Predictors of Ocular Surface Squamous Neoplasia and Conjunctival Squamous Cell Carcinoma among Ugandan Patients: A Hospital-based Study.

Aim: The aim of the study was to assess the predictors of ocular surface squamous neoplasia (OSSN) and conjunctival squamous cell carcinoma (SCC) among Ugandan patients.

Materials And Methods: Patients presenting for removal of ocular surface lesions received human immunodeficiency virus (HIV) testing, completed questionnaires about demographic, behavioral, and historical potential risk factors for conjunctival neoplasia, and had lesions examined for interpalpebral versus other locations, rough versus smooth texture, and number of feeder vessels. Biopsies were classified pathologically using standard definitions classified OSSN and SCC.

Disseminating technology in global surgery.

Background: Effective dissemination of technology in global surgery is vital to realize universal health coverage by 2030. Challenges include a lack of human resource, infrastructure and finance. Understanding these challenges, and exploring opportunities and solutions to overcome them, are essential to improve global surgical care.

Cross sectional study of chronic hepatitis B prevalence among healthcare workers in an urban setting, Sierra Leone.

Introduction: Hepatitis B is a serious public health problem across sub-Saharan Africa. Sierra Leone has no national hepatitis B strategy plan or high quality estimates of prevalence. Healthcare workers are perceived as an at-risk group for hepatitis B.

Public private partnership in in-service training of physicians: the millennium development goal 6-partnership for African clinical training (M-PACT) approach.

Introduction: in-service training of healthcare workers is essential for improving healthcare services and outcome.

Methods: The Millennium Development Goal (MDG) 6 Partnership for African Clinical Training (M-PACT) program was an innovative in-service training approach designed and implemented by the Royal College of Physicians (RCP) and West African College of Physicians (WACP) with funding from Eco Bank Foundation. The goal was to develop sustainable capacity to tackle MDG 6 targets in West Africa through better postgraduate medical education.

Multimodal Imaging and Spatial Analysis of Ebola Retinal Lesions in 14 Survivors of Ebola Virus Disease.

Importance: Differentiation between Ebola retinal lesions and other retinal pathologies in West Africa is important, and the pathogenesis of Ebola retinal disease remains poorly understood.

Objective: To describe the appearance of Ebola virus disease (EVD) retinal lesions using multimodal imaging to enable inferences on potential pathogenesis.

Design, Setting, And Participants: This prospective case series study was carried out at 34 Military Hospital in Freetown, Sierra Leone.

Detection, characterization, and enrollment of donors of Ebola convalescent plasma in Sierra Leone.

Background: Passive therapy with convalescent plasma provides an early opportunity to intervene in Ebola virus disease (EVD). Methods for field screening and selection of potential donors and quantifying plasma antibody are needed.

Study Design And Methods: Recombinant Ebola virus glycoprotein (EBOV GP) was formatted into immunoglobulin G-capture, competitive, and double-antigen bridging enzyme immunoassays (EIAs).

Macroeconomic costs of the unmet burden of surgical disease in Sierra Leone: a retrospective economic analysis.

Objectives: The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist.

Road traffic injuries: Cross-sectional cluster randomized countrywide population data from 4 low-income countries.

Introduction: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income countries using nationally representative survey data.

Medical Officers in Sierra Leone: Surgical Training Opportunities, Challenges and Aspirations.

Background: The critical shortage of human resources for healthcare falls most heavily on sub-Saharan nations such as Sierra Leone, where such workforce deficits have grave impacts on its burden of surgical disease. An important aspect in retention and development of the workforce is training. This study focuses on postgraduate surgical training (formal and short course) and perceptions of opportunities, challenges and aspirations, in a country where more than half of surgical procedures are performed by medical officers.

Herbal medicines use during pregnancy in Sierra Leone: An exploratory cross-sectional study.

Background: The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care.

Aim: This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone.

Mental health care during the Ebola virus disease outbreak in Sierra Leone.

Problem: Reported levels of mental health and psychosocial problems rose during the 2014-2015 Ebola virus disease outbreak in Sierra Leone.

Approach: As part of the emergency response, existing plans to create mental health units within the existing hospital framework were brought forward. A nurse-led mental health and psychosocial support service, with an inpatient liaison service and an outpatient clinic, was set up at the largest government hospital in the country.

Relationship Between Viremia and Specific Organ Damage in Ebola Patients: A Cohort Study.

Background: Pathogenesis of Ebola virus disease remains poorly understood. We used concomitant determination of routine laboratory biomarkers and Ebola viremia to explore the potential role of viral replication in specific organ damage.

Methods: We recruited patients with detectable Ebola viremia admitted to the EMERGENCY Organizzazione Non Governativa Organizzazione Non Lucrativa di Utilità Sociale (ONG ONLUS) Ebola Treatment Center in Sierra Leone.

Implementation of a study to examine the persistence of Ebola virus in the body fluids of Ebola virus disease survivors in Sierra Leone: Methodology and lessons learned.

Background: The 2013-2016 West African Ebola virus disease epidemic was unprecedented in terms of the number of cases and survivors. Prior to this epidemic there was limited data available on the persistence of Ebola virus in survivors' body fluids and the potential risk of transmission, including sexual transmission.

Methodology/principal Findings: Given the urgent need to determine the persistence of Ebola virus in survivors' body fluids, an observational cohort study was designed and implemented during the epidemic response operation in Sierra Leone.

Quality improvement in emergency service delivery: Assessment of knowledge and skills amongst emergency nurses at Connaught Hospital, Sierra Leone.

Introduction: The ability to deliver quality emergency care services is reliant on a well-trained workforce. Since Sierra Leone was declared Ebola free in December 2015, the country has now moved into the post-Ebola reconstructive phase focusing on specialty training of healthcare workers. This development aligns well to the growing momentum for improved emergency medicine as a speciality in other regions of Sub-Saharan Africa.

Safety, productivity and predicted contribution of a surgical task-sharing programme in Sierra Leone.

Background: Surgical task-sharing may be central to expanding the provision of surgical care in low-resource settings. The aims of this paper were to describe the set-up of a new surgical task-sharing training programme for associate clinicians and junior doctors in Sierra Leone, assess its productivity and safety, and estimate its future role in contributing to surgical volume.

Methods: This prospective observational study from a consortium of 16 hospitals evaluated crude in-hospital mortality over 5 years and productivity of operations performed during and after completion of a 3-year surgical training programme.

Ebola Holding Units at government hospitals in Sierra Leone: evidence for a flexible and effective model for safe isolation, early treatment initiation, hospital safety and health system functioning.

The 2014-2015 West African outbreak of Ebola Virus Disease (EVD) claimed the lives of more than 11,000 people and infected over 27,000 across seven countries. Traditional approaches to containing EVD proved inadequate and new approaches for controlling the outbreak were required. The Ministry of Health & Sanitation and King's Sierra Leone Partnership developed a model for Ebola Holding Units (EHUs) at Government Hospitals in the capital city Freetown.

An assessment of nurse-led triage at Connaught Hospital, Sierra Leone in the immediate post-Ebola period.

Introduction: Nurse-led triage, using the South African Triage Scale, was introduced to the emergency centre of the tertiary referral hospital in Freetown, Sierra Leone in early 2014 prior to the Ebola epidemic. The aim of this study was to measure the effectiveness of the process now that the country has been declared free of Ebola.

Methods: The study was conducted over a five-day consecutive period in the adult emergency centre of the main government teaching hospital in December 2015.

Cost-Effectiveness of Two Government District Hospitals in Sub-Saharan Africa.

Background: District hospitals in sub-Saharan Africa are in need of investment if countries are going to progress towards universal health coverage, and meet the sustainable development goals and the Lancet Commission on Global Surgery time-bound targets for 2030. Previous studies have suggested that government hospitals are likely to be highly cost-effective and therefore worthy of investment.

Methods: A retrospective analysis of the inpatient logbooks for two government district hospitals in two sub-Saharan African hospitals was performed.

Backlog and burden of fractures in Sierra Leone and Nepal: Results from nationwide cluster randomized, population-based surveys.

Background: The burden of injury is increasing worldwide; planning for its impact on population health and health systems is urgently needed, particularly in low- and middle-income countries (LMICs). This study aimed to model the burden of fractures and project costs to eliminate avertable fracture-related disability-adjusted life-years (i.e.

Ebola response in Sierra Leone: The impact on children.

The West African Ebola virus disease (EVD) outbreak is the largest ever seen, with over 28,000 cases and 11,300 deaths since early 2014. The magnitude of the outbreak has tested fragile governmental health systems and non-governmental organizations (NGOs) to their limit. Here we discuss the outbreak in the Western Area of Sierra Leone, the shape of the local response and the impact the response had on caring for children suspected of having contracted EVD.