Browsing by Author "Kangbai, Jia Bainga"

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Africa’s COVID-19 third wave: A coupled behavior-disease system in a mutual feedback loop
(2021-10-30) Kangbai, Jia Bainga
A year after COVID-19 was declared a pandemic much of the Africa continent started experiencing spikes in the number of COVID-19 cases and related deaths in what was referred to as the third wave of the pandemic. These spikes came right behind the heels of a second wave of the pandemic that barely went unnoticed in Africa. As of July 2021, Morocco, South Africa, Tunisia, Egypt, Nigeria, Libya, Kenya, Algeria, Zambia and Ethiopia accounted for approximately 86% of the reported increase in COVID-19; these countries were aptly described as being at the forefront of the continent’s third wave of the COVID-19 pandemic. Unlike those countries in Asia and Latin America that experienced what may generally being described as autochthonous COVID-19 third wave, Africa’s third wave COVID-19 cases are widely believed to have been triggered by imported cases. Africa like the rest of the world relaxed its COVID-19 restrictions almost at the same time; hence the continent’s spikes of COVID-19 cases and related deaths during the third wave of the pandemic have raised some questions.
Changing Epidemiology of West Africa Ebola Outbreaks 1994-2014
(Sciencedomain International, 2015-01-07) Kangbai, Jia Bainga
The severity, epidemic duration and general epidemiology of viral epidemic depends on determinants such as viral strain, ecological, environmental and socioeconomic factors.The West Africa Ebola outbreaks in Guinea, Sierra Leone and Liberia in 2014 and in Ivory Coast, Liberia and Gabon in 1994 were reviewed and compared because of their similarity in terms of their geographic location, proximity to each other, pre-outbreak Preparedness status, mortality, epidemic duration, as well as access to international health aid by the affected countries.Data for this study were obtained from the health ministries of Sierra Leone, Guinea, Gabon and Liberia, the United States Center for Disease Control and Prevention (CDC), the World Health Organisation (WHO) published data on Ebola virus disease outbreaks in Guinea, Liberia, Gabon, and Sierra Leone.Sierra Leone recorded its first confirmed Ebola outbreak in 27th May 2014.Both Guinea and Liberia recorded confirmed Ebola outbreaks in March 2014.The 2014 Ebola outbreak in West Africa has a long epidemic duration compared to the 1994 and 1996 outbreaks in Ivory Review Article Kangbai and Koroma; BJMMR, 6(6): 538-546, 2015; Article no.BJMMR.2015.231539 Coast and Gabon respectively partly because of the misdiagnosis of earlier cases and the poor containment measures of the 2014 Ebola outbreak.
Clinical and epidemiological characteristics among probable and confirmed patients with mpox in Sierra Leone reported from January to May 2025
(2025-06-01) Kangbai, Jia Bainga
We analyzed available mpox cases reports in Sierra Leone from January to June 2025 following a historic increase in mpox cases across multiple urban and rural regions in the country. Here, we assessed demographic and clinical data from 187 case reports. Mpox case reports in this study were primarily from Bo (86/187; 46.0%) and Freetown (48/124; 25.7%). Most case reports were from male patients (101/187; 54.0%) as compared to females (86/187; 46.0%), with an overall median age of 26 years (IQR 22-34). The median age was higher among males (30 years; IQR 25-39) then females (24 years; IQR 21-27). Rash, fever, headache, lesions, and generalized pain were reported for all patients, where data was reported. Lymphadenopathy, muscle pain, sore throat, and cough were reported less commonly. Age- and sex-specific interventions, as well as community engagement that includes historically stigmatized groups are critical for mpox containment and mitigation measures in Sierra Leone.
Epidemiological characteristics, clinical manifestations, and treatment outcome of 139 paediatric Ebola patients treated at a Sierra Leone Ebola treatment center
(BioMed Central, 2019-01-24) Kangbai, Jia Bainga
BACKGROUND: The West Africa Ebola Virus Disease (EVD) outbreak in 2014-2016 was declared by the World Health Organization (WHO) a public health emergency of international concern. Most of the previous studies done in Sierra Leone relating to the clinical and epidemiological features of EVD during the 2014-2016 West African outbreak focused on adult EVD patients. There have been conflicting reports about the effects of EVD on children during previous outbreaks. METHODS: This is an observational retrospective analysis of medical data of all laboratory confirmed paediatric EVD patients below 15 years of age who were admitted at the 34 Military Hospital Ebola Treatment Center (ETC) in Wilberforce, Sierra Leone between June 2014 to April 2015. We analyzed the sociodemographic and clinical characteristics of paediatric EVD cases contained in case report forms that were collected by Ebola surveillance officers and clinicians at the 34 Military Hospital ETC. Both univariate and multivariate logistic regression models were used to determine the sociodemographic and clinical characteristics of paediatric EVD patients that were associated with EVD facility-based mortality. RESULTS: The majority of the paediatric EVD cases in this study were female (56.1%), pupils (51.1%), and 43.2% belonged to the age group between 10 years and below 15 years. The median age of the paediatric EVD cases was 9 years (interquartile range = 4 to 11 years). Adjusting for other covariates in the model, male paediatric EVD patient (AOR = 13.4, 95% CI = \[2.07-156-18\], p < 0.05), EVD patient with abdominal pain (AOR = 11.0, 95% CI = \[1.30-161.81\], p < 0.05), vomiting (AOR = 35.7, 95% CI = \[3.43-833.73\], p < 0.05), signs of conjunctivitis (AOR = 17.4, 95% CI = \[1.53-342.21\], p < 0.05) and difficulty in breathing (AOR = 23.3, 95% CI = \[1.92-713.01\], p < 0.05) at the time of admission had increased odds of dying during EVD treatment. CONCLUSIONS: We recommend the adoption of case definitions currently in vigour to cater for specific characteristics of paediatric patients. Subgroups that can be identified by applying the model developed in this study may require special attention and intensified care.
Epidemiological Markers for HIV Infection among First-Time Antenatal Attendees in Sierra Leone: 2012-2015 Longitudinal Study
(2018-03-31) Kangbai, Jia Bainga
Globally it is estimated that 10% of Human Immunodeficiency Virus (HIV) infected patients are coinfected with Hepatitis B Virus (HBV) which is the leading cause of chronic liver diseases including liver cirrhosis and hepatocellular carcinoma. In countries with high HBV endemicity the seroprevalence rate can be as high as 25% with approximately 10% of the HIV infected population coinfected with HBV. HIV and HBV shares similar transmission route and co-infection is common.
Factors associated with length of stay and treatment outcome of Ebola patients treated at an Ebola treatment center in Sierra Leone during the peak period of the West African Ebola outbreak 2013–2016
(BioMed Central, 2021-07-12) Kangbai, Jia Bainga
BACKGROUND: The World Health Organization (WHO) declared the West Africa Ebola epidemic as a Public Health Emergency of International Concern in August 2014. During the outbreak period, there were calls for the affected countries to construct Ebola treatment centres and reliable diagnostic laboratories closer to areas of transmission in order to improve the quality care of Ebola Virus Disease (EVD) patients. Delay in seeking treatment has been reported to have led to poor treatment outcome of EVD patients. Sierra Leone recorded more than 8000 probable and confirmed cases and more than 4000 EVD -related deaths nation-wide. METHODS: In this retrospective study, we investigated the effects of treatment delay, length of symptomatic period, EVD patients' sex, age, occupation, region of residence, and clinical characteristics on the treatment outcome of 205 laboratory-confirmed EVD patients who were admitted at the Kenema Government Hospital Ebola Treatment Center (KGHETC) from 13/09/2014-26/11/2014; i.e. during the peak of 2013-2016 EVD outbreak in Sierra Leone. Specifically also, we determined the factors that were associated with the length of stay for EVD treatment for patients who were discharged alive. RESULTS: Majority (66.3%, n = 205/309) of the 309 suspected EVD patients with medical records at the KGHETC triage during the period under review were tested positive for EVD using reverse-transcriptase-polymerase chain reaction (RT-PCR) and had a definitive treatment outcome. Few (33.7%, n = 104/309) suspected EVD patients were not included in our analysis and were classified thus: 29.1% (n = 90/309) suspect EVD cases with negative RT-PCR results, 4.5% (n = 14/309) suspect cases with non-available RT-PCR result. Of the 205 patients, 99 (48.3%) had a fatal outcome. For EVD patients that survived, we recorded a significant association (- 0.06, 95% Confidence Interval (CI) = - 0.14 - - 0.02, p = 0.004) between the Length of Stay (LOS) and for each kilometer travelled to seek treatment at the KGHETC. However, the association between EVD patients that were low skilled workers (- 5.91, 95% CI = - 24.60 - 12.79, p = 0.73), EVD patients who were children and pupils in junior school (- 0.86, 95% CI = - 12.86 - 11.14, p = 0.73), health seeking delay for EVD patients who resided in Kenema District where the KGHETC was located (- 0.49, 95% CI = - 0.12 - 1.09, p = 0.24), sex (- 1.77, 95% CI = - 8.75 - 5.21, p = 0.50), age (0.21, 95% CI = - 0.36 - 0.77, p = 0.57), referral status (1.21, 95% CI = - 17.67 - 20.09, p = 0.89) and the LOS in surviving patients were not statistically significant. CONCLUSION: The high LOS for either treatment outcome for EVD patients that resided in the district in which the EVD treatment facility was located compared to those patients from other districts implies that health authorities should consider intensive health education with high priority given to seeking early EVD treatment, and the construction of strategic ETCs as important components in their response strategy.
Generation Z and the changing epidemiology of the African Mpox outbreak
(Springer Nature, 2025-08-14) Kangbai, Jia Bainga
Introduction Mpox (formerly known as monkeypox) has re-emerged as a major global public health threat. The Mpox virus, which was previously confined to remote rural settlements, especially in Africa, has been spreading in urban populations. Sierra Leone became the latest country to confirm an Mpox outbreak on January 10, 2025. Since the global Mpox outbreak started in May 2022, over 142,151 laboratory-confirmed cases and 328 deaths have been reported from 133 countries as of May 2025. Africa alone accounted for most of the confirmed cases and deaths. Epidemiology and clade mutation of Mpox Mpox epidemiology has evolved, with two distinct viral clades: clade 1 (Central African) and clade 2 (West African). Both clades exhibit different virulence, transmissibility, and geographic spread. Recently, there has been a notable shift in Mpox epidemiology and transmission dynamics. Specifically, there has been an increase in the number of Mpox cases among commercial sex workers and immunocompromised people. Sexual transmission of Mpox Sexual transmission of Mpox, particularly among Generation Z individuals born between the early 1997 and 2012 poses additional challenges, exacerbating stigma and delaying treatment. Conclusion Children under 15 years have become increasingly affected, accounting for 75% of cases in the Democratic Republic of Congo. Effective Mpox containment requires heightened surveillance, cross-border collaboration, improved vaccination strategies, and education to address stigma and misclassification. The evolving epidemiology of Mpox underscores the need for robust public health responses to mitigate its global impact.
Health Care Facility Network Efficiency and Location Crucial for Ebola Treatment Outcome
(OMICS Publishing Group, 2018) Kangbai, Jia Bainga
**Background:** The application of network analysis in public health research is gaining popularity with the belief that health problems are a product of complex social, political and economic causes.Organisational networks can be used in public health to design and evaluate public health programs.There have been multiple studies in the past relating to public health organisations and HIV/AIDS using organisational networking method.Here we use social network analysis to analyse the association between the network positions of health care facilities and the treatment outcome of Ebola patients from these health care facilities in Sierra Leone. **Methods:** We extracted and later analysed treatment outcome data obtained from the Case Report Forms (CRF) of 117 Ebola patients who sought Ebola treatment at the Kenema Government Hospital from June 2014 to April 2015.For ego network purpose, we considered each Ebola referral health care facility as an ego.Poisson regression analysis was used to determine the association between Ebola mortality rates in a health care facility and the ego's structural holes.Results: The median age, length of stay during Ebola treatment, and the period it takes an Ebola patient to survive treatment following from onset of signs and symptoms were 20 (IQR=17.5 years), 15 (IQR=11 days) and 7 (IQR=5.3days) respectively.There were differences in ego, network efficiency, effective size and constraint for the factors associated with mortality rates for Ebola patients treated at the Kenema Government Hospital.Conclusion: Establishing non-redundant contacts within a health care facility network and expanding their locations can reduce Ebola mortality rates during outbreak.
Lassa Fever in post-Ebola Sierra Leone. Sociodemographics and case fatality rates of in-hospital patients admitted at the Kenema Government Hospital Lassa Fever Ward between 2016-2018
(Springer Science and Business Media LLC, 2019-11-06) Kangbai, Jia Bainga
Background Lassa fever (LF) is a zoonotic acute viral illness mainly found in West Africa. The disease is endemic in some parts of West Africa including Sierra Leone, Liberia, Guinea and Nigeria; while other neighboring countries at high risk of its outbreak since the animal vectors are distributed throughout the region.Methods This is a retrospective mixed cohort study that analysed the treatment history containing the sociodemographic and clinical characteristics of 52 laboratory-confirmed LF cases that were admitted to the Kenema Government Hospital Lassa Fever Ward (KGHLFW) during 2016 to 2018; i.e. during the post Ebola outbreak in Sierra Leone. The LF patients whose treatment history we analysed came from either within or outside Kenema district were the KGHLFW is located.Results Majority (59.6%, n = 31/52) of the LF cases recorded during the period under review were adults; females (65.4%, n = 34/52). 2016 recorded more (40.4%, n = 21/52) LF cases; 2017 (28.8%, n = 15/52) and 2018(30.8%, n = 16/52).Conclusions We highlighted the significance of LF preventive and control measures that can target its seasonal epidemics. These measures could include strategies that can reduce human contact with the rodent vector as well as raise sensitization and awareness about LF among local residents especially those residing along the LF belt in eastern Sierra Leone.
Mpox in Africa: What we know and what is still lacking
(Public Library of Science, 2025-06-12) Kangbai, Jia Bainga
Emerging as a major global health threat, Mpox previously known as Monkeypox has drawn attention due to a worrying surge in cases. This zoonotic disease, native to Central and West Africa, is marked by fever, rash, and lymphadenopathy and is primarily spread through direct contact with infected animals or people and indirectly through contaminated objects. Recent studies have indicated possible sexual transmission, underscoring how human behavior and environmental changes are increasing its prevalence, even though human-to-human transmission is less efficient than that of smallpox. Mpox is endemic in several African countries, and currently, the infection has spread in non-endemic countries, including Rwanda, Uganda, and Kenya. Democratic Republic of Congo is the epicenter of the current Mpox outbreak. From January 1, 2022, to August 6, 2024, sixteen African countries reported Mpox outbreak. Several factors, including population immunity deficiencies and changes to the environment and ecology, have led to the widespread of Mpox in Africa. Challenges such as the fragile healthcare system, limited vaccine availability and access, weak surveillance, and low public awareness poses difficulty in containing the infection in affected countries. Given the potential of Mpox to disrupt several sectors including health systems, which may ultimately reverse progress in achieving the sustainable development goals by 2030. It is imperative for countries, both within and outside Africa, to extend financial aid and human resources to combat the infection effectively.
Public health system in post-pandemic Sierra Leone: a scoping review
(BioMed Central, 2024-12-21) Kangbai, Jia Bainga
BACKGROUND: Since the outbreak of the novel SARS-CoV-2 that caused COVID-19 in 2019, the government of Sierra Leone implemented immediate preventive measures to stop the disease from entering the country. On March 24, 2020, the country declared a state of emergency in response to the emerging global COVID-19 pandemic, even though no confirmed cases had been reported at that time. However, Sierra Leone recorded its first COVID-19 case later in March 2020. While there have been few scoping reviews to date, these primarily focuses on experiences from Western countries or expatriates. The main purpose of this scoping review is to document the various COVID-19 pandemic preparedness measures undertaken by the Sierra Leone health system, assess the impacts of the pandemic on health systems, and document the various responses of health systems implemented across different settings from a home-based perspective. METHODS: We searched peer-reviewed papers and articles under review or submitted for publication in Sierra Leone and the COVID-19 pandemic found in the Web of Science, Scopus, Pubmed, Google Scholar, MedRxiv, and Research Square databases. In addition, we examined gray literature, including Sierra Leone government reports and academic unpublished works on Sierra Leone's COVID-19 situation. Both quantitative and qualitative studies were analyzed, focusing on the Sierra Leone health system or on the essential health services provided by the Sierra Leone health system during the COVID-19 pandemic. RESULTS: Few (48.7%) studies were multi-country studies (i.e., involving different countries and Sierra Leone). The majority (83.7%) were original articles published either in peer-reviewed journals or were deposited in preprint repositories; 10.9% were editorials, commentaries, or news reports; 1 (2.7%) was a working paper; and 1 (2.7%) was personal correspondence. CONCLUSION: Sierra Leone's health system was partially prepared for the COVID-19 pandemic, largely due to its previous experience in managing the Ebola virus disease outbreaks from 2013 to 2016. However, the pandemic had significant impact on other health services. Although the country's response to the pandemic was swift, it fell below average in addressing the scale of the challenges posed by the crisis.
Re-reading ACT, BCG, and Low COVID-19 in Africa
(Springer Nature, 2021) Kangbai, Jia Bainga
October 11, 2020, marks the seventh month since the World Health Organization (WHO) officially declared COVID-19 a pandemic. Unlike other coronavirus diseases, there is a geographically disproportionate distribution of the incidence of COVID-19 cases around the world. We observed a significantly high COVID-19 cases and deaths in countries and territories with no or very small number of malaria cases or no or low national TB cases in 2018. We speculate that the high incidence of COVID-19 cases and deaths in countries less affected by malaria is partly due to overexposure to malaria which led to the regular use of the artemisinin anti-malaria drugs as well as the regular use of bacillus Calmette-Guérin (BCG) vaccine for TB prevention. The vaccine produced an almost life-long immunity to TB and meningitis to its recipients. We are thus calling for a COVID-19 containment and clinical management protocol that will incorporate the use of the anti-malaria ACT drug cocktail and BCG vaccine on compassionate ground.
Regression Modelling and Analysis of Cell phone-Based Syndromic Surveillance Data for Ebola in Sierra Leone
(OMICS Publishing Group, 2016) Kangbai, Jia Bainga
**Aim:** To determine the out degree centrality for multivariate analysis, examine the demographic differences and characteristics of callers who make more calls, and determine 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 cell phone technology.UCINET and Net Draw software were used to determine the out degree centrality used for multivariate analysis.Poisson and logistic regression analyses were used to do multivariable analysis.Result: Women (AOR=0.33,95% CI \[0.14, 0.81\]) was associated with decreased odds of making at least one positive Ebola surveillance call compared to men.Women (IR= 0.63, 95% CI \[0.49, 0.82\]) was also associated with making fewer Ebola surveillance calls compared to men. **Conclusion:** This study shows that the combination of cell phone technology with user-friendly and open-source social network software such as UCINET and Net draw will provide an important adjunct to the traditional measures of epidemiologic surveillance.
Roles and strategies of international humanitarian organisations in handling the Liberia Ebola outbreak
(Springer Science and Business Media LLC, 2019-11-26) Kangbai, Jia Bainga
Background In Early August 2014, the World Health Organisation declared an Ebola Virus Disease (EVD) outbreak in the region of West Africa. The West African EVD outbreak was the largest, most severe, and complex in the nearly four-decade history of this disease. The management of EVD cases in Liberia was similar to the other affected West African countries. Methods We reviewed the method and strategies used by some of the international humanitarian organisations in handling the 2013-2016 Ebola outbreak in Liberia. This report is a collection of personal field experiences in Liberia as well as personal interviews of healthcare personnel working for some of these international organisations working on the Ebola emergency in Liberia. Findings Medecins Sans Frontieres (MSF) was the first humanitarian NGO to deploy medical staff to the field in Liberia during the 2013-2016 EVD outbreak. MSF staffs were already operating in Liberia even before the declaration of the outbreak in August 2014.Conclusions The slow response by the international humanitarian organisations to lend their support in bringing the EVD outbreak to and exhibited the fear the international community have for deadly infectious diseases more than armed conflicts.Recommendations We recommend regularly training in public health emergency preparedness for third world countries that are highly susceptible to health emergencies such as Ebola outbreak to help prepared them ahead of such outbreak.
Severity score for predicting in-facility Ebola treatment outcome
(Elsevier BV, 2020-08-04) Kangbai, Jia Bainga
Purpose Sierra Leone recorded the highest incidence rate for the 2013-2016 West African Ebola outbreak. In this investigation, we used the medical records of Ebola patients with different sociodemographic and clinical features to determine the factors that are associated with Ebola treatment outcome during the 2013-2016 West African Ebola outbreak in Sierra Leone and constructed a predictive in-facility mortality score. Methods We used the anonymized medical records of 1077 laboratory-confirmed pediatric and adult patients with EVD who received treatment at the 34 Military Hospital and the Police Training School Ebola Treatment Centers in Sierra Leone between the period of June 2014 and April 2015. We later determined the in-facility case fatality rates for Ebola, the odds of dying during Ebola treatment, and later constructed a predictive in-facility mortality score for these patients based on their clinical and sociodemographic characteristics. Results We constructed a model that partitioned the study population into three mortality risk groups of equal patient numbers, based on risk scoring: low (score ≤ -5), medium (score -4 to 1), and high-risk group (score ≥ 2). The CFR of patients with EVD belonging to the low- (≤-5), medium (-4 to 1), and high- (≥2) risk groups were 0.56%, 9.75%, and 67.41%, respectively. Conclusions We succeeded in designing an in-facility mortality risk score that reflects EVD clinical severity and can assist in the clinical prioritization of patients with EVD.
Sociodemographic and clinical determinants of in-facility case fatality rate for 938 adult Ebola patients treated at Sierra Leone Ebola treatment center
(BioMed Central, 2020-04-21) Kangbai, Jia Bainga
BACKGROUND: The 2013-2016 West Africa Ebola Virus Disease (EVD) outbreak recorded the highest incidence and mortality since the discovery of the virus in Zaire in 1976; with more than 28,000 probable and confirmed EVD cases and 11,000 deaths. Studies relating to previous outbreaks usually involved small sample sizes. In this study we are set to identify those sociodemographic and clinical features that predict in-facility mortality among EVD patients using a large sample size. METHODS: We analysed the anonymized medical records of 938 laboratory-confirmed EVD patients 15 years old and above who received treatment at The 34 Military Hospital and The Police Training School EVD Treatment Centers in Sierra Leone in the period June 2014 to April 2015. We used both univariable and multivariable logistic regression to determine the predictors for in-facility mortality of these patients based on their sociodemographic and clinical characteristics. RESULTS: The median age of the EVD cases was 33 years (interquartile range = 25 to 40 years). The majority of the EVD cases were male (59.0%) and had secondary level education (79.3%). We reported a low overall in-facility case fatality rate of 26.4%. The associations between case fatality rates and EVD patients who reported fever, abdominal pain, cough, diarrhoea, vomiting, fatigue, haemorrhage, dysphagia, conjunctival injection, dyspnea, and skin rash at the time of admission were all statistically significant (p < 0.05). Our preferred model with the age group 65 years and above alongside the following clinical symptoms; diarrhoea, vomiting, fatigue, dysphagia, conjunctival injection, dyspnea and cough produced a receiver operating characteristic (ROC) curve with an AUC (area under the curve) value of 0.93. CONCLUSIONS: We constructed a simple model that can be optimally used alongside other rapid EVD diagnostic tools to identify EVD in-facility treatment mortality predictors based on the sociodemographic characteristics and clinical symptoms of adult EVD patients. We also reported low EVD cases among patients with secondary and tertiary education. These subpopulations of our patients who are generally informed about the signs and symptoms of EVD, alongside our treatment regimen may have been responsible for our comparatively lower case fatality rate.
Sociodemographic and clinical determinants of in-facility case fatality rate for 938 Ebola patients treated in Sierra Leone
(Springer Science and Business Media LLC, 2019-06-29) Kangbai, Jia Bainga
Background The 2013 – 2016 West Africa Ebola Virus Disease (EVD) outbreak recorded the highest incidence and mortality since the discovery of the virus in Zaire in 1976. Studies relating to previous outbreaks usually involved small sample sizes. In this study we are set to identify those sociodemographic and clinical features that predict in-facility mortality among EVD patients using a large sample size. Methods We analysed the anonymized medical records of 938 laboratory-confirmed EVD patients 15 years old and above that received treatment at the 34 Military Hospital and the Police Training School EVD Treatment Centers in Sierra Leone in the period June 2014 to April 2015. We used both univariable and multivariable logistic regression to determine the predictors for in-facility mortality of these patients based on their sociodemographic and clinical characteristics. Results The median age of the EVD cases was 33 years (interquartile range = 25 to 40 years). The majority of the EVD cases were male (59.0%) and had secondary level education (79.3%). A low overall in-facility case fatality rate of 26.4% was shown. The associations between case fatality rates and EVD patients who reported fever, abdominal pain, cough, diarrhoea, vomiting, fatigue, haemorrhage, dysphagia, conjunctival injection, dyspnoea, and skin rash at the time of admission were statistically significant (p < 0.05). Our preferred model with age group of EVD patients and the presence of the symptoms diarrhoea, vomiting, fatigue, dysphagia, conjunctival injection, dyspnoea and muscle pain produced a receiver operating characteristic (ROC) curve with an AUC (area under the curve) value of 0.94. Conclusions The age of EVD patients, as well those patients who reported vomiting, diarrhoea, fatigue, dysphagia, conjunctival injection, dyspnoea and muscle pain have increased odds of dying during treatment and hence will require prompt and intensive treatment at the time of admission. We argue that the high proportion of individuals with higher educational levels may have been a critical determinant for the low case fatality rate.
Tracking Ebola through cellphone, internet of things and Blockchain technology
(OMICS Publishing Group, 2018) Kangbai, Jia Bainga
**Objective:** In the absence of any approved therapeutics and vaccines to treat or prevent Ebola infection, managing Ebola outbreak largely depends on early case detection and surveillance, real-time communication of surveillance data, and Ebola case management. Here we assessed the possibility of uploading data obtained by Internet of Internet device that monitors cellphone company’s Call Data Records (CDR), national demographic census, national transportation system and Ebola vaccine production databases on a Blockchain platform to conduct real-time Ebola contact tracing, transmission pattern surveillance and vaccine delivery. **Results:** Mobility data obtained by Internet of Things (IoT) from CDR from cellphone companies, national transportation system, and census demographic data can be integrated into a Blockchain platform to provide real-time Ebola surveillance and contact-tracing. While cellphone data provides a unique opportunity to quantify human mobility, Blockchain system magnifies such opportunity by making the data accessible to many actors in real-time. By mounting data from CDR, national population census, national transport system and Ebola vaccine production database on a Blockchain platform will provide additional lens in our understanding of the role played by human population dynamics in the spread as well and containment of Ebola during outbreaks
Virologic Response and Survival Analysis of 281 HbsAg Treatment Naive Patients on Lamivudine Monotherapy in Sierra Leone
(2017-10-06) Kangbai, Jia Bainga
More than 350 million people are infected with Hepatitis B Virus (HBV) globally. The main aim of any chronic hepatitis B therapy is to prevent liver cirrhosis and its sequelae, including Hepatocellular Carcinoma (HCC). This is a cross sectional study that analysed medical records of 281 HBsAg seropositive patients in order to determine those factors that are associated with the reduction in the HBV viral load and the duration of HBV lamivudine monotherapy in order to attain a virological response.