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Onchocerca volvulus: Application of the polymerase chain reaction to identification and strain differentiation of the parasite
(Elsevier BV, 1991-10-01) Meredith, Stefanie E. O.
The relationship between decrease in feed intake and infection with trypanosoma congolense and T. vivax in West African dwarf goats
(Taylor & Francis, 1993-03-01) Wassink, G. J.
Twenty-three mature dwarf goats were used to study whether there is a relationship between the decrease in feed intake for individual goats and infection with T.congolense and T. vivax. Furthermore, it was investigated how rectal temperatures and blood parameters were affected by the T. congolense infection and how changes in these parameters can be used to predict the effect of a T. vivax infection on feed intake. For individual goats a ranking correlation was found between relative dry matter intake and infection (r = 0.59; p < .05). Animals with the most marked decrease in dry matter intake during the T. congolense infection showed a smaller increase in urea and a higher increase in non esterified fatty acids and beta-hydroxy butyrate levels in their blood. Evidence was obtained that the relative decrease in dry matter intake for individual goats during a T. vivax infection can be predicted on the basis of urea and creatinine responses measured in the blood during a previous infection with T. congolense infection.
Inland valley swamp rice development: Malaria, schistosomiasis, onchocerciasis in South Central Sierra Leone
(Elsevier BV, 1994-03-01) Gbakima, A A
The prevalence of malaria, schistosomiasis and onchocerciasis was determined in 1,106 residents of five villages in the Moyamba District, Southern Sierra Leone, to determine whether inland valley swamp (IVS) development was associated with changes in the prevalence of malaria, schistosomiasis and onchocerciasis in these villages. These parasitic diseases were studied in four villages receiving IVS, Food and Agricultural Organization (FAO) assistance and in one village not receiving FAO assistance. Malaria was the most prevalent infection, detected in 42.6% of the persons examined, followed by O. volvulus (17.7%), S. haematobium (0.6%) and S. mansoni (0.3%). Plasmodium falciparum accounted for 90.4% of the malaria infections, followed by P. malaria (2.1%), P. ovale (0.5%), and mixed infections (7.0%). The trend of infection to O. volvulus increased significantly with an increase in age. S. haematobium (0.6%) and S. mansoni (0.3%) infections were low and no Biomphalaria pfeifferi and Bulinus globosus were found in 33 IVS development swamps examined. These data indicate that IVS development is associated with an increase in the prevalence of malaria infection, but not in the prevalence of O. volvulus, S. haematobium and S. mansoni.
Functionality and Antioxidant Properties of Tilapia (Oreochromis niloticus) as Influenced by the Degree of Hydrolysis
(Multidisciplinary Digital Publishing Institute, 2010-04-26) Foh, Mohamed Beva Kelfala
Freeze dried protein powders (Fresh minced meat, FMM and Hot water dip, HWD) from tilapia (Oreochromis niloticus) were hydrolyzed by Alcalase 2.4 L (Alc), Flavourzyme (Flav) and Neutrase (Neut), and investigated for antioxidant activity and their functional properties. FMM and HWD hydrolysed by Alc, exhibiting superior antioxidant activity, had estimated degrees of hydrolysis (DH) of 23.40% and 25.43%, respectively. The maximum values of the 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS), 3-(2-pyridyl) 5,6-bis(4-phenyl-sulphonic acid)-1,2,4-triazine (ferrozine), radical scavenging activities and metal chelating properties were 86.67%, 91.27% and 82.57%, and 84.67%, 92.60% and 78.00% for FMM and HWD, respectively, with a significant difference (P 8,000 Da. At pH 2, FMM and HWD hydrolysates have varying solubilities above 85% (Alc FMM; 91.33%, Flav FMM; 79.5%, Neut FMM; 83.8% and Alc HWD; 90.45%, Flav HWD; 83.5%, and Neut HWD; 85.8%). They have 'U' shaped solubility curves, water holding capacity was in the range of 2.77 and 1.77 mL/g, while oil holding capacity ranged between 3.13 and 2.23 mL/g. FMM and HWD have the highest bulk density of 0.53 and 0.53 for Neutrase and Alcalase 2.4 L, respectively. Foam capacity and stability ranged from 125.5 to 61.4, 138.5 to 45.2, 130.0 to 62.5, and 124.5 to 55.0, 137.5 to 53.3, 129.6 to 62.7 for FMM and HWD hydrolyzed with Alcalase 2.4 L, Flavourzyme and Neutrase, respectively. Tilapia fish protein hydrolysates are thus potential functional food ingredients.
Influence of pH Shift on Functional Properties of Protein Isolated of Tilapia (Oreochromis niloticus) Muscles and of Soy Protein Isolate
(Springer Science+Business Media, 2011-01-10) Foh, Mohamed Beva Kelfala
Improved mapping strategy to better inform policy on the control of schistosomiasis and soil-transmitted helminthiasis in Sierra Leone
(BioMed Central, 2011-06-06) Hodges, Mary
BACKGROUND: 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 Schistosoma mansoni and STHs. RESULTS: The overall prevalence of S. mansoni 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 S. mansoni 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 S. mansoni 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 S. mansoni 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 Ascaris lumbricoides (1.5%, 17.8 epg) and Trichuris trichiura (2.5%, 20.3 epg) was low. CONCLUSIONS: The prediction by previous spatial analysis that S. mansoni was highly endemic across north-eastern Sierra Leone was confirmed with a significant proportion of children heavily or moderately infected. The distribution of S. mansoni 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.
Mass drug administration significantly reduces infection of Schistosoma mansoni and hookworm in school children in the national control program in Sierra Leone
(BioMed Central, 2012-01-22) Hodges, Mary H
BACKGROUND: The first-ever round of school-based mass drug administration (MDA) with praziquantel together with mebendazole targeting school-aged children in endemic districts was conducted in 2009 by the National Neglected Tropical Diseases Control Program. To evaluate the impact of the treatment regimen, a cross-sectional sentinel site survey was conducted 6 months post-MDA. METHODS: Fifteen sentinel schools from six highly endemic districts (according to data from national and pre-MDA surveys) with Schistosoma mansoni affecting over 50% of the population, and moderate to high prevalence of hookworms (> 20%). Approximately 30 children aged 9-14 years were selected from each school and stool samples (one per student) were examined by the Kato-Katz method. RESULTS: The overall prevalence (and intensity) in these sentinel sites pre-MDA of S. mansoni was 69.0% (170.8 epg), hookworm: 41.7% (71.7 epg), Ascaris lumbricoides: 1.8% and Trichuris trichiura: 3.8%. Six months post MDA, the findings were S. mansoni: 38.2% (47.3 epg) and hookworm: 14.5% (8.7 epg), representing a reduction from pre-MDA levels of 44.6% (65.2%) and 72.3% (87.9%) respectively. The proportion of children who were moderately or heavily infected with S. mansoni fell from 35.6% pre MDA to 9.9% post MDA. CONCLUSIONS: Significant reduction in S. mansoni and hookworm infection was achieved by this first round MDA in school-going children in Sierra Leone. This reduction in infection burden can potentially contribute to a reduction of morbidity, such as anaemia, in these children.
High level of Schistosoma mansoni infection in pre-school children in Sierra Leone highlights the need in targeting this age group for praziquantel treatment
(Elsevier BV, 2012-07-20) Hodges, Mary Hamer
Presumptive self-diagnosis of malaria and other febrile illnesses in Sierra Leone
(African Field Epidemiology Network, 2013) Ansumana, Rashid
INTRODUCTION: The objective of this study was to evaluate the prevalence of self-diagnosis of malaria and other febrile illnesses in Bo, Sierra Leone. METHODS: All households in two neighboring sections of Bo were invited to participate in a cross-sectional survey. RESULTS: A total of 882 households (an 85% participation rate) that were home to 5410 individuals participated in the study. Of the 910 individuals reported to have had what the household considered to be malaria in the past month, only 41% were diagnosed by a healthcare professional or a laboratory test. Of the 1402 individuals reported to have had any type of febrile illness within the past six months, only 34% had sought a clinical or laboratory diagnosis. Self-diagnosis of influenza, yellow fever, typhoid, and pneumonia was also common. CONCLUSION: Self-diagnosis and presumptive treatment with antimalarial drugs and other antibiotic medications that are readily available without a prescription may compromise health outcomes for febrile adults and children.
Reemergence of Chikungunya Virus in Bo, Sierra Leone
(Centers for Disease Control and Prevention, 2013-05-24) Ansumana, Rashid
We diagnosed 400 possible IgM-positive cases of chikungunya virus in Bo, Sierra Leone, during July 2012-January 2013 by using lateral flow immunoassays. Cases detected likely represent only a small fraction of total cases. Further laboratory testing is required to confirm this outbreak and characterize the virus.
Factors Associated with Mortality in Febrile Patients in a Government Referral Hospital in the Kenema District of Sierra Leone
(American Society of Tropical Medicine and Hygiene, 2014-11-18) Roth, Prerana
There is a paucity of data on the etiologies and outcomes of febrile illness in rural Sierra Leone, especially in the Lassa-endemic district of Kenema. We conducted a retrospective study of patients with subjective or documented fever (T ≥ 38.0°C) who were admitted to a rural tertiary care hospital in Kenema between November 1, 2011 and October 31, 2012. Of 854 patients admitted during the study period, 429 (50.2%) patients had fever on admission. The most common diagnoses were malaria (27.3%), pneumonia (5.1%), and Lassa fever (4.9%). However, 53.4% of febrile patients had no diagnosis at discharge. The in-hospital mortality rate was 18.9% and associated with documented temperature ≥ 38.0°C (adjusted odds ratio \[AOR\] = 2.89, P = 0.001) and lack of diagnosis at discharge (AOR = 2.04, P = 0.03). Failure to diagnose the majority of febrile adults and its association with increased mortality highlight the need for improved diagnostic capacity to improve patient outcomes.
Exposure to Dioxins and Furans at the Bormeh Kingtom Dumpsite in the Western Area of Sierra Leone
(Scientific Research Publishing, 2015) Mansaray, Abubakarr Sidique
Humans and animals can be exposed to Dioxins and Furans through ingestion of fatty food, skin contact, and breathing contaminated air. Resulting health problems include skin disease, immune problems, and cancers. Managing the release of these chemicals is therefore important. The Stockholm Convention on Persistent Organic Pollutants requires parties to adopt measures that reduce sources of these chemicals. Sierra Leone developed its National Implementation Plan (NIP) in 2008, in compliance with this requirement. However, no known further steps have been taken, particularly at community level. In 2013, the UNDP’s GEF/SGP funded a pilot project to manage the release of Dioxins and Furans from two dumpsites in Freetown, Sierra Leone. This work was sponsored with funds from that project. The work sought to delineate the exposure of communities within and around the Bormeh-Kingtom dumpsite (Kingtom, Kolleh town, Ascension town, Crab town, and Congo town) to the chemicals. The study considered sources of exposure, relative quantities generated per year, and the routes of exposure. This exposure study is a first step in managing the release from those sources. Enumerators deployed at the dumpsite every day, 7:00 AM to 6:00 PM, for three months, quantifying and recording source materials. The amount of source materials dumped per day informed calculation of Dioxin/Furan releases in grams toxicity equivalence per year. The results revealed a release of 128.914 g TEQ/year in air and residue. This implies that the communities are at high risk of inhalation and dermal exposure. Livestock, mainly pigs, are also exposed as they feed on the waste deposited in the dumpsite. Humans in turn feed on the livestock, a recipe for biomagnification. The project team has been working on developing Best Management Practices to suppress the release of the chemicals.
Attitudes toward home-based malaria testing in rural and urban Sierra Leone
(BioMed Central, 2015-02-15) Ranasinghe, Shamika
BACKGROUND: The purpose of this study was to examine malaria testing practices and preferences in Bo, Sierra Leone, and to ascertain interest in and willingness to take a home-based rapid diagnostic test administered by a community health volunteer (CHV) or a trained family member rather than travelling to a clinical facility for laboratory-based testing. METHODS: A population-based, cross-sectional survey of 667 randomly-sampled rural households and 157 urban households was conducted in December 2013 and January 2014. RESULTS: Among rural residents, 69% preferred a self/family- or CHV-conducted home-based malaria test and 20% preferred a laboratory-based test (with others indicating no preference). Among urban residents, these numbers were 38% and 44%, respectively. If offered a home-based test, 28% of rural residents would prefer a self/family-conducted test and 68% would prefer a CHV-assisted test. For urban residents, these numbers were 21% and 77%. In total, 36% of rural and 63% of urban residents reported usually taking a diagnostic test to confirm suspected malaria. The most common reasons for not seeking malaria testing were the cost of testing, waiting to see if the fever resolved on its own, and not wanting to travel to a clinical facility for a test. In total, 32% of rural and 27% of urban participants were very confident they could perform a malaria test on themselves or a family member without assistance, 50% of rural and 62% of urban participants were very confident they could perform a test after training, and 56% of rural and 33% of urban participants said they would pay more for a home-based test than a laboratory-based test. CONCLUSION: Expanding community case management of malaria to include home testing by CHVs and family members may increase the proportion of individuals with febrile illnesses who confirm a positive diagnosis prior to initiating treatment.
Sequence Variability and Geographic Distribution of Lassa Virus, Sierra Leone
(Centers for Disease Control and Prevention, 2015-03-11) Łęski, Tomasz A.
Lassa virus (LASV) is endemic to parts of West Africa and causes highly fatal hemorrhagic fever. The multimammate rat (Mastomys natalensis) is the only known reservoir of LASV. Most human infections result from zoonotic transmission. The very diverse LASV genome has 4 major lineages associated with different geographic locations. We used reverse transcription PCR and resequencing microarrays to detect LASV in 41 of 214 samples from rodents captured at 8 locations in Sierra Leone. Phylogenetic analysis of partial sequences of nucleoprotein (NP), glycoprotein precursor (GPC), and polymerase (L) genes showed 5 separate clades within lineage IV of LASV in this country. The sequence diversity was higher than previously observed; mean diversity was 7.01% for nucleoprotein gene at the nucleotide level. These results may have major implications for designing diagnostic tests and therapeutic agents for LASV infections in Sierra Leone.
Child bed net use before, during, and after a bed net distribution campaign in Bo, Sierra Leone
(BioMed Central, 2015-11-18) Ranasinghe, Shamika
BACKGROUND: This analysis examined how the proportion of children less than 5-years-old who slept under a bed net the previous night changed during and after a national long-lasting insecticidal net (LLIN) distribution campaign in Sierra Leone in November-December 2010. METHODS: A citywide cross-sectional study in 2010-2011 interviewed the caregivers of more than 3000 under-five children from across urban Bo, Sierra Leone. Chi squared tests were used to assess change in use rates over time, and multivariate regression models were used to examine the factors associated with bed net use. RESULTS: Reported rates of last-night bed net use changed from 38.7 % (504/1304) in the months before the LLIN campaign to 21.8 % (78/357) during the week of the campaign to 75.3 % (1045/1387) in the months after the national campaign. The bed net use rate significantly increased (p < 0.01) from before the campaign to after the universal LLIN distribution campaign in all demographic, socioeconomic, and health behaviour groups, even though reported use during the campaign dropped significantly. CONCLUSION: Future malaria prevention efforts will need to promote consistent use of LLINs and address any remaining disparities in insecticide-treated bed net (ITN) use.
The demographics of patients affected by surgical disease in district hospitals in two sub-Saharan African countries: a retrospective descriptive analysis
(Springer International Publishing, 2015-12-01) Grimes, Caris E
BACKGROUND: There is a growing awareness of the importance of surgical disease within global health. We hypothesised that surgical disease in low income countries predominantly affects young adults and may therefore have a significant economic impact. METHODS: We retrospectively reviewed all surgical admission data from two rural government district hospitals in two different sub-Saharan African countries over a 6-month period. We analysed all surgical admissions with respect to patient demographics (age and gender), diagnosis, and procedure performed. RESULTS: Surgical admissions accounted for 12.9 and 19.8 % of all hospital admissions in Malawi and Sierra Leone respectively. 18.5 and 6.2 % of all hospital patients required a surgical procedure in Malawi and Sierra Leone respectively, with the low number in Sierra Leone accounted for in that many of the obstetric admissions were referred to a nearby Medicins Sans Frontiers (MSF) hospital for treatment. 17.9 and 10.5 % of surgical admissions were under the age of 16 in Malawi and Sierra Leone respectively, with 16-35 year olds accounting for 57.3 % of surgical admissions in Sierra Leone and 53.5 % in Malawi. Men accounted for 53.7 and 46.0 % of surgical admissions in Sierra Leone and Malawi respectively. An unexpected finding was the high level of patients who absconded from hospital in Sierra Leone after diagnosis but before treatment. This involved 11.8 % of all surgical patients, including 38 % with a bowel obstruction, 39 % with peritonitis and 20 % with ectopic pregnancy. CONCLUSIONS: Most people affected by disease requiring surgery are young adults and this may have significant economic implications.
Healthcare providers on the frontlines: a qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic
(Oxford University Press, 2016-06-08) McMahon, Shannon A
Although research on the epidemiology and ecology of Ebola has expanded since the 2014-15 outbreak in West Africa, less attention has been paid to the mental health implications and the psychosocial context of the disease for providers working in primary health facilities (rather than Ebola-specific treatment units). This study draws on 54 qualitative interviews with 35 providers working in eight peripheral health units of Sierra Leone's Bo and Kenema Districts. Data collection started near the height of the outbreak in December 2014 and lasted 1 month. Providers recounted changes in their professional, personal and social lives as they became de facto first responders in the outbreak. A theme articulated across interviews was Ebola's destruction of social connectedness and sense of trust within and across health facilities, communities and families. Providers described feeling lonely, ostracized, unloved, afraid, saddened and no longer respected. They also discussed restrictions on behaviors that enhance coping including attending burials and engaging in physical touch (hugging, handshaking, sitting near, or eating with colleagues, patients and family members). Providers described infection prevention measures as necessary but divisive because screening booths and protective equipment inhibited bonding or 'suffering with' patients. To mitigate psychiatric morbidities and maladaptive coping mechanisms-and to prevent the spread of Ebola-researchers and program planners must consider the psychosocial context of this disease and mechanisms to enhance psychological first aid to all health providers, including those in peripheral health settings.
Evaluation of convalescent whole blood for treating Ebola Virus Disease in Freetown, Sierra Leone
(Elsevier BV, 2016-11-17) Sahr, F
Background Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), but less attention has been focused on it for treatment. Method We assessed the effectiveness of convalescent whole blood (CWB) in the treatment of consented EVD patients. We recruited 69 subjects in December 2014 up to April 2015, at the 34 Military Hospital in Wilberforce and the PTS 1 Ebola Treatment Unit in Hastings, Freetown. Forty-four were given CWB, and 25 who consented but preferred to be exempted from the CWB treatment were used to compare clinical outcomes. All were given routine treatment used at the Ebola Treatment Unit. Results One of 44 subjects treated with CWB dropped out of the study and 31 recovered while 12 succumbed to the disease with a case fatality rate of 27.9%. For the group that was given routine treatment without CWB, 11 died with a case fatality rate of 44%. There was a significant difference between admission viral load and viral load after the first 24 h of treatment with convalescent whole blood (P Conclusion CWB is promising for treating EVD in resource-poor settings, especially in the early phases of outbreaks when resource-mobilization is done. Even though our sample size was small and the evaluation was not randomised, our results contribute to existing evidence that convalescent whole blood could be considered as a useful candidate for treating EVD. Further studies that are randomised will be required to further assess the efficacy of CWB as treatment option during any EVD outbreak.
The Safety of Water Supplied at Njala University, Njala Campus
(Scientific Research Publishing, 2017) Mansaray, Abubakarr Sidique
The safety of water is usually determined by comparing its quality to recommended standards. The objective of this work was to determine whether the water supplied on Njala Campus is safe for drinking. The quality parameters investigated include coliform bacteria, turbidity, conductivity, total dissolved solids and nitrates. Samples were stored in a cooler with ice and transported to the laboratory within 30 minutes of collection. A checklist of questions to know the perception of residents was administered. According to the physical and biological results, the water is not safe for consumption. The turbidity and microbial counts were too high in most samples both in the wet and dry seasons. Additionally, over 80% of the respondents did not trust the water supply system. Most of them treat the supplied water by either boiling or disinfection before use. Most respondents complained of water-borne diseases but were not clear whether it is related to the water supplied. The chemical parameters, however, were acceptable: nitrate levels were low. In conclusion, the water is not safe for consumption as far as the physical and biological parameters are concerned. The campus water supply system needs improvement in terms of conveying raw and finished water, filter optimization, and satisfying the chlorine demand.
Surveillance of Vector-Borne Infections (Chikungunya, Dengue, and Malaria) in Bo, Sierra Leone, 2012–2013
(American Society of Tropical Medicine and Hygiene, 2017-08-22) Dariano, Donald F.
Malaria remains a significant cause of morbidity and mortality in West Africa, but the contribution of other vector-borne infections (VBIs) to the burden of disease has been understudied. We used rapid diagnostic tests (RDTs) for three VBIs to test blood samples from 1,795 febrile residents of Bo City, Sierra Leone, over a 1-year period in 2012–2013. In total, 24% of the tests were positive for malaria, fewer than 5% were positive for markers of dengue virus infection, and 39% were positive for IgM directed against chikungunya virus (CHIKV) or a related alphavirus. In total, more than half (55%) of these febrile individuals tested positive for at least one of the three VBIs, which highlights the very high burden of vector-borne diseases in this population. The prevalence of positives on the Chikungunya IgM and dengue tests did not vary significantly with age (P > 0.36), but higher rates of malaria were observed in children < 15 years of age (P < 0.001). Positive results on the Chikungunya IgM RDTs were moderately correlated with rainfall (r2 = 0.599). Based on the high prevalence of positive results on the Chikungunya IgM RDTs from individuals Bo and its environs, there is a need to examine whether an ecological shift toward a greater burden from CHIKV or related alphaviruses is occurring in other parts of Sierra Leone or the West African region.