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Vandy A, Conteh E, Lahai M, Kolipha-Kamara M, Marah M, Marah F, Suma KM, Mattia SC, Tucker KD, Wray VS, Koroma A, Lebbie AU. Physicochemical quality assessment of various brands of paracetamol tablets sold in Freetown Municipality. Heliyon 2024; 10:e25502. [PMID: 38356517 PMCID: PMC10865243 DOI: 10.1016/j.heliyon.2024.e25502] [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: 11/23/2023] [Revised: 01/03/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
Paracetamol is a widely used over-the-counter drug for managing fever and pain, but its quality may vary among different brands, especially in low- and middle-income countries, where counterfeit and substandard medicines are prevalent. This study evaluated the physicochemical properties of fifteen brands of 500 mg paracetamol tablets sold in various pharmacies in Freetown, Sierra Leone using identification tests, friability tests, assay, dissolution tests, and mass variation. The results showed that three brands were not registered with the Pharmacy Board of Sierra Leone, and two brands did not meet the requirement for labelling (no manufacturing date). All the brands met the requirement for mass variation, friability tests and assays. The percentage assay of the different brands ranged from 96.17 %w/w to 101.97 %w/w. However, two brands did not meet the specification for dissolution, with P012 releasing about 21.23 % ± 5.76 of the drug within 45min. Most of the paracetamol brands evaluated met the physicochemical test specification. However, two brands failed the dissolution test, two brands did not meet the labelling requirement and three brands were identified as unregistered products with the National Medicines Regulatory Authority in Sierra Leone. This study underscores the necessity of enhancing monitoring and post-market surveillance of pharmaceuticals in Sierra Leone to ensure they comply with regulatory requirements.
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Affiliation(s)
- Ahmed Vandy
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Eugene Conteh
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Michael Lahai
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Marie Kolipha-Kamara
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Mohamed Marah
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Foday Marah
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Kadiatu M. Suma
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Sia C. Mattia
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Kenneth D.S. Tucker
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Victor S.E. Wray
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Abass Koroma
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
| | - Aiah U. Lebbie
- Faculty of Pharmaceutical Sciences - College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
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Jiba DF, Lakoh S, Wang S, Sun W, Barrie U, Kamara MN, Jalloh AT, Tamba FK, Yendewa GA, Song JW, Yang G. Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study. BMC Infect Dis 2023; 23:762. [PMID: 37932713 PMCID: PMC10626761 DOI: 10.1186/s12879-023-08740-9] [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: 06/13/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV). METHODS A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson's χ2 test, Fisher's exact test and Kruskal-Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P < 0.05. RESULTS Of the 3082 PLHIV individuals in our study, 2294 (74.4%) were female and 2867 (93.0%) were receiving ART. With a median age of 36 years, 211 (6.8%, 95% CI 6.0-7.7) were positive for syphilis. The prevalence of syphilis was highest in people aged 60 years and over (21.1%, 95%CI 14.7-29.2), followed by people aged 50-60 years (15.5%, 95%CI 11.9-19.9) and in the widowed population (11.9%, 95%CI 8.9-15.8). There were no differences in syphilis seropositivity between gender, ART status, ART regimen, duration of ART, HIV viral load and hospital level of care. Older age (50-60 years: adjusted OR 3.49, 95%CI 2.09-5.85 P < 0.001; 60-100 years: adjusted OR 4.28, 95%CI 2.21-8.17, P < 0.001) was an independent predictor of seropositive syphilis. CONCLUSIONS We observed a high prevalence of syphilis among PLHIV. Older people and widowed population have higher syphilis seropositivity. Older age was an independent predictor of syphilis positivity. Therefore, we call for the integration of syphilis screening, treatment and prevention in HIV services.
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Affiliation(s)
- Darlinda F Jiba
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone
| | - Sulaiman Lakoh
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Sustainable Health Systems Sierra Leone, Freetown, Sierra Leone
| | - Shuchao Wang
- Changchun Veterinary Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Wei Sun
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Umu Barrie
- Infectious Disease Research Network, Freetown, Sierra Leone
| | - Matilda N Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Abdulai Tejan Jalloh
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone
| | - Francis K Tamba
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone
| | - George A Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jin-Wen Song
- Senior Department of Infectious Diseases, the Fifth Medical Centre of PLA General Hospital, Beijing, China.
| | - Guang Yang
- Department of Clinical Laboratory, the Fifth Medical Center of PLA General Hospital, Beijing, China.
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Frimpong LK, Okyere SA, Diko SK, Abunyewah M, Erdiaw-Kwasie MO, Commodore TS, Hernandez DO, Kita M. Actor-network analysis of community-based organisations in health pandemics: evidence from the COVID-19 response in Freetown, Sierra Leone. Disasters 2022; 46:903-927. [PMID: 34477244 PMCID: PMC8652973 DOI: 10.1111/disa.12508] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Freetown, Sierra Leone, is confronted with health risks that are compounded by rapid unplanned urbanisation and weak capacities of local government institutions. Addressing them implies a shared responsibility between government and non-state actors. In low-income areas, the role of community-based organisations (CBOs) in combating health disasters is well-recognised. Yet, empirical evidence on how they have utilised their networks and coordinated community-level strategies in responding to the COVID-19 pandemic is scant. This paper, based on a qualitative study in two informal settlements in Freetown, employs actor-network theory to understand how CBOs problematise COVID-19 as a health risk, interact with other entities, and the subsequent tensions that arise. The findings show that community vulnerabilities and past experiences of health disasters informed CBOs' perception of COVID-19 as a communal emergency. In response, they coordinated sensitisation and mobilisation programmes by relying on a network of actors to support COVID-19 risk reduction strategies. Nonetheless, misunderstandings among them caused friction.
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Affiliation(s)
- Louis Kusi Frimpong
- Lecturer at the Department of Geography and Earth Science, University of Environment and Sustainable Development, Ghana
| | - Seth Asare Okyere
- Assistant Professor at the Graduate School of Engineering, Osaka University, Japan
| | - Stephen Kofi Diko
- Assistant Professor at the Department of City and Regional Planning, University of Memphis, United States
| | - Matthew Abunyewah
- Adjunct Senior Lecturer at the School of Architecture and Built Environment, University of Newcastle, Australia
| | | | - Tracy Sidney Commodore
- PhD Candidate at the Institute of Statistical, Social and Economic Research, University of Ghana, Ghana
| | - Daniel Oviedo Hernandez
- Lecturer at the Bartlett Development Planning Unit, University College London, United Kingdom
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Kennedy A, Abosi U, Gilbert C, Mustapha J. Factors associated with adherence to treatment in patients with open angle glaucoma in Sierra Leone, West Africa: patient demographics and questionnaire. Int Ophthalmol 2022. [PMID: 35556205 DOI: 10.1007/s10792-022-02347-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Glaucoma is a significant cause of blindness worldwide. It is more common, presents earlier and is more aggressive in those of African descent. Non-adherence and poor knowledge of glaucoma is a significant barrier to treatment and has been associated with low health literacy. We aim to establish the factors contributing to late presentation, treatment non-adherence and disease progression in glaucoma patients in Sierra Leone. This will help better understand the challenges eye services face, highlight fields requiring development in patient-clinician interaction and identify areas or specific vulnerable patient groups in which resources should be focused. METHODS Prospective, consecutive recruitment of 120 patients with POAG attending the Lowell and Ruth Gess Eye Hospital and the Connaught Government Teaching Hospital, Freetown, Sierra Leone between February and April 2020. Data were collected from 3 sources: (1) review of clinical notes since first attendance, (2) semi-structured interviews and (3) assessment of study participant's drop instillation technique using a structured checklist. Descriptive statistics was performed for demographic data and other relevant data points. Logistic regression was used for analysis of target variables. RESULTS The average age was 62 years with more males (52.6%). Agricultural workers and informal street traders represented 13.2% of participants' occupation. 25.8% of participants had no formal school, and 47.4% had either a degree or a diploma. This is out of proportion with the general population and may represent a hidden demographic of glaucoma patients. Drop instillation technique was successful in 52% of study participants. Notable responses to the questionnaire were 30% of patients did not know the name of their eye condition and 22% had no knowledge of glaucoma. CONCLUSION Investment in a wide-ranging and robust screening programme and public health campaigns targeting these vulnerable groups and high-risk individuals, for example with a positive family history, alongside improved patient education and staff training is required to improve glaucoma care. Support from government, international organisations and the private sector is required to reduce the economic burden of blindness in Sierra Leone.
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Stitterich N, Shepherd J, Koroma MM, Theuring S. Risk factors for preeclampsia and eclampsia at a main referral maternity hospital in Freetown, Sierra Leone: a case-control study. BMC Pregnancy Childbirth 2021; 21:413. [PMID: 34078312 PMCID: PMC8173903 DOI: 10.1186/s12884-021-03874-7] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the African region, 5.6% of pregnancies are estimated to be complicated by preeclampsia and 2.9% by eclampsia, with almost one in ten maternal deaths being associated with hypertensive disorders. In Sierra Leone, representing one of the countries with the highest maternal mortality rates in the world, 16% of maternal deaths were caused by pregnancy-induced hypertension in 2016. In the light of the high burden of preeclampsia and eclampsia (PrE/E) in Sierra Leone, we aimed at assessing population-based risk factors for PrE/E to offer improved management for women at risk. METHODS A facility-based, unmatched observational case-control study was conducted in Princess Christian Maternity Hospital (PCMH). PCMH is situated in Freetown and is the only health care facility providing 'Comprehensive Emergency Obstetric and Neonatal Care services' throughout the entire country. Cases were defined as pregnant or postpartum women diagnosed with PrE/E, and controls as normotensive postpartum women. Data collection was performed with a questionnaire assessing a wide spectrum of factors influencing pregnant women's health. Statistical analysis was performed by estimating a binary logistic regression model. RESULTS We analyzed data of 672 women, 214 cases and 458 controls. The analysis yielded several independent predictors for PrE/E, including family predisposition for PrE/E (AOR = 2.72, 95% CI: 1.46-5.07), preexisting hypertension (AOR = 3.64, 95% CI: 1.32-10.06), a high mid-upper arm circumflex (AOR = 3.09, 95% CI: 1.83-5.22), presence of urinary tract infection during pregnancy (AOR = 2.02, 95% CI: 1.28-3.19), presence of prolonged diarrhoea during pregnancy (AOR = 2.81, 95% CI: 1.63-4.86), low maternal assets (AOR = 2.56, 95% CI: 1.63-4.02), inadequate fruit intake (AOR = 2.58, 95% CI: 1.64-4.06), well or borehole water as the main source of drinking water (AOR = 2.05, 95% CI: 1.31-3.23) and living close to a waste deposit (AOR = 1.94, 95% CI: 1.15-3.25). CONCLUSION Our findings suggest that systematic assessment of identified PrE/E risk factors, including a family predisposition for PrE/E, preexisting hypertension, or obesity, should be performed early on in ANC, followed by continued close monitoring of first signs and symptoms of PrE/E. Additionally, counseling on nutrition, exercise, and water safety is needed throughout pregnancy as well as education on improved hygiene behavior. Further research on sources of environmental pollution in Freetown is urgently required.
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Affiliation(s)
- N Stitterich
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - J Shepherd
- National School of Midwifery, Freetown, Sierra Leone
| | - M M Koroma
- Princess Christian Maternity Hospital, Freetown, Sierra Leone
| | - S Theuring
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
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Ragab H, Mclellan A, Bell N, Mustapha A. Making every death count: institutional mortality accuracy at Ola During Children's Hospital, Sierra Leone. Pan Afr Med J 2020; 37:356. [PMID: 33796170 PMCID: PMC7992407 DOI: 10.11604/pamj.2020.37.356.23607] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/11/2020] [Indexed: 10/31/2022] Open
Abstract
Introduction health care data accuracy feeds the development of sound healthcare policy and the prioritisation of interventions in scarce resource environments. We designed a retrospective study at the sole paediatric government hospital in Sierra Leone to examine mortality statistics, specifically: the accuracy of mortality data collected in 2017; and the quality of cause of death (CoD) reporting for 2017. Methods the retrospective audit included all available mortality statistics collected at the hospital during the 2017 calendar year. For the purpose of calculating a mortality rate, admission data was additionally gathered. Four different hospital entities were identified that collected mortality data (the Monitoring and Evaluation (M&E) office; the nurse ledgers; the office of births and deaths; and the mortuary). Data from each hospital entity were used for the comparative analysis. Results striking differences were found in the rate of hospital mortality reported by different entities. The M&E office (responsible for providing data to the ministry of health and sanitation) reported a hospital mortality rate of 2.94% in 2017. Mortuary and nursing admissions records showed a hospital mortality rate of 18.7%. Discrepancies and issues of quality in CoD reporting between hospital entities were identified. Conclusion significant variations were found in the generation of official hospital mortality data. Mortality data informs health service prioritisation, resource distribution, outcome measures and epidemiological surveillance. Resources to support quality improvement initiatives are needed in the creation of an in-hospital system that reports accurate data with a process for real-time institutional data feedback.
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Affiliation(s)
- Hany Ragab
- Paediatrics, Global Links Program, the Royal College of Paediatrics and Child Health, London, United Kingdom
| | - Andrew Mclellan
- College of Medicine and Allied Health Sciences, Faculty of Nursing, University of Sierra Leone, Freetown, Sierra Leone
| | - Nellie Bell
- Faculty of Paediatrics, Ola During Children's Hospital, Freetown, Sierra Leone
| | - Ayeshatu Mustapha
- Medical Superintendence, Ola During Children's Hospital, Freetown, Sierra Leone
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Howlett PJ, Walder AR, Lisk DR, Fitzgerald F, Sevalie S, Lado M, N'jai A, Brown CS, Sahr F, Sesay F, Read JM, Steptoe PJ, Beare NAV, Dwivedi R, Solbrig M, Deen GF, Solomon T, Semple MG, Scott JT. Case Series of Severe Neurologic Sequelae of Ebola Virus Disease during Epidemic, Sierra Leone. Emerg Infect Dis 2018; 24:1412-1421. [PMID: 30014839 PMCID: PMC6056101 DOI: 10.3201/eid2408.171367] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
We describe a case series of 35 Ebola virus disease (EVD) survivors during the epidemic in West Africa who had neurologic and accompanying psychiatric sequelae. Survivors meeting neurologic criteria were invited from a cohort of 361 EVD survivors to attend a preliminary clinic. Those whose severe neurologic features were documented in the preliminary clinic were referred for specialist neurologic evaluation, ophthalmologic examination, and psychiatric assessment. Of 35 survivors with neurologic sequelae, 13 had migraine headache, 2 stroke, 2 peripheral sensory neuropathy, and 2 peripheral nerve lesions. Of brain computed tomography scans of 17 patients, 3 showed cerebral and/or cerebellar atrophy and 2 confirmed strokes. Sixteen patients required mental health followup; psychiatric disorders were diagnosed in 5. The 10 patients who experienced greatest disability had co-existing physical and mental health conditions. EVD survivors may have ongoing central and peripheral nervous system disorders, including previously unrecognized migraine headaches and stroke.
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Mansaray LR, Huang J, Kamara AA. Mapping deforestation and urban expansion in Freetown, Sierra Leone, from pre- to post-war economic recovery. Environ Monit Assess 2016; 188:470. [PMID: 27418077 DOI: 10.1007/s10661-016-5469-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 07/04/2016] [Indexed: 06/06/2023]
Abstract
Freetown, the capital of Sierra Leone has experienced vast land-cover changes over the past three decades. In Sierra Leone, however, availability of updated land-cover data is still a problem even for environmental managers. This study was therefore, conducted to provide up-to-date land-cover data for Freetown. Multi-temporal Landsat data at 1986, 2001, and 2015 were obtained, and a maximum likelihood supervised classification was employed. Eight land-cover classes or categories were recognized as follows: water, wetland, built-up, dense forest, sparse forest, grassland, barren, and mangrove. Land-cover changes were mapped via post-classification change detection. The persistence, gain, and loss of each land-cover class, and selected land conversions were also quantified. An overall classification accuracy of 87.3 % and a Kappa statistic of 0.85 were obtained for the 2015 map. From 1986 to 2015, water, built-up, grassland, and barren had net gains, whereas forests, wetlands, and mangrove had net loses. Conversion analyses among forests, grassland, and built-up show that built-up had targeted grassland and avoided forests. This study also revealed that, the overall land-cover change at 2001-2015 was higher (28.5 %) than that recorded at 1986-2001 (20.9 %). This is attributable to the population increase in Freetown and the high economic growth and infrastructural development recorded countrywide after the civil war. In view of the rapid land-cover change and its associated environmental impacts, this study recommends the enactment of policies that would strike a balance between urbanization and environmental sustainability in Freetown.
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Affiliation(s)
- Lamin R Mansaray
- Magbosi Land, Water and Environment Research Center (MLWERC), Sierra Leone Agricultural Research Institute (SLARI), PMB 1313, Mile 91, Northern Province, Sierra Leone.
- Institute of Remote Sensing and Information Application, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, 310058, People's Republic of China.
- Key Laboratory of Agricultural Remote Sensing and Information Systems, Zhejiang Province, Hangzhou, 310058, People's Republic of China.
| | - Jingfeng Huang
- Institute of Remote Sensing and Information Application, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, 310058, People's Republic of China
- Key Laboratory of Agricultural Remote Sensing and Information Systems, Zhejiang Province, Hangzhou, 310058, People's Republic of China
| | - Alimamy A Kamara
- Magbosi Land, Water and Environment Research Center (MLWERC), Sierra Leone Agricultural Research Institute (SLARI), PMB 1313, Mile 91, Northern Province, Sierra Leone
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