Pregnancy increases risk of dying from Lassa fever —Study

LASSA fever in pregnancy can increase the chance of a woman dying three folds, hence the need to prioritise pregnant women as a special subgroup of interest for the study of the disease, a study has said.

In a new study, researchers appraised currently available evidence on the adverse effects of Lassa fever in pregnancy from dates of its inception in Nigeria till September 2019.

There were a total of 276 pregnant women included in the studies. The age of the pregnant women ranged from 16 to 39 years. The frequency of symptoms and resulting complications were reported in five or more pregnant women.

It was in the March 2020 edition of the journal, Transactions of The Royal Society of Tropical Medicine and Hygiene.

According to them, the absolute risk of a pregnant woman dying from Lassa fever was estimated at 33.73 per cent while the relative risk of death in pregnant women compared with non-pregnant women was estimated at 2·86.

Complications of Lassa fever that may occur in pregnancy include bleeding after childbirth and premature delivery. And in newborns, complications can include intrauterine growth restriction/retardation, low birth weight and birth defects.

They found no studies to date that have assessed the complications associated with Lassa virus in pregnancy and the mechanisms by which these occur.

They declared that robust prospective studies estimating the true incidence of adverse effect of Lassa fever on the pregnant woman and new babies born to mothers with Lassa fever is required.

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In addition, they said randomised controlled trials to evaluate the efficacy of ribavirin, the antiviral medicine for Lassa fever infection in pregnancy, are urgently needed.

They suggested that point-of-care rapid diagnostics for Lassa virus and harmonised guidelines for management of the pregnant Lassa fever patient is urgently needed to facilitate clinical decision-making and management of Lassa fever in West Africa, particularly in low-resource hard-to-reach environments.

Also, they added that health professionals working with pregnant women in endemic areas should be adequately trained and maintain a high index of suspicion, particularly during peak seasons.

Lassa fever is a zoonotic infection endemic to West Africa and most infections show no symptoms in over 300,000 infections that occur in the region each year.

In the general population, mortality rates range from one to two per cent in mild cases to 15 to 20 per cent in severe cases.

Reports of Lassa fever in pregnant women indicate a poorer prognosis, with deaths ranging from seven per cent in early pregnancy to 30 per cent in late pregnancy.

Newborn death and stillbirth or miscarriage is reportedly high at 75 and 92 per cent, respectively, with most miscarriages occurring in early pregnancy.

NIGERIAN TRIBUNE