School-wide publications

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Start date: 2010

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    Whole-genome sequencing and phylogenetic analysis of the first and second confirmed cases of human infection with Monkeypox virus from Sierra Leone
    (Elsevier BV, 2025-08-12) Yu, Shuo
    Whole-genome sequencing and phylogenetic analysis of the first and second confirmed cases of human infection with Monkeypox virus from Sierra LeoneTo the Editor, We read with great interest the letter by Yadav and colleagues, which detailed the need to focus on understanding the evolutionary trajectory of monkeypox virus. 1 The monkeypox virus (MPXV) is genetically classified into four primary clades (Ia, Ib, IIa, IIb).Notably, the newly identified clade Ib has emerged as the dominant strain in the current Public Health Emergency of International Concern (PHEIC), exemplified by the ongoing outbreak in the Democratic Republic of the Congo. 2 Concurrently, global transmission of clade IIb MPXV persists, underscoring that the ongoing epidemic warrants serious attention.On January 10-11, 2025, Sierra Leone released the case reports of its first two human infections with monkeypox virus during the PHEIC, becoming the final member of the Mano River Alliance to document such cases.Here, we present the two case studies with viral sequencing insights, shedding light on MPXV evolution in West Africa.Case 1 was a male in his twenties working as a car dealer who presented to the hospital in early January.He had traveled to Lungi (Port Loko District) from 26 December 2024 to 5 January 2025 (Fig. 1A).Symptom onset occurred on 6 January.Case 2, a male staff at a restaurant over 20 years old, developed symptoms on 6 January and sought hospital care in January.Both of the vesicle samples were confirmed MPXV-positive by real-time PCR using Monkeypox Virus Nucleic Acid Detection Kit at the Molecular Laboratory of 34th Military Hospital in Sierra Leone on January 10 and 11, respectively (Fig. 1A; Fig. S1 in the Appendix).Mean cycle threshold values were 20.29 for Case 1 and 15.14 for Case 2. The patients were admitted to the infectious disease isolation unit and were managed appropriately.Pre-rash symptoms included fever and headache, with rash involvement of the face, palms, and other cutaneous sites (Fig. S2 in the Appendix).Case 2 additionally presented with genital rashes with dysuria.Both patients denied animal/known case exposure, blood transfusions, travel (except for Case 1's documented trip, Journal of Infection 91 (2025) 106587
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    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.
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    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.
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    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.
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    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.
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    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.
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    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.
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    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.