public Health and Tropical Medicine, Tulane University Newcomb-Tulane College, New Orleans, Louisiana.
Department of Pediatrics, Section of Pediatric Infectious Diseases, School of Medicine, Tulane University, New Orleans, Louisiana.
Am J Trop Med Hyg. 2024 Dec 17;112(3):663-673. doi: 10.4269/ajtmh.23-0709. Print 2025 Mar 5.
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.
病毒性出血热中的拉沙热（LF）和埃博拉病毒病（EVD）已被证明会给幸存者带来长期健康问题。有限的研究指出，感染康复后存在不良生殖健康后果，包括月经不调和流产。本系统评价和荟萃分析的目的是总结拉沙热和埃博拉病毒病女性幸存者生殖健康方面的现有知识。文献从PubMed、Embase、Ovid Medline、护理及相关健康累积索引（CINAHL）完整版、科学网和全球健康数据库中收集，随后在Covidence中进行审查。纳入的研究描述了埃博拉病毒病或拉沙热康复后女性至少一种生殖健康结果。在系统评价中确定了13项研究，所有这些研究仅讨论了埃博拉病毒病幸存者的生殖健康。未发现关于拉沙热幸存者生殖健康的研究。纳入的研究在几内亚、塞拉利昂和利比里亚进行，报告了幸存者中月经不调、流产、性欲减退、盆腔炎、性功能障碍、女性生殖异味和生殖器问题/感染等情况。在对9项研究的荟萃分析中，14.0%的埃博拉病毒病女性幸存者经历了任何不良生殖健康后果。然而，纳入的研究之间存在显著异质性。本研究突出了埃博拉病毒病女性幸存者面临的健康问题，并强调需要更多关于病毒性出血热对女性健康影响的研究。
