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.
Lassa fever is a viral illness in West Africa that is associated with high rates of death among individuals admitted to the hospital for treatment. Monitoring of critically ill patients within the infection’s geographic range is hindered by a lack of equipment and personnel. To better understand vital sign trends and to explore different approaches to patient monitoring, wearable biosensors were used to monitor patients with Lassa fever in Sierra Leone. We found that tachycardia and reduced heart rate variability are associated with poor outcomes, though technical limitations hinder broader implementation of such devices within regions where Lassa fever is present.
© 2025. The Author(s).