Hear it From the Horses' Mouth: Listening to African Professionals in Australia

The study investigated the growing concern of the African professionals who arrived in Australia since 2007. The ongoing concern was based on the lack of job opportunity in their nominated skilled occupation in post arrival in Australia. The study used demographic questionnaire and semi-structured interview to elicit information from forty (40) participants from Western Australia and Northern Territory cities and regional areas. The data analysed provided the needed perspectives about the extreme frustration of the African skilled migrants lack job opportunities in the post arrival in Australia. Based on the findings, the study made some recommendations, including counselling implications on several pathways on how African professionals could gain recognition for opportunities in their professional areas

T-cell epitope polymorphisms of the Plasmodium falciparum circumsporozoite protein among field isolates from Sierra Leone: age-dependent haplotype distribution?

<p>Abstract</p> <p>Background</p> <p>In the context of the development of a successful malaria vaccine, understanding the polymorphisms exhibited by malaria antigens in natural parasite populations is crucial for proper vaccine design. Recent observations have indicated that sequence polymorphisms in the C-terminal T-cell epitopes of the <it>Plasmodium falciparum </it>circumsporozoite protein (Pf<it>csp</it>) are rather low and apparently stable in low endemic areas. This study sought to assess the pattern in a malaria endemic setting in Africa, using samples from Freetown, Sierra Leone.</p> <p>Methods</p> <p>Filter-paper blood samples were collected from subjects at a teaching hospital in Freetown during September–October 2006 and in April–May 2007. The C-terminal portion of the Pf<it>csp </it>gene spanning the Th2R and Th3R epitopes was amplified and directly sequenced; sequences were analysed with subject parameters and polymorphism patterns in Freetown were compared to that in other malaria endemic areas.</p> <p>Results and Discussion</p> <p>Overall, the genetic diversity in Freetown was high. From a total of 99 sequences, 42 haplotypes were identified with at least three accounting for 44.4% (44/99): the 3D7-type (19.2%), a novel type, P-01 (17.2%), and E12 (8.1%). Interestingly, all were unique to the African sub-region and there appeared to be predilection for certain haplotypes to distribute in certain age-groups: the 3D7 type was detected mainly in hospitalized children under 15 years of age, while the P-01 type was common in adult antenatal females (Pearson Chi-square = 48.750, degrees of freedom = 34, <it>P </it>= 0.049). In contrast, the single-haplotype predominance (proportion > 50%) pattern previously identified in Asia was not detected in Freetown.</p> <p>Conclusion</p> <p>Haplotype distribution of the T-cell epitopes of Pf<it>csp </it>in Freetown appeared to vary with age in the study population, and the polymorphism patterns were similar to that observed in neighbouring Gambia, but differed significantly at the sequence level from that observed in Asia. The findings further emphasize the role of local factors in generating polymorphisms in the T-cell epitopes of the <it>P. falciparum </it>circumsporozoite protein.</p

Expressions of psychological distress in Sierra Leone: Implications for community-based prevention and response

Alastair Ager - ORCID 0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563Replaced AM with VoR 2020-08-07Background Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress.Methods Rapid ethnographic methods deployed included 75 case study interviews with community members, 12 key informant pile sorts and 55 key informant interviews. Thematic analysis of data was supported by frequency analysis and multi-dimensional scaling.Results Thirty signs of distress were identified. The only consistent ‘syndrome’ identified with respect to these was a general concept of crase, which referred to psychosis-related presentation but also a wide range of other signs of distress. We did not find consensus on locally defined concepts for mild-moderate forms of mental disorder: people use multiple overlapping signs and terms indicating psychological distress.Conclusions Analysis supports calls to view mental health problems as a ‘continuum of distress’ rather than as discrete categories. This framing is coherent with opportunities for prevention and response in Sierra Leone which do not focus primarily on formal health care service providers but rather involve a range of community-based actors. It also enables attention to be paid to the identification of milder signs of distress with a view to early response and prevention of more severe mental health problems.This research was funded by NIHR Global Health Research Programme 16/136/100, Queen Margaret University.https://doi.org/10.1017/gmh.2020.127pubpu

Establishing an antimicrobial stewardship program in Sierra Leone: a report of the experience of a low-income country in West Africa

Antimicrobial Resistance (AMR) is a growing global health challenge that threatens to undo gains in human and animal health. Prevention and control of AMR requires functional antimicrobial stewardship (AMS) program, which is complex and often difficult to implement in low- and middle-income countries. We aimed to describe the processes of establishing and implementing an AMS program at Connaught Hospital in Sierra Leone. The project involved the setting up of an AMS program, capacity building and performing a global point prevalence survey (GPPS) at Sierra Leone's national referral hospital. Connaught Hospital established a multidisciplinary AMS subcommittee in 2021 to provide AMS services such as awareness campaigns, education and training and review of guidelines. We performed a GPPS on 175 patients, of whom more than half (98, 56.0%) were prescribed an antibiotic: 63 (69.2%) in the surgical wards and 53 (51.2%) in the medical wards. Ceftriaxone (60, 34.3%) and metronidazole (53, 30.3%) were the most common antibiotics prescribed to patients. In conclusion, it is feasible to establish and implement an AMS program in low-income countries, where most hospitalized patients were prescribed an antibiotic

Chapter 9

Niger is a landlocked country in West Africa located between 11°37 ´ and 23°23 ´ north latitude and between 00°10 ´ and 16°00 ´ east longitude, with an area of 1,267,000 square kilometers. Niger shares borders wit

How can health systems be strengthened to control and prevent an Ebola outbreak? a narrative review

The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC) in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases MEDLINE, EMBASE, and Global Health were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs) are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively

Burkina Faso

Burkina Faso is a landlocked country in West Africa covering about 274,000 square kilometers. It is bordered by the Republic of Mali on the north and west; by Cote d’Ivoire on the Southwest; by Ghana, Togo, and Benin on the South; and by Niger on the east. The country has a dry tropical climate with two contrasting seasons. The rainy season generally lasts from May to October, but its duration decreases progressively from the southwest, amounting to only three months in the northern part of the country. Agriculture accounts for 40 percent of the gross domestic product (GDP) and 60 percent of the total exports of Burkina Faso. Its cropped area is 3.5– 4.0 million hectares, representing about 13 percent of the country’s total area and one-third of the arable land. Rainfed agriculture dominates, with largely rudimentary agricultural techniques prevailing among small-scale farmers. Crop production is more diversified in the Sudanian zone (in the southwest), with a variety of roots and tubers (yams, sweet potatoes, and cocoyams), fruits (mangoes, bananas, and citrus fruits), cashews, and sugarcane. The major cash crops are cotton, groundnuts, cowpeas, and sesame..

Increased blood glucose is related to disturbed cerebrovascular pressure reactivity after traumatic brain injury.

BACKGROUND: Increased blood glucose and impaired pressure reactivity (PRx) after traumatic brain injury (TBI) are both known to correlate with unfavorable patient outcome. However, the relationship between these two variables is unknown. METHODS: To test the hypothesis that increased blood glucose leads to increased PRx, we retrospectively analyzed data from 86 traumatic brain injured patients admitted to the Neurocritical Care Unit. Data analyzed included arterial glucose concentration, intracranial pressure (ICP), cerebral perfusion pressure (CPP) and end-tidal CO2. PRx was calculated as the moving correlation coefficient between averaged (10 seconds) arterial blood pressure and ICP. One arterial glucose concentration and one time-aligned PRx value were obtained for each patient, during each day until the fifth day after ictus. RESULTS: Mean arterial glucose concentrations during the first 5 days since ictus were positively correlated with mean PRx (Pearson correlation coefficient = 0.25, p = 0.02). The correlation was strongest on the first day after injury (Pearson correlation coefficient = 0.47, p = 0.008). CONCLUSION: Our preliminary findings indicate that increased blood glucose may impair cerebrovascular reactivity, potentially contributing to a mechanistic link between increased blood glucose and poorer outcome after TBI.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s12028-014-0042-

Niger

Niger is a landlocked country in West Africa located between 11°37´ and 23°23´ north latitude and between 00°10´ and 16°00´ east longitude, with an area of 1,267,000 square kilometers. Niger shares borders with Algeria and Libya in the north, Chad in the east, Nigeria and Benin in the south, and Burkina Faso and Mali in the west. Three-fourths of Niger is covered by the Sahara Desert. The southern part of the country is in the Sahelian climate zone, with Sudan savannah vegetation. The rainy season lasts for only three months, with total rainfall ranging from 150 to 600 millimeters per year in the Sudan savannah; maximum temperatures are high (45°C in the shade in April–May). The vegetation cover is sparse, and nomadic agriculture is dominant..