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. Here, 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. The case fatality rate among participants (n=8) was 62.5%, with a median time from hospital admission to death of 2 days. Our results show that individuals who died (n=5) had higher mean heart rate (126 beats per minute) and respiratory rate (29 breaths per minute), as well as lower mean heart rate variability (10 ms), compared to those that survived (63 beats per minute, 22 breaths per minute, and 59 ms, respectively). Non-survivors also spent a greater proportion of their monitoring period in the age-specific tachycardia range (45.8%) compared to survivors (1.7%). Although real-time monitoring of vital signs using wearable biosensors may have the potential to identify decompensations earlier than traditional bedside vital sign collection in a resource-limited setting, technical improvements are still needed to enable widespread use of this tool, for both clinical and research purposes.

The authors have declared no competing interest.

This study was funded by NIH grant U01AI151812.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study was approved by research ethics boards at Tulane University (IRB #140674) as well as the Sierra Leone Ethics and Scientific Review Committee.

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All data produced in the present study are available upon reasonable request to the authors