scholarly journals Rabies Virus in Sierra Leone: Challenges and Recommended Solutions for Elimination by 2030

2021 ◽  
Author(s):  
Roland Suluku ◽  
Emikpe Benjamin Obukowho ◽  
Abu Macavoray ◽  
Moinina Nelphson Kallon
Keyword(s):  
Sierra Leone ◽  
Rabies Virus ◽  
Low Income ◽  
Viral Disease ◽  
Low Income Countries ◽  
Canine Rabies ◽  
Dog Ownership ◽  
Lack Of Information ◽  
Wildlife Vaccination ◽  
The Government

The objective of this write-up is to find possible solution control canine rabies virus in Sierra Leone and other low-income countries in the world. Rabies is a viral disease affecting both humans and animals in Sierra Leone. The country has no policy on dog ownership and management, two veterinarians, limited access to rabies vaccines and human immunoglobin, and a lack of information about the disease in the country despite increasing dog bite cases and death. There is no wildlife specialist to initiate wildlife vaccination. Continuous vaccination increased awareness, trained personnel in veterinary and wildlife, development of policies on responsible dog ownership and by-laws and increase financial support from the government and private sector will help Sierra Leone eliminate rabies in the first half of the twenty-first century.

scholarly journals No implant, no solution, lost cases to surgery: orthopedic trauma triage for surgery in an NGO hospital in Sierra Leone

2021 ◽  
Author(s):  
F. Wichlas ◽  
V. Hofmann ◽  
M. Moursy ◽  
G. Strada ◽  
C. Deininger
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Sierra Leone ◽  
Low Income ◽  
Soft Tissue Defect ◽  
Low Income Countries ◽  
Pelvic Surgery ◽  
Closed Fractures ◽  
Trauma Triage ◽  
Tissue Defects

Abstract Introduction In low-income countries (LIC), international surgeons face the fact that there are patients they cannot treat. The goal of this study was to identify and analyze patients lost to treatment. Material and methods We analyzed retrospectively the data of 282 trauma victims from a non-governmental organizational (NGO) hospital in Sierra Leone, Africa. During a 3-month period (10.10.2015–08.01.2016), these patients had 367 injuries and underwent 263 orthopedic surgeries. Despite a clear indication, some patients did not receive surgical treatment. We identified these injuries and the reason why they could not be operated. The anatomic region of the injury was evaluated and if they had a bone or soft tissue defect or were infected. Results We identified 95 (25.89%) injuries in 70 patients (47 males; 23 females) that were not be operated. The reasons were lack of specific implants (no implant group; N = 33), no treatment strategy for the injury (no solution group; N = 29), and patients that were lost (lost patient group; N = 33), almost equally distributed by 1/3. In the no implant group were mainly closed fractures and fractures of the pelvis and the proximal femur. The implants needed were locking plates (N = 19), proximal femoral nails (N = 8), and implants for pelvic surgery (N = 6). In the no solution group were nearly all bone (P < 0.0000), soft tissue defects (P < 0.00001) and infections (P = 0.00003) compared to the rest and more open fractures (P < 0.00001). In the lost patients group, most fractures were closed (24 out of 33, P = 0.033). These fractures were mostly not urgent and were postponed repeatedly. Conclusion One quarter of the patients did not receive the surgical treatment needed. Besides acquisition of implants, surgical skills and expertise could be a solution for this issue. Nevertheless, these skills must be passed to local surgeons.

Climate Change And Food Security In Nepal

2013 ◽  
Vol 13 ◽  
pp. 9-19 ◽  
Author(s):  
Krishna Prasad Pant
Keyword(s):  
Climate Change ◽  
Regression Analysis ◽  
Food Security ◽  
Low Income ◽  
Secondary Data ◽  
Low Income Countries ◽  
Farm Production ◽  
Agriculture And Environment ◽  
Policy Measures ◽  
The Government

Climate change is posing a threat on present and future food security in low income countries. But, the actual effect of the climate change on food security is not known. Using secondary data reported by the government, the paper examines the effects of climate change on food security in Nepal in the context of policies of commercialization of farm production. Statistical analysis is used to delineate the situation of food security in the country and regression analysis for exploring the effects of global warming on domestic production of major cereals. The results are discussed at global, national, household and individual levels empirically and qualitatively. The results suggest that a rise in minimum temperature decreases the productivity of rice increasing threat of food insecurity. The paper suggests some policy measures for improving food security situation in the country and open up some areas for further research. The Journal of Agriculture and Environment Vol:13, Jun.2012, Page 9-19 DOI: http://dx.doi.org/10.3126/aej.v13i0.7582

Case Report: Severe Dental Abscess Complications in Rural Sierra Leone

2021 ◽  
Author(s):  
Rosa Roemers ◽  
Aminata I. Sesay ◽  
Musa G. Sesay ◽  
Jan Henk Dubbink ◽  
Heleen M. Koudijs ◽  
...  
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Sierra Leone ◽  
Low Income ◽  
Case Series ◽  
Low Income Countries ◽  
Prevalence Data ◽  
Dental Abscess ◽  
Dental Infections

Prevalence data on severe dental infections is scarce, particularly for low-income countries. Patients with dental abscess complications who presented from September 2020 until December 2020 in two hospitals in Tonkolili District, Sierra Leone, were included into this case series. We report on a total of 20 patients, median age 28 years, with severe complications of dental abscesses, with a mortality rate of 45%. This case series illustrates the severity of the dire consequences of the absence of access to basic dental and oral healthcare.

scholarly journals Adapting Collaborative Approaches for Service Provision to Low-Income Countries: Expert Panel Results

2020 ◽  
Vol 12 (7) ◽  
pp. 2612 ◽  
Author(s):  
Kimberly Pugel ◽  
Amy Javernick-Will ◽  
Matthew Koschmann ◽  
Shawn Peabody ◽  
Karl Linden
Keyword(s):  
Service Delivery ◽  
International Development ◽  
Low Income ◽  
Expert Panel ◽  
Income Country ◽  
Low Income Countries ◽  
Low Income Country ◽  
Government Capacity ◽  
The Government ◽  
Future Practice

The international development sector is increasingly implementing collaborative approaches that facilitate a range of sectoral-level stakeholders to jointly address complex problems facing sustainable public service delivery, for which guidance does not explicitly exist. The literature on collaborative approaches has been built on experiences in high-income countries with vastly different governance capabilities, limiting their global relevance. A Delphi expert panel addressed this need by evaluating 58 factors hypothesized in the literature to contribute to the success of collaborative approaches. The panel rated factors according to their importance in low-income country contexts, on a scale from Not Important to Essential. Experts agreed on the importance of 49 factors, eight of which were essential for success. Rich qualitative data from open-ended responses revealed factors that may be unique to low-income country contexts and to service delivery applications, including how government capacity, politics, donor influence, and culture can influence decisions on structuring leadership and facilitation roles, appropriately engaging the government, and building legitimacy. Key considerations for future practice and research are summarized in a table in the appendix. This study contributes to both literature and practice by identifying the relative importance of factors to consider when designing collaborative approaches in low-income countries with limited governance capabilities.

scholarly journals The Right to Education and ICT during COVID-19: An International Perspective

2020 ◽  
Vol 12 (21) ◽  
pp. 9091
Author(s):  
Luis Miguel Lázaro Lorente ◽  
Ana Ancheta Arrabal ◽  
Cristina Pulido-Montes
Keyword(s):  
Low Income ◽  
International Perspective ◽  
School Closure ◽  
Global Perspective ◽  
Low Income Countries ◽  
Right To Education ◽  
The World ◽  
The Government ◽  
The Right ◽  
The Impact

There is a lack of concluding evidence among epidemiologists and public health specialists about how school closures reduce the spread of COVID-19. Herein, we attend to the generalization of this action throughout the world, specifically in its quest to reduce mortality and avoid infections. Considering the impact on the right to education from a global perspective, this article discusses how COVID-19 has exacerbated inequalities and pre-existing problems in education systems around the world. Therefore, the institutional responses to guaranteeing remote continuity of the teaching–learning process during this educational crisis was compared regionally through international databases. Three categories of analysis were established: infrastructure and equipment, both basic and computer-based, as well as internet access of schools; preparation and means of teachers to develop distance learning; and implemented measures and resources to continue educational processes. The results showed an uneven capacity in terms of response and preparation to face the learning losses derived from school closure, both in low-income regions and within middle- and high-income countries. We concluded that it is essential to articulate inclusive educational policies that support strengthening the government response capacity, especially in low-income countries, to address the sustainability of education.

Extending social protection to persons with disabilities: Exploring the accessibility and the impact of the Disability Fund on the lives of persons with disabilities in Ghana

2018 ◽  
Vol 19 (3) ◽  
pp. 225-245 ◽  
Author(s):  
Maxwell Peprah Opoku ◽  
William Nketsia ◽  
Elvis Agyei-Okyere ◽  
Wisdom Kwadwo Mprah
Keyword(s):  
Low Income ◽  
Social Protection ◽  
Structured Interview ◽  
Low Income Countries ◽  
Economic Activities ◽  
Persons With Disabilities ◽  
The Sustainable Development ◽  
The Government ◽  
Political Units ◽  
The Impact

In many low-income countries, persons with disabilities are consistently denied access to essential services, contributing to a high incidence of poverty among them. The Goal 1 of the Sustainable Development Goals (SDGs) exhorts countries to develop appropriate social protection to serve as a springboard to alleviate poverty among all persons. The government of Ghana has introduced Disability Fund to provide one-off financial support to persons with disabilities through its decentralised political units. This is to enable persons with disability to participate in socio-economic activities. However, after a decade of the establishment of the fund, anecdotal evidence still shows that many persons with disabilities continue to live in deplorable conditions. Therefore, the main aim of this qualitative study was to explore the beneficial impact of the fund on the lives of persons with disabilities in Ghana. A semi-structured interview guide was used to collect data from 48 participants, comprising 20 males and 28 females with disabilities. The narratives from the participants revealed that only a few were able to access the fund. In their quest to access the fund, participants encountered barriers, such as lack of information, delays in disbursement and insufficient funds. The findings underscore the need for re-evaluation of the administration of Disability Fund and its disbursement processes. The implications of the findings for policy reform are extensively discussed.

scholarly journals Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038520
Author(s):  
Maria Lisa Odland ◽  
Tahir Bockarie ◽  
Haja Wurie ◽  
Rashid Ansumana ◽  
Joseph Lamin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Access To Care ◽  
Sierra Leone ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Health System Strengthening ◽  
Low Income Countries

IntroductionPrevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.MethodsThis study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.ResultsOf 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.ConclusionsIn Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed.

scholarly journals COVID-19 and Its Implications in Dental Care

2020 ◽  
pp. 53-57
Author(s):  
H. Inegbenosun ◽  
E. P. Ofiri ◽  
C. C. Azodo
Keyword(s):  
Public Health ◽  
Low Income ◽  
Dental Care ◽  
Public Health Problem ◽  
Low Income Countries ◽  
Dental Procedures ◽  
The World ◽  
Huge Impact ◽  
Dental Practices ◽  
The Government

COVID-19 was first reported in Wuhan, Hubei Province of China a few months ago (December 2019) and had since become a major challenging public health problem for not only China but also many countries around the world. It was on March 11, 2020, characterized by WHO as a pandemic. The pandemic so far has killed more than 526,465 people and infected more than 11,046,917 people around the world as of 05 July 2020. Nigeria currently has 28,167 confirmed COVID-19 cases with 11,462 (40%) discharged, 16,071 (57%) currently receiving treatment at designated facilities across the country and unfortunately 634 (3%) deaths as at the time of writing this manuscript. As far as the authors are aware, there are little or no work carried out on the implications of COVID-19 on dental practices in Nigeria. Recently, COVID-19 was identified in saliva of infected patients and so transmission via aerosols and splatter generated during dental procedures is sure. To limit exposure, there was a need to avoid scheduling patients except for emergency dental care during this outbreak. This limitation on activities of the dental sector has a very huge impact on the economy of the sector as it has already resulted in serious monetary implications for dental practices worldwide. While dental practices in the high-income countries are getting help from their respective Government, those in the middle and low-income countries like Nigeria have been left to wallow in bankruptcy without support. The authors highly recommend that the Government of these neglected countries, step up and support dental practices that are on the brink of closing down due to the low turnout of patients to their practice during this outbreak.

scholarly journals Peritoneal Dialysis Utilization Globally and Opportunities in Lower Income Countries

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Fredric Finkelstein ◽  
Qamar Khan
Keyword(s):  
Peritoneal Dialysis ◽  
Low Income ◽  
Low Income Countries ◽  
Dramatic Improvement ◽  
Middle Income ◽  
Low Resource ◽  
Number Of Patients ◽  
The Government ◽  
Global Increase ◽  
End Stage

There has been an expansion of peritoneal dialysis (PD) utilization globally over the past several years. This has occurred for several reasons. First, there has been a global increase in the number of patients receiving end-stage kidney disease (ESKD) treatment in high income, middle income and low income countries. Second, recent studies have emphasized the reduced cost of PD compared to hemodialysis (HD) if PD supplies can be acquired at a reasonable cost.  Thirdly, it is now widely accepted that since PD is much simpler to do than HD (that is, it does not require large amounts of water, complex water treatment systems, electricity, and machinery), the use of PD in low resource countries has certain obvious advantages. Fourthly, it has become clear from experiences in Hong Kong and Thailand that have developed PD First programs (i.e. the government paying for ESKD care only if PD eligible patients start on PD rather than HD) and programs in Mexico (where there has been limited availability of HD centers) that the vast majority of patients with ESKD, even in low resource countries, are able to successfully be cared for with PD.  And, importantly, as programs expand in low resource countries and experience is gained, outcomes of  PD improve.  Lastly, the International Society of Peritoneal Dialysis (ISPD) has developed comprehensive guidelines for the care of PD patients that has resulted in a dramatic improvement in outcomes for PD patients over the last several years.

scholarly journals Epidemic Spread and Its Management Through Governance and Leadership Response Influencing the Arising Challenges Around COVID-19 in Pakistan—A Lesson Learnt for Low Income Countries With Limited Resource

2020 ◽  
Vol 8 ◽  
Author(s):  
Ahsan Nawaz ◽  
Xing Su ◽  
Muhammad Qasim Barkat ◽  
Sana Asghar ◽  
Ali Asad ◽  
...  
Keyword(s):  
Low Income ◽  
Preventive Measures ◽  
National Level ◽  
Limited Resource ◽  
Low Income Countries ◽  
Strict Adherence ◽  
Similar Work ◽  
The Usa ◽  
The Government ◽  
Global Statistics

The coronavirus disease (COVID-19) was first reported in China (Wuhan) at the end of 2019. It has rapidly spread over 216 countries, including the USA, UK, Europe, Russia, and many Asian countries. It has affected more than 4.5 million people, and around 0.3 million deaths have been reported globally. Many preventive measures have been adopted worldwide to mitigate its spread. The government of Pakistan has also taken many preventive measures to combat the COVID-19 outbreak, such as rapid response by governance, continuous monitoring of the pandemic spread in the affected areas, and integration of resources from multiple sectors, including health, education, defense, and media. According to global statistics, the number of COVID-19 cases in the country remained remarkably lower than the expected number for the first 169 days, as compared to other countries. A total of 286,674 confirmed cases, including 16,475 active, 6,139 deaths, and 264,060 (92%) recoveries were reported. The study finds that strict adherence to national policies, effective governance, and unity at the national level resulted in better outcomes. Hence, the preventive measures, rapid responses, and strategies adopted for combating the challenges could be adopted as a learning tool for other countries having similar work environments and financial constraints. This paper can help and guide governance/public actions in response to the possible rebound of coronavirus this fall/winter.

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