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Kamara IF, Tengbe SM, Bah AJ, Nuwagira I, Ali DB, Koroma FF, Kamara RZ, Lakoh S, Sesay S, Russell JBW, Theobald S, Lyons M. Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study. BMC Public Health 2024; 24:783. [PMID: 38481202 PMCID: PMC10935859 DOI: 10.1186/s12889-024-18158-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay). METHODS AND MATERIALS We conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension. RESULTS Of the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6-38.8%), diastolic blood pressure was 39.9% (95% CI 35.2-44.6), and participants with diabetes were 2.2% (95% CI 0.7-3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49-36.39) and > 60 years (AOR 8.05; 95% CI 2.22-29.12), separated (AOR = 1.34; 95% 1.02-7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81-7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09-6.91) were found to be independently associated with hypertension. CONCLUSION The prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services.
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Affiliation(s)
- Ibrahim Franklyn Kamara
- World Health Organization Sierra Leone, 21A-B Riverside Drive, Off Kingharman Road, Freetown, Sierra Leone
| | | | - Abdulai Jawo Bah
- College of Medicine and Allied Health Sciences, University of Sierra Leone, A.J.Momoh Street, Freetown, Sierra Leone
| | - Innocent Nuwagira
- World Health Organization Sierra Leone, 21A-B Riverside Drive, Off Kingharman Road, Freetown, Sierra Leone
| | - Desta Betula Ali
- Ministry of Health, 4th Floor, Youyi Building, Freetown, Sierra Leone
| | - Fanny F Koroma
- Ministry of Health, 4th Floor, Youyi Building, Freetown, Sierra Leone
| | - Rugiatu Z Kamara
- United States CDC Country Office, EOC, Wilkinson Road, Freetown, Sierra Leone
| | - Sulaiman Lakoh
- Ministry of Health, 4th Floor, Youyi Building, Freetown, Sierra Leone
| | - Santigie Sesay
- Ministry of Health, 4th Floor, Youyi Building, Freetown, Sierra Leone
| | - James B W Russell
- Ministry of Health, 4th Floor, Youyi Building, Freetown, Sierra Leone
- College of Medicine and Allied Health Sciences, University of Sierra Leone, A.J.Momoh Street, Freetown, Sierra Leone
| | - Sally Theobald
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Mary Lyons
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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James PB, Yendewa GA, Bah AJ, Osborne A, Kpagoi SS, Margao EK, Kangbai J, Wardle J. Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey. BMC Pregnancy Childbirth 2023; 23:810. [PMID: 37993807 PMCID: PMC10664373 DOI: 10.1186/s12884-023-06126-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND A nationwide assessment of the link between women's empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women's empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data. METHOD We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15-49 years who gave birth in the five years preceding the survey were included. Outcome variable was "home birth of their last child among women in the five years preceding the 2019 SLDHS. Women's empowerment parameters include women's knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses. RESULTS Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low [aOR 2.04; 95% CI 1.43-2.92] and medium [aOR 1.44; 95%CI 1.05-1.97] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home [aOR 1.38; 95% CI1.09-1.74]. In addition, women with no [aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits [aOR 2.08; 95% CI:1.51-2.88] and for whom distance to a health facility was a major problem [aOR 1.95; 95% CI1.49-2.56] were more likely to have had a homebirth. However, no statistically significant association was observed between a women's decision-making power and home birth [aOR 1.11; 95% CI 0.86-1.41]. CONCLUSION Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - George A Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Augustus Osborne
- Department of Biological Sciences, School of Environmental Sciences, Njala University, Njala Campus, Njala, Sierra Leone
| | - Satta Sylvia Kpagoi
- Bo Government Hospital, Ministry of Health and Sanitation, Bo, Sierra Leone
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
| | - Emmanuel Kamanda Margao
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jia Kangbai
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
- Faculty of Health Sciences and Disaster Management, Eastern Technical University of Sierra Leone, Kenema, Sierra Leone
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia
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Klein EK, Bond L, McLean KE, Feika M, Bah AJ, Betancourt TS. Navigating the Tension between Fatherhood Ideals and Realities of a Post-Conflict Setting: A Phenomenological Study of Former Child Soldiers in Sierra Leone. SSM Qual Res Health 2023; 3:100227. [PMID: 38107407 PMCID: PMC10722571 DOI: 10.1016/j.ssmqr.2023.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The concept of "fatherhood" in many African countries has traditionally been understood in terms of instrumental support to one's family, most notably, financial provision. However, in Sierra Leone and elsewhere, this narrow understanding of fatherhood is changing as a result of shifting demographic trends and responses to recent crises such as the Ebola pandemic and the aftermath of a civil war. Very little is understood about how male former children associated with armed forces and armed groups (CAAFAG) are navigating fatherhood and understanding their roles as fathers, particularly as many have grown up without fathers or parents themselves and experienced violence. Our study builds upon previous ethnographic research in Sierra Leone, and uses a phenomenological approach to understand 1) the meaning and importance of fatherhood to former child soldiers in Sierra Leone, 2) what fatherhood looks like normatively and ideally, with attention to norms about nurturing care as well as violence, and 3) how ideals of fatherhood may or may not be in tension with socioeconomic circumstances. We find that CAAFAG fathers in Sierra Leone are committed to providing emotional support, encouragement, and a loving upbringing in addition to striving to provide financially. CAAFAG fathers experienced the greatest tension between their ideals of fatherhood and their socio-economic circumstances in terms of financial support, such as paying school fees. In other words, fathers felt inhibited in becoming the types of fathers they hoped to be due to their experiences in a post-conflict, resource-constrained environment.
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Affiliation(s)
- Elizabeth K Klein
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - Laura Bond
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - Kristen E McLean
- International Studies Program, College of Charleston, 66 George Street, Charleston, SC, 29424, USA
| | - Mahmoud Feika
- Caritas Freetown, 19 Savage Street, Freetown, Sierra Leone
| | - Abdulai Jawo Bah
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Musselburgh, Musselburgh, EH21 6UU, UK
| | - Theresa S Betancourt
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
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James PB, Gyasi RM, Kasilo OMJ, Wardle J, Bah AJ, Yendewa GA, Mwaka AD. The use of traditional medicine practitioner services for childhood illnesses among childbearing women: a multilevel analysis of demographic and health surveys in 32 sub-Saharan African countries. BMC Complement Med Ther 2023; 23:137. [PMID: 37120536 PMCID: PMC10148432 DOI: 10.1186/s12906-023-03972-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/25/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Insights into the use of traditional medicine practitioners (TMP)-for common childhood diseases such as diarrhea and respiratory infections are important to understand the role of Traditional Medicine (TM) in reducing the increasing childhood morbidity and mortality in sub-Saharan Africa (SSA). However, a comprehensive picture of TMP utilisation and its associated factors for childhood illness in SSA is lacking. This study aimed to estimate the prevalence of the use of traditional medicine practitioner services to treat childhood illnesses among women with children under five years old and to identify individual and community-level factors associated with TMP use in SSA. METHODS The analysis used Demographic and Health Surveys (DHS) dataset collected between 2010 and 2021 among 353,463 under-fives children from 32 SSA countries. Our outcome variable was the use of TMP for childhood illness, defined as having diarrhoea or fever/cough or both. Using STATA v14, we employed the random effect meta-analysis to estimate the pooled prevalence of TMP use for childhood illness and a two-level multivariable multilevel modelling to determine the individual and community-level factors associated with consultation of a TMP. RESULTS Approximately [2.80% (95%CI: 1.88-3.90)] women who sought healthcare for childhood illnesses utilised the service of a TMP with the highest occurring in Cote d'Ivoire [16.3% (95%CI: 13.87-19.06)] and Guinea (13.80% (95%CI: 10.74-17.57)] but the lowest in Sierra Leone [0.10%(95%CI:0.01-1.61)]. Specifically, approximately [1.95% (95%CI: 1.33-2.68)] and [1.09% (95%CI:0.67-1.60)] of women sought the service of a TMP for childhood diarrhea and fever/cough, respectively. Women with no formal education [AOR = 1.62;95%CI:1.23-2.12], no media access [AOR = 1.19;95%CI:1.02-1.39), who lived in a male-headed household [AOR = 1.64;95%CI:1.27-2.11], without health insurance [AOR = 2.37;95%CI: 1.53-3.66], who considered it a problem getting permission to visit a health facility [AOR = 1.23;95%CI:1.03-1.47] and who perceived the size of their children at birth to be above average[AOR = 1.20;95%CI:1.03-1.41] had higher odds of using TMP for childhood illnesses. CONCLUSIONS Although the prevalence of TMP for childhood illnesses appeared low, our findings highlight that TMPs continue to play a critical role in managing childhood illnesses in SSA. It is essential that policymakers and service providers should incorporate the potential role of TMPs in the design, review and implementation of child health policies in SSA. Also, the interventions for curtailing childhood illnesses should be focused on the characteristics of women who use TMPs for childhood diseases identified in our study.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Razak M Gyasi
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Ossy Muganga Julius Kasilo
- WHO Regional Office for Africa, Universal Health Coverage Life Course Cluster, Brazzaville, Republic of Congo
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - George A Yendewa
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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James PB, Osborne A, Bah AJ, Margao EK, Conteh-Barrat M. Sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia: a secondary analysis of the 2017 Global school-based student health surveys. Contracept Reprod Med 2022; 7:27. [PMID: 36566228 DOI: 10.1186/s40834-022-00193-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/18/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sierra Leone and Liberia have experienced civil wars and, recently, Ebola outbreaks that led to profound economic hardship, psychopathologies and family disruptions. These factors are associated with sexual risk behaviours among youths. However, there is very little information on sexual risk behaviour among Sierra Leonean and Liberian school-going adolescents. The present study assessed the prevalence and determinants of sexual risk behaviours among school-going adolescents (10-19 years) in Sierra Leone and Liberia. METHOD: We used publicly available nationally representative cross-sectional datasets of the 2017 Sierra Leone and Liberia Global school health survey. The sample consisted of 2798 and 2744 school-going adolescents from Sierra Leone and Liberia, respectively. Complex sample descriptive and regression analysis was used to analyse our data. RESULTS The majority of adolescents in the two countries were involved in multiple sexual risk behaviour (80.2%), with a higher prevalence observed in Sierra Leone (85.2%) than in Liberia (75.3%). Liberian adolescents showed lesser odds of indulging in multiple sexual risk behaviours than their Sierra Leonean counterparts (AOR = 0.572; 95%CI: 0.345-0.946). Male, compared to females, were more likely to engage in multiple sexual risk behaviour (AOR = 2.310;95%CI:1.543-3.458), with a similar pattern observed in both countries. Alcohol use was associated with multiple sexual risk behaviour (AOR = 3.064; 95%CI: 2.137-4.392). Also, in Sierra Leone and Liberia, adolescents with one and two or more forms of psychological distress were more likely to have ever had sex than those who did not show any form of psychological distress. Missing class/school was associated with multiple sexual risk behaviour (AOR = 1.655; 95%CI:1.133-2.418). Peer support was only found to be a protective factor against no condom use among Liberian adolescents (AOR = 0.608; 95%CI: 0.435-0.850). Less parental support was only associated with ever had sex among adolescents in Sierra Leone (AOR = 2.027; 95%CI: 1.322-3.107) but not in Liberia (AOR = 1.034; 95%CI: 0.650-1.644). CONCLUSION Our study found a high sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. Our finding highlights the need to strengthen sexual and reproductive health education in schools and communities that incorporate mental health promotion activities tailored to this group.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia. .,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Augustus Osborne
- Department of Biological Sciences, School of Environmental Sciences, Njala University, Njala Campus, Njala, Sierra Leone
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Emmanuel Kamanda Margao
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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James PB, Osborne A, Babawo LS, Bah AJ, Margao EK. The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries. BMC Public Health 2022; 22:2358. [PMID: 36527019 PMCID: PMC9756616 DOI: 10.1186/s12889-022-14855-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries. METHODS We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively. RESULTS More than half [n = 4430, 53.8% (43.9-63.8)], two-fifth [n = 3242, 39.5% (33.2-45.9) and two-thirds of adolescents [n = 4838, 65.6% (57.5-73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR = 1.48;95%CI: 1.12-1.94], early sexual debut [AOR = 1.81(1.47-2.22)], having two or more sexual partners [AOR = 1.30(1.06-1.58)] and no/minimal parental support [AOR = 1.54(1.17-2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR = 1.37 (1.09-1.73)], early sexual debut [AOR = 1.83(1.48-2.27) and having no parental support [AOR = 1.64(1.34-2.00)]. CONCLUSION Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.
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Affiliation(s)
- Peter Bai James
- grid.1031.30000000121532610National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480 Australia ,grid.442296.f0000 0001 2290 9707Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Augustus Osborne
- grid.469452.80000 0001 0721 6195Department of Biological Sciences, School of Environmental Sciences, Njala University, Njala, Sierra Leone
| | - Lawrence Sao Babawo
- grid.469452.80000 0001 0721 6195Department of Nursing, School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
| | - Abdulai Jawo Bah
- grid.442296.f0000 0001 2290 9707Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone ,grid.104846.fInstitute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Emmanuel Kamanda Margao
- grid.442296.f0000 0001 2290 9707Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Fofanah BD, Abrahamyan A, Maruta A, Kallon C, Thekkur P, Kamara IF, Njuguna CK, Squire JS, Kanu JS, Bah AJ, Lakoh S, Kamara D, Hermans V, Zachariah R. Achieving Minimum Standards for Infection Prevention and Control in Sierra Leone: Urgent Need for a Quantum Leap in Progress in the COVID-19 Era! Int J Environ Res Public Health 2022; 19:5642. [PMID: 35565037 PMCID: PMC9102022 DOI: 10.3390/ijerph19095642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Good Infection prevention and control (IPC) is vital for tackling antimicrobial resistance and limiting health care-associated infections. We compared IPC performance before (2019) and during the COVID-19 (2021) era at the national IPC unit and all regional (4) and district hospitals (8) in Sierra Leone. METHODS Cross-sectional assessments using standardized World Health Organizations IPC checklists. IPC performance scores were graded as inadequate = 0-25%, basic = 25.1-50%, intermediate = 50.1-75%, and advanced = 75.1-100%. RESULTS Overall performance improved from 'basic' to 'intermediate' at the national IPC unit (41% in 2019 to 58% in 2021) and at regional hospitals (37% in 2019 to 54% in 2021) but remained 'basic' at district hospitals (37% in 2019 to 50% in 2021). Priority gaps at the national IPC unit included lack of: a dedicated IPC budget, monitoring the effectiveness of IPC trainings and health care-associated infection surveillance. Gaps at hospitals included no assessment of hospital staffing needs, inadequate infrastructure for IPC and lack of a well-defined monitoring plan with clear goals, targets and activities. CONCLUSION Although there is encouraging progress in IPC performance, it is slower than desired in light of the COVID-19 pandemic. There is urgent need to mobilize political will, leadership and resources and make a quantum leap forward.
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Affiliation(s)
- Bobson Derrick Fofanah
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - Arpine Abrahamyan
- Tuberculosis Research and Prevention Center (TBRPC), Yerevan 0014, Armenia;
| | - Anna Maruta
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - Christiana Kallon
- National Infection Prevention and Control Coordinating Unit, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Pruthu Thekkur
- Centre for Operational Research, International Union against Tuberculosis and Lung Disease, 75001 Paris, France;
| | - Ibrahim Franklyn Kamara
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - Charles Kuria Njuguna
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - James Sylvester Squire
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.)
| | - Joseph Sam Kanu
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.)
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (A.J.B.); (S.L.)
| | - Abdulai Jawo Bah
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (A.J.B.); (S.L.)
- Institute of Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Sulaiman Lakoh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (A.J.B.); (S.L.)
- Department of Medicine, University of Sierra Leone Teaching Hospitals Complex, Freetown 00232, Sierra Leone
| | - Dauda Kamara
- Water, Sanitation, and Hygiene (WASH) Program, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Veerle Hermans
- Médecins Sans Frontières, Operational Centre Brussels, 68, Rue de Gasperich, 1617 Luxembourg, Belgium;
| | - Rony Zachariah
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), Avenue Appia 20, 1211 Geneva, Switzerland;
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James PB, Bah AJ, Kabba JA, Kassim SA, Dalinjong PA. Prevalence and correlates of current tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in 22 African countries: a secondary analysis of the 2013-2018 global youth tobacco surveys. Arch Public Health 2022; 80:121. [PMID: 35422011 PMCID: PMC9009031 DOI: 10.1186/s13690-022-00881-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/07/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Our study examined the prevalence and associated factors of tobacco product use and non-users' susceptibility to using tobacco products among school-going adolescents in 22 African countries. METHODS We analyzed the cross-sectional 2013-2018 Global Youth Tobacco Survey (GYTS) data from 22 African countries. We conducted complex sampling descriptive and logistic regression analyses. RESULTS The overall prevalence of current use of any tobacco product among adolescents was 19.1%, with more males (23.7%) than females (13.7%) being current users. Zimbabwe and Morocco were the highest (47.1%) and least (12.6%) reported prevalence, respectively. Being male (AOR = 1.93;95%CI:1.61-2.32), being 16 and older(AOR = 1.37;95%CI:1.01-1.86), exposure to secondhand smoke within (AOR = 1.98;95%CI:1.69-2.32) and outside (AOR = 1.37;95%CI:1.13-1.65) the home, not knowledgeable about the harmful effect of secondhand smoke (AOR = 1.44;95%CI:1.20-1.74), exposure to tobacco industry promotion (AOR = 3.05;95%CI:2.68-3.47) and not in favour of banning smoking in enclosed places (AOR = 1.32;95%CI:1.08-1.60) were associated with current use of any tobacco product. The prevalence of the susceptibility to using tobacco products among never users of tobacco products was 12.2%, with no significant gender difference. Mozambique (24.6%) and Algeria (4.5%) had the highest and least prevalence of susceptibility to using tobacco products among never users, respectively. Exposure to tobacco industry promotion (AOR = 1.54;95%CI:1.31-1.82), those not in favour of banning smoking in enclosed places (AOR = 1.29;95%CI:1.14-1.45) and those not exposed to anti-smoking school education (AOR = 1.24;95%CI:1.06-1.46) were associated with susceptibility to using any tobacco product among never users of tobacco products. CONCLUSION Our study reports that tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in the 22 African countries is high. As part of public health efforts, governments and other stakeholders need to fully implement anti-tobacco use campaigns, enforce a complete ban on tobacco promotion and advertising, institute educational programs for families, and anti-tobacco use education for the general public and in schools in line with WHO Framework Convention on Tobacco Control guidelines.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, 2480, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China
| | - Said Abasse Kassim
- Département de Management, Centre de Recherche en Gestion des Services de Sante, Faculté des sciences de l'administration (FSA), Université Laval (UL), Centre Hospitalière Universitaire (CHU) de Québec, Québec, CA, G1V 0A6, Canada
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9
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Thomas F, Abiri OT, Komeh JP, Conteh TA, Bah AJ, Kanu JS, Terry R, Abrahamyan A, Thekkur P, Zachariah R. Inconsistent Country-Wide Reporting of Adverse Drug Reactions to Antimicrobials in Sierra Leone (2017-2021): A Wake-Up Call to Improve Reporting. Int J Environ Res Public Health 2022; 19:ijerph19063264. [PMID: 35328953 PMCID: PMC8952810 DOI: 10.3390/ijerph19063264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 01/25/2023]
Abstract
Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they can cause life-threatening illness, permanent disabilities, and death. We assessed country-wide ADR reporting on antimicrobials and their outcomes. Methods: A cross-sectional study was conducted using individual case safety reports (ICSRs) entered into the national pharmacovigilance database (VigiFlow) during 2017−2021. Results: Of 566 ICSRs, inconsistent reporting was seen, with the highest reporting in 2017 and 2019 (mass drug campaigns for deworming), zero reporting in 2018 (reasons unknown), and only a handful in 2020 and 2021 (since COVID-19). Of 566 ICSRs, 90% were for antiparasitics (actively reported during mass campaigns), while the rest (passive reporting from health facilities) included 8% antibiotics, 7% antivirals, and 0.2% antifungals. In total, 90% of the reports took >30 days to be entered (median = 165; range 2−420 days), while 44% had <75% of all variables filled in (desired target = 100%). There were 10 serious ADRs, 18 drug withdrawals, and 60% of ADRs affected the gastrointestinal system. The patient outcomes (N-566) were: recovered (59.5%), recovering (35.5%), not recovered (1.4%), death (0.2%), and unknown (3.4%). There was no final ascertainment of ‘recovering’ outcomes. Conclusions: ADR reporting is inconsistent, with delays and incomplete data. This is a wake-up call for introducing active reporting and setting performance targets.
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Affiliation(s)
- Fawzi Thomas
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
- Correspondence: ; Tel.: +23-27946-0264
| | - Onome T. Abiri
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
| | - James P. Komeh
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
| | - Thomas A. Conteh
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 02717, Sierra Leone; (O.T.A.); (J.P.K.); (T.A.C.)
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
| | - Abdulai Jawo Bah
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
- Institute of Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Joseph Sam Kanu
- College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown 02717, Sierra Leone; (A.J.B.); (J.S.K.)
- National Disease Surveillance Program, Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 02717, Sierra Leone
| | - Robert Terry
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland; (R.T.); (R.Z.)
| | - Arpine Abrahamyan
- Tuberculosis Research and Prevention NGO (TB-RPC), Yerevan 0014, Armenia;
| | - Pruthu Thekkur
- Centre for Operational Research, International Union against Tuberculosis and Lung Disease, 75001 Paris, France;
| | - Rony Zachariah
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland; (R.T.); (R.Z.)
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10
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Raven J, Wurie H, Baba A, Bah AJ, Dean L, Hawkins K, Idriss A, Kollie K, Nallo GE, Steege R, Theobald S. Supporting community health workers in fragile settings from a gender perspective: a qualitative study. BMJ Open 2022; 12:e052577. [PMID: 35121601 PMCID: PMC8819829 DOI: 10.1136/bmjopen-2021-052577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore how gender influences the way community health workers (CHWs) are managed and supported and the effects on their work experiences. SETTING Two districts in three fragile countries. Sierra Leone-Kenema and Bonthe districts; Liberia-two districts in Grand Bassa county one with international support for CHW activities and one without: Democratic Republic of Congo (DRC)-Aru and Bunia districts in Ituri Province. PARTICIPANTS AND METHODS Qualitative interviews with decision-makers and managers working in community health programmes and managing CHWs (n=36); life history interviews and photovoice with CHWs (n=15, in Sierra Leone only). RESULTS While policies were put in place in Sierra Leone and Liberia to attract women to the newly paid position of CHW after the Ebola outbreak, these good intentions evaporated in practice. Gender norms at the community level, literacy levels and patriarchal expectations surrounding paid work meant that fewer women than imagined took up the role. Only in DRC, there were more women than men working as CHWs. Gender roles, norms and expectations in all contexts also affected retention and progression as well as safety, security and travel (over long distance and at night). Women CHWs also juggle between household and childcare responsibilities. Despite this, they were more likely to retain their position while men were more likely to leave and seek better paid employment. CHWs demonstrated agency in negotiating and challenging gender norms within their work and interactions supporting families. CONCLUSIONS Gender roles and relations shape CHW experiences across multiple levels of the health system. Health systems need to develop gender transformative human resource management strategies to address gender inequities and restrictive gender norms for this critical interface cadre.
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Affiliation(s)
- Joanna Raven
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | - Haja Wurie
- Department of Nursing, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Amuda Baba
- Institut Panafricain de Santé Communautaire et Medecine Tropicale, Bunia, Democratic Republic of the Congo
| | - Abdulai Jawo Bah
- Department of Pharmacology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | | | - Ayesha Idriss
- Department of Pharmacology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Karsor Kollie
- Neglected Tropical Disease Program, Ministry of Health, Monrovia, Liberia
| | - Gartee E Nallo
- University of Liberia Pacific Institute for Research and Evaluation, Monrovia, Liberia
| | - Rosie Steege
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK
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11
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James PB, Wardle J, Gyasi RM, Steel A, Adams J, Kabba JA, Bah AJ, Lahai M, Conteh EB. Health-related quality of life among Ebola survivors in Sierra Leone: the role of socio-demographic, health-related and psycho-social factors. Health Qual Life Outcomes 2022; 20:10. [PMID: 35033102 PMCID: PMC8761046 DOI: 10.1186/s12955-022-01916-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Evidence of how social factors affect the health-related quality of life (HRQoL) of Ebola virus disease (EVD) survivors is limited. Our study explores the association between socio-demographic, health-related and psycho-social (stigma) factors and EVD survivors' health-related quality of life (HRQoL) in Sierra Leone. Methods We conducted a nationwide cross-sectional study among 358 EVD survivors between January and August 2018. We used a multistage sampling method to recruit EVD survivors, and the RAND 36-Item Health Survey item was used to assess the HRQoL. Data were analysed using descriptive statistics and multiple linear regression. Results When comparing by each dimension in relation to their respective summary scores, role limitation physical [0.00 (50.00)] and role limitation emotional [0.00 (33.33)] were the most affected physical health and mental health domains among EVD survivors respectively. EVD survivors who were older (β = − 3.90, 95% CI − 6.47 to − 1.32, p = 0.003), had no formal education (β = − 2.80, 95% CI − 5.16 to − 0.43, p = 0.021), experienced a unit increase in the number of post-Ebola symptoms (β = − 1.08, 95% CI − 1.74 to − 0.43, p < 0.001) and experienced a unit increase in enacted stigma (β = − 2.61, 95% CI − 4.02 to − 1.20, p < 0.001) were more likely to report a decreased level of physical health. EVD survivors who experienced a unit increase in the time spent in the Ebola treatment centre (β = − 0.60, 95% CI − 0.103 to − 0.18, p = 0.006) and those who experienced a unit increase in enacted Stigma were more likely to report decreased levels of mental health (β = − 1.50, 95% CI − 2.67 to − 0.33, p = 0.012). Conclusion Sociodemographic, health-related, and psycho-social factors were significantly associated with decrease levels of HRQoL. Our findings improve our understanding of the factors that might influence the HRQoL and suggest the need for EVD survivors to be provided with a comprehensive healthcare package that caters for their physical and mental health needs.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia. .,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia.,Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Faculty of Basic Medical Sciences College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Michael Lahai
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eugene B Conteh
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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12
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Abstract
Background There are limited data regarding the long-term health effects of child survivors of the 2013-2016 West African Ebola virus disease (EVD) outbreak. Here, we assess post-Ebola sequelae among EVD child survivors by comparing the self-reported symptoms between EVD child survivors and their close household contacts over one year after the end of the outbreak. Methods EVD child survivors(n=159) and their close contacts(n=303) were enrolled in Western and Eastern Sierra Leone. Demographics and self-reported symptoms data were collected using an interviewer-administered questionnaire. We compared a list of self-reported symptoms between EVD child survivors and their close household contacts using backward stepwise logistic regression. Results EVD child survivors were more likely to be orphans compared to their close contacts. Musculoskeletal, ocular, auditory and neurological symptoms were more prevalent among Ebola child survivors than their close contacts (p<0.001). Joint pain and headache were the most common self-reported symptoms in EVD child survivors and their close contacts. Joint pain (AOR=2.633; 95 % CI:1.31-5.28, p=0.006), eye pain (AOR=4.56;95 %CI: 2.16-9.64, p<0.001), hearing loss (AOR=3.85; 95 %CI: 1.15-12.87, p=0.029), memory impairment (AOR=7.76;0.95 %CI: 1.34-45.01 p=0.022), mood changes (AOR=5.07; 95 %CI: 2.35-10.94, p<0.001) were more common among survivors than their contacts. Conclusions Our data suggest that EVD child survivors have higher odds than their close contacts of suffering from musculoskeletal, ophthalmic, auditory and neurological impairment more than a year after the end of the EVD outbreak. Routine screening, treatment and monitoring of these symptoms is required to prevent long-term disability among EVD child survivors. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02957-w.
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Affiliation(s)
- Claudette Amuzu
- Braun School of Public Health, Hadassah/Hebrew University, Jerusalem, Israel
| | - Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia. .,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Queen Margaret University Edinburgh, Musselburgh, Scotland, UK
| | | | - Shepherd Roee Singer
- Braun School of Public Health, Hadassah/Hebrew University, Jerusalem, Israel.,Israel Ministry of Health, Jerusalem, Israel
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Hopwood H, Sevalie S, Herman MO, Harris D, Collet K, Bah AJ, Beynon F. The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units. Int J Ment Health Syst 2021; 15:31. [PMID: 33832523 PMCID: PMC8033705 DOI: 10.1186/s13033-021-00455-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa the treatment gap for mental disorders is high. In 2009, 98.0% of people with mental illness in Sierra Leone were not receiving treatment, partly due to the absence of public psychiatric facilities outside the capital. In response, the Ministry of Health and Sanitation rolled out nurse-led mental health units (MHU) to every district. This study aims to retrospectively evaluate the uptake of these services by examining the pathways to care, diagnosis, management, and treatment gap, to provide insight into the functioning of these units and the potential burden of mental health disorders in Sierra Leone. METHODS We evaluated the roll out of MHU using summary data from all units between 1 st January 2015 and 1 st January 2017, to establish the burden of diagnoses among service users, pathways to care, treatments provided, and treatment gaps. Negative binomial regressions examine bivariate relationships between diagnoses, treatments, and medication inaccessibility with demographics (age and sex), location (Freetown vs the rest and Ebola endemic regions vs the rest) and year. RESULTS We collected data from 15 MHU covering 13 districts in 24 months. There were 2401 referrals. The largest age category was 25-34 (23.4%). The prominent diagnoses were epilepsy (43.5%, associated with children) and psychosis (17.5%, associated with males). Reported depression (8.6%) and suicide attempts (33 patients) were low. Ebola endemic regions reported higher rates of grief, trauma, and medically unexplained symptoms. In 24.7% of cases where medication was required, it was not accessible. CONCLUSIONS Nurse-led MHU can have a modest effect on the treatment gap in resource constrained environments such as Sierra Leone, particularly in epilepsy and psychosis.
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Affiliation(s)
- Helen Hopwood
- King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone.
| | | | - Moshi Optat Herman
- Kings College London Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Dawn Harris
- King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone
| | | | | | - Fenella Beynon
- King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Freetown, Sierra Leone
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14
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Kanu S, James PB, Bah AJ, Kabba JA, Kamara MS, Williams CEE, Kanu JS. Healthcare Workers' Knowledge, Attitude, Practice and Perceived Health Facility Preparedness Regarding COVID-19 in Sierra Leone. J Multidiscip Healthc 2021; 14:67-80. [PMID: 33469299 PMCID: PMC7810694 DOI: 10.2147/jmdh.s287156] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background Healthcare workers (HCWs) are known to spearhead the fight against the COVID-19 pandemic. As such, their knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are considered critical to the success of the current COVID-19 response efforts. This study aims to determine HCWs’ KAP toward COVID-19 and assesses their perception of their healthcare facilities preparedness to respond appropriately to the ongoing COVID-19 pandemic in Sierra Leone. Methods We conducted an online cross-sectional study among HCWs (n=516) between 1st May 2020 and 30th June 2020. We collected our data using a self-administered structured questionnaire via email and online social media platforms. We analyzed our data using descriptive statistics and regression analysis (p<0.05). Results Close to three-fourth of HCWs (n=375, 72.7%) were knowledgeable regarding COVID-19. Doctors were more knowledgeable than community health workers and laboratory technicians (AOR= 2.48, 95% CI: 1.16–5.31, p=0.019) regarding COVID-19. Close to two-thirds of HCWs (n=301, 58.3%) HCWs show positive attitudes toward COVID-19. Being male (AOR=2.08, 95% CI: 1.36–3.20, p=0.001) and directly involved in COVID-19 patient care (AOR=3.21, 95% CI: 1.88–5.48, p<0.001) were identified as predictors of positive attitude towards COVID-19. HCWs are generally adhering to COVID-19 safe practices with majority indicating that they regularly wash or sanitize their hands (n=510, 98.8%) and used facemask at point of care (n=499, 96.7%). Majority of HCWs are of the view that their healthcare facilities are ill-prepared to adequately respond to COVID-19 with majority (n= 400, 77.5%) of them stating that their facilities lack enough personal protective equipment. Conclusion HCWs in Sierra Leone showed good knowledge, positive attitude and practice regarding COVID-19. However, HCWs are of the view that their healthcare facilities are ill-prepared to respond adequately to the COVID-19 outbreak. Health authorities and policymakers need to provide the necessary resources to allow HCWs to work in a safe environment.
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Affiliation(s)
- Sulaiman Kanu
- University of Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Musa Salieu Kamara
- University of Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | | | - Joseph Sam Kanu
- Directorate of Disease Prevention and Control, Ministry of Health and Sanitation, Freetown, Sierra Leone
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Kabba JA, Bah AJ, James PB, Chang J, Kitchen C, Jiang M, Zhao M, Fang Y. Patients satisfaction with free healthcare pharmaceutical services in Sierra Leone: a national cross-sectional study. Int J Clin Pharm 2020; 43:556-565. [PMID: 33025447 DOI: 10.1007/s11096-020-01163-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/11/2020] [Accepted: 09/21/2020] [Indexed: 11/28/2022]
Abstract
Background Patient satisfaction is a critical construct of quality of pharmaceutical care in that it reflects whether a given service is meeting patients' expectations and consistent with their values. The government of Sierra Leone in 2010 introduced a free healthcare policy, which includes free pharmaceutical services for under-five children, lactating mothers, and pregnant women at all governments hospitals nationawide. Objectives The main objective of this study is to evaluate patient's satisfaction with the pharmaceutical services received from public hospitals implementing the free healthcare policy. Setting Four randomly selected public hospitals in Sierra Leone, one from each of the four regions, providing free healthcare services. Methods A cross-sectional design, using an interview-administered questionnaire, was employed in this study. Data were analyzed in SPSS, continuous and categorical data were computed descriptively. Responses to the open question were quantified and analyzed thematically. Adjusted and crude logistical models were used to assess factors associated with satisfaction, and significance was taken at p < 0.05. Main outcome measure Patients satisfaction with pharmaceutical services provided in public hospitals in Sierra Leone. Results Overall, 797 questionnaires were analyzed. The majority of patients seeking free pharmaceutical services were satisfied (n = 470, 56%) or very satisfied (n = 229, 28.7%) with the services they received. Pharmacy staff which includes pharmacists and pharmacy techincians demonstrated good communication skills while delivering services, but lacked technical details like; how to handle (n = 187, 23.5%) and store (n = 135, 16.9%) drugs and their potential side effects (n = 253, 31.8%). Low satisfaction was observed with the lack of private area for patients counseling (n = 474, 60.1%), and a convenient waiting area (n = 229, 28.7%). Respondents also thought the pharmacy was too small (n = 191, 24.6%) and with less than optimal lighting system (n = 120, 15.0%). Dissatisfaction was associated with college/university students or graduates [AOR: 0.211 (0.083-0.537), p = 0.001] and those with household incomes less than SLL 1,000,000 [AOR: 0.391 (0.155-0.987) p = 0.047]. Conclusions Patients were generally satisfied with pharmaceutical services received; however, infrastructural upgrades of the pharmacy like a comfortable waiting area and private counselling area within the pharmacy scores low in their satisfaction level. Improvement on the pharmacy structure, and motivated pharmacy staff with the right technical training will enhance the effective delivery of quality pharmaceutical care within the free healthcare.
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Affiliation(s)
- John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute of Global Health and Development, School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Mingyue Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China. .,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China. .,Shaanxi Center for Health Reform and Development Research, Xi'an, China. .,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China.
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Bah AJ, James PB, Bah N, Sesay AB, Sevalie S, Kanu JS. Prevalence of anxiety, depression and post-traumatic stress disorder among Ebola survivors in northern Sierra Leone: a cross-sectional study. BMC Public Health 2020; 20:1391. [PMID: 32917162 PMCID: PMC7485189 DOI: 10.1186/s12889-020-09507-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background There is limited data available on the long-term mental health impact of Ebola virus disease (EVD) on survivors despite the disease experience of survivors meeting the criteria of a traumatic event as defined in the Diagnostic and Statistical Manual of Mental Disorders version IV (DSM IV). This study aimed to assess the prevalence and predictive factors of anxiety, depression and posttraumatic stress disorder among EVD survivors, approximately 2 years after discharge from the Ebola treatment centre (ETC). Methods We conducted a cross-sectional study between May and August 2017 among 197 adults Ebola survivors in Bombali district, Northern Sierra Leone. We collected information about demographics, mental health status and possible predictive factors. The HAD scale was used to measure anxiety and depression. PTSD was measured using the PTSD-checklist (PCL). Chi-square test or Fisher exact two-tailed tests were used to test for associations and the multiple logistic regressions model to determine factors that were independently associated with the outcome variables. Results The mean anxiety, depression and PTSD scores were (5.0 ± 3.9), (7.1 ± 3.8) and (39.5 ± 6.4) respectively. Based on cut-off scores, the prevalence of anxiety (HADs score ≥ 8), depression (HADs score ≥ 8) and PTSD (PCL ≥ 45) among Ebola survivors were (n = 49, 24.9%), (n = 93, 47.2%) and (n = 43, 21.8%) respectively. Older Ebola survivors (≥30 years) were more likely to show symptoms of depression (AOR = 8.5, 95% CI: 2.68–27.01, p = 0.001) and anxiety (AOR = 3.04; 95%CI: 1.2–7.7, p = 0.019) compared to younger ones (< 30 years). In addition, Ebola survivors who experienced a decreased level of exercise post-ETC discharge were more likely to show symptoms of depression (AOR = 2.63; 95%CI: 1.25–5.54, p = 0.011) and anxiety (AOR = 3.60; 95%CI: 1.33–9.72, p = 0.012) compared to those whose exercise remained the same post-ETC discharge. Conclusion Our findings show that anxiety, depression and PTSD are common among the Ebola survivors in Bombali district, Northern Sierra Leone, and that underscores the need to diagnose and manage mental health morbidities among Ebola survivors long after their recovery from Ebola virus disease. Cognitive Behaviour Therapy (CBT) and Interpersonal Therapy (IPT) need to be explored as part of overall mental healthcare package interventions.
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Affiliation(s)
- Abdulai Jawo Bah
- Faculty of Basic Medical Sciences College of Medicine and Allied Health Sciences University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK.,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. .,Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
| | - Nuhu Bah
- Directorate of Drugs and Medical Supplies Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Amara Bangali Sesay
- Directorate of Drugs and Medical Supplies Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Joseph Sam Kanu
- Directorate of Disease Prevention and Control, Ministry of Health and Sanitation, Freetown, Sierra Leone
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17
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Raven J, Wurie H, Idriss A, Bah AJ, Baba A, Nallo G, Kollie KK, Dean L, Steege R, Martineau T, Theobald S. How should community health workers in fragile contexts be supported: qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo. Hum Resour Health 2020; 18:58. [PMID: 32770998 PMCID: PMC7414260 DOI: 10.1186/s12960-020-00494-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/18/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Community health workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings-Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre. METHODS We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n = 37), life history interviews with CHWs (n = 15) and reviewed policy documents. RESULTS Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role. This has implications for the selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs' scope of work is varied and may change over time, requiring ongoing training. The modular, local and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and developing a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is vital to retention and performance of CHWs. But there are challenges with supervision, scarcity of supplies, inadequate community recognition and unfulfilled promises about allowances. Clear communication about incentives with facility staff and communities is required as is their timely delivery. CONCLUSIONS This is the first study that has explored the management of CHWs in fragile settings. CHWs' interface role between communities and health systems is critical because of their embedded positionality and the trusting relationships they (often) have. Their challenges are aligned to those generally faced by CHWs but chronic fragility exacerbates them and requires innovative problem solving to ensure that countries and communities are not left behind in reforming the way that CHWs are supported.
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Affiliation(s)
- Joanna Raven
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ayesha Idriss
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Abdulai Jawo Bah
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Amuda Baba
- Institut Panafricain de Santé Communautaire et Medecine Tropicale, Bunia, Ituri Province Democratic Republic of Congo
| | - Gartee Nallo
- University of Liberia Pacific Institute for Research and Evaluation, Monrovia, Liberia
| | - Karsor K. Kollie
- Neglected Tropical Disease Program, Liberia Ministry of Health, Monrovia, Liberia
| | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Rosie Steege
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Tim Martineau
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
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Lahai M, James PB, Wannang NN, Wurie HR, Conteh S, Bah AJ, Samai M. A cross-sectional study on caregivers' perspective of the quality of life and adherence of paediatric HIV patients to highly active antiretroviral therapy. BMC Pediatr 2020; 20:286. [PMID: 32517722 PMCID: PMC7282047 DOI: 10.1186/s12887-020-02194-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART. Methods We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children’s Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee. Results The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p = 0.019*) to the physical health domain (mean = 64.61 SD = 8.1). Caregiver HIV status showed a strong association with the physical (mean = 58.3, SD = 11.7 and p = 0.024*), and psychological health domains (mean = 68.2, SD = 14.7 and p = 0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean = 58.0, SD = 10.6, p < 0.001), psychological (mean 68.2 SD = 14.81 p < 0.001) and environmental health domains (mean = 59.7, SD = 13.47, p < 0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p = 0.014) and adherent paediatric patients (p = 0.005). Nuclear family also showed a strong association with psychological (p < 0.001) and environmental (p = 0.001) health domains. Conclusion This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.
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Affiliation(s)
- Michael Lahai
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, 00232, Sierra Leone.
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, 00232, Sierra Leone
| | | | - Haja Ramatulai Wurie
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Sorie Conteh
- Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, 00232, Sierra Leone
| | - Mohamed Samai
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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19
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James PB, Wardle J, Steel A, Adams J, Bah AJ, Sevalie S. Providing healthcare to Ebola survivors: A qualitative exploratory investigation of healthcare providers' views and experiences in Sierra Leone. Glob Public Health 2020; 15:1380-1395. [PMID: 32379008 DOI: 10.1080/17441692.2020.1762105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although the experiences of healthcare workers regarding caring for Ebola patients during the West African Ebola outbreak have been explored, little is known about healthcare workers' experiences in providing care to Ebola survivors. We employed a qualitative design to address this gap in the literature. Healthcare providers described the health complaints of Ebola survivors as similar to those of ordinary patients, but disproportionately frequent and severe. During the Ebola outbreak, fear of infection with the Ebola virus affected healthcare providers' confidence to provide care to survivors leading to the provision of symptomatic or no treatment. At the close of the Ebola outbreak, healthcare providers cited previous experience in providing care to Ebola patients, being more knowledgeable, peer support, commitment to professional duty and the implementation of the CPES programme as motivators that helped boost their confidence to providing care. However, healthcare providers described the unavailability of medicines, the inability to undertake laboratory investigations, the lack of access to specialised care and uncoordinated referrals from peripheral health units as their current challenges to providing care. Such enablers and barriers need to be prioritised within the Sierra Leone health system to further strengthen initiatives aimed at improving healthcare delivery to Ebola survivors.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.,National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdulai Jawo Bah
- Institute for Global Health and Development, Queen Margaret University, Edinburg, Scotland, UK.,Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Stephen Sevalie
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Joint Medical Unit, Republic of Sierra Leone Armed Forces, 34 Military Hospital Wilberforce Freetown, Freetown, Sierra Leone.,Sustainable Health systems, Freetown, Sierra Leone
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20
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James PB, Wardle J, Steel A, Adams J, Bah AJ, Sevalie S. Traditional and complementary medicine use among Ebola survivors in Sierra Leone: a qualitative exploratory study of the perspectives of healthcare workers providing care to Ebola survivors. BMC Complement Med Ther 2020; 20:137. [PMID: 32375765 PMCID: PMC7201764 DOI: 10.1186/s12906-020-02931-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Considerable number of patients, including Ebola survivors, in Sierra Leone, are using traditional and complementary medicine (T&CM). Healthcare providers' (HCPs) views about T&CM is crucial in addressing the increased need for T&CM among patients. However, healthcare providers' views about T&CM in Sierra Leone is unknown. Our study explores healthcare providers' knowledge of and perception towards T&CM and how that influence their personal and professional T&CM use, communication with Ebola survivors about T&CM as well as its integration into the healthcare system in Sierra Leone. METHODS We employed a qualitative exploratory study design using semi-structured interviews to collect data from 15 conveniently sampled HCPs in all four geographical regions of Sierra Leone. We analysed our data using thematic network analysis framework. RESULTS Healthcare providers perceived their knowledge about T&CM to be low and considered T&CM to be less effective and less safe than conventional medicine as well as not evidence-based. HCPs perception of T&CM as non-scientific and their lack of knowledge of T&CM were the key barriers to HCPs' self-use and recommendation as well as their lack of detailed discussion about T&CM with Ebola survivors. HCPs are open to T&CM integration into mainstream healthcare in Sierra Leone although at their terms. However, they believe that T&CM integration could be enhanced by effective professional regulation of T&CM practice, and by improving T&CM evidenced-based knowledge through education, training and research. CONCLUSION Changing HCPs' negative perception of and increasing their knowledge about T&CM is critical to promoting effective communication with Ebola survivors regarding T&CM and its integration into the healthcare system in Sierra Leone. Strategies such as educational interventions for HCPs, conducting rigorous T&CM research, proper education and training of T&CM practitioners and effective professional regulation of T&CM practice could help in that direction.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Teaching Hospital Freetown, First floor Administrative Building, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW 2480 Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
| | - Abdulai Jawo Bah
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Stephen Sevalie
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Joint Medical Unit, Republic of Sierra Leone Armed Forces, 34 Military Hospital Wilberforce Freetown, Freetown, Sierra Leone
- Sustainable Health Systems, Freetown, Sierra Leone
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21
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Harris D, Endale T, Lind UH, Sevalie S, Bah AJ, Jalloh A, Baingana F. Mental health in Sierra Leone. BJPsych Int 2019; 17:14-16. [PMID: 34287429 PMCID: PMC8277533 DOI: 10.1192/bji.2019.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 03/23/2019] [Accepted: 06/07/2019] [Indexed: 11/23/2022] Open
Abstract
Sierra Leone is a West African country with a population of just over 7 million. Many Sierra Leoneans lived through the psychologically distressing events of the civil war (1991–2002), the 2014 Ebola outbreak and frequent floods. Traditionally, mental health services have been delivered at the oldest mental health hospital in sub-Saharan Africa, with no services available anywhere else in the country. Mental illness remains highly stigmatised. Recent advances include revision of the Mental Health Policy and Strategic Plan and the strengthening of mental health governance and district services. Many challenges lie ahead, with the crucial next steps including securing a national budget line for mental health, reviewing mental health legislation, systematising training of mental health specialists and prioritising the procurement of psychotropic medications. National and international commitment must be made to reduce the treatment gap and provide quality care for people with mental illness in Sierra Leone.
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Affiliation(s)
- Dawn Harris
- Mental Health Coordinator, King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Sierra Leone.
| | - Tarik Endale
- Mental Health Volunteer, King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Sierra Leone
| | - Unn Hege Lind
- Mental Health Volunteer, King's Sierra Leone Partnership, King's Global Health Partnerships, King's Centre for Global Health and Health Partnerships, School of Population and Environmental Sciences, King's College London, Sierra Leone
| | - Stephen Sevalie
- Commanding Officer, Joint Medical Unit, Republic of Sierra Leone Armed Forces, Sierra Leone
| | - Abdulai Jawo Bah
- Lecturer, Department of Pharmacology, College of Medicine and Allied Sciences, University of Sierra Leone, Sierra Leone
| | - Abdul Jalloh
- Specalist Psychiatrist, Hospital Care Manager, Sierra Leone Psychiatric Teaching Hospital; and Lecturer, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
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Jalloh MB, Bah AJ, James PB, Sevalie S, Hann K, Shmueli A. Impact of the free healthcare initiative on wealth-related inequity in the utilization of maternal & child health services in Sierra Leone. BMC Health Serv Res 2019; 19:352. [PMID: 31159785 PMCID: PMC6547484 DOI: 10.1186/s12913-019-4181-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 05/24/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND As a result of financial barriers to the utilization of Maternal and Child Health (MCH) services, the Government of Sierra Leone launched the Free Health Care Initiative (FHCI) in 2010. This study aimed to examine the impact of the FHCI on wealth related inequity in the utilization of three MCH services. METHODS We analysed data from 2008 to 2013 Sierra Leone Demographic Health Surveys (SLDHS) using 2008 SLDHS as a baseline. Seven thousand three hundred seventy-four and 16,658 women of reproductive age were interviewed in the 2008 and 2013 SLDHS respectively. We employed a binomial logistic regression to evaluate wealth related inequity in the utilization of institutional delivery. Concentration curves and indices were used to measure the inequity in the utilization of antenatal care (ANC) visits and postnatal care (PNC) reviews. Test of significance was performed for the difference in odds and concentration indexes obtained for the 2008 and 2013 SLDHS. RESULTS There was an overall improvement in the utilization of MCH services following the FHCI with a 30% increase in institutional delivery rate, 24% increment in more than four focused ANC visits and 33% increment in complete PNC reviews. Wealth related inequity in institutional delivery has increased but to the advantage of the rich, highly educated, and urban residents. Results of the inequity statistics demonstrate that PNC reviews were more equally distributed in 2008 than ANC visits, and, in 2013, the poorest respondents ranked by wealth index utilized more PNC reviews than their richest counterparts. For ANC visits, the change in concentration index was from 0.008331[95% CI (0.008188, 0.008474)] in 2008 to - 0.002263 [95% CI (- 0.002322, - 0.002204)] in 2013. The change in concentration index for PNC reviews was from - 0.001732 [95% CI (- 0.001746, - 0.001718)] in 2008 to - 0.001771 [95% CI (- 0.001779, - 0.001763)] in 2013. All changes were significant (p value < 0.001). CONCLUSION The FHCI appears to be improving access to and utilization of MCH services, narrowing the inequity in ANC visits and PNC reviews, but is insufficient in addressing wealth- related inequity that exists for institutional deliveries. If Sierra Leone is to realize a significant reduction in maternal and child mortality rates, it needs to strengthen the effective implementation of FHCI considering incorporating a sector wide approach (SWAp) or a "Health in all Policy" framework to reach the less educated, rural residents and ensuring culturally sensitive quality services.
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Affiliation(s)
- Mohamed Boie Jalloh
- Department of Health Management and Economics, School of Public Health, The Hebrew University of Jerusalem, Jerusalem, Israel. .,34 Military Hospital Wilberforce, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.,Sustainable Health Systems, Freetown, Sierra Leone
| | - Peter Bai James
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.,Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, Sydney, NSW, 2007, Australia
| | - Steven Sevalie
- 34 Military Hospital Wilberforce, Freetown, Sierra Leone.,College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.,Sustainable Health Systems, Freetown, Sierra Leone
| | - Katrina Hann
- Sustainable Health Systems, Freetown, Sierra Leone
| | - Amir Shmueli
- Department of Health Management and Economics, School of Public Health, The Hebrew University of Jerusalem, Jerusalem, Israel
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James PB, Kaikai AI, Bah AJ, Steel A, Wardle J. Herbal medicine use during breastfeeding: a cross-sectional study among mothers visiting public health facilities in the Western area of Sierra Leone. BMC Complement Altern Med 2019; 19:66. [PMID: 30876454 PMCID: PMC6420723 DOI: 10.1186/s12906-019-2479-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 03/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of medications, including herbal medicines during breastfeeding is always a concern among women. Currently, there is no published evidence on whether Sierra Leonean women use herbal medicine during breastfeeding. This study investigates the prevalence, correlates and pattern of herbal medicine use during breastfeeding. METHODOLOGY We conducted a cross-sectional study among 378 current breastfeeding mothers visiting public healthcare facilities within the Western area of Sierra Leone. Descriptive statistics and logistic regression analysis were used for data analysis. RESULTS Over a third of mothers (n = 140, 37.0%) used herbal medicine during breastfeeding. However, very few herbal medicine users (2.1%, n = 3) used herbal medicine to augment breastfeeding. Dietary changes were the most common method used to increase breast milk supply (93.9%, n = 355) with cassava leaves sauce and tubers being the most common dietary addition. Mothers with children more than six months old were more likely to use herbal medicine than mothers with younger children (OR:1.8; CI:1.13-2.85,p = 0.013). Among herbal medicine users, only 11.4% (n = 16) disclosed their herbal medicine use to their conventional healthcare providers. CONCLUSION The use of herbal medicine among breastfeeding mothers attending public health facilities in the Western area of Sierra Leone is common. Whilst this use is not usually specific to increasing breast milk supply, our study indicates that herbal medicines may be used to 'cleanse' initial breast milk.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Angela Isata Kaikai
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, QLD 4006 Australia
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
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James PB, Kamara H, Bah AJ, Steel A, Wardle J. Herbal medicine use among hypertensive patients attending public and private health facilities in Freetown Sierra Leone. Complement Ther Clin Pract 2018; 31:7-15. [PMID: 29705483 DOI: 10.1016/j.ctcp.2018.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/21/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown. METHODS AND MATERIALS We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. RESULTS Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider. CONCLUSION There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Halimatu Kamara
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia; Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, Brisbane, QLD 4006, Australia.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia.
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James PB, Bah AJ, Margao EK, Hanson C, Kabba JA, Jamshed SQ. Exploring the Knowledge and Perception of Generic Medicines among Final Year Undergraduate Medical, Pharmacy, and Nursing Students in Sierra Leone: A Comparative Cross-Sectional Approach. Pharmacy (Basel) 2018; 6:pharmacy6010003. [PMID: 29300350 PMCID: PMC5874542 DOI: 10.3390/pharmacy6010003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/22/2017] [Accepted: 01/01/2018] [Indexed: 11/16/2022] Open
Abstract
Most low-income nations have national medicine policy that emphasized the use of generic medicines in the public health sector. However, the use of generics is often debatable as there are concerns over its efficacy, quality, and safety compared to their branded counterparts. This study was conducted to compare the knowledge and perception of generic medicines among final year undergraduate medical, pharmacy, and nursing students in Sierra Leone. We conducted a questionnaire-based cross-sectional study among these students at the College of Medicine and Allied Health Sciences University of Sierra Leone. Out of the 62 students, only two (2/62, 3.2%) knew about the acceptable bioequivalence limit. At least half of respondents in all three groups agreed that all generics are therapeutically equivalent to their innovator brand. At least half of the medicine (21/42, 50%) and nursing (6/9, 66.6%) students, compared to pharmacy students (5/11, 45.5%), believed that higher safety standards are required for proprietary medicines than for generic medicines. Most of them agreed that they need more information on the safety, quality, and efficacy aspects of generics (59/62, 95.2%). All three groups of healthcare students, despite variations in their responses, demonstrated a deficiency in knowledge and misconception regarding generic medicines. Training on issues surrounding generic drugs in healthcare training institutions is highly needed among future healthcare providers in Sierra Leone.
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Affiliation(s)
- Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
- Faculty of Health, University of Technology Sydney, Sydney 2007, Australia.
| | - Abdulai Jawo Bah
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Emmanuel Kamanda Margao
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Christian Hanson
- Pharmacy Board of Sierra Leone, Ministry of Health and Sanitation, New England Ville Freetown, Freetown, Sierra Leone.
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an 710061, China.
- Directorate of Drugs and Medical Supplies, Ministry of Health and Sanitation, New England Ville Freetown, Freetown, Sierra Leone.
| | - Shazia Qasim Jamshed
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia.
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James PB, Bah AJ, Tommy MS, Wardle J, Steel A. Herbal medicines use during pregnancy in Sierra Leone: An exploratory cross-sectional study. Women Birth 2017; 31:e302-e309. [PMID: 29254852 DOI: 10.1016/j.wombi.2017.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/06/2017] [Accepted: 12/04/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care. AIM This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone. METHODS A cross-sectional study was conducted among pregnant women (n=134) who were at least 18 years of age and who have had at least one previous pregnancy, using face to face interview. Descriptive statistics, univariate and multivariate logistic regression analysis were used for data analysis. RESULTS The response rate was 82.7%. Nearly two-thirds of pregnant women reported using herbal medicine (62.7%). Herbal medicine users were more likely to be Muslim than Christian. Luffa acutangula (L.) Roxb was the most cited herbal medicine used and was mostly indicated for urinary tract infection and pedal oedema. Perceived effectiveness and safety over conventional medicine (70.2%) was key driver for use, and majority did not disclose their use of herbs to their maternal health professional (95.2%). CONCLUSION Herbal medicine use among pregnant women in this study was widespread. Maternal health providers should be aware of this relatively common practice and routinely discuss and educate pregnant women on the potential risks and benefits associated with the use of herbs.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2007, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.
| | - Michael Steven Tommy
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2007, Australia.
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2007, Australia; Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, Brisbane, QLD 4006, Australia.
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James PB, Bah AJ, Kondorvoh IM. Exploring self-use, attitude and interest to study complementary and alternative medicine (CAM) among final year undergraduate medical, pharmacy and nursing students in Sierra Leone: a comparative study. Altern Ther Health Med 2016; 16:121. [PMID: 27118576 PMCID: PMC4847196 DOI: 10.1186/s12906-016-1102-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/21/2016] [Indexed: 01/09/2023]
Abstract
Background CAM inclusion into the curricula of health training institutions, a strategy for its integration into the main stream healthcare delivery system is growing globally. Future healthcare professionals knowledge and perception of CAM are key determinants to its successful integration. Thus, the main objective of this study was to compare the use, attitude and interest to study CAM among final year undergraduate medical, pharmacy and nursing students at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Methods A questionnaire based cross-sectional survey was carried out among final year medical, pharmacy and nursing students enrolled at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Chi square, fisher exact two tailed test and Kruskal-wallis test were used to analyze data collected. Results Close to two-thirds (61 %) of all the three groups of final year students used one form of CAM or the other with pharmacy (72.7 %) and nursing (55.6 %) students being the highest and least users respectively. No significant difference was observed among the three groups. In general, final year students in all three cadres demonstrated a positive attitude toward CAM (33.80 ± 3. 2) with medical students showing more positive attitude than pharmacy (p = 0.022) and nursing student (p = 0.008). No significant difference in attitude was observed between students in pharmacy and nursing programs (p = 0.354). More than three quarter (76.6 %) of the students in all the three groups indicated their interest in studying CAM, with preference for the subject to be taught as an elective module (81.6 %). Conclusion An appreciable number of final year medical, pharmacy and nursing students at COMAHS-USL have used at least one CAM modality and demonstrated an overall positive attitude towards CAM. Interest to study CAM was also observed among most of them even though they preferred it to be taught as an elective module. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1102-4) contains supplementary material, which is available to authorized users.
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Shufei F, Yi W, Juqing A, Bah AJ, Xiumei G. GW25-e3314 Clinical application of “treating different diseases with the same method” - Xuefu Zhuyu Capsule (a traditional Chinese patent medicine) for blood stasis syndrome. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.06.970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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