Assessment of knowledge, attitude and practice on family planning among women of reproductive age at hospitals and clinic centers in the rural Western Sierra Leone

Informed decisions about one's sexual and reproductive health can be made through family planning. Women of reproductive age in rural Sierra Leone's Western area were asked to participate in a survey to determine their attitudes and knowledge toward family planning and the use of contraceptives. A descriptive cross-sectional study survey was conducted in the Western Area Rural of Sierra Leone. Females in the range of 15 to 49 years old were included in the study. The research was conducted from November 2021 to December 2021. Using a pre-designed and pretested questionnaire, 180 women were assessed for their knowledge, attitudes, and practices regarding family planning. According to the study, all participants knew about family planning, but only 68.3% had used contraceptives. There were more than half who learned about it from the media. The study found that 95% of participants had a positive attitude towards contraceptives. Most commonly, contraceptives used were oral pills (31.6), injections (21.1%), implants (19.1%), lactational amenorrhea (13.8%), condoms (8.8%), and intrauterine devices (5%). In our study, the most common reasons given by participants for not using contraceptives were; not willing to disclose 52.6%, a desire for a child 19.2%, fear of side effects 15.7%, currently pregnant 8.7%, and against religious beliefs 3.5%. The study shows that even if people are aware and educated about contraceptives, they may not use them. Educating and motivating people and improving access to family planning services are still necessary to improve the effectiveness and appropriateness of contraceptive use and halt the population growth trend. (Afr J Reprod Health 2022; 26 [6]:15-21).

Next-generation Sequencing Study of Pathogens in Serum from Patients with Febrile Jaundice in Sierra Leone / 生物医学与环境科学（英文）

OBJECTIVE@#People in Western Africa suffer greatly from febrile jaundice, which is caused by a variety of pathogens. However, yellow fever virus (YFV) is the only pathogen under surveillance in Sierra Leone owing to the undeveloped medical and public health system there. Most of the results of YFV identification are negative. Elucidation of the pathogen spectrum is required to reduce the prevalence of febrile jaundice.@*METHODS@#In the present study, we used Ion Torrent semiconductor sequencing to profile the pathogen spectrum in archived YFV-negative sera from 96 patients in Sierra Leone who presented with unexplained febrile jaundice.@*RESULTS@#The most frequently identified sequencing reads belonged to the following pathogens: cytomegalovirus (89.58%), Epstein-Barr virus (55.21%), hepatitis C virus (34.38%), rhinovirus (28.13%), hepatitis A virus (20.83%), coxsackievirus (10.42%), Ebola virus (8.33%), hepatitis E virus (8.33%), lyssavirus (4.17%), leptospirosis (4.17%), chikungunya virus (2.08%), Crimean-Congo hemorrhagic fever virus (1.04%), and hepatitis B virus (1.04%).@*CONCLUSION@#The distribution of sequencing reads suggests a broader spectrum of pathogens for consideration in clinical diagnostics and epidemiological surveillance in Sierra Leone.

A century of onchocerciasis in Sierra Leone

In 1926, Blacklock first described onchocerciasis (OV) transmission by black fly, Simulium damnosum in Sierra Leone. In the 1950-1960's, high OV prevalence was demonstrated along the rivers and the existence of black flies nationwide except around the capital and the coastal plain of Bonthe. In 1957, control efforts started with insecticides along the river breeding sites. In 1974, the Onchocerciasis Control Programme focusing on vector control was launched, extending to Sierra Leone in the 1980s. From 1995, the African Programme for Onchocerciasis Control commenced community-directed treatment with ivermectin (CDTI) in hyper- [microfilaridermia (mf) prevalence≥40%] and meso- (nodule prevalence 20%-39%) sites. To be effective programme, coverage among the eligible population over five years of age needed be at least 80%. In the mid-1990s, the rebel war stopped vector control and effective CDTI was not established until 2006. Baseline data using skin snips from 39 sentinel villages found the average OV mf prevalence was 53.1% (28.9 mf/snip). From October 2008, albendazole was added in phases to CDTI for all communities in all 14 districts for lymphatic filariasis (LF) elimination. In 2010, after five rounds of effective MDA, OV mf prevalence was 21.1% (8.29 mf/snip). Males had higher prevalence and density than females in both studies. Since then, OV control (acknowledging transmission continues) has transitioned to OV elimination assuming transmission can be interrupted once mf prevalence is less than 5%. In 2017, a rapid assessment was integrated into LF-Transmission Assessment Survey and independently in 8 and 4 districts respectively, designed by the Survey Sample Builder. Children aged 5-9 years were randomly selected from 177 clusters and tested by OV-16 (Rapid Diagnostic Tests, SD BIOLINE) using finger-prick blood samples. Overall, 17 441 children participated and 347 (2.0%) were positive (M: 2.4% versus F: 1.6%) (P10%). The LF- Transmission Assessment Survey sampling methodology does not take cognizance of black fly breeding sites, but did demonstrate ongoing transmission and another 4-5 rounds were advisable. A technical advisory committee has been established with representation from international experts to help plan for accreditation of onchocerciasis elimination around 2025.

The Ebola-countering Operations in Sierra Leone Between UK and China and their implications:a comparative analysis / 军事医学

The UK Ebola-countering Operation in Sierra Leone from September 2014 to November 2015 called Operation Gritrock and its countermeasures were briefly introduced , such as the national strategy , aero-maritime deployment , self medical support , base-oriented training and international cooperation .A comparative analysis was made of operations of the same type between the UK and China in terms of mission-orientation, command and control , deployment timeline , past experience, deployment routes, logistics and assistance effects.Four implications for China′s military function construction in future international disaster relief operations were also summarized at the strategic , operational and tactical levels .

Pharmaceutical administration for anti-ebola outbreak mission of chinese military medical aid team in sierra leone / 中国药学杂志

OBJECTIVE: To summarize lessons of the medicine provision and management learned from the anti-Ebola outbreak mission in Sierra Leone executed by Chinese military medical aid team. METHODS: Summarizing the medicine preparing, shipping, storage and management procedure during the whole task period from 16 Sep, 2014 to 21 Mar, 2015. Anlyzing lessons and knowledge we have learned from the mission. RESULTS: According to the local health system situation and currently outbreak characters, the pharmaceutical group of the Chinese military medical aid team have prepared almost all types and dosages of medicines needed for the whole mission. Through feasible transportation pathway including cold chain, medicines were shipped to destination safely. Classified storage, detailed management and sorting system insured the high quality of the medicine distribution. CONCLUSION: The effective provision and scientific management of the pharmaceutical support of military medical aid team have made a good model for the emergency medical aid action abroad. The experiences we have obtained from this mission may be useful for the future performing of similar major overseas task of Chinese military.

Fertility status, Degradation Rate and Vulnerability Potential of Soils of Sowa Chiefdom in Southern Sierra Leone.

The present research was undertaken to study the fertility status of physicochemical properties and assess the degradation rate and vulnerability potential of soils of Sowa Chiefdom and suggest best management practices. Thirty-two composite samples from 0-20 and 20-40 cm were collected at fifteen locations and studied. The soils exhibited an irregular trend in particle size distribution with high proportion of sand in decreasing trend of sandy loam > sandy clay loam > loamy sand > sandy clay > clay. The soils were slightly acidic to moderately acidic in soil reaction (soil pH) with low to high organic carbon, medium to high nitrogen and low to high phosphorus. The content of exchangeable Ca2+ was medium to high, exchangeable Mg2+ was high, exchangeable Na+ was low to high and exchangeable K+ was low. The level of exchangeable acidity was low although the pH was slight to moderately acidic. The effective CEC values were within themedium to high range and the base saturation was high, thus indicating the potential availability of basic elements in the soils. The organic carbon, total nitrogen, available phosphorus, exchangeable Ca and Mg and base saturation were neither degraded nor vulnerable to degradation and therefore better soil quality indicators while exchangeable K was extremely degraded and highly vulnerable to degradation and therefore a poor soil quality indicator. The texture, soil pH, exchangeable Na and effective CEC showed moderate rate of degradation and vulnerability and these might be good soil quality indicators in the long term if the recommended soil management strategies are adopted.

Use of Antimicrobial Medicines among University Students in Sierra Leone.

Aims: Misuse of antimicrobial medicines is a major contributory factor to development of resistant strains of micro-organisms, therapeutic failure and increased healthcare costs in many countries. To identify pattern of antimicrobial use among undergraduate students of the University of Sierra Leone and to determine possible gaps in their understanding of appropriate use of these therapeutic agents. Study Design: A cross-sectional survey of the students using a structured questionnaire and a stratified random sampling method to obtain the respective number of students from each college. Place and Duration of Study: Registered undergraduates in the three Colleges of the University of Sierra Leone, between March and June 2012. Methodology: A 25-item structured questionnaire was administered on a random sample of four hundred and eighteen (418) undergraduates of the University. The instrument explored respondents’ pattern of self-medication with antimicrobials, knowledge of the indications for use and sources of supply. Results: Most students reported having self-medicated with antimicrobials at various times and there were gaps in their understanding of the medicines; with about 67% having some knowledge of correct indications for use. Majority of them (70%) obtained the medicines on demand from open drug markets without prescriptions and the medicines were used for such ailments as common colds and diarrhea. Previous experiences of treating similar symptoms ranked highest as the factor affecting demand and penicillins topped the list of commonly used antimicrobials. Most of the students did not complete full regimen of the medication for reasons of cost, long duration of treatment and side effects. Conclusion: There were knowledge gaps in the proper use of antimicrobial medicines and unrestricted access to prescription drugs was a major factor of misuse. The existing drug laws in the country should be strengthened to control indiscriminate sale and distribution. Basic courses on rational medicine use may need to be incorporated in the general studies programme of the University; with emphasis on the consequences of indiscriminate use of antimicrobial medicines.