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Sierra Leone

J Daniel Kelly, Eugene T Richardson, Michael Drasher, M Bailor Barrie, Sahr Karku, Mohamed Kamara, Katrina Hann, Kerry Dierberg, Allan Hubbard, Christina P Lindan, Paul E Farmer, George W Rutherford, Sheri D Weiser
Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cross-sectional study in two Ebola-affected communities in Kono district, Sierra Leone, from November 2015 to September 2016. We enrolled persons who were determined to have been exposed to Ebola virus. We assessed the association of food insecurity, using an adapted version of the Household Food Insecurity Access Scale, a nine-item scale well validated across Africa, with having been diagnosed with EVD and having died of EVD, using logistic regression models with cluster-adjusted standard errors...
March 19, 2018: American Journal of Tropical Medicine and Hygiene
Angus Fayia Tengbeh, Luisa Enria, Elizabeth Smout, Thomas Mooney, Mike Callaghan, David Ishola, Bailah Leigh, Deborah Watson-Jones, Brian Greenwood, Heidi Larson, Shelley Lees
The 2014-2016 Ebola epidemic presented a challenging setting in which to carry out clinical trials. This paper reports findings from social science research carried out in Kambia, Northern Sierra Leone during first year of an Ebola vaccine trial (August 2015-July 2016). The social science team collected data through ethnographic observation, 42 in depth interviews; 4 life narratives; 200 exit interviews; 31 key informant interviews; and 8 focus group discussions with trial participants and community members not enrolled in the trial...
March 5, 2018: Social Science & Medicine
Kara N Durski, Andrea M McCollum, Yoshinori Nakazawa, Brett W Petersen, Mary G Reynolds, Sylvie Briand, Mamoudou Harouna Djingarey, Victoria Olson, Inger K Damon, Asheena Khalakdina
The recent apparent increase in human monkeypox cases across a wide geographic area, the potential for further spread, and the lack of reliable surveillance have raised the level of concern for this emerging zoonosis. In November 2017, the World Health Organization (WHO), in collaboration with CDC, hosted an informal consultation on monkeypox with researchers, global health partners, ministries of health, and orthopoxvirus experts to review and discuss human monkeypox in African countries where cases have been recently detected and also identify components of surveillance and response that need improvement...
March 16, 2018: MMWR. Morbidity and Mortality Weekly Report
Caris E Grimes, Matthew Quaife, Thaim B Kamara, Christopher B D Lavy, Andy J M Leather, Håkon A Bolkan
OBJECTIVES: The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care. DESIGN: We used estimates of total, met and unmet need from two main sources-a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone...
March 14, 2018: BMJ Open
Nathali Gunawardena, Ghose Bishwajit, Sanni Yaya
Background: For exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994). The model comprises delay in deciding to seek care (delay 1), delay in reaching the health facility (delay 2), and delay in receiving quality care once at the health facility (delay 3). Few studies have comprehensively dealt with the health systems delays that prevent the receipt of timely and appropriate obstetric care once a woman reaches a health facility (phase III delays)...
2018: Frontiers in Public Health
Susan L Erikson
Evidence from Sierra Leone reveals the significant limitations of big data in disease detection and containment efforts. Early in the 2014-2016 Ebola epidemic in West Africa, media heralded HealthMap's ability to detect the outbreak from newsfeeds. Later, big data-specifically, call detail record (CDR) data collected from millions of cell phones-was hyped as useful for stopping the disease by tracking contagious people. It did not work. In this article, I trace the causes of big data's containment failures...
March 8, 2018: Medical Anthropology Quarterly
Dattesh R Davé, Neeraja Nagarjan, Joseph K Canner, Adam L Kushner, Barclay T Stewart
PURPOSE: Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. METHODS: The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014...
February 20, 2018: Burns: Journal of the International Society for Burn Injuries
Syed Nabeel Zafar, Joseph K Canner, Neeraja Nagarajan, Adam L Kushner
INTRODUCTION: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income countries using nationally representative survey data. METHODS: The Surgeons Overseas Assessment of Surgical Needs (SOSAS) survey tool was administered in four countries: Sierra Leone, Rwanda, Nepal and Uganda. We performed nationally representative cross-sectional, cluster randomized surveys in each country...
February 19, 2018: International Journal of Surgery
Lucy November, Jane Sandall
BACKGROUND: In Sierra Leone, 34% of pregnancies and 40% of maternal deaths are in the adolescent population. Risks are known to be higher for younger adolescents, this being borne out by a household survey in Eastern Freetown in 2015. This current qualitative study, funded by Wellbeing of Women's international midwifery fellowship, was conducted to explore the causes of this high incidence of maternal death for younger teenagers, and to identify possible interventions to improve outcomes...
February 21, 2018: Reproductive Health
Laura Treacy, Håkon A Bolkan, Mette Sagbakken
BACKGROUND: Sierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist...
2018: PloS One
Nadege Goumkwa Mafopa, Gianluca Russo, Raoul Emeric Guetiya Wadoum, Emmanuel Iwerima, Vincent Batwala, Marta Giovanetti, Antonella Minutolo, Patrick Turay, Thomas B Turay, Brima Kargbo, Massimo Amicosante, Maurizio Mattei, Carla Montesano
A serosurvey of anti-Ebola Zaire virus nucleoprotein IgG prevalence was carried out among Ebola virus disease survivors and their Community Contacts in Bombali District, Sierra Leone. Our data suggest that the specie of Ebola virus ( Zaire ) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response.
December 31, 2017: Journal of Public Health in Africa
Kristin Post
The unprecedented scale of the Ebola epidemic in West Africa in 2014-15 caught the world by surprise. Zaire Ebolavirus had not previously been documented in Guinea, Sierra Leone, or Liberia. However, since this strain of filovirus was first identified in 1976, scientists have been studying the disease and its origins. They have identified forest-dwelling animals that carry the virus, and some that die from it, but have yet to isolate how it is transmitted from animals to humans. During the height of the Ebola outbreak in West Africa, some public health messages addressed the link among Ebola, wild animals, and humans...
January 2018: Health Security
Grazia Caleo, Jennifer Duncombe, Freya Jephcott, Kamalini Lokuge, Clair Mills, Evita Looijen, Fivi Theoharaki, Ronald Kremer, Karline Kleijer, James Squire, Manjo Lamin, Beverley Stringer, Helen A Weiss, Daniel Culli, Gian Luca Di Tanna, Jane Greig
BACKGROUND: Little is understood of Ebola virus disease (EVD) transmission dynamics and community compliance with control measures over time. Understanding these interactions is essential if interventions are to be effective in future outbreaks. We conducted a mixed-methods study to explore these factors in a rural village that experienced sustained EVD transmission in Kailahun District, Sierra Leone. METHODS: We reconstructed transmission dynamics using a cross-sectional survey conducted in April 2015, and cross-referenced our results with surveillance, burial, and Ebola Management Centre (EMC) data...
February 13, 2018: BMC Public Health
Sagar Chawla, Shaheen Kurani, Sherry M Wren, Barclay Stewart, Gilbert Burnham, Adam Kushner, Thomas McIntyre
BACKGROUND: Access to reliable energy has been identified as a global priority and codified within United Nations Sustainable Goal 7 and the Electrify Africa Act of 2015. Reliable hospital access to electricity is necessary to provide safe surgical care. The current state of electrical availability in hospitals in low- and middle-income countries (LMICs) throughout the world is not well known. This study aimed to review the surgical capacity literature and document the availability of electricity and generators...
March 2018: Journal of Surgical Research
Samantha Waterman, Elaine Catherine Margaret Hunter, Charles L Cole, Lauren Jayne Evans, Neil Greenberg, G James Rubin, Alison Beck
BACKGROUND: Following the 2014 Ebola virus disease (EVD) outbreak in West Africa, the UK Department for International Development funded South London and Maudsley National Health Service (NHS) to develop a psychological intervention that ex-Ebola Treatment Centre (ETC) staff could be trained to deliver to their peers to improve mental health in Sierra Leone. AIM: The two key aims were to assess the feasibility of training a national team to deliver a cognitive behavioural therapy (CBT)-based group intervention, and to evaluate the effectiveness of the overall intervention within this population...
March 2018: International Journal of Social Psychiatry
Lucy Wilks, Andrew Leather, Peter Matthew George, Thaim Bay Kamara
BACKGROUND: The critical shortage of human resources for healthcare falls most heavily on sub-Saharan nations such as Sierra Leone, where such workforce deficits have grave impacts on its burden of surgical disease. An important aspect in retention and development of the workforce is training. This study focuses on postgraduate surgical training (formal and short course) and perceptions of opportunities, challenges and aspirations, in a country where more than half of surgical procedures are performed by medical officers...
February 5, 2018: Journal of Surgical Education
Rashid Ansumana, Donald F Dariano, Kathryn H Jacobsen, Tomasz A Leski, Joseph M Lamin, Joseph Lahai, Umaru Bangura, Alfred S Bockarie, Chris R Taitt, Chadwick Yasuda, Moses J Bockarie, David A Stenger
OBJECTIVE: The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg) among febrile individuals tested at Mercy Hospital Research Laboratory (MHRL) in Bo, Sierra Leone. RESULTS: A total of 860 febrile individuals ages 5 years and older were tested by MHRL between July 2012 and June 2013 with a Standard Diagnostics Bioline HBsAg rapid diagnostic test. The overall HBsAg prevalence rate was 13.7%, including a rate of 15.5% among males and 12...
February 8, 2018: BMC Research Notes
Jesse Bonwitt, Michael Dawson, Martin Kandeh, Rashid Ansumana, Foday Sahr, Hannah Brown, Ann H Kelly
Following the 2013-2016 outbreak of Ebola virus disease (EVD) in West Africa, governments across the region imposed a ban on the hunting and consumption of meat from wild animals. This injunction was accompanied by public health messages emphasising the infectious potential of wild meat, or 'bushmeat.' Using qualitative methods, we examine the local reception and impact of these interventions. Fieldwork was focused in 9 villages in the Eastern and Southern provinces of Sierra Leone between August and December 2015...
January 31, 2018: Social Science & Medicine
Vijay Kumar Chattu
The 2014 Ebola epidemic was the largest in history, affecting Guinea, Liberia, Sierra Leone, Nigeria, and Mali in West Africa. The International Health Regulations are legally binding in 194 countries including all the member states of WHO "to prevent, protect against, control, and provide a public health response to the international spread of disease." Since the Caribbean Community region heavily depends on tourism, a single case of the disease anywhere in the region could have serious negative consequences for the rest of the region's tourism industry...
July 2017: Journal of Family Medicine and Primary Care
Joanna Raven, Sushil Baral, Haja Wurie, Sophie Witter, Mohamed Samai, Pravin Paudel, Hom Nath Subedi, Tim Martineau, Helen Elsey, Sally Theobald
BACKGROUND: Health workers are critical to the performance of health systems; yet, evidence about their coping strategies and support needs during and post crisis is lacking. There is very limited discussion about how research teams should respond when unexpected crises occur during on-going research. This paper critically presents the approaches and findings of two health systems research projects that explored and evaluated health worker performance and were adapted during crises, and provides lessons learnt on re-orientating research when the unexpected occurs...
February 7, 2018: Health Research Policy and Systems
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