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Sierra Leone continues to struggle for relief from Lassa fever

This short article in The Lancet describes the issues faced by the medical relief charity MERLIN, which provides Lassa fever services in Sierra Leone, during and after the civil war. 

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Lassa fever in post-conflict Sierra Leone

This resource presents observations of case fatality rates of Lassa fever in Sierra Leone after the civil war and compared to studies completed prior to the conflict. Peak presentation of Lassa fever cases occurs in the dry season, which is consistent with previous studies. This paper's studies also confirmed reports conducted prior to the civil war that indicate that infants, children, young adults, and pregnant women are disproportionately impacted by Lassa fever.

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Evidence that rodent control strategies ought to be improved to enhance food security and reduce the risk of rodent-borne illnesses within subsistence farming villages in the plague/endemic West Nile region, Uganda

This resource presents a survey of 37 households from 17 subsistence farming villages within the West Nile region of Uganda. This revealed that rodents cause both pre- and post-harvest damage to crops. Evidence of rodent access to stored foods was reported in conjunction with each of the reported storage practices, and the paper suggests that current efforts are inadequate for effectively reducing rodent abundance in homes.

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Lassa Fever: a rodent-human interaction

This resource examines the sites of interactions between humans and the multimammate mouse, Mastomys natalensis. It presents findings such as new arenaviruses in other African rodents and in snakes, that  argue preferably toward the host-switching concept. The recent emergence in Sierra Leone, the absence of virus positive Mastomys between the two endemic zones and poor virus diversity in the Mano River area also point in the direction of a unique import of Lassa virus from Nigeria to Sierra Leone during the 19th century. This resource also discusses the hypothesis of human displacements through the Atlantic slave trade and its abolition in 1807.

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Case-control study of Mastomys natalensis and humans in Lassa virus-infected households in Sierra Leone

This resource studied Lassa virus infection and antibodies in households where Lassa fever cases occurred and compared these to those in the nearest neighbour houses and "far" houses located across the village. It reports on rodent infection and human anti-body prevalence. 

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Housing equity for health equity: A rights-based approach to the control of Lassa fever in post-war Sierra Leone

This resource focuses on Lassa fever as a matter of human rights, proposing a strategy to improve housing quality, and discusses how housing equity has the potential to improve health equity and ultimately economic productivity in Sierra Leone. The paper is designed to spur discussion and action towards the provision of housing as part of efforts to prevent disease.

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Acute sensorineural deafness in Lassa fever

This resource describes a prospective audiometric evaluation of 69 hospitalized febrile patients in Sierra Leone, West Africa, that revealed a sensorineural hearing deficit (SNHD) in 14 (29%) of 49 confirmed cases of Lassa fever and in 0 of 20 febrile controls. This study found that lassa fever is associated with an incidence of SNHD, which considerably exceeds that previously reported with any other postnatally acquired infection.

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World Health Organisation: Lassa fever in Sierra Leone

This is an update on Lassa fever in Sierra Leone from the 14th June 1996. 

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At home with Mastomys and Rattus: Human-rodent interactions and potential for primary transmission of Lassa virus in domestic spaces

In this study housing characteristics and domestic organization were fund to have an impact on the direct and indirect, intentional and unintentional contact with rodents indoors. More research on housing and environmental modification, as well as food storage are important for prevention against LASV transmission.

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The process and practice of diagnosis: Innovations in diagnostics for Lassa fever in Sierra Leone

Chapter 5 of Annie Wilkinson’s PhD thesis, provides a detailed description of health seeking behaviours for Lassa Fever in rural Sierra Leone. In this context, people interpreted and managed Lassa Fever in light of their familiarity with a wide range of other diseases, some of which were viewed as dangerous and others less so; in contexts where sickness, health and treatment were marked by uncertainty; and where hospitals were not necessarily perceived to be sites of good care.  An important insight is that people differentiated ‘big sick’ or ‘hospital sick’ from an ordinary or ‘small’ sick and it was partly on the basis of this distinction that people would choose to access care.

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