Knowledge, Perception of Risk and Attitude of Sierra Leone Military Personnel towards Colleagues with HIV/AIDS

The aim of this survey was to gain an insight into the level of knowledge, perception of risk and attitude of Sierra Leone Military personnel towards colleagues with HIV/AIDS. Four hundred and fifty (450) randomly selected male and female military personnel including officers and other ranks from six battalions were surveyed with a standard questionnaire. Results of this survey demonstrated a relatively low level of knowledge of HIV and AIDS amongst the survey population as evidenced by the 40% and 52% of participants stating that HIV is transmitted by mosquito bites and from public toilets respectively. An equally low perception of risk of the infection was demonstrated from the responses of the participants about attitude towards HIV infected colleagues. Three-fourth of the participants indicated that nobody should be informed if a colleague is HIV positive, with almost all the participants expressing their willingness to take care of an HIV/AIDS person in their household. Varying responses obtained demonstrate the necessity for scaling-up HIV education within the Republic of Sierra Leone Armed Forces. More resources most therefore be made available to the HIV/AIDS office of the Republic of Sierra Leone Armed Forces so that HIV education activities can be extended to all the brigades and battalions. Keywords: Knowledge, Perception, Attitude, HIV/AIDS

Treatment of Uncomplicated Falciparum Malaria with Artesunate-Amodiaquine Combination Therapy (ACT) in a Rural Fishing Community in Sierra Leone

Until recently, Chloroquine was the mainstay for malaria chemotherapy in Africa because it is cheap, safe and practicable for out-patient use. Resistance to this drug has however over the past decade, presented a major public health problem with therapeutic and prophylactic implications. As a response to the emergence of resistance to the commonly used antimalarial drugs, the World Health Organisation (WHO) now recommends the use of artemisinin-based combination therapies (ACTs). We assessed the therapeutic efficacy of oral Artesunate-Amodiaquine hydrochloride combination therapy in the treatment of uncomplicated falciparum malaria in a rural fishing community in Sierra Leone. One hundred and fourteen (114) participants aged 0 – 5 years attending the Outpatient Department of Gbondapi Health Centre were screened for recruitment into the study of which 70 fulfilled the inclusion criteria. Artesunate-Amodiaquine hydrochloride combined drug which passed the general counterfeit test of the Ministry of Health and Sanitation was used in the study. Adequate Clinical and parasitological Response (ACPR) was observed in 97% of the study population. Mean parasite clearance time in the participants with ACPR was found to be 24 hours (range 24 –72 hours). All 3% of the treatment failures were observed to be Early Treatment Failures (ETF). Results from the study indicate that Artesunate-Amodiaquine hydrochloride combination therapy is an effective antimalarial drug in a high transmission zone like Sierra Leone, and in the event that the drug is not effective, the results will be evident within one day of commencement of treatment

Prevalence and Intensity of Intestinal Helminth Parasites and Their Response to Treatment with Albendazole in a Rural Community in Sierra Leone

Helminth infections can be an important public health problem in most developing countries. Stool samples from five hundred and fourteen (514) participants in Gbondapi village were examined to determine the prevalence and intensity of intestinal helminths using the Kato-Katz method. The efficacy of a single dose of 200mg and 400mg albendazole in adults and subjects below and above 2 years respectively was also assessed. Seventy-nine (15.4%) of the 514 subjects were infected with at least one intestinal helminth. Data collected was analysed using Epi info statistical package. The most prevalent intestinal helminth was Hookworm (7.6%) followed by Ascaris lumbricoides (5.3%) and Strongyloides stercoralis (3.9%). The least prevalent helminth was Schistosoma mansoni (1.6%). The worm burden was generally light with mean egg counts ranging between 83 – 927eggs/gram of stool. Albendazole had an excellent safety record and found to be highly effective against Ascaris lumbricoides. In order to break the cycle of infection and re-infection in rural communities, programs embracing health education, mass treatment with albendazole, improved sanitation and the provision of protected water sources must be implemented

Nutritional Status of Children in Displacement Camps in Sierra Leone

Civil wars have resulted in the displacement of millions of people worldwide and have forced many into temporary displacement camps. Sometimes, most are caught in prolonged and overcrowded refugee camps, which provide ideal grounds for the transmission of diseases, increased risk for acute respiratory infections, diarrhoeal diseases, and malnutrition. In this study, stunting, under nutrition, and wasting were measured among 454 children under the age of 10 years in four internally displaced persons (IDP) camps. Stunting was found to be the most common nutritional abnormality in all four IDP camps with the highest prevalence rate (29.3%) in the Trade Center Camp and lowest (14.2%) in the National Workshop Camp. This study indicates that forced internal displacement results in high prevalence of stunting, wasting and underweight among children.Key Words: Nutritional status, Children, Displacement, Sierra Leone

Improved mapping strategy to better inform policy on the control of schistosomiasis and soil-transmitted helminthiasis in Sierra Leone

<p>Abstract</p> <p>Background</p> <p>Schistosomiasis and soil-transmitted helminthiasis (STH) are endemic in Sierra Leone confirmed by national mapping in 2008. To better inform planning of preventive chemotherapy strategy, another survey was conducted before mass drug administration (MDA) in seven districts according to the mapping results or local knowledge. Fifty-nine chiefdoms and one school in every chiefdom were selected. Thirty school children aged 9-14 years from each school (total: 1760) were examined by parasitological methods for infection with <it>Schistosoma mansoni </it>and STHs.</p> <p>Results</p> <p>The overall prevalence of <it>S. mansoni </it>was 40.2% (95% confidence interval (CI): 37.9-42.5%), particularly in Kailahun (63.3%), Kenema (46.7%), Koinadugu (41.9%) and Kono (71.7%). The results demonstrated the focal distribution of <it>S. mansoni </it>in Bo, Tonkolili and Bombali districts with prevalence ranging from 0.0-63.3%, 3.3-90.0% and 0.0-67.9% respectively. The arithmetic mean intensity of <it>S. mansoni </it>infection was 95.4 epg (95% CI: 61.4-129.5 epg), Heavy mean intensity of infection was found in Kailahun (120.2 epg), Kenema (104.5 epg), Koinadugu (112.3 epg) and Kono (250.3 epg). Heavy or moderate infection with <it>S. mansoni </it>occurred in 20.7% of children examined. Hookworm prevalence was moderate: 31.2% (95% CI: 29.1-33.4%), but high in Bo (50.0%) and Tonkolili (56.7%). Hookworm intensity of infection was light with a mean epg of 53.0 (95% CI: 38.4-67.7 epg). Prevalence and intensity of <it>Ascaris lumbricoides </it>(1.5%, 17.8 epg) and <it>Trichuris trichiura </it>(2.5%, 20.3 epg) was low.</p> <p>Conclusions</p> <p>The prediction by previous spatial analysis that <it>S. mansoni </it>was highly endemic across north-eastern Sierra Leone was confirmed with a significant proportion of children heavily or moderately infected. The distribution of <it>S. mansoni </it>in Bo, Tonkolili and Bombali districts ranged widely, highlighting the importance of considering the nature of focal transmission in national mapping exercises. These results were used to refine the MDA for schistosomiasis control to chiefdom implementation units rather than the entire district in these 3 districts. The survey demonstrated that sufficient number of survey sites for schistosomiasis mapping in each district should be used to provide a better national planning of MDA activities, and that it is affordable with the contributions from all parties involved and national resources mobilized.</p

Geographical Distribution of Intestinal Schistosomiasis and Soil-Transmitted Helminthiasis and Preventive Chemotherapy Strategies in Sierra Leone

The common intestinal roundworm, whipworm and hookworm (together known as soil-transmitted helminthes - STHs) together with schistosomes or bilharzia are responsible for extensive ill health, reduced life expectancy and death in sub-Saharan Africa. These diseases are transmitted in areas of poor water supply and sanitation. In order to implement an appropriate national control program, knowledge of the prevalence and geographical distribution of these diseases is required. A national survey was performed in Sierra Leone in 2008. Overall prevalence of intestinal schistosomiasis was 18.4% and that of STHs was 39.1%. Intestinal schistosomiasis was mainly prevalent in the northern and eastern regions while STH is widespread in the country. The results justify routine de-worming for pre-school children, school age children, women of childbearing age, and adults at high risk twice a year. The results also justify using anti-schistosomiasis drug (praziquantel) in school age children, all women of childbearing age, and adults at high risk annually or biennially depending upon the prevalence in the areas

COP27 climate change conference: urgent action needed for Africa and the world

The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods.1 These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5oC compared with pre-industrial levels

Combined Spatial Prediction of Schistosomiasis and Soil-Transmitted Helminthiasis in Sierra Leone: A Tool for Integrated Disease Control

Two forms of schistosomiasis or bilharzia (intestinal and urogenital) exist in Sierra Leone. The main control strategy for this disease currently is through mass drug administration (MDA) according to the World Health Organization recommended anthelminthic chemotherapy guidelines, and others include snail control, behavior change, and safe water, sanitation and hygiene. Survey on distribution and prevalence of the disease is vital to the planning of MDA in each district. The distribution of intestinal schistosomiasis in the country has been reported previously. The current national survey showed that urogenital schistosomiasis has a specific focal distribution particularly in the central and eastern regions of the country, most prevalent in Bo (24.6%), Koinadugu (20.4%) and Kono (25.3%) districts. Using a simple probabilistic model, this map was combined with the previously reported maps on intestinal schistosomiasis and the combined schistosomiasis prevalence was estimated. The combined schistosomiasis map highlights the presence of high-risk communities in an extensive area in the northeastern half of the country, which provides a tool for planning the national MDA activities

COP27 climate change conference: Urgent action needed for Africa and the world

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Isolation of Angola-like Marburg virus from Egyptian rousette bats from West Africa.

Marburg virus (MARV) causes sporadic outbreaks of severe Marburg virus disease (MVD). Most MVD outbreaks originated in East Africa and field studies in East Africa, South Africa, Zambia, and Gabon identified the Egyptian rousette bat (ERB; Rousettus aegyptiacus) as a natural reservoir. However, the largest recorded&nbsp;MVD outbreak with the highest case-fatality ratio happened in 2005 in Angola, where direct spillover from bats was not&nbsp; shown. Here, collaborative studies by the Centers for Disease Control and Prevention, Njala University, University of California, Davis USAID-PREDICT, and the University of Makeni identify MARV circulating in ERBs in Sierra Leone. PCR, antibody and virus isolation data from 1755 bats of 42 species shows active MARV infection in approximately 2.5% of ERBs. Phylogenetic analysis identifies MARVs that are similar to the Angola strain. These results provide evidence of MARV circulation in West Africa and demonstrate the value of pathogen surveillance to identify previously undetected threats