Concept: Susu people
Kambia District is located in northwestern Sierra Leone along the international border with Guinea. The district is dominated by forest and swamp habitat and has a population of approximately 270,000 persons (approximately 5% of the nation’s population) who live in rural villages and predominantly subsist on farming and trading. During 2014-2015, the remoteness of the area, a highly porous border with Guinea, and strong traditional beliefs about health care and sickness led to unique challenges in controlling the Ebola Virus Disease (Ebola) outbreak within the district.
Six-year-old Fatou was exposed to Ebola at her uncle’s funeral in Forécariah, a district along Guinea’s border with Sierra Leone where about 50% of all Guinea’s Ebola cases since February 2015 have occurred.(1) Fatou’s entire family was registered as contacts to be monitored for the next 21 days, during which the disease could develop. A contact tracer began making daily visits to check their temperatures and evaluate them for symptoms. For the first few days, everything seemed fine, but on the fifth day, Fatou was found to have fever and vomiting. A response team was dispatched to bring her to . . .
This paper discusses the establishment of a clinical trial of an Ebola vaccine candidate in Kambia District, Northern Sierra Leone during the epidemic, and analyses the role of social science research in ensuring that lessons from the socio-political context, the recent experience of the Ebola outbreak, and learning from previous clinical trials were incorporated in the development of community engagement strategies. The paper aims to provide a case study of an integrated social science and communications system in the start-up phase of the clinical trial.
The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20-December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic.
The largest and most complex Ebola epidemic in history is believed to have started with the infection of a 2-year-old boy in South-eastern Guinea in late 2013. Within a year, thousands of children and their families had contracted the virus, many had died and many more were orphaned. We reflect on our experiences of volunteering at the Kerry Town Ebola Treatment Centre in Sierra Leone between January and February 2015, where we were deployed to care for just a few of these children as part of the Save The Children team.