School-wide publications

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    Stratified Sampling of Neighborhood Sections for Population Estimation: A Case Study of Bo City, Sierra Leone
    (Public Library of Science, 2015-07-15) Hillson, Roger
    There is a need for better estimators of population size in places that have undergone rapid growth and where collection of census data is difficult. We explored simulated estimates of urban population based on survey data from Bo, Sierra Leone, using two approaches: (1) stratified sampling from across 20 neighborhoods and (2) stratified single-stage cluster sampling of only four randomly-sampled neighborhoods. The stratification variables evaluated were (a) occupants per individual residence, (b) occupants per neighborhood, and (c) residential structures per neighborhood. For method (1), stratification variable (a) yielded the most accurate re-estimate of the current total population. Stratification variable (c), which can be estimated from aerial photography and zoning type verification, and variable (b), which could be ascertained by surveying a limited number of households, increased the accuracy of method (2). Small household-level surveys with appropriate sampling methods can yield reasonably accurate estimations of urban populations.
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    High prevalence of multidrug resistant Enterobacteriaceae isolated from outpatient urine samples but not the hospital environment in Bo, Sierra Leone
    (BioMed Central, 2016-04-18) Łęski, Tomasz A.
    BACKGROUND: The rising level of antimicrobial resistance among bacterial pathogens is one of the most significant public health problems globally. While the antibiotic resistance of clinically important bacteria is closely tracked in many developed countries, the types and levels of resistance and multidrug resistance (MDR) among pathogens currently circulating in most countries of sub-Saharan Africa are virtually unknown. METHODS: From December 2013 to April 2014, we collected 93 urine specimens from all outpatients showing symptoms of urinary tract infection (UTI) and 189 fomite swabs from a small hospital in Bo, Sierra Leone. Culture on chromogenic agar combined with biochemical and DNA sequence-based assays was used to detect and identify the bacterial isolates. Their antimicrobial susceptibilities were determined using a panel of 11 antibiotics or antibiotic combinations. RESULTS: The 70 Enterobacteriaceae urine isolates were identified as Citrobacter freundii (n = 22), Klebsiella pneumoniae (n = 15), Enterobacter cloacae (n = 15), Escherichia coli (n = 13), Enterobacter sp./Leclercia sp. (n = 4) and Escherichia hermannii (n = 1). Antimicrobial susceptibility testing demonstrated that 85.7 % of these isolates were MDR while 64.3 % produced an extended-spectrum ß-lactamase (ESBL). The most notable observations included widespread resistance to sulphonamides (91.4 %), chloramphenicol (72.9 %), gentamycin (72.9 %), ampicillin with sulbactam (51.4 %) and ciprofloxacin (47.1 %) with C. freundii exhibiting the highest and E. coli the lowest prevalence of multidrug resistance. The environmental cultures resulted in only five Enterobacteriaceae isolates out of 189 collected with lower overall antibiotic resistance. CONCLUSIONS: The surprisingly high proportion of C. freundii found in urine of patients with suspected UTI supports earlier findings of the growing role of this pathogen in UTIs in low-resource countries. The isolates of all analyzed species showed worryingly high levels of resistance to both first- and second-line antibiotics as well as a high frequency of MDR and ESBL phenotypes, which likely resulted from the lack of consistent antibiotic stewardship policies in Sierra Leone. Analysis of hospital environmental isolates however suggested that fomites in this naturally ventilated hospital were not a major reservoir for Enterobacteriaceae or antibiotic resistance determinants.
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    The Recharge Potential of Groundwater in the Mokonde Community in Southern Sierra Leone
    (Scientific Research Publishing, 2015) Mansaray, Abubakarr Sidique
    Understanding the hydrologic budget is crucial in planning for community based water supply. The water budget includes rainfall intensity, groundwater recharge, interception, evapotranspiration, and surface runoff. The percentage of rain going to recharge groundwater, rivers, and lakes is very important from the standpoint of human water consumption and ecosystems service. The objective of this work is to determine the recharge potential of groundwater in the Mokonde Community, Southern Sierra Leone. The community is dependent on wells as the main source of domestic water supply. This research need was born out of the absence of available data to show the relationship between rainfall amounts and groundwater recharge in the study area. In this study we monitored groundwater in a well at the United Methodist Church (UMC) compound at Ngegba Street. Automatic water logging devices were deployed to take readings in water level fluctuations every 15 minutes. Monitoring continued throughout the hydrological year of Sierra Leone. A rain gauge was deployed at neighboring UMC Primary School, and daily rainfall records taken at 9:00 a.m. Our team members also deployed at the well on a daily basis to collect data on abstraction of water. The results revealed, through a 29-year rainfall data and the Specific Yield, that 1170 mm of rainfall (48%) was the maximum potential of rainfall that would make groundwater a convenient source of water supply in the area. This demand was higher with the recent 1-year rainfall data. Increase in settlement had likely led to reduction in pervious area, and hence more and more rainfall needed for recharge. The time it took for maximum recharge (4 weeks) was shorter than that for maximum discharge (28 - 30 weeks). Groundwater flowed southwards towards the Gbengitay stream, which drained into the Tia River. These results would inform first step in delineating the water balance in the study area. Future studies could include the quality aspect, stream/river flow, interception and evapotranspiration. These pieces of information are required to help informed decision for water security.