School-wide publications

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Start date: 2025

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    Towards elimination of Neglected Tropical Diseases: Strengthening partnerships, fostering collaboration, and promoting country ownership
    (Elsevier BV, 2025-01-29) Karutu, Carol
    Neglected Tropical Diseases (NTDs) represent a significant global health burden, disproportionately affecting over a billion people in some of the world's most impoverished communities \[1,2\]. These diseases include a range of parasitic, viral, and bacterial infections, such as dengue, human African trypanosomiasis (HAT), leishmaniasis, lymphatic filariasis (LF), onchocerciasis, schistosomiasis and trachoma \[2\].
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    The changing funding landscape for infectious disease research and control: implications for resource-limited countries
    (Elsevier BV, 2025-03-01) Bockarie, Moses J
    We now live in an interconnected world where global health has become a critical concern for governments, international organizations, civil society, and individuals. Many emerging and re-emerging infectious disease threats, efforts to manage them, must be addressed collaboratively. In recent years, the pressures on overseas aid budgets of higher income countries like United Kingdom (UK) and United States (US) have impacted support for infectious disease research and control. As disease agents do not respect borders, promoting international health security should be the key focus of overseas aid, encompassing initiatives to combat infectious diseases like COVID-19, Ebola, mpox, malaria and neglected tropical diseases (NTDs).
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    Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
    (Elsevier BV, 2025-01-28) Midzi, Nicholas
    OBJECTIVES: Zimbabwe is endemic for lymphatic filariasis (LF) with 39 districts identified for mass drug administration (MDA) in 2014. The objective of this study was to reassess the current population requiring MDA. METHODS: The LF confirmatory mapping method was used to evaluate the prevalence of circulating filarial antigens among school-aged children (9-14 years) in previously endemic districts. This was achieved through a cross-sectional survey between 2021 and 2023, applying a cluster sampling approach across 39 districts, targeting 18,720 children to assess ongoing LF transmission. RESULTS: The findings revealed a significant decline in LF prevalence, with an overall rate of 0.43%. Importantly, 82.05% of districts previously identified as endemic were reclassified as nonendemic. Only seven districts retained endemic status, necessitating continued MDA using the triple-drug therapy regimen. Population estimates based on 2022 census data indicated that 1.19 million individuals across these districts require MDA, representing an 84.4% reduction compared to previous estimates. Despite the progress, the persistence of low-level transmission in certain districts highlights the need for sustained surveillance and morbidity management services, including hydrocele surgery and lymphedema care. CONCLUSION: There was a significant reduction in the number of people requiring MDA. The decline in LF endemicity is attributed to a combination of factors, including prior rounds of MDA and vector control initiatives including historical interventions, such as dichlorodiphenyltrichloroethane spraying against human African trypanosomiasis.
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    Rapid Surge of Mpox in Sierra Leone: Public Health Challenges
    (Elsevier BV, 2025-07-15) Mathiang, James Riak
    Sierra Leone is currently facing an unprecedented escalation in mpox cases, placing severe strain on its already fragile health system. On 10 January 2025, this west African nation confirmed its first mpox case, following the 2022 global outbreak, and declared a public health emergency three days later \[1\]. However, neither of the first two confirmed cases reported direct contact with infected individuals or animals, although the index case had recently travelled to the airport town of Lungi in Port Loko District between December 26, 2024, and January 6, 2025 \[1\].
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    Mpox in Sierra Leone: what’s behind the recent surge and why west Africa is at risk
    (The Conversation Media Group Ltd, 2025-06-23) Kangbai, Jia
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    Malaria resurgence in Africa: confronting the challenges
    (Elsevier BV, 2025-08-15) Ntoumi, Francine
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    Integrated Strategies Addressing Predisposing, Enabling, and Illness-Level Factors Influencing Healthcare-Seeking Behavior among Pregnant Women and Newborn Mothers: Insights from Sierra Leone
    (Springer Science and Business Media LLC, 2025-08-27) Viah, Rennie
    Background Maternal and newborn health outcomes in Sierra Leone remain among the poorest globally, driven by a complex interplay of socio-demographic, systemic, and behavioral factors. Understanding how integrated strategies influence healthcare-seeking behavior is critical for tailoring interventions that reduce delays and improve maternal outcomes. This study aimed to identify high-impact strategies addressing predisposing, enabling, and illness-level factors that affect maternal and newborn healthcare-seeking behavior in Bo District, Sierra Leone. Methods A descriptive cross-sectional study was conducted at Bo Government Hospital (urban) and Tikonko Maternity Home (rural) between January – May 2024. Using simple random sampling, 500 participants (294 pregnant women and 206 mothers of children under five) were selected from facility attendance lists. Quantitative data was collected through structured interviews using a digital questionnaire administered via the ONA platform. Descriptive analysis was performed using SPSS version 26 to identify patterns in healthcare-seeking preferences and perceived effectiveness of integrated health strategies. Results The mean age of pregnant participants was 24.83 years (SD = 4.74), and the average household income showed substantial disparity (Mean = 335.03 NLE; SD = 668.49). Regarding predisposing factors, the preferred strategies included prenatal education (25.91%) and community outreach for early antenatal care (24.12%). Enabling factors were most influenced by transportation support (24.6%) and access to affordable care (24.21%). Illness-level strategies prioritized by participants included strengthening maternal health surveillance systems (27.55%) and prenatal screening services (23.08%). Education level, income, and parity were key determinants of healthcare-seeking behavior. Conclusion Integrated strategies that combine health education, community outreach, logistical and financial support, and health system strengthening are the most effective in influencing maternal and newborn healthcare-seeking behavior. Culturally tailored, equitable, and evidence-informed approaches help improve maternal health service utilization in low-resource settings like Sierra Leone.
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    From Reaction to Resilience: The WHO Pandemic Agreement as a Blueprint for Global Health Equity
    (Elsevier BV, 2025-06-02) Hassan, Md Zakiul
    In May 2025, 124 WHO Member States adopted the first-ever Pandemic Agreement, rooted in principles of human dignity, equity, solidarity, and sovereignty, at the 78th World Health Assembly \[1\]. The COVID-19 pandemic exposed how unprepared the world was to face a pandemic and resistant to sharing \[2,3\]. From vaccine nationalism to fractured supply chains and the marginalization of low- and middle-income countries (LMICs) in scientific discovery and access, the world was caught flat-footed, despite prior warnings \[4,5\].
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    Factors associated with perceived barriers to canine rabies vaccination among owners of unvaccinated dogs in Sierra Leone
    (Elsevier BV, 2025-09-27) Mshelbwala, Philip P
    Dog vaccination is the most effective method for preventing rabies virus transmission and human deaths. However, in Sierra Leone, vaccination rates remain low, and the reasons for non-vaccination are not well understood. We analysed 2023 household survey data using a hierarchical Bayesian multinomial regression to provide insight into perceived barriers to canine rabies vaccination among owners of unvaccinated dogs. Our results indicated that of the 2558 dog-owning households interviewed, only 14 % (358) reported having fully vaccinated their dogs. Of the 2200 respondents with unvaccinated dogs, most (71.6 %) didn't know how to access rabies vaccination services, 17.6 % cited cost, and 10.8 % believed it was unimportant. Posterior distribution of our model showed that urban residents had 91 % lower odds of believing rabies vaccination was unimportant compared to rural residents (OR = 0.11, 95 % CrI: 0.02-0.34). Similarly, individuals with tertiary education had 28 % lower odds of believing rabies vaccination was unimportant (OR = 0.72, 95 % CrI: 0.31-1.59), though this effect is uncertain despite an 80 % probability of being protective. Respondents in areas without veterinary services were more likely to cite cost as a barrier. Students were significantly less likely than civil servants to consider rabies vaccination unimportant (OR = 0.41, 95 % CrI: 0.17-0.95). In contrast, owners of free-roaming dogs were significantly twice as likely to believe that rabies vaccination was unimportant (OR = 2.41, 95 % CrI: 1.15-5.59). Those with partially confined dogs were significantly more likely to report not knowing how to access rabies vaccination services (OR = 1.99, 95 % CrI: 1.39-2.86). Compared to households citing cost, those in the Eastern Province were significantly less likely to report that the vaccine is unimportant. Respondents in the Western Area were significantly less likely to report cost as a barrier. In contrast, households in the Eastern were more likely to report cost as a barrier. These findings suggest that barriers to dog vaccination in Sierra Leone are shaped by a combination of informational, socioeconomic, and geographic factors. Improving public awareness, especially in rural areas, and expanding access to veterinary services could help address key obstacles. Tailored outreach strategies that consider education levels, occupation types, and local infrastructure are recommended to enhance vaccination uptake and support rabies prevention efforts.