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Permanent URI for this collectionhttps://dspace.njala.edu.sl/handle/20.500.144402/169

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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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    Adult malaria mortality during 2019 at Bo Government Hospital, Sierra Leone
    (Bill & Melinda Gates Foundation, 2023-03-15) Kpagoi, Satta Sylvia T K
    It is uncertain whether malaria is an important cause of death among adults in endemic areas. We performed a chart review of adults admitted to Bo Government Hospital during 2019. Of 893 admissions, 149 (59% female, mean age 58.5 years) had a laboratory diagnosis of malaria and 22 (14.8%) died. Mortality was significantly higher among patients with severe malaria compared with those who had non-severe malaria (6/20 \[30%\] versus 16/129 \[12.4%\], p =0.031). Our results suggest that malaria is a common cause of death in hospitalized Sierra Leonian adults.
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    Strengthening health system resilience during COVID-19: a qualitative study of national-level decision-makers in Guinea and Sierra Leone
    (BMJ, 2025-12-01) Fischer, Hanna-Tina
    INTRODUCTION: 4 years after the Ebola outbreak, the arrival of COVID-19 presented West Africa with a new shock. Despite widespread disruptions, malaria service continuity remained a priority in both countries. In Sierra Leone, the proportion of pregnant women receiving at least three doses of intermittent preventive treatment increased from 36% in 2018 to 50% in 2021. Similarly, insecticide-treated net ownership in Guinea rose from 44% to 63%, reflecting the ability of national programmes to sustain essential interventions despite pandemic-related constraints. Against this backdrop, this study investigates the strategies used to strengthen health system resilience in Guinea and Sierra Leone during the pandemic. Specifically, it explores how both countries responded to the pandemic's demands and mitigated potential negative effects on health service delivery, using malaria as an example of routine care. METHODS: We conducted a document review and interviewed 36 key informants (16 in Guinea and 20 in Sierra Leone) leading malaria elimination efforts and the national COVID-19 response. The review included malaria surveillance data and health performance reports to contextualise our qualitative findings. Interviews identified strategic responses by decision-makers overseeing malaria and COVID-19 efforts. This qualitative approach offers an in-depth understanding of decision-making within broader health systems. RESULTS: Three major themes were shared between countries: (1) 'Responding quickly and decisively to COVID-19', (2) 'Ensuring continuity of essential services during the pandemic' and (3) 'Improving health system responsiveness, despite contextual challenges'. The document review confirmed sustained malaria service delivery, with minimal declines in outpatient consultations compared to Ebola. CONCLUSIONS: Strategies used in both countries enabled the health systems to absorb the acute shock of COVID-19, adapt to the challenges and transform aspects to improve responsiveness. Institutionalising these policies and fostering agility could enhance pandemic preparedness and contribute to stronger health systems in these and other low-income countries in the region.