Department of Environmental Health Sciences

Permanent URI for this collectionhttps://dspace.njala.edu.sl/handle/20.500.144402/168

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    Regression Modelling and Analysis of Cell phone-Based Syndromic Surveillance Data for Ebola in Sierra Leone
    (OMICS Publishing Group, 2016) Kangbai, Jia Bainga
    **Aim:** To determine the out degree centrality for multivariate analysis, examine the demographic differences and characteristics of callers who make more calls, and determine callers who are more likely to make at least one positive Ebola call.Methods: Surveillance data for 393 suspected Ebola cases (192 males, 201 females) were collected from October 23, 2014 to June 28, 2015 using cell phone technology.UCINET and Net Draw software were used to determine the out degree centrality used for multivariate analysis.Poisson and logistic regression analyses were used to do multivariable analysis.Result: Women (AOR=0.33,95% CI \[0.14, 0.81\]) was associated with decreased odds of making at least one positive Ebola surveillance call compared to men.Women (IR= 0.63, 95% CI \[0.49, 0.82\]) was also associated with making fewer Ebola surveillance calls compared to men. **Conclusion:** This study shows that the combination of cell phone technology with user-friendly and open-source social network software such as UCINET and Net draw will provide an important adjunct to the traditional measures of epidemiologic surveillance.
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    COMMERCIAL DRINKING WATER QUALITY AND SAFETY IN BO CITY, SIERRA LEONE
    (African Journals OnLine, 2016-08-16) Kamara, Abu-Bakarr S.
    Many people who lack reliable access to a quality and safe drinking water source in or near the home rely on commercial drinking water products, such as machine-filled sachet water, that may be of variable quality.A participatory geographic information system was used in conjunction with distribution point and vendor census in the study area to identify a total of 36 water sources across Bo city that are used for commercial water production. These include 6 water sources and the production facilities for 10 brands of machine-filled factory-produced water sachets as well as the 10 sources and finished samples for 10hand-tied plastic-bagged water producers. Water samples from all 16 water sources and 20 commercial water products purchased from randomly-selected retail outlets and street vendors were tested for microbiological and physicochemical properties. Workers at all of these facilities were also interviewed about their knowledge and practices.All of the machine-filled sachet waters were free of microbial contamination, but several of the hand- tied water sachets, all filled from unlined local wells, and had coliform bacteria. Both machine-filled sachet water and hand-tied sachet water had pH levels that were below the World Health Organization’s recommended range. Water with acidic pH can cause corrosion of the metal pipes used with wells and can release those potentially harmful minerals into drinking water. Water factory workers used a variety of water treatment methods to purify their products; hand-tied sachets generally used only cloth filters to purify the water and often stored water in open containers. Improved quality of commercial water products would improve health in Sierra Leone.
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    Virologic Response and Survival Analysis of 281 HbsAg Treatment Naive Patients on Lamivudine Monotherapy in Sierra Leone
    (2017-10-06) Kangbai, Jia Bainga
    More than 350 million people are infected with Hepatitis B Virus (HBV) globally. The main aim of any chronic hepatitis B therapy is to prevent liver cirrhosis and its sequelae, including Hepatocellular Carcinoma (HCC). This is a cross sectional study that analysed medical records of 281 HBsAg seropositive patients in order to determine those factors that are associated with the reduction in the HBV viral load and the duration of HBV lamivudine monotherapy in order to attain a virological response.
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    The prevalence of type 2 diabetes in urban Bo, Sierra Leone, and in the 16 countries of the West Africa region
    (Wiley, 2017-04-26) Sundufu, Abu James
    BACKGROUND: The goal of this study was to measure the prevalence of diabetes among adults in urban Bo, Sierra Leone, and to compare the new results to the diabetes prevalence rates reported from studies across West Africa. METHODS: A total of 694 outpatients ages 18 and older at Bo Government Hospital were tested for diabetes between January 2012 and December 2014. Diabetes was defined as a fasting blood sugar level of ≥126 mg/dL (≥7.0 mmol/L). RESULTS: The overall prevalence of diabetes was 6.2% (43/694). Diabetes prevalence increased from 0.8% (2/256) among patients ages 18 to 29 years to 3.9% (8/204) among patients ages 30 to 39, 8.4% (11/131) among patients ages 40 to 49, 19.0% (12/63) among patients ages 50 to 59, and 25.0% (10/40) among patients ages 60 and older. The prevalence of diabetes was 5.2% among females and 7.4% among males. After adjusting the study population to the age and sex distribution of the national population, the standardized prevalence of diabetes was 7.0%. The only previously published study of diabetes in Sierra Leone found a much lower 2.4% prevalence rate in 1997. A comprehensive literature search identified studies from across West Africa (including Benin, Burkina Faso, Cabo Verde, Côte d'Ivoire, the Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo) that illustrate an increasing rate of diabetes and impaired glucose tolerance in the region. CONCLUSIONS: It is important for hospitals and clinics across West Africa to increase their ability to diagnose, monitor, and treat type 2 diabetes in urban and rural areas.
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    Tracking Ebola through cellphone, internet of things and Blockchain technology
    (OMICS Publishing Group, 2018) Kangbai, Jia Bainga
    **Objective:** In the absence of any approved therapeutics and vaccines to treat or prevent Ebola infection, managing Ebola outbreak largely depends on early case detection and surveillance, real-time communication of surveillance data, and Ebola case management. Here we assessed the possibility of uploading data obtained by Internet of Internet device that monitors cellphone company’s Call Data Records (CDR), national demographic census, national transportation system and Ebola vaccine production databases on a Blockchain platform to conduct real-time Ebola contact tracing, transmission pattern surveillance and vaccine delivery. **Results:** Mobility data obtained by Internet of Things (IoT) from CDR from cellphone companies, national transportation system, and census demographic data can be integrated into a Blockchain platform to provide real-time Ebola surveillance and contact-tracing. While cellphone data provides a unique opportunity to quantify human mobility, Blockchain system magnifies such opportunity by making the data accessible to many actors in real-time. By mounting data from CDR, national population census, national transport system and Ebola vaccine production database on a Blockchain platform will provide additional lens in our understanding of the role played by human population dynamics in the spread as well and containment of Ebola during outbreaks
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    Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone
    (Hindawi Publishing Corporation, 2018) James, Peter Bai
    In resource‐poor countries where access to infertility care is limited, women may turn to traditional medicine to achieve motherhood. It is unknown whether Sierra Leonean women with such condition use herbal medicine. This study investigates the prevalence and factors associated with herbal medicine use among women seeking care for infertility. This was a questionnaire‐based cross‐sectional study conducted among women seeking care for infertility at various clinics within Freetown, Sierra Leone. Data analysis included Chi‐square tests and logistic regression. Out of the 167 women that participated, 36.5% used herbal medicine for infertility treatment. Women with no formal (AOR 4.03, CL: 1.38–11.76, p = 0.011), primary education (AOR: 6.23, CL: 2.02–19.23, p = 0.001) and those that visited a traditional medicine practitioner (AOR: 20.05, CL: 2.10–192.28, p = 0.009) as well as women suffering from other reproductive health problems (AOR: 2.57, CL: 1.13–5.83, p = 0.024) were more likely to use herbal medicines. Friends and family (n = 57, 96.7%) were the main influencers of herbal medicine use. Only (n = 12) 19.7% of users disclosed their status to their healthcare provider. Over half (n = 32, 52.5%) could not remember the name of the herb they used. Luffa acutangula (n = 29, 100%) was the herbal medicinal plant users could recall. Herbal medicine use among women seeking care for infertility in Freetown is common. Healthcare providers should be aware of the potential dyadic use of herbal and allopathic medicines by their patients and be knowledgeable about commonly used herbal remedies as well as being proactive in communicating the potential risks and benefits associated with their use.
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    Health Care Facility Network Efficiency and Location Crucial for Ebola Treatment Outcome
    (OMICS Publishing Group, 2018) Kangbai, Jia Bainga
    **Background:** The application of network analysis in public health research is gaining popularity with the belief that health problems are a product of complex social, political and economic causes.Organisational networks can be used in public health to design and evaluate public health programs.There have been multiple studies in the past relating to public health organisations and HIV/AIDS using organisational networking method.Here we use social network analysis to analyse the association between the network positions of health care facilities and the treatment outcome of Ebola patients from these health care facilities in Sierra Leone. **Methods:** We extracted and later analysed treatment outcome data obtained from the Case Report Forms (CRF) of 117 Ebola patients who sought Ebola treatment at the Kenema Government Hospital from June 2014 to April 2015.For ego network purpose, we considered each Ebola referral health care facility as an ego.Poisson regression analysis was used to determine the association between Ebola mortality rates in a health care facility and the ego's structural holes.Results: The median age, length of stay during Ebola treatment, and the period it takes an Ebola patient to survive treatment following from onset of signs and symptoms were 20 (IQR=17.5 years), 15 (IQR=11 days) and 7 (IQR=5.3days) respectively.There were differences in ego, network efficiency, effective size and constraint for the factors associated with mortality rates for Ebola patients treated at the Kenema Government Hospital.Conclusion: Establishing non-redundant contacts within a health care facility network and expanding their locations can reduce Ebola mortality rates during outbreak.
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    Epidemiological Markers for HIV Infection among First-Time Antenatal Attendees in Sierra Leone: 2012-2015 Longitudinal Study
    (2018-03-31) Kangbai, Jia Bainga
    Globally it is estimated that 10% of Human Immunodeficiency Virus (HIV) infected patients are coinfected with Hepatitis B Virus (HBV) which is the leading cause of chronic liver diseases including liver cirrhosis and hepatocellular carcinoma. In countries with high HBV endemicity the seroprevalence rate can be as high as 25% with approximately 10% of the HIV infected population coinfected with HBV. HIV and HBV shares similar transmission route and co-infection is common.
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    Epidemiological characteristics, clinical manifestations, and treatment outcome of 139 paediatric Ebola patients treated at a Sierra Leone Ebola treatment center
    (BioMed Central, 2019-01-24) Kangbai, Jia Bainga
    BACKGROUND: The West Africa Ebola Virus Disease (EVD) outbreak in 2014-2016 was declared by the World Health Organization (WHO) a public health emergency of international concern. Most of the previous studies done in Sierra Leone relating to the clinical and epidemiological features of EVD during the 2014-2016 West African outbreak focused on adult EVD patients. There have been conflicting reports about the effects of EVD on children during previous outbreaks. METHODS: This is an observational retrospective analysis of medical data of all laboratory confirmed paediatric EVD patients below 15 years of age who were admitted at the 34 Military Hospital Ebola Treatment Center (ETC) in Wilberforce, Sierra Leone between June 2014 to April 2015. We analyzed the sociodemographic and clinical characteristics of paediatric EVD cases contained in case report forms that were collected by Ebola surveillance officers and clinicians at the 34 Military Hospital ETC. Both univariate and multivariate logistic regression models were used to determine the sociodemographic and clinical characteristics of paediatric EVD patients that were associated with EVD facility-based mortality. RESULTS: The majority of the paediatric EVD cases in this study were female (56.1%), pupils (51.1%), and 43.2% belonged to the age group between 10 years and below 15 years. The median age of the paediatric EVD cases was 9 years (interquartile range = 4 to 11 years). Adjusting for other covariates in the model, male paediatric EVD patient (AOR = 13.4, 95% CI = \[2.07-156-18\], p < 0.05), EVD patient with abdominal pain (AOR = 11.0, 95% CI = \[1.30-161.81\], p < 0.05), vomiting (AOR = 35.7, 95% CI = \[3.43-833.73\], p < 0.05), signs of conjunctivitis (AOR = 17.4, 95% CI = \[1.53-342.21\], p < 0.05) and difficulty in breathing (AOR = 23.3, 95% CI = \[1.92-713.01\], p < 0.05) at the time of admission had increased odds of dying during EVD treatment. CONCLUSIONS: We recommend the adoption of case definitions currently in vigour to cater for specific characteristics of paediatric patients. Subgroups that can be identified by applying the model developed in this study may require special attention and intensified care.