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Sierra Leone

Thespina Yamanis, Elisabeth Nolan, Susan Shepler
BACKGROUND: Future infectious disease epidemics are likely to disproportionately affect countries with weak health systems, exacerbating global vulnerability. To decrease the severity of epidemics in these settings, lessons can be drawn from the Ebola outbreak in West Africa. There is a dearth of literature on public perceptions of the public health response system that required citizens to report and treat Ebola cases. Epidemiological reports suggested that there were delays in diagnosis and treatment...
October 2016: PLoS Neglected Tropical Diseases
Sara Andertun, Åsa Hörnsten, Senada Hajdarevic
AIM: The aim of this study was to describe Norwegian healthcare staffs' experiences of participating in care of patients with Ebola virus disease in Sierra Leone. BACKGROUND: Ebola is one of the most feared viruses known. Ebola virus disease is highly contagious with high mortality. The few qualitative studies made on experiences among healthcare professionals have highlighted problems as lack of protective resources, insufficient personnel and risk of societal stigmatization...
October 16, 2016: Journal of Advanced Nursing
Mireia Jané, Mª José Vidal, Mar Maresma, Ana Martínez, Gloria Carmona, Ana Rodés, Nuria Torner, Josep Álvarez, Maria-Rosa Sala, Irene Barrabeig
The Ebola outbreak in Guinea Conakry was notified to the World Health Organization (WHO) in March 2014. It is the most complex Ebola outbreak to date, affecting Guinea Conakry as well as the surrounding countries and with a risk of the disease spreading outside Africa. For this reason, the World Health Organization declared this Ebola outbreak an international public health emergency in August 2014. The Public Health Agency of Catalonia, through the Spanish Alert and Emergencies Coordination Network, initiated public health actions in March 2014, developing a single protocol of action to be applied by all the health care providers in the whole Catalan territory, advice for travellers and voluntary workers arriving from affected countries and a weekly newsletter addressed to health professionals...
October 11, 2016: Gaceta Sanitaria
(no author information available yet)
Background Data from studies in nonhuman primates suggest that the triple monoclonal antibody cocktail ZMapp is a promising immune-based treatment for Ebola virus disease (EVD). Methods Beginning in March 2015, we conducted a randomized, controlled trial of ZMapp plus the current standard of care as compared with the current standard of care alone in patients with EVD that was diagnosed in West Africa by polymerase-chain-reaction (PCR) assay. Eligible patients of any age were randomly assigned in a 1:1 ratio to receive either the current standard of care or the current standard of care plus three intravenous infusions of ZMapp (50 mg per kilogram of body weight, administered every third day)...
October 13, 2016: New England Journal of Medicine
Linda Valeri, Oscar Patterson-Lomba, Yared Gurmu, Akweley Ablorh, Jennifer Bobb, F William Townes, Guy Harling
BACKGROUND: The recent Ebola virus disease (EVD) outbreak in West Africa has spread wider than any previous human EVD epidemic. While individual-level risk factors that contribute to the spread of EVD have been studied, the population-level attributes of subnational regions associated with outbreak severity have not yet been considered. METHODS: To investigate the area-level predictors of EVD dynamics, we integrated time series data on cumulative reported cases of EVD from the World Health Organization and covariate data from the Demographic and Health Surveys...
2016: PloS One
Sara L Morales-Lázaro, Itzel Llorente, Félix Sierra-Ramírez, Ana E López-Romero, Miguel Ortíz-Rentería, Barbara Serrano-Flores, Sidney A Simon, León D Islas, Tamara Rosenbaum
The transient receptor potential vanilloid 1 (TRPV1) ion channel is mainly found in primary nociceptive afferents whose activity has been linked to pathophysiological conditions including pain, itch and inflammation. Consequently, it is important to identify naturally occurring antagonists of this channel. Here we show that a naturally occurring monounsaturated fatty acid, oleic acid, inhibits TRPV1 activity, and also pain and itch responses in mice by interacting with the vanilloid (capsaicin)-binding pocket and promoting the stabilization of a closed state conformation...
October 10, 2016: Nature Communications
M Aletti, H Savini, C Ficko, J Bordes, A Cambon, M Billhot, G Velut, H Granier, T De Greslan, T Carmoi
The clinical spectrum of Ebola virus disease (EVD) ranges from very serious forms with organ failure and death within days to paucisymptomatic forms and perhaps even asymptomatic. The authors propose a focus on the clinical manifestations of EVD, on prognosis and on therapeutic aspects (excluding resuscitation). This work extracts from the literature the main data gathered during the 2014-2015 epidemic that raged in Guinea Conakry and Sierra Leone. These two countries, even if they are separated by a border, are one and the same population base...
October 4, 2016: La Revue de Médecine Interne
Aileen E O'Hearn, Matthew A Voorhees, David P Fetterer, Nadia Wauquier, Moinya R Coomber, James Bangura, Joseph N Fair, Jean-Paul Gonzalez, Randal J Schoepp
BACKGROUND: Sub-Saharan Africa is home to a variety of pathogens, but disease surveillance and the healthcare infrastructure necessary for proper management and control are severely limited. Lassa virus, the cause of Lassa fever, a severe hemorrhagic fever in humans is endemic in West Africa. In Sierra Leone at the Kenema Government Hospital Lassa Diagnostic Laboratory, up to 70 % of acute patient samples suspected of Lassa fever test negative for Lassa virus infection. This large amount of acute undiagnosed febrile illness can be attributed in part to an array of hemorrhagic fever and arthropod-borne viruses causing disease that goes undetected and untreated...
October 3, 2016: Virology Journal
Reshma Roshania, Michaela Mallow, Nelson Dunbar, David Mansary, Pranav Shetty, Taralyn Lyon, Kacey Pham, Matthew Abad, Erin Shedd, Anh-Minh A Tran, Sarah Cundy, Adam C Levine
BACKGROUND: The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest ever recorded. Starting in September 2014, International Medical Corps (IMC) managed 5 Ebola treatment units (ETUs) in Liberia and Sierra Leone, which cumulatively cared for about 2,500 patients. We conducted a retrospective cohort study of patient data collected at the 5 ETUs over 1 year of operations. METHODS: To collect clinical and epidemiological data from the patient care areas, each chart was either manually copied across the fence between the high-risk zone and low-risk zone, imaged across the fence, or imaged in the high-risk zone...
September 28, 2016: Global Health, Science and Practice
Corrado Cancedda, Sheila M Davis, Kerry L Dierberg, Jonathan Lascher, J Daniel Kelly, Mohammed Bailor Barrie, Alimamy Philip Koroma, Peter George, Adikali Alpha Kamara, Ronald Marsh, Manso S Sumbuya, Cameron T Nutt, Kirstin W Scott, Edgar Thomas, Katherine Bollbach, Andrew Sesay, Ahmidu Barrie, Elizabeth Barrera, Kathryn Barron, John Welch, Nahid Bhadelia, Raphael G Frankfurter, Ophelia M Dahl, Sarthak Das, Rebecca E Rollins, Bryan Eustis, Amanda Schwartz, Piero Pertile, Ilias Pavlopoulos, Allan Mayfield, Regan H Marsh, Yusupha Dibba, Danielle Kloepper, Andrew Hall, Karin Huster, Michael Grady, Kimberly Spray, David A Walton, Fodei Daboh, Cora Nally, Sahr James, Gabriel S Warren, Joyce Chang, Michael Drasher, Gina Lamin, Sherry Bangura, Ann C Miller, Annie P Michaelis, Ryan McBain, M Jana Broadhurst, Megan Murray, Eugene T Richardson, Ted Philip, Gary L Gottlieb, Joia S Mukherjee, Paul E Farmer
An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities...
October 15, 2016: Journal of Infectious Diseases
A M Moulin
Vaccine trials against Ebola virus have been conceived and organized, in August 2014, after the epidemic started in three countries of West Africa. If the preparedness had been missing, the planners tried to anticipate the resistance to vaccination, in Guinea, Sierra Leone and Liberia. This article offers a retrospective view on the resistances to vaccination throughout its history, from smallpox inoculation to anti-polio vaccine. Resistances have been linked to the political contexts and the rejection of an oppressive power, either local or foreign, as well as mistakes and scientific uncertainties...
September 29, 2016: Bulletin de la Société de Pathologie Exotique
Santiago Ávila-Ríos, Claudia García-Morales, Margarita Matías-Florentino, Karla A Romero-Mora, Daniela Tapia-Trejo, Verónica S Quiroz-Morales, Helena Reyes-Gopar, Hezhao Ji, Paul Sandstrom, Jesús Casillas-Rodríguez, Juan Sierra-Madero, Eddie A León-Juárez, Marisol Valenzuela-Lara, Carlos Magis-Rodríguez, Patricia Uribe-Zuñiga, Gustavo Reyes-Terán
BACKGROUND: WHO has developed a global HIV-drug resistance surveillance strategy, including assessment of pretreatment HIV-drug resistance. We aimed to do a nationally representative survey of pretreatment HIV-drug resistance in Mexico using WHO-recommended methods. METHODS: Among 161 Ministry of Health antiretroviral therapy (ART) clinics in Mexico, the largest, including 90% of ART initiators within the Ministry of Health (66 in total), were eligible for the survey...
September 14, 2016: Lancet HIV
Daniel R Jacobson, Alice A Alexander, Clement Tagoe, W T Garvey, Scott M Williams, Sara Tishkoff, David Modiano, Sodiomon B Sirima, Issa Kalidi, Amadou Toure, Joel N Buxbaum
BACKGROUND: Transthyretin (TTR) pV142I (rs76992529-A) is one of the 113 variants in the human TTR gene associated with systemic amyloidosis. It results from a G to A transition at a CG dinucleotide in the codon for amino acid 122 of the mature protein (TTR V122I). The allele frequency is 0.0173 in African Americans. METHODS: PCR-based assays to genotype 2767 DNA samples obtained from participants in genetic studies from various African populations supplemented with sequencing data from 529 samples within the 1000 Genomes Project...
September 2016: Molecular Genetics & Genomic Medicine
Felicity Fitzgerald, Asad Naveed, Kevin Wing, Musa Gbessay, J C G Ross, Francesco Checchi, Daniel Youkee, Mohammed Boie Jalloh, David Baion, Ayeshatu Mustapha, Hawanatu Jah, Sandra Lako, Shefali Oza, Sabah Boufkhed, Reynold Feury, Julia A Bielicki, Diana M Gibb, Nigel Klein, Foday Sahr, Shunmay Yeung
Little is known about potentially modifiable factors in Ebola virus disease in children. We undertook a retrospective cohort study of children <13 years old admitted to 11 Ebola holding units in the Western Area, Sierra Leone, during 2014-2015 to identify factors affecting outcome. Primary outcome was death or discharge after transfer to Ebola treatment centers. All 309 Ebola virus-positive children 2 days-12 years old were included; outcomes were available for 282 (91%). Case-fatality was 57%, and 55% of deaths occurred in Ebola holding units...
October 2016: Emerging Infectious Diseases
Maru Aregawi, Samuel J Smith, Musa Sillah-Kanu, John Seppeh, Anitta R Y Kamara, Ryan O Williams, John J Aponte, Andrea Bosman, Pedro Alonso
BACKGROUND: As emergency response to the Ebola epidemic, the Government of Sierra Leone and its partners implemented a large-scale Mass Drug Administration (MDA) with artesunate-amodiaquine (ASAQ) covering >2.7 million people in the districts hardest hit by Ebola during December 2014-January 2015. The World Health Organization (WHO) and the National Malaria Control Programme (NMCP) evaluated the impact of the MDA on malaria morbidity at health facilities and the number of Ebola alerts received at District Ebola Command Centres...
2016: Malaria Journal
Isabel Comino, Fernando Fernández-Bañares, María Esteve, Luís Ortigosa, Gemma Castillejo, Blanca Fambuena, Carmen Ribes-Koninckx, Carlos Sierra, Alfonso Rodríguez-Herrera, José Carlos Salazar, Ángel Caunedo, J M Marugán-Miguelsanz, José Antonio Garrote, Santiago Vivas, Oreste Lo Iacono, Alejandro Nuñez, Luis Vaquero, Ana María Vegas, Laura Crespo, Luis Fernández-Salazar, Eduardo Arranz, Victoria Alejandra Jiménez-García, Marco Antonio Montes-Cano, Beatriz Espín, Ana Galera, Justo Valverde, Francisco José Girón, Miguel Bolonio, Antonio Millán, Francesc Martínez Cerezo, César Guajardo, José Ramón Alberto, Mercé Rosinach, Verónica Segura, Francisco León, Jorge Marinich, Alba Muñoz-Suano, Manuel Romero-Gómez, Ángel Cebolla, Carolina Sousa
OBJECTIVES: Treatment for celiac disease (CD) is a lifelong strict gluten-free diet (GFD). Patients should be followed-up with dietary interviews and serology as CD markers to ensure adherence to the diet. However, none of these methods offer an accurate measure of dietary compliance. Our aim was to evaluate the measurement of gluten immunogenic peptides (GIP) in stools as a marker of GFD adherence in CD patients and compare it with traditional methods of GFD monitoring. METHODS: We performed a prospective, nonrandomized, multicenter study including 188 CD patients on GFD and 84 healthy controls...
October 2016: American Journal of Gastroenterology
Jia B Kangbai
OBJECTIVE: To explore and visualize the connectivity of suspected Ebola cases and surveillance callers who used cellphone technology in Moyamba District in Sierra Leone for Ebola surveillance, and to examine the demographic differences and characteristics of Ebola surveillance callers who make more calls as well as those callers who are more likely to make at least one positive Ebola call. METHODS: Surveillance data for 393 suspected Ebola cases (192 males, 201 females) were collected from October 23, 2014 to June 28, 2015 using cellphone technology...
September 2016: Asian Pacific Journal of Tropical Medicine
Jolie Kaner, Sarah Schaack
Near the end of 2013, an outbreak of Zaire ebolavirus (EBOV) began in Guinea, subsequently spreading to neighboring Liberia and Sierra Leone. As this epidemic grew, important public health questions emerged about how and why this outbreak was so different from previous episodes. This review provides a synthetic synopsis of the 2014-15 outbreak, with the aim of understanding its unprecedented spread. We present a summary of the history of previous epidemics, describe the structure and genetics of the ebolavirus, and review our current understanding of viral vectors and the latest treatment practices...
2016: Globalization and Health
Ming Ni, Chen Chen, Jun Qian, Hai-Xia Xiao, Wei-Feng Shi, Yang Luo, Hai-Yin Wang, Zhen Li, Jun Wu, Pei-Song Xu, Su-Hong Chen, Gary Wong, Yuhai Bi, Zhi-Ping Xia, Wei Li, Hui-Jun Lu, Juncai Ma, Yi-Gang Tong, Hui Zeng, Sheng-Qi Wang, George F Gao, Xiao-Chen Bo, Di Liu
Since 2013, West Africa has encountered the largest Ebola virus (EBOV) disease outbreak on record, and Sierra Leone is the worst-affected country, with nearly half of the infections. By means of next-generation sequencing and phylogeographic analysis, the epidemiology and transmission of EBOV have been well elucidated. However, the intra-host dynamics that mainly reflect viral-host interactions still need to be studied. Here, we show a total of 710 intra-host single nucleotide variations (iSNVs) from deep-sequenced samples from EBOV-infected patients, through a well-tailored bioinformatics pipeline...
2016: Nature Microbiology
Bobbie R Erickson, Tara K Sealy, Tim Flietstra, Laura Morgan, Brima Kargbo, Victor E Matt-Lebby, Aridth Gibbons, Ayan K Chakrabarti, James Graziano, Lance Presser, Mike Flint, Brian H Bird, Shelley Brown, John D Klena, Dianna M Blau, Aaron C Brault, Jessica A Belser, Johanna S Salzer, Amy J Schuh, Michael Lo, Marko Zivcec, Rachael A Priestley, Meredith Pyle, Christin Goodman, Scott Bearden, Brian R Amman, Alison Basile, Éric Bergeron, Michael D Bowen, Kimberly A Dodd, Molly M Freeman, Laura K McMullan, Christopher D Paddock, Brandy J Russell, Angela J Sanchez, Jonathan S Towner, David Wang, Galina E Zemtsova, Robyn A Stoddard, Maryann Turnsek, Lisa Wiggleton Guerrero, Shannon L Emery, Janae Stovall, Markus H Kainulainen, Jamie L Perniciaro, Slavica Mijatovic-Rustempasic, Gulchekhra Shakirova, Jörn Winter, Christopher Sexton, Feng Liu, Kimetha Slater, Raydel Anderson, Lauren Andersen, Cheng-Feng Chiang, Wen-Pin Tzeng, Samuel J Crowe, Matthew J Maenner, Christina F Spiropoulou, Stuart T Nichol, Ute Ströher
During the Ebola virus outbreak of 2013-2016, the Viral Special Pathogens Branch field laboratory in Sierra Leone tested approximately 26 000 specimens between August 2014 and October 2015. Analysis of the B2M endogenous control Ct values showed its utility in monitoring specimen quality, comparing results with different specimen types, and interpretation of results. For live patients, blood is the most sensitive specimen type and oral swabs have little diagnostic utility. However, swabs are highly sensitive for diagnostic testing of corpses...
October 15, 2016: Journal of Infectious Diseases
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