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Background: Human immunodeficiency virus (HIV) infection is an important risk factor for Coronavirus Disease 2019 (COVID‐19), but data on the prevalence of COVID‐19 among people living with HIV (PLWH) is limited in low‐income countries. Our aim was to assess the seroprevalence of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) specific antibodies and associated factors among PLWH in Sierra Leone. Methods: We conducted a cross‐sectional survey of PLWH aged 18 years or older in Sierra Leone between August 2022 and January 2023. Participants were tested for SARS‐CoV‐2 antibodies using a rapid SARS‐CoV‐2 antibody (immunoglobulin M/immunoglobulin G [IgG]) kits. Stepwise logistic regression was used to explore factors associated with SARS‐CoV‐2 antibody seroprevalence with a significance level of p <.05. Results: In our study, 33.4% (1031/3085) participants had received a COVID‐19 vaccine, and 75.7% were SARS‐CoV‐2 IgG positive. Higher IgG seroprevalence was observed in females (77.2% vs. 71.4%, p =.001), adults over 60 years (88.2%), those with suppressed HIV RNA (80.7% vs. 51.7%, p <.001), antiretroviral therapy (ART)‐experienced individuals (77.9% vs. 44.6%, p <.001), and vaccinated participants (80.7% vs. 73.2%, p <.001). Patients 60 years or older had the highest odds of IgG seroprevalence (adjusted odds ratio [aOR] = 2.73, 95% CI = 1.68–4.65). Female sex (aOR = 1.28, 95%CI = 1.05–1.56), COVID‐19 vaccination (aOR = 1.54, 95% CI = 1.27–1.86), and ART (aOR = 2.20, 95% CI = 1.56–3.11) increased the odds, whereas HIV RNA ≥ 1000 copies/mL (aOR = 0.32, 95% CI = 0.26–0.40) reduced the odds of IgG seroprevalence. Conclusions: We observed a high seroprevalence of SARS‐CoV‐2 antibody among PLWH in Sierra Leone. We recommend the introduction of targeted vaccination for PLWH with a high risk of severe COVID‐19, especially those with an unsuppressed HIV viral load. [ABSTRACT FROM AUTHOR]

The 2014-2016 West Africa Ebola virus disease (EVD) epidemic resulted in an estimated 3,956 deaths and 10,168 survivors in Sierra Leone (1). The use of high quality specialty services by [...]

aimba Kargbo,3 Andrew Clarke,4,5 Sherry Bangura,6 Mariatu Kargbo,6 Hawa Mariama Sesay,7 Abdul H Kamara,6 Jamil Bangura,6 Alie F Kamara,6 Sophie Allieu,1 Hassan Rogers,1 Maurizio Mattei,8 Vittorio Colizzi,9 Carla Montesano,8 Edwin JJ Momoh1,31Department of Public Health, Microbiology and Immunology, Ernest Bai Koroma University of Science and Technology, Makeni, Sierra Leone; 2 34th Military Hospital, The Republic of Sierra Leone Armed Forces, Freetown, Sierra Leone; 3Department of Agriculture and Food Security; Ernest Bai Koroma University of Science and Technology, Makeni, Sierra Leone; 4Global Programs Division, Save the Children UK, London, UK; 5Department/Division of Health Research, Lancaster University, Lancaster, UK; 6Sierra Leone Association of Ebola Survivors, Freetown, Sierra Leone; 7Department of Public Health, University of Makeni, Makeni, Sierra Leone; 8Department of Biology, University of Rome Tor Vergata, Rome, Italy; 9Department of Sciences and Technology, Evangelical University of Cameroon, Bandjoun, Cameroon*These authors contributed equally to this workCorrespondence: Raoul Emeric Guetiya Wadoum; Edwin JJ Momoh, Email [email protected] ; [email protected] ; [email protected] Background: The clinical management of persistent medical conditions affecting Ebola survivors, generally described as a post-Ebola syndrome, remains a public health concern. We aimed to analyze Ebola survivors' laboratory biomarkers as compared to their non-infected household relatives to identify biomarkers that could guide the identification of survivors at increased risk of developing severe at odds with the non-severe post-Ebola syndrome. Materials and Methods: Data were extracted from medical records of the Ebola survivors clinic, and we included only Ebola survivor's parameters recorded during the first baseline follow-up visit 2 weeks interval after their second negative PCR result. Moreover, household non-infected family contacts of survivors visiting the clinic during the same period were recruited as community control. Results: The mean age of survivors was 32.65 (IQR: 15.5, 38.25) years, and Ebola IgG immunoglobulin was detected in all, thus confirming their status. The statistical significance (all p < 0.05) observed in monocyte percentage (MONO%), cluster of differentiation 4 percentage (CD4%), alanine aminotransferase (ALT), creatinine (CREA), and creatinine kinase (C-kinase) proved to be clinically significant as compared to the household relatives' group. Interestingly, the linear regression analysis indicated that the duration at ETU was negatively associated with lymphocyte percentage with a 5% lymphocyte decrease per day spent at ETU. Finally, there was a significant (p < 0.05) association between hematological (Hb, PCV, MCV, MCH), biochemical (ALT, CREA, C-kinase, T-cholesterol, triglycerides) parameters and the risk of developing severe complications. Conclusion: We recommend clinicians closely monitor Hb, PCV, MCV, MCH, ALT, CREA, C-kinase, T-cholesterol, triglycerides and lymphocytes as clinically relevant laboratory biomarkers to identify survivors at higher risk of developing severe post-acute syndrome upon discharge from Ebola treatment unit including headache, abdominal pain, chest pain, ocular complication, arthralgia, hearing difficulty and erectile dysfunction which can impact health-related quality of life among Ebola survivors. [ABSTRACT FROM AUTHOR]

The Ebola virus disease, formerly known as Ebola hemorrhagic fever, is a severe and often fatal zoonosis in humans. The 2013– 2016 West African Ebola outbreak had distinctive characteristics, and it was the largest and most complex epidemic since the virus discovery in 1976. Although the 2018– 2020 Ebola outbreak in the Democratic Republic of the Congo had many similarities, there were additional challenges due to the presence of armed rebel groups at the epicenters of the epidemic. Despite these challenges, the extraordinary commitment of the World Health Organization (WHO) regional office for Africa, in collaboration with Africa Union (AU) member states through the Africa Centres for Disease Control and Prevention (Africa CDC), and WHO's prompt declaration of a Public Health Emergency of International Concern (PHEIC) shepherded an effective coordinated response to contain the epidemic. Learning from previous Ebola virus epidemics and the current Coronavirus disease 2019 (COVID-19) pandemic, the AU member states should strengthen inter-state coordination towards the development and implementation of a preparedness and readiness plan which will enable the continent to build and sustain resilient capacities to prevent, detect, and respond to future outbreaks following the International Health Regulations (IHR). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Infectious disease surveillance has long been a challenge for low-income countries like Sierra Leone. Traditional approaches based on paper and Short Message Service (SMS) were subject to severe delays in obtaining, transmitting, and analyzing information., Methods: During the China aid operation for fighting Ebola since the end of 2014, a mobile electronic surveillance system for infectious diseases (MESSID) was developed in collaboration with the Republic of Sierra Leone Armed Forces (RSLAF), which comprised an Android-based reporting system and a complementary web-based program designed by Active Server Page.NET (ASP.NET) with the main functions including surveillance, real-time reporting, and risk assessment of infectious diseases., Results: MESSID was successfully registered in June 2016 and had been used by all medical and health institutions in RSLAF. From June 1, 2016 to July 5, 2021, 34,419 cases were diagnosed with 47 infectious diseases of 5 categories, with a total of 42 clinical symptoms. Compared to traditional approaches based on paper and SMS, the MESSID showed flexibility, high efficiency, convenience, and acceptability., Discussion: MESSID is an accessible tool for surveillance of infectious diseases in Sierra Leone and possibly in other African countries with similar needs, capable of improving timeliness of disease reporting, thus rendering a timely outbreak detection and response., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2021.)