Long-term maternal outcomes 5 years after cesarean section in Sierra Leone: A prospective cohort study.

Cesarean section (CS) is a life-saving procedure when performed for the right indication but carries substantial risks, specifically during subsequent pregnancies. The aim of this study was to evaluate obstetric outcomes for women 5 years after a CS performed by medical doctors and associate clinicians. This was a prospective multi-center observational study of women who had a CS at any of nine hospitals in Sierra Leone.

So, what's best? Accuracy and acceptance of thermometers in triage and inpatients in a low-resource tropical setting - The MaTe study.

Objectives: We searched for the most-suitable thermometry method in the low-resource, tropical setting of Sierra Leone, both in terms of accuracy and also patient and user acceptance.

Methods: We conducted a prospective comparative study of different methods of body temperature measurement. Each participant had their temperature taken by four different methods: non-contact infrared temperature (NCIT), axillary, tympanic membrane and rectal measurements.

Technical Perspective for Video Based Assessment of Surgeries in Low-Resource Settings.

Objective: Scalable digital learning environments are essential to sustain surgical training programs worldwide. Detailed images of surgeries enriched with educational annotations are vital to train the eyes of the learners. Here, we report a low-cost method, deployed in a low-resource setting in West Africa, which may contribute to the growth of use in open-sourced digital surgical resources world-wide.

Vacuum births and barriers to its use: An observational study in governmental hospitals in Sierra Leone.

Objectives: Assisted vaginal births (AVD) can prevent unnecessary caesarean sections (CS). The number of CS is increasing rapidly in sub-Saharan Africa; these are still associated with high perioperative mortality rates. The aim of this study is to define the proportion of AVD in governmental hospitals in Sierra Leone and examine barriers to its use.

Inguinal hernia surgery learning curves by associate clinicians.

Background: Open inguinal hernia repair is the most commonly performed procedure in general surgery in sub-Saharan Africa, but data on its learning curve are lacking. This study evaluated the learning curve characteristics to improve surgical training and enable scaling up hernia surgery in low- and middle-income countries.

Methods: Logbook data of associate clinicians enrolled in a surgical training program in Sierra Leone were collected and their first 55 hernia surgeries following the Bassini technique (herniorrhaphies) were analyzed in cohorts of five cases.

PREvalence Study on Surgical COnditions (PRESSCO) 2020: A Population-Based Cross-Sectional Countrywide Survey on Surgical Conditions in Post-Ebola Outbreak Sierra Leone.

Background: Understanding the burden of diseases requiring surgical care at national levels is essential to advance universal health coverage. The PREvalence Study on Surgical COnditions (PRESSCO) 2020 is a cross-sectional household survey to estimate the prevalence of physical conditions needing surgical consultation, to investigate healthcare-seeking behavior, and to assess changes from before the West African Ebola epidemic.

Methods: This study (ISRCTN: 12353489) was built upon the Surgeons Overseas Surgical Needs Assessment (SOSAS) tool, including expansions.

Case Report: Acral Melanoma with Giant Local Recurrence in Rural Sierra Leone.

Malignant melanoma is rare in West Africa. Few cases of giant melanoma have been reported globally. We present a case of acral melanoma with giant local recurrence on the foot of a black-skinned woman from rural Sierra Leone, managed with below-knee amputation.

Complicated Odontogenic Infections at 2 District Hospitals in Tonkolili District, Sierra Leone: Protocol for a Prospective Observational Cohort Study (DELAY).

Background: Deficits in global oral health care are paramount, and complications of odontogenic infections constitute a considerable global health problem, particularly in low-income countries. A high mortality rate has been observed for patients who have been admitted with complicated odontogenic infections to our facilities in Tonkolili District, Sierra Leone, although exact data have not been published yet. Data regarding who in this region is at risk and why are lacking.

Case Report: Severe Dental Abscess Complications in Rural Sierra Leone.

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%.

People with amputations in rural Sierra Leone: the impact of 3D-printed prostheses.

We report the case of a man with a transhumeral amputation in a rural area of Sierra Leone. The patient had fractured his humerus during a football match. Due to lack of transportation and medical centres nearby, the patient was seen by a traditional healer.

Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural population in Sierra Leone - an observational cohort study.

Background: There is a huge unmet global need for affordable prostheses. Amputations often happen in Sierra Leone due to serious infections, complex wounds, traffic accidents and delayed patient presentation to the hospital. However, purchasing a prosthesis is still beyond reach for most Sierra Leonean amputees.

Tropical pyomyositis: an update.

Tropical pyomyositis (TP) is a life-threatening bacterial infection of the skeletal muscle that occurs particularly among children, young adults and those with immunocompromised conditions. The appropriate diagnosis and treatment are often delayed due to its non-specific signs, leading to fatal consequences. Staphylococcus aureus, especially methicillin-susceptible S.

Improving antimicrobial stewardship in the outpatient department of a district general hospital in Sierra Leone.

There is global concern over increasing antibiotic resistance rates due to poor antimicrobial stewardship, particularly in low-income and middle-income countries where there are limited diagnostic facilities, fewer doctors per capita and inadequate control over the production and sale of antibiotics. This quality improvement project was designed to improve the antimicrobial prescriptions practices of paramedical staff in the outpatient department of a rural district general hospital in Masanga, Sierra Leone, West Africa. At baseline, 57 of 66 (86%) of patients were prescribed at least one antimicrobial.

Caesarean section performed by medical doctors and associate clinicians in Sierra Leone.

Background: Many countries lack sufficient medical doctors to provide safe and affordable surgical and emergency obstetric care. Task-sharing with associate clinicians (ACs) has been suggested to fill this gap. The aim of this study was to assess maternal and neonatal outcomes of caesarean sections performed by ACs and doctors.

Urine pregnancy test (UPT) hCG negative molar pregnancy: a short report from Masanga/Sierra Leone.

In Masanga, Sierra Leone, a multigravid woman presented with a urine pregnancy test negative molar pregnancy. This can be explained by the 'hook-effect'. In resource-poor settings where quantitative serum hCG cannot be determined, it is of paramount importance to remain vigilant of the diagnosis of molar pregnancy.

A Modified Case Definition to Facilitate Essential Hospital Care During Ebola Outbreaks.

During the late phase of the large West-African Ebola virus disease (EVD) outbreak, the majority of patients were cared for in designated treatment centers. However, the preexisting healthcare infrastructure was already overwhelmed by the outbreak. This had a huge impact on other, non-EVD-related diseases, causing an unprecedented increase in morbidity and mortality, which most likely exceeded the toll due to EVD directly.