By: Kemo Cham
Nearly a decade after the West African Ebola epidemic was declared over, Sierra Leone has launched a groundbreaking study to examine the long-term immune response and the experiences of Ebola survivors. Researchers from Sierra Leone, Japan, and the United States are collaborating on this important investigation to explore how the lives of survivors and their close contacts have evolved since the end of the epidemic, and to understand the biological and social challenges they face.
The study, which focuses on the long-term immunological memory of survivors, will investigate whether their immune systems retain memory and protection against the Ebola virus 10 years after the outbreak. It will also explore the social and contextual factors influencing their lives post-epidemic, shedding light on the challenges faced by survivors and their families. The research aims to raise awareness about the adaptations and difficulties of those affected by one of the deadliest viruses in history and advocate for enhanced support for their well-being.
“By better understanding the immune response of Ebola survivors, we hope to contribute to the development of better vaccines and therapeutics,” said Professor Alhaji Umar N’jai, Sierra Leone’s Lead Principal Investigator on the study. He emphasized that the study will also provide crucial insights into the genetic background of asymptomatically infected individuals.
The primary aim of the study is to assess the host-pathogen immune response of Ebola virus disease (EVD) survivors and close contacts. Researchers will focus on the retention of immune memory by examining the B and T cells of survivors and their contacts. The findings will be instrumental in creating more effective vaccines and therapeutics for Ebola.
Prof. N’jai, a biomedical scientist and researcher with the University of Sierra Leone and Koinadugu College, is collaborating with Prof. Yoshi Kawaoka from the University of Tokyo and Dr. Peter Halfmann from the University of Wisconsin-Madison. These experts are long-time collaborators in the field of Ebola research.
“This study will provide valuable data on the long-term immune response to Ebola, particularly in individuals who were asymptomatic or had mild symptoms,” Prof. N’jai explained.
What makes this study particularly significant is that it is the first long-term (over 10 years) serological study of its kind. According to Prof. N’jai, it combines serological, epidemiological, and anthropological approaches to understand post-Ebola sequelae and the effects on infected individuals. This type of comprehensive research has never been conducted before.
“We are entering new territory,” Prof. N’jai said. “This research will provide critical insights into the long-term effects of Ebola, including both the physical and psychological challenges faced by survivors.”
The study comes 11 years after the World Health Organization (WHO) declared the end of the West African Ebola epidemic, which ravaged Sierra Leone, Guinea, and Liberia. The epidemic, which began in 2013 and was officially declared over in 2016, was the largest and deadliest outbreak on record. By the end of the epidemic, there were 28,616 cases and 11,325 deaths across seven countries.
Sierra Leone was hit hardest, with 17,323 survivors, including 3,589 in Sierra Leone alone. Abdulai Dumbuya, one of the survivors, is among the 70 volunteers participating in the study. He recalled the physical and emotional toll of surviving Ebola.
“It has been a long time since we were asked about how we are faring,” said Dumbuya at an orientation ceremony for the study participants. “Many of us still have problems like vision difficulties, joint pain, and fatigue, which developed after my encounter with Ebola.”
The research team is working closely with the Sierra Leone Association of Ebola Survivors (SLAES), led by Abdulai Kargbo. Kargbo expressed hope that the study would bring attention to the ongoing struggles of survivors and lead to better support systems.
“Many of us have been going through a lot. The feedback from this study will benefit us all,” Kargbo said.
The orientation for the study participants included focused group discussions, where survivors shared their experiences and challenges, including ongoing health issues such as joint pain, fatigue, and psychological distress. Survivors have also reported significant mental health struggles, including anxiety, depression, and post-traumatic stress disorder (PTSD).
Prof. N’jai and his colleagues aim to understand not just the biological mechanisms underlying long-term health complications but also the support needs of survivors. They hope to turn the tragedy of the Ebola outbreak into a global health solution by generating valuable data to inform future healthcare responses.
“A study like this will help us determine whether the immune system still provides protection after years of exposure,” said Dr. Mohamed Jalloh, a co-investigator in the study. “For Sierra Leone, this means we will take the lead in global knowledge production on Ebola and shift the narrative from one of tragedy to one of resilience and solutions in global health.”
This pioneering study will provide a deeper understanding of the long-term impact of Ebola, offering hope for survivors and setting the stage for future global health initiatives. As the research progresses, it promises to not only improve healthcare outcomes for those affected by the epidemic but also contribute to a global understanding of the virus’s long-term effects.