Continuous vital sign monitoring of acute Lassa fever using wearable biosensor devices in West Africa.

BACKGROUND

Lassa fever is a fulminant viral illness associated with high in-hospital mortality. This disease constitutes a serious public health concern in West Africa, in particular Nigeria and the Mano River Union region (Guinea, Liberia, and Sierra Leone). In Sierra Leone, continuous monitoring of critically ill patients is hindered by a lack of equipment and personnel.

METHODS

We used wearable biosensor devices to remotely monitor hospitalized individuals with acute Lassa fever in order to describe vital sign trends that may be associated with clinical outcome and to evaluate the feasibility of this approach in a resource-limited setting.

RESULTS

The case fatality rate among participants (n = 8) was 62.5%, with a median time from hospital presentation to death of 2 days. Our results show that non-survivors (n = 5) spent a greater proportion of their monitoring period in the age-specific tachycardia range (45.8%) compared to survivors (1.7%), and had lower mean heart rate variability (10 ms) compared to those that survived (59 ms). Due to inconsistent sensor adhesion, as well as Bluetooth and cellular connectivity issues, over 80% of collected vital sign data was discarded for poor quality.

CONCLUSIONS

Real-time monitoring of vital signs using wearable biosensors may have the potential to identify individuals at increased risk for poor outcomes in Lassa fever by detecting age-specific tachycardia and reductions in heart rate variability. Whether this represents an improvement upon traditional bedside vital sign collection in resource-limited settings is not clear, as a substantial proportion of monitoring data was of poor quality. Technical improvements in sensor connectivity and adhesion are needed to enable widespread use of this device, for both clinical and research purposes.