scholarly journals Homecare for sick family members while waiting for medical help during the 2014-2015 Ebola outbreak in Sierra Leone: a mixed methods study

2020 ◽  
Vol 5 (7) ◽  
pp. e002732
Author(s):  
Kirsten Schmidt-Hellerau ◽  
Maike Winters ◽  
Padraig Lyons ◽  
Bailah Leigh ◽  
Mohammad B Jalloh ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Disease Transmission ◽  
Household Survey ◽  
Population Level ◽  
Protective Measure ◽  
Structured Interviews ◽  
Specific Knowledge ◽  
Protective Measures ◽  
Practical Advice ◽  
Sick Person

IntroductionCaring for an Ebola patient is a known risk factor for disease transmission. In Sierra Leone during the outbreak in 2014/2015, isolation of patients in specialised facilities was not always immediately available and caring for a relative at home was sometimes the only alternative. This study sought to assess population-level protective caregiving intentions, to understand how families cared for their sick and to explore perceived barriers and facilitators influencing caregiving behaviours.MethodsData from a nationwide household survey conducted in December 2014 were used to assess intended protective behaviours if caring for a family member with suspected Ebola. Their association with socio-demographic variables, Ebola-specific knowledge and risk perception was analysed using multilevel logistic regression. To put the results into context, semi-structured interviews with caregivers were conducted in Freetown.ResultsEbola-specific knowledge was positively associated with the intention to avoid touching a sick person and their bodily fluids (adjusted OR (AOR) 1.29; 95% CI 1.01 to 1.54) and the intention to take multiple protective measures (AOR 1.38; 95% CI 1.16 to 1.63). Compared with residing in the mostly urban Western Area, respondents from the initial epicentre of the outbreak (Eastern Province) had increased odds to avoid touching a sick person or their body fluids (AOR 4.74; 95% CI 2.55 to 8.81) and to take more than one protective measure (AOR 2.94; 95% CI 1.37 to 6.34). However, interviews revealed that caregivers, who were mostly aware of the risk of transmission and general protective measures, felt constrained by different contextual factors. Withholding care was not seen as an option and there was a perceived lack of practical advice.ConclusionsEbola outbreak responses need to take the sociocultural reality of caregiving and the availability of resources into account, offering adapted and acceptable practical advice. The necessity to care for a loved one when no alternatives exist should not be underestimated.

scholarly journals Understanding patterns of adherence to COVID-19 mitigation measures: a qualitative interview study

2021 ◽  
Author(s):  
Sarah Denford ◽  
Kate S Morton ◽  
Helen Lambert ◽  
Juan Zhang ◽  
Louise E Smith ◽  
...  
Keyword(s):  
Low Income ◽  
Population Level ◽  
Mitigation Measures ◽  
Structured Interviews ◽  
Topic Guide ◽  
Protective Measures ◽  
Qualitative Interview Study ◽  
Reduce Risk ◽  
Nuanced Understanding ◽  
Minority Ethnic

Abstract Background Evidence highlights the disproportionate impact of measures that have been introduced to reduce the spread of coronavirus on individuals from Black, Asian and minority ethnic (BAME) communities, and among those on a low income. An understanding of barriers to adherence in these populations is needed. In this qualitative study, we examined the patterns of adherence to mitigation measures and reasons underpinning these behaviors. Methods Semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation during the pandemic and to explore the reasons underpinning this behavior. Results We identified three categories of adherence to lockdown measures: (i) caution-motivated super-adherence (ii) risk-adapted partial-adherence and (iii) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures and perceived importance of/need for the behavior. Conclusions This research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.

scholarly journals Health Perceptions in Relation to Child Health and Mortality in a Rural Context, Sierra Leone: A Mixed Method Study

2021 ◽  
Vol 18 (1) ◽  
pp. 308
Author(s):  
Camilla Midtgaard Eriksen ◽  
Monica Lauridsen Kujabi ◽  
Aminata Sulaiman Kanu ◽  
Gabriel Gulis
Keyword(s):  
Child Health ◽  
Sierra Leone ◽  
Mixed Method ◽  
Child Survival ◽  
Household Survey ◽  
Childhood Mortality ◽  
Personal Hygiene ◽  
Structured Interviews ◽  
God's Will ◽  
Watery Stool

Child survival and wellbeing remain a global health challenge despite vast development within the area and a significant decline in mortality rates of children under five years of age. This study investigates the perceived causes of ill health and childhood mortality in the context of five villages located in the Tonkolili district of Sierra Leone. Mixed method methodology was applied in this study consisting of both quantitative and qualitative data contribution. The quantitative part consisted of a household survey on child health, where 341 households, equivalent to 50.6% of the total number of households in the five villages, participated with a response rate of 100%. The qualitative part consisted of six semi structured interviews—one with a health care worker and five with mothers from each village. The main perceived reason for child morbidity was inadequate care of children related to personal hygiene of the child, hygiene and safety in the environment, in-sufficient nutrition, inadequate supervision and poor healthcare seeking behavior. Additionally, reasons given for disease included supernatural forces such as witchcraft. In relation to the survey, the perceived causes of child mortality for ill children in the villages were mainly malaria (33.6%), diarrhea (11.6%), pneumonia (8.6%), and unknown (26%). The observed symptoms of illness among children were fever (43.7%), cough and difficulty breathing (10.7%), frequent watery stool (10.3%) and no symptoms (20.3%). The perception of ill health in children was mainly associated with the parent’s ability to cater for the child’s physical needs, but also associated with external factors such as witchcraft and “God’s will”. In addition, biomedical causes for disease and supernatural causes for disease were seen to coexist.

scholarly journals Understanding patterns of adherence to COVID-19 mitigation measures: A qualitative interview study.

2020 ◽  
Author(s):  
Sarah Denford ◽  
Kate S Morton ◽  
Helen Lambert ◽  
Juan Zhang ◽  
Louise E. Smith ◽  
...  
Keyword(s):  
Low Income ◽  
Population Level ◽  
Mitigation Measures ◽  
Structured Interviews ◽  
Protective Measures ◽  
Qualitative Interview Study ◽  
Nuanced Understanding ◽  
The Uk ◽  
Detrimental Impact ◽  
Minority Ethnic

In an effort to reduce the spread of COVID-19, the UK government has introduced a series of mitigation measures. The success of these measures in preventing transmission is dependent on adherence, which is currently considered to be low. Evidence highlights the disproportionate impact of mitigation measures on individuals from Black, Asian and minority ethnic (BAME) groups, as well as among those on a low income, and an understanding of barriers to adherence in these populations is needed. In this qualitative study we examined patterns of adherence to mitigation measures and reasons underpinning these behaviors among people from BAME and low income communities. Semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation measures during the COVID-19 pandemic, and to explore in detail the reasons underpinning this behavior. Data were analyzed using thematic analysis following which charts were used to help compare concepts within and between participants and develop an understanding of patterns of adherence. Participants were confused by the constantly changing and seemingly contradictory rules and guidance. As a result, decisions were made about how best to protect themselves and their household from COVID-19, and from the detrimental impact of lockdown restrictions. This was not always in line with government advice. We identified three categories of adherence to lockdown measures 1) caution motivated super-adherence 2) risk-adapted partial-adherence and 3) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures, and perceived importance of/need for the behavior. This research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. Information about viral transmission could help people assess the risk associated with partial-adherence more accurately. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.

scholarly journals Evaluation of health system readiness and coverage of intermittent preventive treatment of malaria in infants (IPTi) in Kambia district to inform national scale-up in Sierra Leone

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Lahuerta ◽  
Roberta Sutton ◽  
Anthony Mansaray ◽  
Oliver Eleeza ◽  
Brigette Gleason ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Phase 1 ◽  
Scale Up ◽  
Intermittent Preventive Treatment ◽  
Vaccine Dose ◽  
Preventive Treatment ◽  
Household Survey ◽  
Register Data ◽  
Phase 2 ◽  
Pentavalent Vaccine

Abstract Background Intermittent preventive treatment of malaria in infants (IPTi) with sulfadoxine-pyrimethamine (SP) is a proven strategy to protect infants against malaria. Sierra Leone is the first country to implement IPTi nationwide. IPTi implementation was evaluated in Kambia, one of two initial pilot districts, to assess quality and coverage of IPTi services. Methods This mixed-methods evaluation had two phases, conducted 3 (phase 1) and 15–17 months (phase 2) after IPTi implementation. Methods included: assessments of 18 health facilities (HF), including register data abstraction (phases 1 and 2); a knowledge, attitudes and practices survey with 20 health workers (HWs) in phase 1; second-generation sequencing of SP resistance markers (pre-IPTi and phase 2); and a cluster-sample household survey among caregivers of children aged 3–15 months (phase 2). IPTi and vaccination coverage from the household survey were calculated from child health cards and maternal recall and weighted for the complex sampling design. Interrupted time series analysis using a Poisson regression model was used to assess changes in malaria cases at HF before and after IPTi implementation. Results Most HWs (19/20) interviewed had been trained on IPTi; 16/19 reported feeling well prepared to administer it. Nearly all HFs (17/18 in phase 1; 18/18 in phase 2) had SP for IPTi in stock. The proportion of parasite alleles with dhps K540E mutations increased but remained below the 50% WHO-recommended threshold for IPTi (4.1% pre-IPTi [95%CI 2–7%]; 11% post-IPTi [95%CI 8–15%], p < 0.01). From the household survey, 299/459 (67.4%) children ≥ 10 weeks old received the first dose of IPTi (versus 80.4% for second pentavalent vaccine, given simultaneously); 274/444 (62.5%) children ≥ 14 weeks old received the second IPTi dose (versus 65.4% for third pentavalent vaccine); and 83/217 (36.4%) children ≥ 9 months old received the third IPTi dose (versus 52.2% for first measles vaccine dose). HF register data indicated no change in confirmed malaria cases among infants after IPTi implementation. Conclusions Kambia district was able to scale up IPTi swiftly and provide necessary health systems support. The gaps between IPTi and childhood vaccine coverage need to be further investigated and addressed to optimize the success of the national IPTi programme.

The Experience of Violence Against Women Who Use Injection Drugs: An Exploratory Qualitative Study

2020 ◽  
pp. 084456212097957
Author(s):  
Cynthia Kitson ◽  
Patrick O’Byrne
Keyword(s):  
Qualitative Study ◽  
Violence Against Women ◽  
Disease Transmission ◽  
Homeless Women ◽  
Structured Interviews ◽  
Infectious Disease Transmission ◽  
Injection Drugs ◽  
Authority Figures ◽  
Canadian Context ◽  
Societal Violence

Background While literature exists about persons who use injection drugs, few studies explore the experience of women who use these substances. Furthermore, even less research specifically focuses on the lives and experiences of homeless women who use injection drugs. What literature does exist, moreover, is often dated and primarily addresses concerns about infectious disease transmission among these women; and some highlight that these women have lives fraught with violence. Purpose To update this knowledge and better understand the lives of women who use injection drugs in the Canadian context. Methods We undertook an exploratory qualitative study and we engaged in semi-structured interviews with 31 homeless women who use injection drugs in downtown Ottawa, Canada. We analyzed the data using the principles of applied thematic analysis. Results Our data identified that violence pervaded the lives of our participants and that these experiences of violence could be categorized into three main areas: early and lifelong experiences of violence; violence with authority figures (e.g., police, healthcare); and societal violence toward women who use injection drugs. Conclusions We take these findings to mean that, violence toward women is rampant in Canada (not just internationally) and that healthcare workers play a role in propagating and addressing this violence.

The experiences and needs of children living with a parent with young onset dementia: results from the NeedYD study

2013 ◽  
Vol 26 (12) ◽  
pp. 2001-2010 ◽  
Author(s):  
Joany K. Millenaar ◽  
Deliane van Vliet ◽  
Christian Bakker ◽  
Myrra J. F. J. Vernooij-Dassen ◽  
Raymond T. C. M. Koopmans ◽  
...  
Keyword(s):  
Coping Styles ◽  
Specific Information ◽  
Structured Interviews ◽  
Specific Knowledge ◽  
Young Onset ◽  
Care And Support ◽  
Young Parent ◽  
Young Onset Dementia ◽  
The Impact ◽  
Family Centered

ABSTRACTBackground:Children of patients with young onset dementia (YOD) who are confronted with a parent who has a progressive disease, often assist in caregiving tasks, which may have a great impact on their lives. The objective of the present study is to explore the experiences of children living with a young parent with dementia with a specific focus on the children's needs.Methods:Semi-structured interviews with 14 adolescent children between the ages of 15 and 27 years of patients with YOD were analyzed using inductive content analysis. Themes were identified based on the established codes.Results:The emerging categories were divided into three themes that demonstrated the impact of dementia on daily life, different ways of coping with the disease, and children's need for care and support. The children had difficulties managing all of the responsibilities and showed concerns about their future. To deal with these problems, they demonstrated various coping styles, such as avoidant or adaptive coping. Although most children were initially reluctant to seek professional care, several of them expressed the need for practical guidance to address the changing behavior of their parent. The children felt more comfortable talking to someone who was familiar with their situation and who had specific knowledge of YOD and the available services.Conclusion:In addition to practical information, more accessible and specific information about the diagnosis and the course of YOD is needed to provide a better understanding of the disease for the children. These findings underline the need for a personal, family-centered approach.

NOTE ON THE UNIQUENESS OF AN ENDEMIC EQUILIBRIUM OF AN EPIDEMIC MODEL WITH BOOSTING OF IMMUNITY

2021 ◽  
pp. 1-12
Author(s):  
LIU YANG ◽  
YUKIHIKO NAKATA
Keyword(s):  
Epidemic Model ◽  
Disease Transmission ◽  
Immune Status ◽  
Natural Infection ◽  
Population Level ◽  
Qualitative Property ◽  
Endemic Equilibrium ◽  
Unique Existence ◽  
Nonlinear Version ◽  
Age Dependent

For some diseases, it is recognized that immunity acquired by natural infection and vaccination subsequently wanes. As such, immunity provides temporal protection to recovered individuals from an infection. An immune period is extended owing to boosting of immunity by asymptomatic re-exposure to an infection. An individual’s immune status plays an important role in the spread of infectious diseases at the population level. We study an age-dependent epidemic model formulated as a nonlinear version of the Aron epidemic model, which incorporates boosting of immunity by a system of delay equations and study the existence of an endemic equilibrium to observe whether boosting of immunity changes the qualitative property of the existence of the equilibrium. We establish a sufficient condition related to the strength of disease transmission from subclinical and clinical infective populations, for the unique existence of an endemic equilibrium.

scholarly journals Risk Communication and Ebola-Specific Knowledge and Behavior during 2014–2015 Outbreak, Sierra Leone

2018 ◽  
Vol 24 (2) ◽  
pp. 336-344 ◽  
Author(s):  
Maike Winters ◽  
Mohamed F. Jalloh ◽  
Paul Sengeh ◽  
Mohammad B. Jalloh ◽  
Lansana Conteh ◽  
...  
Keyword(s):  
Risk Communication ◽  
Sierra Leone ◽  
Specific Knowledge ◽  
And Behavior

scholarly journals Vaccinating Adolescents and Children Significantly Reduces COVID-19 Morbidity and Mortality across All Ages: A Popula-Tion-Based Modeling Study Using the UK as an Example

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1180
Author(s):  
Tinevimbo Shiri ◽  
Marc Evans ◽  
Carla A. Talarico ◽  
Angharad R. Morgan ◽  
Maaz Mussad ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Age Groups ◽  
Population Level ◽  
Vital Role ◽  
Morbidity And Mortality ◽  
Transmission Model ◽  
Base Case ◽  
Global Public Health ◽  
The Uk ◽  
The Impact

Debate persists around the risk–benefit balance of vaccinating adolescents and children against COVID-19. Central to this debate is quantifying the contribution of adolescents and children to the transmission of SARS-CoV-2, and the potential impact of vaccinating these age groups. In this study, we present a novel SEIR mathematical disease transmission model that quantifies the impact of different vaccination strategies on population-level SARS-CoV-2 infections and clinical outcomes. The model employs both age- and time-dependent social mixing patterns to capture the impact of changes in restrictions. The model was used to assess the impact of vaccinating adolescents and children on the natural history of the COVID-19 pandemic across all age groups, using the UK as an example. The base case model demonstrates significant increases in COVID-19 disease burden in the UK following a relaxation of restrictions, if vaccines are limited to those ≥18 years and vulnerable adolescents (≥12 years). Including adolescents and children in the vaccination program could reduce overall COVID-related mortality by 57%, and reduce cases of long COVID by 75%. This study demonstrates that vaccinating adolescents and children has the potential to play a vital role in reducing SARS-CoV-2 infections, and subsequent COVID-19 morbidity and mortality, across all ages. Our results have major global public health implications and provide valuable information to inform a potential pandemic exit strategy.

scholarly journals Sea turtles support sustainable livelihoods at Ostional, Costa Rica

Oryx ◽  
2018 ◽  
Vol 53 (1) ◽  
pp. 81-91 ◽  
Author(s):  
Mallika Sardeshpande ◽  
Douglas MacMillan
Keyword(s):  
Costa Rica ◽  
Local Community ◽  
Sustainable Livelihoods ◽  
Household Survey ◽  
Sea Turtle ◽  
Environmental Conservation ◽  
Current Status ◽  
Structured Interviews ◽  
Olive Ridley ◽  
Nesting Site

AbstractOstional in Costa Rica is the second largest nesting site of the olive ridley sea turtle Lepidochelys olivacea, which is categorized as Vulnerable on the IUCN Red List. In Ostional the local community helps maintain the nesting site and collects olive ridley eggs for consumption and trade within Costa Rica. Since its inception in 1987 the egg harvesting project has integrated sea turtle conservation with community development. We assessed the current status of this project in terms of community awareness, dependency, involvement and perceptions, using a household survey and semi-structured interviews with key informants. We also compared some of our findings with those of previous studies at the site, finding that the project has fewer dependents, primary livelihood activities have shifted towards tourism and hospitality, and respondents are more aware about environmental conservation and stewardship. We map outcomes of the project with the Sustainable Livelihoods Framework, and suggest that further capacity building for research and tourism could contribute towards sustaining the turtle population, local livelihoods, and the community-based conservation institution.

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