School-wide publications

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

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Subject: search.filters.subject.Malaria

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Now showing 1 - 5 of 5
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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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    Are malaria transmission-blocking vaccines acceptable to high burden communities? Results from a mixed methods study in Bo, Sierra Leone
    (BioMed Central, 2021-04-13) McCoy, Kaci D
    BACKGROUND: Malaria transmission-blocking vaccines (TBVs) could help break the cycle of malaria transmission by conferring community rather than individual protection. When introducing new intervention strategies, uptake is dependent on acceptability, not just efficacy. In this exploratory study on acceptability of TBVs in Sierra Leone, it was hypothesized that TBVs would be largely acceptable to adults and health workers in areas with relatively few ongoing malaria interventions, and that (i) knowledge of malaria and vaccines, (ii) health behaviours associated with malaria and vaccines, and (iii) attitudes towards different vaccines types could lead to greater TBV acceptability. METHODS: This study used a mixed methods approach in Bo, Sierra Leone, to understand community knowledge, attitudes, and practices related to malaria and vaccination in general. This included: (i) a population-based cross-sectional survey (n=615 adults), (ii) 6 focus group discussions with parents, and (iii) 20 key informant interviews. The concept of a TBV was explained to participants before they were asked about their willingness to accept this vaccine modality as part of an integrated malaria elimination programme. RESULTS: This study found that most adults would be willing to receive a TBV vaccine. Respondents noted mostly positive past experiences with adult and childhood vaccinations for other infectious diseases and high levels of engagement in other malaria prevention behaviors such as bed nets. Perceived barriers to TBV acceptance were largely focused on general community-level distribution of a vaccine, including personal fears of vaccination and possible costs. After an explanation of the TBV mechanism, nearly all focus group and interview participants believed that community members would accept the vaccine as part of an integrated malaria control approach. Both parents and health workers offered insight on how to successfully roll-out a future TBV vaccination programme. CONCLUSIONS: The willingness of community members in Bo, Sierra Leone to accept a TBV as part of an integrated anti-malarial strategy suggests that the atypical mechanism of TBV action might not be an obstacle to future clinical trials. This study's findings suggests that perceived general barriers to vaccination implementation, such as perceived personal fears and vaccine cost, must be addressed in future clinical and implementation research studies.
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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.
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    Forecasting malaria cases using climate variability in Sierra Leone
    (BioMed Central, 2025-05-20) Jalloh, Saidu Wurie
    Malaria continues to pose a public health challenge in Sierra Leone, where timely and accurate forecasting can guide more effective interventions. Although seasonal models such as Seasonal Autoregressive Integrated Moving Average (SARIMA) have traditionally been employed for disease forecasting, Artificial Neural Networks (ANNs) have gained attention for capturing complex temporal patterns that linear models may not fully capture. This study compares the forecasting performance of SARIMA and ANN models in forecasting malaria cases using malaria case data from 2018 to 2023. A baseline SARIMA model was developed and improved with exogenous climatic variables (precipitation, maximum temperature, and mean relative humidity) to form a SARIMAX approach. In parallel, an ANN was trained solely on historical malaria cases, without adding climatic variables. SARIMA offered reasonable predictive capabilities but was outperformed by the ANN, which captured complex temporal patterns more effectively, decreasing forecast errors and improving its coefficient of determination \$\$(R^2)\$\$ . The SARIMA model achieved an MAPE of 12.01%, which improved further to an MAPE of 11.45% with the inclusion of climatic variables. A strong positive correlation between precipitation (r = 0.68) and malaria cases was observed, while maximum temperature showed a moderate negative correlation (r = \$\$-0.45\$\$ ), and mean relative humidity demonstrated a moderate positive correlation (r = 0.55). The ANN model outperformed both the baseline SARIMA and SARIMAX models with the lowest MAPE of 6.68%. These findings underscore the ANN’s ability to capture non-linear dynamics, even without explicit climate inputs. These results reinforce the value of machine learning modelling approaches in guiding malaria control strategies, particularly in high-burden settings like Sierra Leone.