1
|
Best KC, Ameh E, Weldon C, Shwe D, Maigari IM, Turaki I, Ma’an ND, Yilgwan CS, Makishima T, Weaver S, Paessler S, Shehu NY. Double stigma: a cross-sectional study of Lassa patients with hearing loss in North Central Nigeria. Front Public Health 2024; 12:1395939. [PMID: 39076422 PMCID: PMC11284147 DOI: 10.3389/fpubh.2024.1395939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/01/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Lassa fever is a zoonotic infectious disease endemic in West Africa with a high case-fatality rate and reported stigmatization of surviving patients. This study examines discrimination among survivors of Lassa fever (LF) complicated by hearing loss (HL). Methods This cross-sectional qualitative study used an in-depth interview guide to collect information from patients with HL about their experience of stigma. Interviews were conducted by a trained team of interviewers at the Jos University Teaching Hospital between January and April 2022 in Hausa language after informed consent was obtained. Recordings of the interviews were transcribed and translated from Hausa to English. Data analysis was conducted using NVivo software using a thematic framework approach. Results Most (73%) respondents were male (n = 11); 27% were female (n = 4). The median age was 35 years (interquartile range, 16.5). Some Lassa fever patients experienced stigma and discrimination (53%) including isolation and withdrawal of family and community support during and after illness. HL increased stigma, as some patients were labeled "deaf" by other community members, increasing perceived stigma and devaluation. HL affected the socio-economic wellbeing of some who could not communicate well with their families and customers and constrained social interactions, evoking pain and apathy. Some survivors of LF and victims of its sequelae of HL experienced double stigmatization. While they were ill with LF, a third of respondents reported avoidance and isolation by family and community members who withdrew care and support both to them and their close family members. These forms of stigmatization strained their relationships. Conclusion There is a need to address stigma in LF survivors who develop HL through concerted community-owned awareness to improve their quality of life along with a robust social support system to aid prevention.
Collapse
Affiliation(s)
- Kachollom C. Best
- Department of Sociology, Faculty of Social Sciences, University of Jos, Jos, Nigeria
- West African Center for Emerging Infectious Diseases, Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel Ameh
- West African Center for Emerging Infectious Diseases, Jos University Teaching Hospital, Jos, Nigeria
| | - Caroline Weldon
- Department of Microbiology, University of Texas Medical Branch, Galveston, TX, United States
| | - David Shwe
- Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria
| | - Ibrahim Mahmood Maigari
- Department of Internal Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Ishaku Turaki
- Department of Otorhinolaryngology, Jos University Teaching Hospital, Jos, Nigeria
| | - Nuhu D. Ma’an
- Department of Otorhinolaryngology, Jos University Teaching Hospital, Jos, Nigeria
| | | | - Tomoko Makishima
- Department of Ear, Nose and Throat, University of Texas Medical Branch, Galveston, TX, United States
| | - Scott Weaver
- Department of Microbiology, University of Texas Medical Branch, Galveston, TX, United States
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States
| | - Nathan Y. Shehu
- West African Center for Emerging Infectious Diseases, Jos University Teaching Hospital, Jos, Nigeria
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States
| |
Collapse
|
2
|
Smith DRM, Turner J, Fahr P, Attfield LA, Bessell PR, Donnelly CA, Gibb R, Jones KE, Redding DW, Asogun D, Ayodeji OO, Azuogu BN, Fischer WA, Jan K, Olayinka AT, Wohl DA, Torkelson AA, Dinkel KA, Nixon EJ, Pouwels KB, Hollingsworth TD. Health and economic impacts of Lassa vaccination campaigns in West Africa. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.26.24303394. [PMID: 38978680 PMCID: PMC11230338 DOI: 10.1101/2024.02.26.24303394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Lassa fever is a zoonotic disease identified by the World Health Organization (WHO) as having pandemic potential. This study estimates the health-economic burden of Lassa fever throughout West Africa and projects impacts of a series of vaccination campaigns. We also model the emergence of "Lassa-X" - a hypothetical pandemic Lassa virus variant - and project impacts of achieving 100 Days Mission vaccination targets. Our model predicted 2.7M (95% uncertainty interval: 2.1M-3.4M) Lassa virus infections annually, resulting over ten years in 2.0M (793.8K-3.9M) disability-adjusted life years (DALYs). The most effective vaccination strategy was a population-wide preventive campaign primarily targeting WHO-classified "endemic" districts. Under conservative vaccine efficacy assumptions, this campaign averted $20.1M ($8.2M-$39.0M) in lost DALY value and $128.2M ($67.2M-$231.9M) in societal costs (International dollars 2021). Reactive vaccination in response to local outbreaks averted just one-tenth the health-economic burden of preventive campaigns. In the event of Lassa-X emerging, spreading throughout West Africa and causing approximately 1.2M DALYs within two years, 100 Days Mission vaccination averted 22% of DALYs given a vaccine 70% effective against disease, and 74% of DALYs given a vaccine 70% effective against both infection and disease. These findings suggest how vaccination could alleviate Lassa fever's burden and assist in pandemic preparedness.
Collapse
|
3
|
Kamara ABS, Moseray A, Fatoma P, Mayei A, Lamin J, Sankoh O, Rogers MK. Analysing the association between perceived knowledge, and attitudes on Lassa Fever infections and mortality risk factors in lower Bambara Chiefdom. BMC Public Health 2024; 24:1684. [PMID: 38914994 PMCID: PMC11197251 DOI: 10.1186/s12889-024-19170-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Lassa fever (LF) presents significant public health challenges in Sierra Leone, particularly in the Lower Bambara Chiefdom. This study aims to deeply understand how knowledge and attitudes towards LF correlate with community-driven prevention and control measures. METHODS A descriptive cross-sectional quantitative approach was used to conduct the research. Data from 2167 participants were collected using an Android-based survey from 1st February 2022 to 14th February 2022. Respondents' knowledge of LF causes, risk factors, transmission modes, and preventive measures were evaluated through a multiple-choice questionnaire, and attitudes toward prevention and control were measured on a 5-point Likert scale. Quantitative data were analyzed using SPSS version 26.0 and frequencies were presented in count, percentage, and table. Chi-square statistics were used to test for associations. RESULTS Among the 2167 participants, over half were males (1184, 54.60%), farmers (1406, 64.90%), married (monogamous) (1428, 65.90%), and had never attended school (1336, 61.70%). Respondents demonstrated high knowledge levels of LF across socio-demographic groups (33% to 100%) and shared a positive attitude towards prevention and control (mean score of 26.77 on a 5-40 scale). Educational level, religious beliefs, and occupational status significantly influenced LF knowledge (p < 0.05). Specifically, illiterates had a high knowledge score of 48.24%, while those with tertiary education had the highest score at 83.33%. Additionally, a Pearson correlation analysis revealed a positive linear relationship between the degree of knowledge and positive attitude towards LF infection and mortality risk factors (r = 0.090, p = 0.02). CONCLUSION High LF knowledge in Lower Bambara Chiefdom positively influences prevention attitudes. Education, religion, and occupation are key factors. Tailored interventions enhance public health efforts.
Collapse
Affiliation(s)
- Abu-Bakarr S Kamara
- Department of Environmental Health Sciences, School of Community Health Sciences, Njala University, Bo Campus, Bo City, Sierra Leone.
| | - Andrew Moseray
- Department of Environmental Health Sciences, School of Community Health Sciences, Njala University, Bo Campus, Bo City, Sierra Leone
| | - Patrick Fatoma
- Department of Environmental Health Sciences, School of Community Health Sciences, Njala University, Bo Campus, Bo City, Sierra Leone
| | - Alhassan Mayei
- Department of Environmental Health Sciences, School of Community Health Sciences, Njala University, Bo Campus, Bo City, Sierra Leone
| | - Joseph Lamin
- Department of Environmental Health Sciences, School of Community Health Sciences, Njala University, Bo Campus, Bo City, Sierra Leone
| | - Osman Sankoh
- University of Management and Technology, Kissy Dockyard, Freetown, Sierra Leone
- School of Community Health Sciences, Bo Campus, Njala University, Sierra Leone, Bo City
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mohamed Kemoh Rogers
- School of Community Health Sciences, Bo Campus, Njala University, Sierra Leone, Bo City
| |
Collapse
|
4
|
Ofori B, Twum S, Nkansah Yeboah S, Ansah F, Amofa Nketia Sarpong K. Towards the development of cost-effective point-of-care diagnostic tools for poverty-related infectious diseases in sub-Saharan Africa. PeerJ 2024; 12:e17198. [PMID: 38915381 PMCID: PMC11195550 DOI: 10.7717/peerj.17198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/14/2024] [Indexed: 06/26/2024] Open
Abstract
In this review, we examine the current landscape of point-of-care testing (POCT) diagnostic tools designed for poverty-related infectious diseases (PRIDs) in sub-Saharan Africa (sSA) while delineating key avenues for future advancements. Our analysis encompasses both established and emerging diagnostic methods for PRIDs, addressing the persistent challenges in POCT tool development and deployment, such as cost, accessibility, and reliability. We emphasize recent advancements in POCT diagnostic tools as well as platforms poised to enhance diagnostic testing in sSA. Recognizing the urgency for affordable and widely accessible POCT diagnostic tools to detect PRIDs in sSA, we advocate for a multidisciplinary approach. This approach integrates current and emerging diagnostic methods, explicitly addressing challenges hindering point-of-care (POC) tool development. Furthermore, it recognizes the profound impact of misdiagnosis on public and global health, emphasizing the need for effective tools. To facilitate the successful development and implementation of POCT diagnostic tools in sSA, we propose strategies including the creation of multi-analyte detection POCT tools, the implementation of education and training programs, community engagement initiatives, fostering public-private collaborations, and the establishment of reliable supply chains. Through these concerted efforts, we aim to accelerate the development of POCT in the sSA region, ensuring its effectiveness and accessibility in addressing the diagnostic challenges associated with PRIDs.
Collapse
Affiliation(s)
- Benedict Ofori
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Seth Twum
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Silas Nkansah Yeboah
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kwabena Amofa Nketia Sarpong
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| |
Collapse
|
5
|
Reyna RA, Littlefield KE, Shehu N, Makishima T, Maruyama J, Paessler S. The Importance of Lassa Fever and Its Disease Management in West Africa. Viruses 2024; 16:266. [PMID: 38400041 PMCID: PMC10892767 DOI: 10.3390/v16020266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/21/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Lassa virus (LASV) is a zoonotic pathogen endemic throughout western Africa and is responsible for a human disease known as Lassa fever (LF). Historically, LASV has been emphasized as one of the greatest public health threats in West Africa, with up to 300,000 cases and 5000 associated deaths per year. This, and the fact that the disease has been reported in travelers, has driven a rapid production of various vaccine candidates. Several of these vaccines are currently in clinical development, despite limitations in understanding the immune response to infection. Alarmingly, the host immune response has been implicated in the induction of sensorineural hearing loss in LF survivors, legitimately raising safety questions about any future vaccines as well as efficacy in preventing potential hearing loss. The objective of this article is to revisit the importance and prevalence of LF in West Africa, with focus on Nigeria, and discuss current therapeutic approaches and ongoing vaccine development. In addition, we aim to emphasize the need for more scientific studies relating to LF-associated hearing loss, and to promote critical discussion about potential risks and benefits of vaccinating the population in endemic regions of West Africa.
Collapse
Affiliation(s)
- Rachel A. Reyna
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Kirsten E. Littlefield
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Nathan Shehu
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Infectious Disease Unit, Department of Medicine, Jos University Teaching Hospital, Jos P.M.B. 2076, Nigeria
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| |
Collapse
|
6
|
SAMSON T, AROMOLARAN O, AKINGBADE T. Lassa fever cases and mortality in Nigeria: Quantile Regression vs. Machine Learning Models. J Public Health Afr 2023; 14:2712. [PMID: 38259425 PMCID: PMC10801397 DOI: 10.4081/jphia.2024.2712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Lassa fever (LF) is caused by the Lassa fever virus (LFV). It is endemic in West Africa, of which % of the infections are ascribed to Nigeria. This disease affects mostly the productive age and hence a proper understanding of the dynamics of this disease will help in formulating policies that would help in curbing the spread of LF. The objective of this study is to compare the performance of quantile regression models with that of Machine Learning models in. Data between between 7th January 2018 2018 and 17th December, 2022 on suspected cases, confirmed cases and deaths resulting from LF were retrieved from the Nigeria Centre for Disease Control (NCDC). The data obtained were fitted to quantile regression models (QRM) at 25, 50 and 75% as well as to Machine learning models. The response variable being confirmed cases and mortality due to Lassa fever in Nigeria while the independent variables were total confirmed cases, the week, month and year. Result showed that the highest monthly mean confirmed cases (56) and mortality (9) from LF were reported in February. The first quarter of the year reported the highest cases of both confirmed cases and deaths in Nigeria. Result also revealed that for the confirmed cases, quantile regression at 50% outperformed the best of the MLM, Gaussian-matern5/2 GPR (RMSE=10.3393 vs. 11.615), while for mortality, the medium Gaussian SVM (RMSE=1.6441 vs. 1.8352) outperformed QRM. Quantile regression model at 50% better captured the dynamics of the confirmed cases of LF in Nigeria while the medium Gaussian SVM better captured the mortality of LF in Nigeria. Among the features selected, confirmed cases was found to be the most important feature that drive its mortality with the implication that as the confirmed cases of Lassa fever increases, is a significant increase in its mortality. This therefore necessitates a need for a better intervention measures that will help curb Lassa fever mortality as a result of the increase in the confirmed cases. There is also a need for promotion of good community hygiene which could include; discouraging rodents from entering homes and putting food in rodent proof containers to avoid contamination to help hart the spread of Lassa fever in Nigeria.
Collapse
Affiliation(s)
- T.K SAMSON
- Statistics Programme, College of Agriculture, Engineering and Science
| | - O. AROMOLARAN
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
| | - T. AKINGBADE
- Statistics Programme, College of Agriculture, Engineering and Science
| |
Collapse
|