Exploring self-use, attitude and interest to study complementary and alternative medicine (CAM) among final year undergraduate medical, pharmacy and nursing students in Sierra Leone: a comparative study.

Background: CAM inclusion into the curricula of health training institutions, a strategy for its integration into the main stream healthcare delivery system is growing globally. Future healthcare professionals knowledge and perception of CAM are key determinants to its successful integration. Thus, the main objective of this study was to compare the use, attitude and interest to study CAM among final year undergraduate medical, pharmacy and nursing students at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL).

Assessing unmet anaesthesia need in Sierra Leone: a secondary analysis of a cluster-randomized, cross-sectional, countrywide survey.

Objectives: To determine the unmet anaesthesia need in a low resource region.

Introduction: Surgery and anæsthesia services in low- and middle-income countries (LMICs) are under-equipped, under-staffed, and unable to meet current surgical need. There is little objective measure as to the true extent and nature of unmet need.

The Surgical Workforce and Surgical Provider Productivity in Sierra Leone: A Countrywide Inventory.

Background: Limited data exist on surgical providers and their scope of practice in low-income countries (LICs). The aim of this study was to assess the distribution and productivity of all surgical providers in an LIC, and to evaluate correlations between the surgical workforce availability, productivity, rates, and volume of surgery at the district and hospital levels.

Methods: Data on surgeries and surgical providers from 56 (93.

Surgery in the time of Ebola: how events impacted on a single surgical institution in Sierra Leone.

Introduction: The mortality and morbidity of Ebola extends far wider than those contracting the disease. Surgical activity in Sierra Leone has been severely disrupted by the epidemic.

Method: This is a retrospective study examining the effect of the 2014-2015 Ebola virus epidemic on surgical activity in a Sierra Leone's main teaching hospital.

A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response.

The outbreak of Ebola virus disease in West Africa is the largest ever recorded. Numerous treatment alternatives for Ebola have been considered, including widely available repurposed drugs, but initiation of enrollment into clinical trials has been limited. The proposed trial is an adaptive platform design.

The demographics of patients affected by surgical disease in district hospitals in two sub-Saharan African countries: a retrospective descriptive analysis.

Background: There is a growing awareness of the importance of surgical disease within global health. We hypothesised that surgical disease in low income countries predominantly affects young adults and may therefore have a significant economic impact.

Methods: We retrospectively reviewed all surgical admission data from two rural government district hospitals in two different sub-Saharan African countries over a 6-month period.

Assessment of Environmental Contamination and Environmental Decontamination Practices within an Ebola Holding Unit, Freetown, Sierra Leone.

Evidence to inform decontamination practices at Ebola holding units (EHUs) and treatment centres is lacking. We conducted an audit of decontamination procedures inside Connaught Hospital EHU in Freetown, Sierra Leone, by assessing environmental swab specimens for evidence of contamination with Ebola virus by RT-PCR. Swabs were collected following discharge of Ebola Virus Disease (EVD) patients before and after routine decontamination.

Self-reported Determinants of Access to Surgical Care in 3 Developing Countries.

Importance: Surgical care is recognized as a growing component of global public health.

Objective: To assess self-reported barriers to access of surgical care in Sierra Leone, Rwanda, and Nepal using the validated Surgeons OverSeas Assessment of Surgical Need tool.

Design, Setting, And Participants: Data for this cross-sectional, cluster-based population survey were collected from households in Rwanda (October 2011), Sierra Leone (January 2012), and Nepal (May and June 2014) using the Surgeons OverSeas Assessment of Surgical Need tool.

Generation of national political priority for surgery: a qualitative case study of three low-income and middle-income countries.

Background: Surgical conditions exert a major health burden in low-income and middle-income countries (LMICs), yet surgery remains a low priority on national health agendas. Little is known about the national factors that influence whether surgery is prioritised in LMICs. We investigated factors that could facilitate or prevent surgery from being a health priority in three LMICs.

Who is performing surgery in low-income settings: a countrywide inventory of the surgical workforce distribution and scope of practice in Sierra Leone.

Background: Scope of practice and in-country distribution of surgical providers in low-income countries remains insufficiently described. Through a nationwide comprehensive inventory of surgical procedures and providers in Sierra Leone, we aimed to present the geographic distribution, medical training, and productivity of surgical providers in a low-income country.

Methods: Following exhaustive sampling, a total of 60 facilities performing surgery in Sierra Leone 2012 was identified.

Rectal bleeding and endoscopy need in Sierra Leone: results of a nationwide, community-based survey.

Background: Low-income and middle-income countries (LMICs) face a large burden of gastrointestinal diseases that benefit from prompt endoscopic diagnosis and treatment. This study aimed to estimate the prevalence of gross rectal bleeding among adults in Sierra Leone.

Methods: A cluster randomised, cross-sectional household survey using the SOSAS tool was undertaken in Sierra Leone.

Demographics of patients affected by surgical disease in rural hospitals in two sub-Saharan African countries: a retrospective analysis.

Background: Awareness is growing of both the importance of surgical disease as a major cause of death and disability in low-income and middle-income countries (LMICs) and the cost-effectiveness of fairly simple surgical interventions. We hypothesised that surgical disease predominantly affects young adults and is therefore significant in both the macroeconomic effect of untreated disease and the microeconomic effects on patients and families in low-resource settings.

Methods: We retrospectively reviewed all admission data from two rural government district hospitals, Bo District Hospital in Sierra Leone and Thyolo District Hospital in Malawi.

Rates of caesarean section and total volume of surgery in Sierra Leone: a retrospective survey.

Background: Surgical services are essential components of health-care systems. Monitoring of surgical activity is important, but resource demanding. Simpler tools to estimate surgical volume, particularly in low-income countries, are needed.

Surgical care needs of low-resource populations: an estimate of the prevalence of surgically treatable conditions and avoidable deaths in 48 countries.

Background: Surgical care needs in low-resource countries are increasingly recognised as an important aspect of global health, yet data for the size of the problem are insufficient. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a population-based cluster survey previously used in Nepal, Rwanda, and Sierra Leone.

Methods: Using previously published SOSAS data from three resource-poor countries (Nepal, Rwanda, and Sierra Leone), a weighted average of overall prevalence of surgically treatable conditions was estimated and the number of deaths that could have been avoided by providing access to surgical care was calculated for the broader community of low-resource countries.

Clinical features of patients isolated for suspected Ebola virus disease at Connaught Hospital, Freetown, Sierra Leone: a retrospective cohort study.

Background: The size of the west African Ebola virus disease outbreak led to the urgent establishment of Ebola holding unit facilities for isolation and diagnostic testing of patients with suspected Ebola virus disease. Following the onset of the outbreak in Sierra Leone, patients presenting to Connaught Hospital in Freetown were screened for suspected Ebola virus disease on arrival and, if necessary, were admitted to the on-site Ebola holding unit. Since demand for beds in this unit greatly exceeded capacity, we aimed to improve the selection of patients with suspected Ebola virus disease for admission by identifying presenting clinical characteristics that were predictive of a confirmed diagnosis.

Towards host-directed therapies for tuberculosis.

The treatment of tuberculosis is based on combinations of drugs that directly target Mycobacterium tuberculosis. A new global initiative is now focusing on a complementary approach of developing adjunct host-directed therapies.

Engaging staff to improve quality and safety in an austere medical environment: a case-control study in two Sierra Leonean hospitals.

Quality Problem Or Issue: Inadequate observance of basic processes in patient care such as patient monitoring and documentation practices are potential impediments to the timely diagnoses and management of patients. These gaps exist in low resource settings such as Sierra Leone and can be attributed to a myriad of factors such as workforce and technology deficiencies.

Initial Assessment: In the study site, only 12.

Met and unmet needs for surgery in Sierra Leone: A comprehensive, retrospective, countrywide survey from all health care facilities performing operations in 2012.

Background: Understanding a country's baseline operative actors and capacity is critical to improving the quality of services and outcomes. The aim of this study was to describe all operative providers and national operative production, to evaluate district and nationwide population rates for operations, and to estimate unmet operative need in Sierra Leone.

Methods: A nationwide, exhaustive, retrospective, facility-based study of operative actors and surgical procedures was performed in Sierra Leone.

An assessment of surgical and anesthesia staff at 10 government hospitals in Sierra Leone.

Importance: Strengthening workforce capacity to deliver essential surgical and anesthesia care has been identified as a strategy for addressing the unmet burden of morbidity and mortality in under-resourced countries. Sierra Leone is one of the poorest countries in the world and faces the challenge of stretching limited resources to provide appropriate health care for a population of 6 million.

Objectives: To investigate the training of surgical and anesthesia staff in Sierra Leone and to build an evidence base for future health care policy and training programs tailored to local needs.

Prevalence of thoracic surgical care need in a developing country: results of a cluster-randomized, cross-sectional nationwide survey.

Background: Developing countries without established surgical capacity face heightened morbidity and mortality from poorly understood, untreated thoracic surgical impairments. This study sought to estimate the prevalence of thoracic surgical need in a low-income country and consider contributing factors involved.

Methods: Cluster-randomized, cross-sectional nationwide survey using the Surgeons OverSeas Assessment of Surgical Need tool in Sierra Leone from January 9-February 3, 2012.