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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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Healthcare providers on the frontlines: A qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic

This paper describes the stigma experienced by health care workers during the Ebola epidemic in Sierra Leone, and recommends psychological support mechanisms for medical staff working in epidemic contexts.

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Power, fairness and trust : understanding and engaging with vaccine trial participants and communities in the setting up the EVOVAC-Salone vaccine trial in Sierra Leone

In this article the authors discuss the implementation of an Ebola vaccine trial in Kambia district in Sierra Leone during and after the epidemic. They analyze the role of social science research for the development of community engagement strategies. The authors give special attention to the analysis of rumours as source of information and explanation about resistance rooted in a much deeper sociopolitical context.

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Improving burial practices and cemetery management during an Ebola virus disease epidemic — Sierra Leone, 2014

This piece is a summary of an assessment conducted in Sierra Leone on the acceptability of safe, nontraditional burial practices and cemetery management during the Ebola Outbreak. Both measures aimed the control of the virus transmission. Some of the findings were: scarce burial teams, miscoordination among Ebola response bodies, lack of systematic procedures for testing and reporting results on dead bodies from Laboratories, inadequate cementerie space, no acceptance of safe burial practices by communities. These finding informed a standard operating procedure (SOP) for safe, dignified medical burials.

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Stigma and the ethics of public health: Not can we but should we

This article examines the burdens which stigmatization can place on those who are already at a social disadvantage more generally across different public health interventions, and the ways in which stigmatization impacts on the human right to dignity and poses a potential threat to public health work.

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Poor housing quality increases risk of rodent infestation and Lassa fever in refugee camps of Sierra Leone

To determine risk of Lassa fever in households in Sierra Leonean refugee camps, this paper analysed the spatial relationships between households with a Lassa case and focal locations of potential rodent habitats. Quality and hygiene factors of households were assessed to determine possible risk factors for household rodent infestation and occurrence of Lassa fever.

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Participation of women and children in hunting activities in Sierra Leone and implications for control of zoonotic infections

This paper underscores the challenges of interventions, surveillance, research and sensitization campaigns. To address such complexity, intervention strategies should become more diversified and context-specific. In particular the role of children should be recognised; specific intervention strategies should be tailored to children's specific hunting practices.

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Rat-Atouille: A mixed method study to characterize rodent hunting and consumption in the context of Lassa fever

This paper investigated the consumption of rodents, including the reservoir species of Lassa fever, and found this is widespread and does not neatly tally against generational or gender lines. Further, it found that the reasons for rodent consumption are multifactorial, including taste preferences, food security, and opportunistic behaviour.

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Safe intensive-care management of a severe case of Lassa fever with simple barrier nursing techniques

This resource describes the case-management of Lassa fever in a specific patient and the difficulties encountered in repatriating her for diagnosis and management, which is unavailable in Sierra Leone, are described.The experience with this case has implications for the medical care and safe handling of Lassa fever in both endemic and nonendemic areas.

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Popular concerns about medical research projects in sub-Saharan Africa – a critical voice in debates about medical research ethics

This resource aims to move beyond the dismissal of stories about blood-stealing and trade in body parts as ‘mere’ rumour, based on erroneous belief or traditional superstition, and to instead appreciate them as modern commentaries on social relations that involve, and extend far beyond, scientific medical research.

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