Prevalence, types and determinants of organ failure among hospitalized adult Lassa fever patients in a tertiary hospital in South-East Nigeria

Abstract

Introduction Lassa fever (LF) is an acute viral haemorrhagic fever (VHF) endemic to parts of West Africa. Multi-organ failure is a frequent cause of death in patients hospitalized with LF. This study determined the prevalence, types, and determinants of organ failure among adult patients with confirmed LF managed at the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State, Nigeria. Methods This hospital-based, cross-sectional study enrolled adults (≥ 18 years) with real-time polymerase chain reaction (RT-PCR) confirmed LF from October 2022 to April 2023 at AEFUTHA. Data were collected using a modified Nigeria Centre for Disease Control and Prevention (NCDC) VHF case investigation form, including socio-demographics, medical history, and laboratory tests. Logistic regression models were used to assess the determinants of organ failure and in-hospital all-cause mortality. Results Sixty adult patients were enrolled, with a mean age of 35.2 years (range: 18–62), and 73.3% (44) were males. Organ failure occurred in 50% (30) of cases, with acute kidney injury, AKI (33.3%), central nervous system dysfunction (25%), and liver failure (20%) being most frequent. Multi-organ failure was seen in 33.3% (20) of participants. In-hospital mortality was recorded in 25% (15) of participants. Duration of hospital stay was comparable between patients with organ failure (10 days, IQR=15.00) and those without organ failure (10.5 days, IQR=6.00), p= 0.35. Elevated urea levels (AOR 1.44, 95% C.I.: 1.04 – 2.05) and GCS <13 (AOR: 0.23, 95% C.I.: 0.06 – 0.81) predicted organ failure. In-hospital mortality was independently associated with respiratory failure (AOR 8.88, 95%CI: 1.77 – 44.41) and AKI (AOR 20.00, 95%CI:4.09 – 97.81). Conclusion Our LF cohort experienced a high frequency of organ failure, with respiratory failure and AKI independently predictive of mortality. Treatment outcome of hospitalized LF patients can potentially be improved through early, targeted monitoring and support of organ function.