Diffusion of Technologies by the Tikonko Agricultural Extension Centre (TAEC) to Farmers of the Tikonko Chiefdom in Sierra Leone: Impacts, Problems, Proposed Solutions, and an Updated Outlook

Sierra Leone is a west African nation with about two-thirds of its population engaged in agriculture but it cannot feed itself. The country’s agricultural activities were disrupted by a decade-long Civil War that created a great need for improved farming technologies. The Tikonko Agricultural Extension Centre (TAEC) operates in the Tikonko Chiefdom to assist local farmers in improving food production through the fabrication of farm tools to be adopted and used by farmers. This study was conducted to investigate the impacts of the TAEC’s technologies on farmers and their communities in the Tikonko Chiefdom and identify problems and solutions associated with the technologies and their diffusion. The target population included farmers (N = 318) who used TAEC’s technologies and TAEC staff (N = 18) who were involved in the diffusion process. A majority of the farmers adopted and used TAEC’s technologies readily, which they perceived had considerable impact on their farming practices and communities. The relevance of TAEC’s technologies to farmers in Tikonko Chiefdom was also evident. However, the participating farmers and TAEC staff encountered numerous problems. A majority agreed that the diffusion and adoption process could be improved by increasing the farmers’ access to loans. Providing appropriate technologies that can be adopted by low income farmers stands to increase their productivity and self-reliance while improving their nations’ food security. It is undeniable that technologies contributing to food sufficiency and alleviating poverty are needed throughout the developing world; policymakers must be reminded of this condition continually

Participation of women and children in hunting activities in Sierra Leone and implications for control of zoonotic infections

The emergence of infectious diseases of zoonotic origin highlights the need to understand social practices at the animal-human interface. This study provides a qualitative account of interactions between humans and wild animals in predominantly Mende villages of southern Sierra Leone. We conducted fieldwork over 4 months including participant and direct observations, semi-structured interviews (n = 47), spontaneously occurring focus group discussions (n = 12), school essays and informal interviews to describe behaviours that may serve as pathways for zoonotic infection. In this region, hunting is the primary form of contact with wild animals. We describe how these interactions are shaped by socio-cultural contexts, including opportunities to access economic resources and by social obligations and constraints. Our research suggests that the potential for exposure to zoonotic pathogens is more widely distributed across different age, gender and social groups than previously appreciated. We highlight the role of children in hunting, an age group that has previously not been discussed in the context of hunting. The breadth of the "at risk" population forces reconsideration of how we conceptualize, trace and monitor pathogen exposure

Transect sampling strategies for semi-detailed characterization of inland valley systems

For the semi-detailed characterization of inland valleys systems in the Ivory Coast, transect sampling was used to describe valley morphology, soils, and land use characteristics. Initially, for each valley one transect with a width of 200 to 400 m was proposed. More recently, use of a larger number of transects has been suggested. However, there is no statistical basis for either the number of transects to be described or their optimal width. Two sets of aerial photographs (1979, scale 1:50 000, and 1996, scale 1:20 000) of the Boundiali key area were processed and the results digitized. Using GIS, sets of transects with different width were made, and used for the determination of the sample size for estimating the land use ratio and the valley bottom ratio at valley system level with given confidence intervals. These results were validated with data from the field and with sets of pre-selected transects. The calculated sample size is based on simple random sampling and depends on both transect width and variability in the study area. For the characterization of inland valleys with reasonable confidence intervals, the sample size for random sampling is too large for the semi-detailed characterization method. Smaller samples of transects selected on the basis of sub-recent aerial photographs gave comparable results for land cover characteristics estimation as the larger samples for random sampling. There is scope for reducing sample size by formalizing criteria for transect placement on the basis of the earlier aerial photographs

Transect sampling strategies for semi-detailed characterization of inland valley systems

For the semi-detailed characterization of inland valleys systems in the Ivory Coast, transect sampling was used to describe valley morphology, soils, and land use characteristics. Initially, for each valley one transect with a width of 200 to 400 m was proposed. More recently, use of a larger number of transects has been suggested. However, there is no statistical basis for either the number of transects to be described or their optimal width. Two sets of aerial photographs (1979, scale 1:50 000, and 1996, scale 1:20 000) of the Boundiali key area were processed and the results digitized. Using GIS, sets of transects with different width were made, and used for the determination of the sample size for estimating the land use ratio and the valley bottom ratio at valley system level with given confidence intervals. These results were validated with data from the field and with sets of pre-selected transects. The calculated sample size is based on simple random sampling and depends on both transect width and variability in the study area. For the characterization of inland valleys with reasonable confidence intervals, the sample size for random sampling is too large for the semi-detailed characterization method. Smaller samples of transects selected on the basis of sub-recent aerial photographs gave comparable results for land cover characteristics estimation as the larger samples for random sampling. There is scope for reducing sample size by formalizing criteria for transect placement on the basis of the earlier aerial photographs

Concern for information privacy:a cross-nation study of the United Kingdom and South Africa

Individuals have differing levels of information privacy concern, formed by their expectations and the confidence they have that organisations meet this in practice. Variance in privacy laws and national factors may also play a role. This study analyses individuals’ information privacy expectation and confidence across two nations, the United Kingdom and South Africa, through a survey of 1463 respondents. The findings indicate that the expectation for privacy in both countries are very high. However, numerous significant differences exist between expectations and confidence when examining privacy principles. The overall results for both countries show that there is a gap in terms of the privacy expectations of respondents compared to the confidence they have in whether organisations are meeting their expectations. Governments, regulators, and organisations with an online presence need to consider individuals’ expectations and ensure that controls that meet regulatory requirements, as well as expectations, are in place

Isoniazid preventive treatment among child contacts of adults with smear-positive tuberculosis in The Gambia.

Setting: Greater Banjul area of The Gambia. Objectives: To evaluate uptake, adherence and completion of treatment among tuberculosis (TB) exposed children in The Gambia when isoniazid preventive treatment (IPT) is delivered at home Design: Child (age <5 years) contacts of adults with smear-positive TB were prospectively enrolled. Following symptom screening, tuberculin skin testing and clinical evaluation where indicated, those without disease were placed on daily isoniazid, provided monthly at home. Adherence was assessed by pill counts and IsoScreen™ urine test. Results: Of 404 contacts aged <5 years, 368 (91.1%) were offered IPT. Of the 328 (89.4%) for whom consent was received and who commenced IPT, 18 (5.5%) dropped out and 310 (94.5%) remained on IPT to the end of the 6-month regimen. Altogether, 255/328 children (77.7%, 95%CI 73.2-82.2) completed all 6 months, with good adherence. The IsoScreen test was positive in 85.3% (435/510) of all tests among those defined as having good adherence by pill count and in 16% (8/50) of those defined as having poor adherence (P < 0.001). A cascade of care analysis showed an overall completion rate with good adherence of 61% for all child contacts. Conclusion: Home-delivered IPT among child contacts of adults with smear-positive TB in The Gambia achieved verifiable high uptake and adherence rates. System rather than patient factors are likely to determine the success of IPT at national level

Lassa Fever in Post-Conflict Sierra Leone

Background: Lassa fever (LF), an often-fatal hemorrhagic disease caused by Lassa virus (LASV), is a major public health threat in West Africa. When the violent civil conflict in Sierra Leone (1991 to 2002) ended, an international consortium assisted in restoration of the LF program at Kenema Government Hospital (KGH) in an area with the world's highest incidence of the disease. Methodology/Principal Findings Clinical and laboratory records of patients presenting to the KGH Lassa Ward in the post-conflict period were organized electronically. Recombinant antigen-based LF immunoassays were used to assess LASV antigenemia and LASV-specific antibodies in patients who met criteria for suspected LF. KGH has been reestablished as a center for LF treatment and research, with over 500 suspected cases now presenting yearly. Higher case fatality rates (CFRs) in LF patients were observed compared to studies conducted prior to the civil conflict. Different criteria for defining LF stages and differences in sensitivity of assays likely account for these differences. The highest incidence of LF in Sierra Leone was observed during the dry season. LF cases were observed in ten of Sierra Leone's thirteen districts, with numerous cases from outside the traditional endemic zone. Deaths in patients presenting with LASV antigenemia were skewed towards individuals less than 29 years of age. Women self-reporting as pregnant were significantly overrepresented among LASV antigenemic patients. The CFR of ribavirin-treated patients presenting early in acute infection was lower than in untreated subjects. Conclusions/Significance: Lassa fever remains a major public health threat in Sierra Leone. Outreach activities should expand because LF may be more widespread in Sierra Leone than previously recognized. Enhanced case finding to ensure rapid diagnosis and treatment is imperative to reduce mortality. Even with ribavirin treatment, there was a high rate of fatalities underscoring the need to develop more effective and/or supplemental treatments for LF

High SARS-CoV-2 incidence and asymptomatic fraction during Delta and Omicron BA.1 waves in The Gambia

Little is known about SARS-CoV-2 infection risk in African countries with high levels of infection-driven immunity and low vaccine coverage. We conducted a prospective cohort study of 349 participants from 52 households in The Gambia between March 2021 and June 2022, with routine weekly SARS-CoV-2 RT-PCR and 6-monthly SARS-CoV-2 serology. Attack rates of 45% and 57% were seen during Delta and Omicron BA.1 waves respectively. Eighty-four percent of RT-PCR-positive infections were asymptomatic. Children under 5-years had a lower incidence of infection than 18-49-year-olds. One prior SARS-CoV-2 infection reduced infection risk during the Delta wave only, with immunity from ≥2 prior infections required to reduce the risk of infection with early Omicron lineage viruses. In an African population with high levels of infection-driven immunity and low vaccine coverage, we find high attack rates during SARS-CoV-2 waves, with a high proportion of asymptomatic infections and young children remaining relatively protected from infection

Mass Drug Administration With High-Dose Ivermectin and Dihydroartemisinin-Piperaquine for Malaria Elimination in an Area of Low Transmission With High Coverage of Malaria Control Interventions: Protocol for the MASSIV Cluster Randomized Clinical Trial

Background: With a decline in malaria burden, innovative interventions and tools are required to reduce malaria transmission further. Mass drug administration (MDA) of artemisinin-based combination therapy (ACT) has been identified as a potential tool to further reduce malaria transmission, where coverage of vector control interventions is already high. However, the impact is limited in time. Combining an ACT with an endectocide treatment that is able to reduce vector survival, such as ivermectin (IVM), could increase the impact of MDA and offer a new tool to reduce malaria transmission. Objective: The study objective is to evaluate the impact of MDA with IVM plus dihydroartemisinin-piperaquine (DP) on malaria transmission in an area with high coverage of malaria control interventions. Methods: The study is a cluster randomized trial in the Upper River Region of The Gambia and included 32 villages (16 control and 16 intervention). A buffer zone of ~2 km was created around all intervention clusters. MDA with IVM plus DP was implemented in all intervention villages and the buffer zones; control villages received standard malaria interventions according to the Gambian National Malaria Control Program plans. Results: The MDA campaigns were carried out from August to October 2018 for the first year and from July to September 2019 for the second year. Statistical analysis will commence once the database is completed, cleaned, and locked. Conclusions: This is the first cluster randomized clinical trial of MDA with IVM plus DP. The results will provide evidence on the impact of MDA with IVM plus DP on malaria transmission. Trial Registration: ClinicalTrials.gov NCT03576313; https://clinicaltrials.gov/ct2/show/NCT03576313 International Registered Report Identifier (IRRID): DERR1-10.2196/2090