The influence of the Ebola outbreak on presumptive and active tuberculosis in Bombali District, Sierra Leone.

Setting: Bombali District, rural Sierra Leone. Objective: To compare the number of patients with presumptive tuberculosis (TB), the number of patients registered with TB (including testing for the human immunodeficiency virus [HIV] and initiation on antiretroviral therapy [ART]) and treatment outcomes during the pre-Ebola, Ebola and post-Ebola disease outbreak periods between 2013 and 2016. Design: This was a cross-sectional study and retrospective cohort analysis of treatment outcomes. Results: The mean monthly number of patients with presumptive TB before, during and post-Ebola was respectively 169, 145 and 210. The mean monthly number of registered TB cases was respectively 57, 57 and 96. Smear-positive TB was the most frequent type of TB, at 75%, 66% and 77%. The proportion of TB patients tested for HIV was 82% pre-Ebola, 74% Ebola and 99% post-Ebola. The proportion of HIV-positive patients with TB initiated on ART was respectively 46%, 85% and 100%. Treatment success among TB patients was 71% in the pre-Ebola period and 89% in the Ebola period (P < 0.001). Conclusion: During the Ebola outbreak, there were decreases in the number of presumptive TB patients and in the proportions of patients diagnosed with smear-positive TB and tested for HIV. The initiation of ART in HIV-infected TB patients and treatment outcomes remained acceptable. Pre-emptive actions are needed to maintain adequate control activities in future outbreaks

HIV prevalence in suspected Ebola cases during the 2014–2016 Ebola epidemic in Sierra Leone

Abstract Background The 2014–2016 Ebola virus epidemic in West Africa was the largest outbreak of Ebola virus disease (EVD) in history. Clarifying the influence of other prevalent diseases such as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) will help improve treatment and supportive care of patients with EVD. Case presentation We examined HIV and hepatitis C virus (HCV) antibody prevalence among suspected EVD cases from the Sierra Leone-China Friendship Biological Safety Laboratory during the epidemic in Sierra Leone. HIV and HCV antibodies were tested in 678 EVD-negative samples by enzyme-linked immunosorbent assay. A high HIV prevalence (17.6%) and low HCV prevalence (0.22%) were observed among the suspected cases. Notably, we found decreased HIV positive rates among the suspected cases over the course of the epidemic. This suggests a potentially beneficial effect of an improved public health system after assistance from the World Health Organization and other international aid organizations. Conclusions This EVD epidemic had a considerable impact on the public health system and influenced the prevalence of HIV found among suspected cases in Sierra Leone, but also provided an opportunity to establish a better surveillance network for infectious diseases

A practice mining system for the delivery of sustainable retirement villages

© 2018 Elsevier Ltd With the wide recognition of sustainable development, a range of sustainable practices has been incorporated into the development and operation of retirement villages to provide a sustainable living environment for residents in Australia. The retirement village sector is seeking effective methods of reusing these historical practices to facilitate the future development and operation of sustainable retirement villages. However, this is challenging and there has been no research to date into this issue. Therefore, this study aims to develop a practice mining system (PMS) to address the research gap. By using multiple case studies for data collection and case-based reasoning (CBR) for data mining, the study develops the CBR-PMS, which comprises a Data Transforming and Location System, a Data Warehouse, and a Data Mining and Reusing Engine. The CBR-PMS is a data management and mining system that can be adopted to retain, capture, reuse, and revise prior sustainable practices to facilitate the future development and operation of sustainable retirement villages. Case studies and expert judgements are used in its demonstrations and validation, and satisfactory performance is achieved. It is concluded that the CBR-PMS is an effective tool for retaining and transferring prior practices and acts as an innovative tool of knowledge management and organizational learning in the retirement living sector. Although the CBR-PMS is at its conceptual stage and requires some automation to make it user-friendly, it provides practical insights into the development of a sustainable living environment and benefits the development of data mining systems for other sustainability initiatives