School-wide publications

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Start date: 2020Has files: No

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    What’s in a name? Why giving monkeypox a new one is a good idea
    (The Conversation Media Group Ltd, 2022-06-20) Bockarie, Moses
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    Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy
    (BioMed Central, 2020-12-01) Wiens, Kirsten E
    BACKGROUND: Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes. METHODS: We used a Bayesian geostatistical model and data from household surveys to map the percentage of children with diarrhea that received (1) any ORS, (2) only RHF, or (3) no oral rehydration treatment between 2000 and 2018. This approach allowed examination of whether RHF was replaced with ORS before and after interventions, policies, and external events that may have impacted healthcare access. RESULTS: We found that RHF was replaced with ORS in most Sierra Leone districts, except those most impacted by the Ebola outbreak. In addition, RHF was replaced in northern but not in southern Mali, and RHF was not replaced anywhere in Senegal. In Senegal, there was no statistical evidence that a national policy promoting ORS use was associated with increases in coverage. In Sierra Leone, ORS coverage increased following a national policy change that abolished health costs for children. CONCLUSIONS: Children in parts of Mali and Senegal have been left behind during ORS scale-up. Improved messaging on effective diarrhea treatment and/or increased ORS access such as through reducing treatment costs may be needed to prevent child deaths in these areas.
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    Role of parent’s teachers association in enhancing discipline in secondary schools in Makeni City, Northern Sierra Leone
    (2022-09-06) Turay, Edwin Augustine Junior
    Despite the Government effort of ensuring community direct involvement and ownership of development projects in their locality such as education, the extent of parents input in students discipline through the Parent Teachers Association (PTA) remains obscure in many secondary schools. This study was to determine the role of Parents Teachers Association (PTA) in enhancing discipline in Public Secondary Schools in Makeni City, Northern Sierra Leone. The study was guided by four research questions that investigated the following aspects: The activities of PTA in enhancing students‟ discipline, the extent to which PTA role enhances discipline, the challenges facing PTA in students discipline management and suggestions on how the PTA can be more effective in enhancing discipline. The study employed both quantitative and qualitative research methodologies with a cross-sectional survey and phenomenological design. The target population consisted of 4 Government assisted public secondary schools, principals, discipline masters, PTA members, class teachers, and all students of the 4 public secondary schools in Makeni City. The sample size consisted of 4 principals, 4 discipline masters, 36 class teachers, 36 PTA members and 160 students. Data was collected by use of interview guides, questionnaires, and document analysis guide, which were personally administered by the researcher. Quantitative data was analyzed in frequencies and percentages using SPSS version 20, while qualitative data was organized into themes and analyzed descriptively. Conclusions and recommendations were made based on the findings there of.
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    Dog rabies control in West and Central Africa: A review
    (Elsevier BV, 2020-05-11) Mbilo, Céline
    Rabies is a neglected but preventable zoonotic disease that predominantly affects the most vulnerable populations living in remote rural areas of resource-limited countries. To date, every country on the African mainland is considered endemic for dog-mediated rabies with an estimated 21'500 human rabies deaths occurring each year. In 2018, the United Against Rabies collaboration launched the Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. The epidemiology of rabies from most Western and Central African countries remains poorly defined, making it difficult to assess the overall rabies situation and progress towards the 2030 goal. In this review, we attempt to provide an overview of the current rabies situation in 22 West and Central African countries based on published scientific literature and information obtained from rabies focal points. To this end, information was collected on i) established surveillance, ii) diagnostic capacity, iii) post-exposure prophylaxis (PEP) availability and coverage, iv) dog population estimates, v) dog vaccination campaigns, vi) animal and human health communication (One Health), vii) molecular studies, viii) Knowledge, Attitude and Practices (KAP), ix) cost estimates and x) national control strategies. Although rabies is a notifiable disease in the majority of the studied countries, national surveillance systems do not adequately capture the disease. A general lack of rabies diagnostic capacity has an additional negative impact on rabies surveillance and attempts to estimate rabies burden. Recurrent shortages of human rabies vaccine are reported by all of the countries, with vaccine availability usually limited to major urban centers but no country has yet adopted the new WHO-recommended 1-week intradermal vaccination regimen. Most countries carry out subsidized mass dog vaccination campaigns on World Rabies Day. Such activities are indispensable to keep rabies in the public consciousness but are not of the scale and intensity that is required to eliminate rabies from the dog population. Countries will need to scale up the intensity of their campaigns, if they are to progress towards the 2030 goal. But more than half of the countries do not yet have reliable figures on their dog populations. Only two countries reached stage 2 on the Stepwise Approach towards Rabies Elimination ladder - indicating that their national governments have truly prioritized rabies elimination and are thus providing the necessary support and political buy-in required to achieve success. In summary, the sub-region of West and Central Africa seems to be divided into countries which have accepted the challenge to eliminate rabies with governments committed to pushing forward rabies elimination, while other countries have achieved some progress, but elimination efforts remain stuck due to lacking government commitment and financial constraints. The possibility to meet the 2030 goal without international solidarity is low, because more than two-thirds of the countries rank in the low human development group (HDI ≤ 152). Leading countries should act as role models, sharing their experiences and capacities so that no country is left behind. Unified and with international support it is possible to reach the common goal of zero human rabies deaths by 2030.
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    Community-based antibiotic access and use in six low-income and middle-income countries: a mixed-method approach
    (Elsevier BV, 2021-03-12) Do, Nga T T
    BACKGROUND: Antimicrobial misuse is common in low-income and middle-income countries (LMICs), and this practice is a driver of antibiotic resistance. We compared community-based antibiotic access and use practices across communities in LMICs to identify contextually specific targets for interventions to improve antibiotic use practices. METHODS: We did quantitative and qualitative assessments of antibiotic access and use in six LMICs across Africa (Mozambique, Ghana, and South Africa) and Asia (Bangladesh, Vietnam, and Thailand) over a 2·5-year study period (July 1, 2016-Dec 31, 2018). We did quantitative assessments of community antibiotic access and use through supplier mapping, customer exit interviews, and household surveys. These quantitative assessments were triangulated with qualitative drug supplier and consumer interviews and discussions. FINDINGS: Vietnam and Bangladesh had the largest proportions of non-licensed antibiotic dispensing points. For mild illness, drug stores were the most common point of contact when seeking antibiotics in most countries, except South Africa and Mozambique, where public facilities were most common. Self-medication with antibiotics was found to be widespread in Vietnam (55·2% of antibiotics dispensed without prescription), Bangladesh (45·7%), and Ghana (36·1%), but less so in Mozambique (8·0%), South Africa (1·2%), and Thailand (3·9%). Self-medication was considered to be less time consuming, cheaper, and overall, more convenient than accessing them through health-care facilities. Factors determining where treatment was sought often involved relevant policies, trust in the supplier and the drug, disease severity, and whether the antibiotic was intended for a child. Confusion regarding how to identify oral antibiotics was revealed in both Africa and Asia. INTERPRETATION: Contextual complexities and differences between countries with different incomes, policy frameworks, and cultural norms were revealed. These contextual differences render a single strategy inadequate and instead necessitate context-tailored, integrated intervention packages to improve antibiotic use in LMICs as part of global efforts to combat antibiotic resistance. FUNDING: Wellcome Trust and Volkswagen Foundation.
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    Child, maternal, and adult mortality in Sierra Leone: nationally representative mortality survey 2018–20
    (Elsevier BV, 2021-11-25) Carshon-Marsh, Ronald
    BACKGROUND: Sierra Leone's child and maternal mortality rates are among the highest in the world. However, little is known about the causes of premature mortality in the country. To rectify this, the Ministry of Health and Sanitation of Sierra Leone launched the Sierra Leone Sample Registration System (SL-SRS) of births and deaths. Here, we report cause-specific mortality from the first SL-SRS round, representing deaths from 2018 to 2020. METHODS: The Countrywide Mortality Surveillance for Action platform established the SL-SRS, which involved conducting electronic verbal autopsies in 678 randomly selected villages and urban blocks throughout the country. 61 surveyors, in teams of four or five, enrolled people and ascertained deaths of individuals younger than 70 years in 2019-20, capturing verbal autopsies on deaths from 2018 to 2020. Centrally, two trained physicians independently assigned causes of death according to the International Classification of Diseases (tenth edition). SL-SRS death proportions were applied to 5-year mortality averages from the UN World Population Prospects (2019) to derive cause-specific death totals and risks of death nationally and in four Sierra Leone regions, with comparisons made with the Western region where Freetown, the capital, is located. We compared SL-SRS results with the cause-specific mortality estimates for Sierra Leone in the 2019 WHO Global Health Estimates. FINDINGS: Between Sept 1, 2019, and Dec 15, 2020, we enrolled 343 000 people and ascertained 8374 deaths of individuals younger than 70 years. Malaria was the leading cause of death in children and adults, nationally and in each region, representing 22% of deaths under age 70 years in 2020. Other infectious diseases accounted for an additional 16% of deaths. Overall maternal mortality ratio was 510 deaths per 100 000 livebirths (95% CI 483-538), and neonatal mortality rate was 31·1 deaths per 1000 livebirths (95% CI 30·4-31·8), both among the highest rates in the world. Haemorrhage was the major cause of maternal mortality and birth asphyxia or trauma was the major cause of neonatal mortality. Excess deaths were not detected in the months of 2020 corresponding to the peak of the COVID-19 pandemic. Half of the deaths occurred in rural areas and at home. If the Northern, Eastern, and Southern regions of Sierra Leone had the lower death rates observed in the Western region, about 20 000 deaths (just over a quarter of national total deaths in people younger than 70 years) would have been avoided. WHO model-based data vastly underestimated malaria deaths and some specific causes of injury deaths, and substantially overestimated maternal mortality. INTERPRETATION: Over 60% of individuals in Sierra Leone die prematurely, before age 70 years, most from preventable or treatable causes. Nationally representative mortality surveys such as the SL-SRS are of high value in providing reliable cause-of-death information to set public health priorities and target interventions in low-income countries. FUNDING: Bill & Melinda Gates Foundation, Canadian Institutes of Health Research, Queen Elizabeth Scholarship Program.
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    Climate change and the rising incidence of vector-borne diseases globally
    (Elsevier BV, 2023-12-13) George, Angella M
    As the world experiences warmer weather, heat waves and flooding, the climate change is leading to the geographical expansion of mosquitos, which are known vectors of a range of infectious diseases like dengue, malaria, chikungunya, yellow fever, rift valley fever, West Nile fever, Japanese encephalitis and Zika which affect millions of people worldwide (1). Climate change now threatens the spread of vector-borne diseases to previously low-risk areas in Africa, Asia, Europe, and the Americas (2-7) According to the World Health Organization (WHO), an additional 250,000 deaths per year will occur in the next decades as a result of malnutrition, heat stress and vector-borne diseases (8).
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    Transformative potential of artificial intelligence on health care and research in Africa
    (Elsevier BV, 2024-03-13) Bockarie, Moses J
    The rise of Artificial Intelligence (AI) stands out as a revolutionary technological force, surpassing the transformative impact observed during the transition to web and mobile technologies.\[1,2\] Advances in technology present opportunities for enhancing scientific discovery, accelerating human progress, and improving quality of life. AI, a broad term covering machine and deep learning algorithms emulating human intelligence, has led to the development of various algorithms aiding tasks in public health, from workflow optimization to diagnostics and forecasting.
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    The role of new dengue vaccines in curtailing the emerging global threat of dengue outbreaks arising from mass gathering sporting and religious events
    (Elsevier BV, 2024-08-20) Petersen, Eskild
    The risk of outbreaks of arthropod-borne pathogens arising from mass gathering events is ever increasing due to the rising number of travellers from arbovirus endemic areas, and the expansion and adaptation of arthropod vectors such as mosquitoes worldwide due to climate and environmental change \[1-4\]. Indeed, introduction of dengue virus (DENV) was a concern at the recent Olympic Games in Paris 2024, Japan 2020 and Brazil 2014 but outbreaks did not happen \[5-7\].