scholarly journals Barriers and facilitators to reporting deaths following Ebola surveillance in Sierra Leone: implications for sustainable mortality surveillance based on an exploratory qualitative assessment

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042976
Author(s):  
Mohamed F Jalloh ◽  
John Kinsman ◽  
James Conteh ◽  
Reinhard Kaiser ◽  
Amara Jambai ◽  
...  
Keyword(s):  
Rural Communities ◽  
Sierra Leone ◽  
Qualitative Content Analysis ◽  
Qualitative Assessment ◽  
Western Area ◽  
Social Mobilisation ◽  
Death Notification ◽  
Severity Of The Disease ◽  
Willingness To Report ◽  
Mortality Surveillance

ObjectivesTo understand the barriers contributing to the more than threefold decline in the number of deaths (of all causes) reported to a national toll free telephone line (1-1-7) after the 2014–2016 Ebola outbreak ended in Sierra Leone and explore opportunities for improving routine death reporting as part of a nationwide mortality surveillance system.DesignAn exploratory qualitative assessment comprising 32 in-depth interviews (16 in Kenema district and 16 in Western Area). All interviews were audio-recorded, transcribed and analysed using qualitative content analysis to identify themes.SettingParticipants were selected from urban and rural communities in two districts that experienced varying levels of Ebola cases during the outbreak. All interviews were conducted in August 2017 in the post-Ebola-outbreak context in Sierra Leone when the Sierra Leone Ministry of Health and Sanitation was continuing to mandate reporting of all deaths.ParticipantsFamily members of deceased persons whose deaths were not reported to the 1-1-7 system.ResultsDeath reporting barriers were driven by the lack of awareness to report all deaths, lack of services linked to reporting, negative experiences from the Ebola outbreak including prohibition of traditional burial rituals, perception that inevitable deaths do not need to be reported and situations where prompt burials may be needed. Facilitators of future willingness to report deaths were largely influenced by the perceived communicability and severity of the disease, unexplained circumstances of the death that need investigation and the potential to leverage existing death notification practices through local leaders.ConclusionsSocial mobilisation and risk communication efforts are needed to help the public understand the importance and benefits of sustained and ongoing death reporting after an Ebola outbreak. Localised practices for informal death notification through community leaders could be integrated into the formal reporting system to capture community-based deaths that may otherwise be missed.

scholarly journals Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

2016 ◽  
Vol 11 (2) ◽  
pp. 221-232 ◽  
Author(s):  
Barbara J. Blake ◽  
Gloria A. Jones Taylor ◽  
Richard L. Sowell
Keyword(s):  
United States ◽  
African American ◽  
Rural Communities ◽  
African American Men ◽  
Qualitative Content Analysis ◽  
The United States ◽  
Health Concern ◽  
Treatment And Prevention ◽  
Age Related ◽  
Living With Hiv

The HIV (human immunodeficiency virus) epidemic in the United States remains a serious public health concern. Despite treatment and prevention efforts, approximately 50,000 new HIV cases are transmitted each year. Estimates indicate that 44% of all people diagnosed with HIV are living in the southern region of the United States. African Americans represent 13.2% of the United States population; however, 44% (19,540) of reported new HIV cases in 2014 were diagnosed within this ethnic group. The majority of cases were diagnosed in men (73%, 14,305). In the United States, it is estimated that 21% of adults living with HIV are 50 years or older. There exists limited data regarding how well African American men are aging with HIV disease. The purpose of this study was to explore the perceptions and experiences of older African American men living with HIV in rural Georgia. Data were collected from 35 older African American men living with HIV using focus groups and face-to-face personal interviews. Qualitative content analysis revealed six overlapping themes: (1) Stigma; (2) Doing Fine, Most of the Time; (3) Coping With Age-Related Diseases and HIV; (4) Self-Care; (5) Family Support; and (6) Access to Resources. The findings from this study provide new insights into the lives of rural HIV-infected African American men, expands our understanding of how they manage the disease, and why many return to or remain in rural communities.

scholarly journals A Household-Based Cross-Sectional Survey of Knowledge, Awareness and Practice Regarding Malaria in Western Area Rural District, Sierra Leone

2021 ◽  
Vol 9 ◽  
Author(s):  
Lili Wang ◽  
Jianhai Yin ◽  
Canjun Zheng ◽  
Samuel Juana Smith ◽  
Esther Ngegba ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Public Awareness ◽  
Malaria Prevention ◽  
Rural District ◽  
Control Measures ◽  
Capital City ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Western Area ◽  
Route Of Transmission

Sierra Leone is a highly endemic area for malaria, and the implementation of the National Malaria Strategic Plan (2016–2020) has reached its midpoint in 2018. To provide more specific guidance for interventions in the future, a household-based cross-sectional survey was conducted to elucidate the knowledge, awareness and practices regarding malaria and malarial control measures among the general public. Three communities (Grafton, Jui, and Kossoh) in the Western Area Rural District that were in close proximity to Sierra Leone's capital city of Freetown were included. Households were randomly selected and interviewed with a structured questionnaire covering malaria infection, diagnosis, treatment and prevention, as well as knowledge of malaria prevention. As a result, a total of 262 qualified questionnaires were included. The average cost for meals per day is ~30,000 Leones in each household. The rate of awareness, indicated by reporting having heard of malaria, was 98.1% (257/262), and 86.6% (227/262) of the respondents knew that mosquito bites are the main route of transmission. In addition, 80.9% (212/262) of the respondents sought health advice or treatment for the illness, and a similar percentage of respondents had been tested for malaria, mostly with rapid diagnostic tests (RDTs). A high demand for long-lasting insecticidal nets (72.1%) matched the serious shortage (61.8%, 162/262), and of the households that reported a lack of nets, 66 had children younger than 5 years old. In conclusion, public awareness of malaria prevention is high, based on this survey, although there was a limited use of preventive measures in these three communities and the malaria burden was still high. Therefore, the public's knowledge of malaria should be sustained and reinforced, and the distribution and use of malaria prevention measures should be promoted to supprt the achievement of the planned objectives.

Sierra Leone

2020 ◽  
Author(s):  
Marius Schneider ◽  
Vanessa Ferguson
Keyword(s):  
Civil War ◽  
Sierra Leone ◽  
Capital City ◽  
Urban District ◽  
The West ◽  
Independent State ◽  
Coastal City ◽  
Western Area ◽  
British Colony ◽  
Commonwealth Of Nations

Sierra Leone is located on the west coast of Africa, with an area of 71,740 square kilometres (km), bordered by Guinea, Liberia, and a coast line on the Atlantic Ocean of 402 km. The capital of Sierra Leone is the coastal city of Freetown and commands one of the world’s largest natural harbours. It has a population of 7.557 million (2017). The Western Area Urban District, which includes the capital city of Freetown, has a population density of 1,224 people per square kilometre. Formerly a British colony, Sierra Leone became an independent state within the Commonwealth of Nations in 1961 and attained republican status on 19 April 1971. The Sierra Leone civil war took place from 1991 until 2002, a war which had a devastating effect on the country and its economy. Since 2002. Sierra Leone has been in the process of rebuilding and regeneration following the civil war. Official business hours are from Monday to Friday from 0800 to 1700. The currency of Sierra Leone is the Leone (Le).

On the Pragmatics of Qualitative Assessment

2006 ◽  
Vol 22 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Jan Schilling
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Assessment Process ◽  
Qualitative Assessment ◽  
Group Discussions ◽  
Leadership Theories ◽  
Implicit Leadership ◽  
Implicit Leadership Theories ◽  
Textual Data ◽  
Quantitative Analyses

Using the example of a project on the assessment of implicit leadership theories, this article aims to describe qualitative content analysis as a systematic, rule-based process of analyzing verbal and textual data (e.g., interviews, group discussions, documents). Steps and typical problems in the qualitative assessment process are addressed and guidelines for decision and action presented. The steps include transcription of interview tapes into raw data, condensing and structuring the data, building and applying a category system, displaying data and results for concluding analyses and interpretation. Necessary checks for securing the quality of the assessment are shown for each step. Ideas for the combination of qualitative and quantitative analyses are presented, and applications of qualitative content analysis in the field of psychological assessment discussed.

scholarly journals Knowledge, awareness and practices of malaria in Western Area Rural District, Sierra Leone: a household-based cross-sectional survey in the middle of National Malaria Strategic Plan (2016-2020)

2020 ◽  
Author(s):  
Lili WANG ◽  
Jianhai Yin ◽  
Canjun Zheng ◽  
Samuel Juana Smith ◽  
Esther Ngegba ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Public Awareness ◽  
Scale Up ◽  
Strategic Plan ◽  
Malaria Prevention ◽  
Rural District ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Western Area ◽  
Route Of Transmission

Abstract Background The malaria epidemic is high in Sierra Leone, and the implementation of the National Malaria Strategic Plan (2016-2020) has reached its middle stage. In order to guide the interventions more specifically in future, a household-based cross-sectional survey was conducted to understand the public perception of knowledge, attitudes and practices of malaria and its control.Methods Three communities (Grafton, Jui and Kossoh) in Western Area Rural District within close proximity to Sierra Leone’s capital city of Freetown were included. Households were randomly selected and interviewed with a structural questionnaire covering malaria infection, diagnosis, treatment and prevention, as well as the knowledge of malaria prevention, in collaboration with the National Malaria Control Program of the Ministry of Health and Sanitation, Sierra Leone. Results A total of 262 qualified questionnaires were included. The average cost for meals per day is around 30000 Leones in each household. The awareness rate of having heard of malaria is 98.1% (257/262) and knowing mosquito biting as its main route of transmission is 86.6% (227/262) respectively. And 80.9% (212/262) of the respondents sought health advice or treatment for the illness, and similar percentage of them could be tested for malaria, mostly through RDTs. A great demand of long-lasting insecticidal nets (72.1%) was raised to fulfill the high shortage (61.8%, 162/262) in households, and of them there were 66 families having children under five years old.Conclusion Malaria burden is still high. Although public awareness of malaria prevention sounds well in this survey, the fact that the coverage of supplies and the use of preventive measures against malaria is low in households within the three communities. It is suggested that an advanced campaign should be carried out to scale up not only the knowledge on malaria but also the actual coverage and usage of malaria prevention measures, contributing to the achievements of planned objectives.

scholarly journals Assessing the performance of real-time epidemic forecasts: A case study of Ebola in the Western Area Region of Sierra Leone, 2014–15

2017 ◽  
Author(s):  
Sebastian Funk ◽  
Anton Camacho ◽  
Adam J. Kucharski ◽  
Rachel Lowe ◽  
Rosalind M. Eggo ◽  
...  
Keyword(s):  
Decision Making ◽  
Mathematical Models ◽  
Real Time ◽  
Sierra Leone ◽  
Mechanistic Model ◽  
Disease Outbreaks ◽  
Forecast Model ◽  
Null Models ◽  
Trade Offs ◽  
Western Area

AbstractReal-time forecasts based on mathematical models can inform critical decision-making during infectious disease outbreaks. Yet, epidemic forecasts are rarely evaluated during or after the event, and there is little guidance on the best metrics for assessment. Here, we propose an evaluation approach that disentangles different components of forecasting ability using metrics that separately assess the calibration, sharpness and unbiasedness of forecasts. This makes it possible to assess not just how close a forecast was to reality but also how well uncertainty has been quantified. We used this approach to analyse the performance of weekly forecasts we generated in real time in Western Area, Sierra Leone, during the 2013–16 Ebola epidemic in West Africa. We investigated a range of forecast model variants based on the model fits generated at the time with a semi-mechanistic model, and found that good probabilistic calibration was achievable at short time horizons of one or two weeks ahead but models were increasingly inaccurate at longer forecasting horizons. This suggests that forecasts may have been of good enough quality to inform decision making requiring predictions a few weeks ahead of time but not longer, reflecting the high level of uncertainty in the processes driving the trajectory of the epidemic. Comparing forecasts based on the semi-mechanistic model to simpler null models showed that the best semi-mechanistic model variant performed better than the null models with respect to probabilistic calibration, and that this would have been identified from the earliest stages of the outbreak. As forecasts become a routine part of the toolkit in public health, standards for evaluation of performance will be important for assessing quality and improving credibility of mathematical models, and for elucidating difficulties and trade-offs when aiming to make the most useful and reliable forecasts.

scholarly journals Determinants of low birth weight deliveries at five referral hospitals in Western Area Urban district, Sierra Leone

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
David Kabba Kargbo ◽  
Kofi Nyarko ◽  
Samuel Sackey ◽  
Adolphina Addo-Lartey ◽  
Ernest Kenu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Sierra Leone ◽  
Health Care Providers ◽  
Care Providers ◽  
Urban District ◽  
Factors Associated ◽  
Western Area ◽  
Inter Pregnancy Interval

Abstract Background Low birth weight (LBW) contributes significantly to infant and child mortality. Each year, about 20 1million deliveries are LBW with 96.5% occurring in developing countries. Whiles the incidence of LBW is reducing in other districts of Sierra Leone, it has been reported to be increasing in the Western Area Urban district. Determining the risk factors in a specific geographic area is important for identifying mothers at risk and thereby for planning and taking appropriate action. The current study sought to identify factors associated with LBW deliveries in the Western Area Urban district of Sierra Leone. Methods A hospital-based unmatched 1:2 case-control study was conducted among mothers who delivered live singleton babies from November, 2019 to February, 2020 in five referral health facilities. Mothers were conveniently sampled and sequentially enrolled into the study after delivery. Their antenatal care cards were reviewed and a pre-tested questionnaire administered to the mothers. Data analysis was done using Stata 15.0 and association between maternal socio-demographic, socio-economic, obstetric and lifestyle factors and LBW assessed using bivariable and multivariable logistic regression analyses. Results A total of 438 mothers (146 cases and 292 controls), mean age: 24.2 (±5.8) and 26.1 (±5.5) years for cases and controls respectively participated in the study. Multivariable analysis revealed that being unemployed (AoR = 2.52, 95% CI 1.16–5.49, p = 0.020), having anaemia during pregnancy (AoR = 3.88, 95% CI 1.90–7.90, p <  0.001), having less than 2 years inter-pregnancy interval (AoR = 2.53, 95% CI 1.11–5.73, p = 0.026), and smoking cigarettes during pregnancy (AoR = 4.36, 95% CI 1.94–9.80, p <  0.001) were significantly associated with having LBW babies. Conclusion Factors associated with LBW identified were unemployment, anaemia during pregnancy, < 2 years inter-pregnancy interval and cigarette smoking during pregnancy. Health care providers should screen and sensitize mothers on the risk factors of LBW during antenatal sessions.

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