Feasibility of introducing integrated disease surveillance and response into curricula of public health training institutions in Sierra Leone: the process and lessons learnt.

Introduction: Response to public health emergencies is a big challenge in African countries due to inadequate workforce. Integrated Disease Surveillance and Response (IDSR) is a strategy implemented by African member states of WHO to strengthen capacity for disease surveillance and response at all levels. Despite successful implementation of IDSR in most countries, one of the challenges that persists is that of inadequate trained workforce competent enough for public health surveillance.

Improving global health security through implementation of the National Action Plan for Health Security in Sierra Leone, 2018-2021: lessons from the field.

Background: All countries are required to implement International Health Regulations (IHR) through development and implementation of multi-year National Action Plans for Health Security (NAPHS). IHR implementation requires annual operational planning which involves several tools such as NAPHS, State Party Annual Report (SPAR), Joint External Evaluation (JEE) and WHO IHR Benchmarks tool. Sierra Leone has successfully improved IHR capacities across the years through successful annual operational planning using the above tools.

Innovative approach to monitor performance of integrated disease surveillance and response after the Ebola outbreak in Sierra Leone: lessons from the field.

Background: Supervision of healthcare workers improves performance if done in a supportive and objective manner. Regular supervision is a support function of Integrated Disease Surveillance and Response (IDSR) strategy and allows systematic monitoring of IDSR implementation. Starting 2015, WHO and other development partners supported the Ministry of Health and Sanitation (MoHS) to revitalize IDSR in Sierra Leone and to monitor progress through supportive supervision assessments.

After action review of the response to an outbreak of Lassa fever in Sierra Leone, 2019: Best practices and lessons learnt.

Background: In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two that were exported to the Netherlands. The outbreak tested multiple technical capacities in the International Health Regulations (2005) in a real-life setting.

A challenging response to a Lassa fever outbreak in a non endemic area of Sierra Leone in 2019 with export of cases to The Netherlands.

Introduction: On November 20, 2019, the Sierra Leone International Health Regulations (IHR) National Focal Point was notified of an exported case of Lassa fever in The Netherlands, by a Dutch doctor who previously practiced in a rural hospital in Sierra Leone. This report describes the extent of the outbreak, possible sources of infection, and the outbreak response measures taken.

Methods: Response measures implemented to control the outbreak included coordination across multiple countries and cities, outbreak investigation, active case finding, contact tracing and monitoring, laboratory investigation, and isolation and treatment of cases.

Impact Evaluation of the Kenya Frontline Field Epidemiology Training Program: Repeated-Measures Study.

Background: In 2014, Kenya's Field Epidemiology and Laboratory Training Program (FELTP) initiated a 3-month field-based frontline training, Field Epidemiology Training Program (FETP-F), for local public health workers.

Objective: This study aimed to measure the effect of FETP-F on participant workplace practices regarding quality and consistency of public health data, critical interaction with public health data, and improvements in on-time reporting (OTR).

Methods: Between February and April 2017, FELTP conducted a mixed methods evaluation via online survey to examine outcomes achieved among all 215 graduates from 2014 and 2015.

A protracted cholera outbreak among residents in an urban setting, Nairobi county, Kenya, 2015.

Introduction: in 2015, a cholera outbreak was confirmed in Nairobi county, Kenya, which we investigated to identify risk factors for infection and recommend control measures.

Methods: we analyzed national cholera surveillance data to describe epidemiological patterns and carried out a case-control study to find reasons for the Nairobi county outbreak. Suspected cholera cases were Nairobi residents aged >2 years with acute watery diarrhea (>4 stools/≤12 hours) and illness onset 1-14 May 2015.

Institutionalized data quality assessments: a critical pathway to improving the accuracy of integrated disease surveillance data in Sierra Leone.

Background: Public health agencies require valid, timely and complete health information for early detection of outbreaks. Towards the end of the Ebola Virus Disease (EVD) outbreak in 2015, the Ministry of Health and Sanitation (MoHS), Sierra Leone revitalized the Integrated Disease Surveillance and Response System (IDSR). Data quality assessments were conducted to monitor accuracy of IDSR data.

Factors associated with malnutrition in children < 5 years in western Kenya: a hospital-based unmatched case control study.

Background: Globally, under-nutrition accounts for > 3 million deaths annually among children < 5 years, with Kenya having ~ 35,000 deaths. This study aimed to identify factors associated with malnutrition in children aged < 5 years in western Kenya.

Methods: We conducted a hospital-based unmatched case-control study between May and June 2017.

Prevalence and factors associated with chronic kidney disease among medical inpatients at the Kenyatta National Hospital, Kenya, 2018: a cross-sectional study.

Introduction: The burden of chronic kidney disease (CKD) is increasing worldwide. Few studies in low and low-middle income countries have estimated the prevalence of CKD. We aimed to estimate prevalence and factors associated with CKD among medical inpatients at the largest referral hospital in Kenya.

A Public Health Response to a Mudslide in Freetown, Sierra Leone, 2017: Lessons Learnt.

On August 14, 2017, a 6-kilometer mudslide occurred in Regent Area, Western Area District of Sierra Leone following a torrential downpour that lasted 3 days. More than 300 houses along River Juba were submerged; 1141 people were reported dead or missing and 5905 displaced. In response to the mudslide, the World Health Organization (WHO) Country Office in Sierra Leone moved swiftly to verify the emergency and constitute an incident management team to coordinate the response.

Cholera outbreak during a scientific conference at a Nairobi hotel, Kenya 2017.

Background: Cholera globally affects 1.3-4.0 million people and causes 21 000-143 000 deaths annually.

Revitalization of integrated disease surveillance and response in Sierra Leone post Ebola virus disease outbreak.

Background: The Ministry of Health and Sanitation (MOHS) in Sierra Leone partially rolled out the implementation of Integrated Disease Surveillance and Response (IDSR) in 2003. After the Ebola virus disease outbreak in 2014-2015, there was need to strengthen IDSR to ensure prompt detection and response to epidemic-prone diseases. We describe the processes, successes and challenges of revitalizing public health surveillance in a country recovering from a protracted Ebola virus disease outbreak.

Predictors of loss to follow up among HIV-exposed children within the prevention of mother to child transmission cascade, Kericho County, Kenya, 2016.

Introduction: HIV-exposed infants (HEI) lost-to-follow-up (LTFU) remains a problem in sub Saharan Africa (SSA). In 2015, SSA accounted >90% of the 150,000 new infant HIV infections, with an estimated 13,000 reported in Kenya. Despite proven and effective HIV interventions, many HEI fail to benefit because of LTFU.

Folate deficiency and utilization of folic acid fortified flour among pregnant women attending antenatal clinic at Pumwani Maternity Hospital, Kenya, 2015.

Introduction: in 2012, the Government of Kenya amended the Food, Drug and Chemical Substances Act to make the fortification of maize and wheat flour with folic acid mandatory. We assessed folate deficiency, awareness and use of folic acid fortified flour among pregnant women receiving antenatal care (ANC) at a clinic at Pumwani Maternity Hospital, Kenya, 2015.

Methods: we conducted a cross-sectional survey at Pumwani Maternity Hospital between October and November 2014.

An outbreak of cholera in western Kenya, 2015: a case control study.

Introduction: in February 2015, an outbreak of acute watery diarrhea was reported in two sub counties in western Kenya. e 01 serotype Ogawa was isolated from 26 cases and from water samples collected from a river mainly used by residents of the two sub-counties for domestic purposes. We carried out an investigation to determine factors associated with the outbreak.

Factors associated with interruption of tuberculosis treatment among patients in Nandi County, Kenya 2015.

Introduction: Kenya is ranked 15th on the list of 22 high-tuberculosis (TB) burden countries with a case notification rate of 440 cases per 100,000 persons. Interruption of TB treatment is one of the major obstacles to effective TB treatment and control. Since 2009, emphasis has been on direct observation treatment short-course (DOTS) to ensure adherence.

Etiology of bacterial meningitis: a cross-sectional study among patients admitted in a semi-urban hospital in Nairobi, Kenya.

Introduction: bacterial meningitis, responsible for childhood morbidity and mortality, can also lead to permanent neurological disability among survivors. This study conducted from January to December, 2015 used standard bacteriological and molecular methods to investigate the etiology of three common causes of bacterial meningitis among hospitalized patients admitted at a semi-urban hospital in Nairobi, Kenya.

Methods: a total of 196 patients admitted at Mama Lucy Kibaki with clinically diagnosed meningitis were recruited into this cross-sectional study.

Male partner involvement in efforts to eliminate mother-to-child transmission of HIV in Kisumu County, Western Kenya, 2015.

Introduction: rates of caesarean sections (CS) have been rising globally over time. Our study sought to identify factors associated with CS among mothers delivering at Mama Lucy Kibaki Hospital in Nairobi city county, Kenya.

Methods: we conducted an unmatched case-control study using a 1:2 case-to-control ratio.

Male partner involvement in efforts to eliminate mother-to-child transmission of HIV in Kisumu County, Western Kenya, 2015.

Introduction: male partner involvement in elimination of mother-to-child transmission (eMTCT) of HIV activities remains low in Western Kenya, despite its importance in reducing rates of child HIV transmission. We sought to identify factors associated with male partner involvement in eMTCT in Kisumu East sub-County, Western Kenya.

Methods: we conducted a cross-sectional study among women aged ≥ 18 years who had children aged ≤ 12 months and were attending a child health clinic for immunization services in one of four Western Kenya health centers between February and April, 2015.

Factors associated with uptake of dual contraception among HIV-infected women in Bungoma County, Kenya: a cross-sectional study.

Introduction: dual contraception, the use of non-barrier contraceptive method in combination with condoms, is an effective strategy in the elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) and the achievement of zero new HIV infections. Despite its effectiveness, dual contraception use among HIV-infected women in Kenya remains low. We identified factors associated with dual contraceptive uptake in Bungoma County, Kenya.

Systems, supplies, and staff: a mixed-methods study of health care workers' experiences and health facility preparedness during a large national cholera outbreak, Kenya 2015.

Background: From December 2014 to September 2016, a cholera outbreak in Kenya, the largest since 2010, caused 16,840 reported cases and 256 deaths. The outbreak affected 30 of Kenya's 47 counties and occurred shortly after the decentralization of many healthcare services to the county level. This mixed-methods study, conducted June-July 2015, assessed cholera preparedness in Homa Bay, Nairobi, and Mombasa counties and explored clinic- and community-based health care workers' (HCW) experiences during outbreak response.