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PubMed2004

Homicidal violence during foreign military missions--prevention and legal issues.

OBJECTIVES: The study involved Nigerian soldiers engaged in peacekeeping missions in Liberia and Yugoslavia. Using case illustrations, the study sought to describe patterns of homicidal violence among soldiers from the same country or soldiers from allied forces, and to suggest possible reasons for the attacks. DESIGN AND SETTING: Nigeria was actively involved in peacekeeping missions in Liberia between 1990 and 1996. During this period, intentional homicidal attacks occurred among the Nigerian military personnel. Post-homicidal interviews conducted among the perpetrators were combined with evidence obtained at military courts to produce the case studies. SUBJECTS: Six Nigerian military personnel who attacked other Nigerians or soldiers from allied forces, with homicidal intent. RESULTS: Possible predisposing and precipitating factors for these attacks were highlighted. The possibility of recognising these factors before embarking on overseas missions was discussed, so that preventive measures could be instituted as far as possible. Finally, medico-legal implications of homicide in the military were discussed. CONCLUSIONS: A certain degree of pre-combat selection is essential to exclude soldiers with definite severe psychopathology. A clearly defined length of duty in the mission areas and adequate communication with home could reduce maladjustment. Health personnel deployed to mission areas should be very conversant with mental health issues so that early recognition of psychological maladjustment is possible.

Adult↗
PubMed1990

On the reproductive activity of the female Onchocerca volvulus.

Onchocerca volvulus worms, extracted from nodules by collagenase digestion, stained with haematoxylin and cleared in glycerol, were unravelled for longitudinal examination and later embedded in brain blocks for study of serial transverse sections. A classification system for female worms is proposed, based on the reproductive status of 446 worms from Guatemala, 94 from Liberia and 125 from Mali. They were categorized into fecund, inseminated specimens; uninseminated, but potentially fertile specimens, shedding ova destined to degenerate; worms changing from the uninseminated to the inseminated state and vice versa, which were few in number; old worms, with degenerate ovaries, whose genital tracts were either empty or had disappeared; and moribund or dead worms, characterized by loss of turgor, collapse and degeneration, calcification, or invasion by polymorphic, basophilic cells. Potentially fertile worms shed oocytes continuously and, when they were inseminated, embryonic development ensured. No evidence was found of a periodic cycle of reproduction. Inseminated worms were found in nodules without a male worm, and uninseminated worms in nodules harbouring male worms. Measurements are recorded of portions of the female reproductive tract and of the length of uterus occupied by the various embryonic stages in fully fecund worms. A significant difference in the length of the body behind the first and second ovaries was observed as between worms from West African savanna (Mali) and forest (Liberia). Limited observations were also made on meiosis in the oocyte, penetration of the oocyte by sperm, formation of the ovum, syngamy and zygote formation.

Animals↗
PubMed1990

Complications of hypertension in adult urban Liberians.

A one-year prospective study of the complications of hypertension was carried out in the Medical Wards of the John F. Kennedy Hospital in Monrovia, Liberia. Of all medical admissions 15.6% (105 out of 672) were due to hypertension with its complications. Of the hypertensives, 72.4% (76 of 105) came from the lower socio-economic class. Heart disease with 55.2% (58 of 105) was the commonest complication. Next was stroke with 31.4% (33 of 105). Of the cases of heart disease, only one had suffered a myocardial infarction, the rest had congestive cardiac failure (CCF) without coronary heart disease. Severe hypertensive retinopathy was found in only four patients all of whom had severe uraemia. Hypertensive CCF constituted 41.1% (57 of 139) of all cases of CCF admitted to our hospital. All the complications and deaths were more common in males than in females and they were not uncommon in the young. Chronic renal failure, with 100% mortality, had the worst prognosis. 60.0% of the patients had not previously been diagnosed as hypertensive. There is an urgent need for health education in Liberia to inform the people of the dangers of uncontrolled hypertension and to encourage them to get their blood pressure measured periodically thus improving the early detection and initiation of antihypertensive treatment to prevent the complications of hypertension.

Adult↗
PubMed1980

The susceptibility of Liberian Culex quinquefasciatus to Wuchereria bancrofti in Sri Lanka.

Strains of Culex quinquefasciatus collected in Liberia showed low susceptibility to Wuchereria bancrofti from Liberian donors. However, when the same mosquito strains were fed on W. bancrofti donors from Sri Lanka they showed equally high susceptibility as Sri Lankan C. quinquefasciatus simultaneously fed on the same donors. A Liberian strain did not respond to selection for refractoriness. Thus the strains of W. bancrofti from Liberia and Sri Lanka differ in their ability to infect specific mosquito strains and it is concluded that Liberian C. quinquefasciatus could not provide genes for use in the construction of a refractory strain intended for the replacement of Sri Lankan vector populations.

Animals↗
PubMed1980

Electron microscope study of the cuticle of male and female Onchocerca volvulus from various geographic areas.

Male and female Onchocerca volvulus from Liberia, Upper Volta, Tanzania and Guatemala were examined by scanning and by transmission electron microscopy. In the cuticle of the female a basal, a median and a cortical layer can be differentiated. The outer limitation of the cuticle is an irregularly folded surface membrane. Excluding the anterior region the entire cuticle of the worm is covered by a coat. A regular fine honey-comb structure of the surface is found in the anterior region of the female. The morphology of the mouth, the amphidial openings, the papillae and the vulva, as well as the anus and the phasmidial openings, are presented. The cuticle of the male is also composed of a basal, a median and a cortical layer. The surface membrane shows a regular honey-comb pattern, which covers the entire worm with the exception of the anterior and posterior ends, but no coat was found. The cephalic region looks like that of the female. Papillae are arranged around the anus and the caudal tip. The variability of these papillae regarding their number and distribution is presented. The type of the two spicules and of the canal of the longer one is illustrated. The comparison of the worms from Liberia, Upper Volta, Tanzania and Guatemala revealed no morphological differences. Groups of males were examined statistically for differences of the distribution of the posterior papillae, but no geographical differences could be proven.

Animals↗
PubMed1981

[The torus palatinus].

The existing investigations about the Torus palatinus are not comparable. The tori are not described in all morphological details and very often without quantitative registrations. The present paper tries to show an economic way of quantifying and describing the Torus palatinus. Skulls from Griesheim (Kreis Darmstadt-Dieburg, Western Germany; "Fränkisches Gräberfeld"), Langd (Kreis Giessen, West Germany; "Alter Friedhof"), India and Pakistan, as well as crania of a population of chimpanzees from Eastern Liberia have been investigated. In the series from Griesheim and Langd the Torus palatinus was found in 32.7% and 34.5% respectively, in the examined crania from India and Pakistan the torus appears only in 3.7% of the individuals. The skulls of the chimpanzees from Eastern Liberia show the Torus palatinus much more frequently than it has been observed until now (in 17% of the crania).

Animals↗
PubMedDate not supplied

[Prevalence of tuberculosis among the immigrant population in Ceuta, Spain].

BACKGROUND: The immigrant populations from sub-Saharan and Maghreb countries are groups in high risk of contracting tuberculosis. An analysis is made of the prevalence of tuberculosis infection among one group of these immigrants in Ceuta for the purpose of finding possible differences in their incidental behavior according to the country or geographical region from which they came. METHODS: A descriptive cross-sectional study of a sample of 2,223 immigrants (1979 males and 244 females) from different African countries (mainly Nigeria, Mali, Guinea-Bissau, Cameroon, Ghana, Sierra Leona, Democratic Republic of Congo and Liberia) at the Calamocarro refugee camp in Ceuta. A Mantoux intradermic reaction test was performed following the previously-established protocol, the data for three cut-off points being presented. RESULTS: The immigrants came from 36 African countries, 89.0% being males and 11.0% females (p < 0.001), respectively averaging in age from 24.9 +/- 4.3 to 23.4 +/- 4.1. A reaction to the Mantoux text of 10 mm or more was found in 32.6%, that is 33.2% among males and 27.9% among females (p = 0.09). Solely 1.1% showing 5-10 mm hardening of probable vaccination-related cause. By geographical regions, the highest rates were found among immigrants from the Democratic Republic of Congo (65.1%) and Cameroon (48.4%), followed far behind by Nigeria (34.0%), Liberia (32.7%), Mauritania (29.1%), Sierra Leona (28.8%), Ivory Coast (27.8%), Guinea-Bissau (27.4%), Ghana (26.3%), Algeria (25.6%), Mali (24.1%) and the Republic of Guinea (20.9%) (p < 0.0001). CONCLUSIONS: The immigrant population from central African countries shows a higher prevalence of tuberculosis infection, comprising a group at risk of contracting this disease. Therefore, it is of fundamental importance to implement specific programs to actively detect tuberculosis infection during their stay in our city, taking advantage of their being grouped together upon entry into our country, prior to their final emigration to localities throughout the mainland and subsequent mixing among the host country population.

Adolescent↗
PubMed2006

[Detection of anti-Lassa antibodies in the Western Forest area of the Ivory Coast].

Lassa fever is an African viral hemorrhagic fever (VHF) known to be endemic in a number of West African countries including Nigeria, Sierra Leone, Liberia and Guinea. Despite having common borders with Liberia and Guinea, Côte d'Ivoire has never reported any cases of Lassa fever. In March 2000, as part of a research project on VHF--mainly yellow fever, Lassa fever and Ebola fever--in Guinea and Cote d'Ivoire, an exploratory survey was conducted to assess knowledge about VHF and immunological status against Lassa virus among forest workers in the Duekoue and Guiglo regions. One hundred and sixty-three male forest workers were interviewed using a questionnaire designed to assess risk factors for VHF exposure and personal medical history over the last 12 months. Detection of IgG antibodies against Lassa virus was performed by immunofluorescence assay with Lassa virus antigens from the Josiah and Las/AV strains. The overall prevalence of IgG antibodies was 26% (42/161). Among the Lassa IgG positive subjects, 38.5% were loggers including 20% that were positive at a serum dilution of 1/40 and 46.7% were national park workers or forest rangers including 69% that were positive at a dilution of 1/40 and more. Forty-one percent of subjects had heard of VHF including 14% who attributed it to animals and 2% who attributed it to plants. Contact with rodents was frequent and more than 50% of subjects had either eaten or skinned rodents. Although the prevalence of anti-Lassa IgG antibodies seemed high in the study population, no conclusion can be about level of exposure to Lassa virus.

Adult↗
PubMed1982

The fine structure of adult Onchocerca volvulus. I. The cuticle, the hypodermis and the muscle cell of the male worm.

The fine structure of the cuticle, the hypodermis and the muscle cells of five male worms from Liberia and of two male worms, at least five years old, from Upper Volta is described. The cuticle in the lateral regions is thicker and consists of more layers than in the dorsal and ventral regions. The innermost zone of the hypodermis contains a wide labyrinth of extracellular clefts. The muscle cells are of the shallow coelomyarian type. Bacteria were found in the hypodermis of worms from Liberia and Upper Volta. The hypodermis and the muscle cells contained various other inclusions and particles. Some of them were formed by aggregations of regularly arranged membranes and lamellae. Although all the worms had been alive at the moment of fixation, severe degenerative alterations of the hypodermis and the muscle cells could be observed. Only the cuticular morphology was more or less constant in all seven worms.

Animals↗
PubMed1987

Establishment of Parliamentary Council on Population and Development, June 1987.

The Government of Liberia has established a Parliamentary Council on Population and Development which is to have the following duties: a) to work to enact a national population policy; b) to mobilize effective financial support for population policy and programs; c) to encourage evaluation and implementation of policies to promote population and family and sex education in and out of school; d) to improve child health and survival; and e) to spearhead population awareness campaigns. The Council is also to "initiate legislation in support of policies that will help improve the status of women by ensuring the provision of increased education strategies, equal opportunities in employment and education, family planning, including natural family planning, elimination of cultural practices and beliefs which discriminate against women, and birth spacing that will enable spouses or couples to have the pregnancies they want and when they want them, confident that they can adequately take care of their offspring and enrich their quality of life from infancy to maturity, as well as ensuring health of mothers."

Africa↗
PubMed1995

Interval censored survival data and multistate compartmental models in the analysis of first appearance of Plasmodium falciparum parasites in infants.

A statistical model for interval censored data is described. Assuming a piecewise constant incidence enables us to analyse very unbalanced data in a generalized linear model. The distribution of age at first appearance of P. falciparum parasites in infants in Liberia has been estimated. A new graphical method for presentation of test results on all children was developed. In an illness--death model it is described how the proportion of undetected and detected malaria parasitemias depends on parasite rates and testing frequency. The incidence of detectable malaria parasitemia was 0.14 per month in infants under 4 months of age, and 0.60 per month in children over 4 months (p < 0.001). The congenital resistance to malaria in African infants living in a highly endemic area had largely disappeared by the age of 4 months; before this age children were partly protected.

Age Distribution↗
PubMed1990

Safety of and compliance with community-based ivermectin therapy.

In a study of the safety, acceptability, and efficacy of ivermectin for community-based mass treatment of onchocerciasis, the drug was issued twice, one year apart, to the population of a rubber plantation (14,000 people) in Liberia, where over 80% of the adults have Onchocerca volvulus infection. The plantation microfilarial load in a sample of adults was reduced by 86% 6 months after initial treatment and by 78% after 1 year. Compliance was 97% with each round of treatment. After the initial treatment of 7699 people, 101 (1.3%) had moderate adverse reactions. After re-treatment only 37 (0.5%) people had moderate adverse reactions. No ivermectin-related death or severe adverse reactions occurred. The data show that community-based treatment with ivermectin is well accepted and effective in reducing microfilarial loads. Ivermectin is likely to provide the first realistic means of chemotherapy-based control of onchocerciasis on a mass scale.

Adolescent↗
PubMed1990

Pregnancy outcome after inadvertent ivermectin treatment during community-based distribution.

Ivermectin is the drug of choice for community-based treatment of onchocerciasis. Since pregnancy testing during mass distribution campaigns is not feasible, the safety of ivermectin in pregnancy must be established. During a 3-year study, ivermectin was distributed to the population of a rubber plantation (14,000 people) in Liberia. Only 31% of women were aware of their pregnancy status during the first month; it was calculated that about half of women in the first trimester of pregnancy are likely to be treated inadvertently. 203 children born to women inadvertently treated during pregnancy were identified. In this limited sample, there was no significant difference in birth defects between treated and untreated mothers in the same population or compared with a reference population. Children of treated and untreated mothers showed no difference in developmental status or disease patterns. Further surveillance is necessary; however, since no major effects of ivermectin on pregnancy outcome were detected, there seems no need to change existing strategies of ivermectin distribution.

Abnormalities, Drug-Induced↗
PubMed1985

Clean water provision in rural areas of less developed countries.

The decade of the 1980s is declared as a time to solve global domestic water supply problems. By 1990 international goals include the provision of adequate quantities of clean water to every person on earth. Such goals are justified on the basis of human health, economic well being, political development and equity and public safety. Drawing upon observations from Ethiopia, Malaysia and Liberia, cases where attempts to provide domestic water to villagers and rural town dwellers are presented. In all cited cases attempts to provide safe water have failed or are in jeopardy. Conclusions drawn from these cases include acknowledgement that global goals will best be achieved by approaching local problems one-by-one and recognizing the technical, environmental and human constraints upon safe water provision interact differently from one site to another. To properly plan, implement and maintain safe water systems the current technical solutions must be combined with the contributions of social and environmental scientists on a case-by-case basis.

Communicable Disease Control↗
PubMed1985

Malaria in Liberian children and mothers: biocultural perceptions of illness vs clinical evidence of disease.

1046 non-hospitalized children and mothers from various regions of Liberia were studied to determine the relationships between their indigenous perceptions of malaria illness with on-going Plasmodium parasitemia and annual incidence of clinical malaria. Eleven pediatric and 14 maternal signs and symptoms of malaria were described, ranked by cultural severity, and evaluated biomedically. Between cultural perceptions of the severity of illness and biomedical evidence of the severity of disease, significant rank order correlations are observed for children (rho = 0.713, P less than 0.01) and mothers (rho = 0.875, P less than 0.001). Clinical, parasitological and cultural concordance were observed for 'anorexia', 'joint pain', 'abdominal tenderness', 'nausea', 'chills', 'severe headache', 'stomach pain', and 'dizziness'. Five other symptoms however either over or underpredicted observed levels of biomedically confirmed malaria: 'fever', 'convulsions', 'vomiting', 'body weakness' and 'psychological distress'. Biomedical studies revealed a parasite rate among children of 68.6%, a mean annual incidence of pediatric clinical malaria of 3.12; and a mean annual incidence of maternal clinical malaria of 2.42. Clinical malaria demonstrated a very early onset among newborns and a shift in acute parasitemia to a chronic status around 2.3 years of age. A significant positive linear correlation (r = 0.75, P less than 0.01) was observed between parasitological and clinical measures of malaria in children. The indigenous perspectives on malaria and the biomedically predictive powers of various biocultural symptoms are discussed and evaluated as an integrative and valuable means of assessing the impact of malaria in an endemic region.

Adolescent↗
PubMed1998

Effects of a refugee-assistance programme on host population in Guinea as measured by obstetric interventions.

BACKGROUND: Since 1990, 500000 people have fled from Liberia and Sierra Leone to Guinea, west Africa, where the government allowed them to settle freely, and provided medical assistance. We assessed whether the host population gained better access to hospital care during 1988-96. METHODS: In Guéckédou prefecture, we used data on major obstetric interventions performed in the district hospital between January, 1988, and August, 1996, and estimated the expected number of births to calculate the rate of major obstetric interventions for the host population. We calculated rates for 1988-90, 1991-93, and 1994-96 for three rural areas with different numbers of refugees. FINDINGS: Rates of major obstetric interventions for the host population increased from 0.03% (95% CI 0-0.09) to 1.06% (0.74-1.38) in the area with high numbers of refugees, from 0.34% (0.22-0.45) to 0.92% (0.74-1.11) in the area with medium numbers, and from 0.07% (0-0.17) to 0.27% (0.08-0.46) in the area with low numbers. The rate ratio over time was 4.35 (2.64-7.15), 1.70 (1.40-2.07), and 1.94 (0.97-3.87) for these areas, respectively. The rates of major obstetric interventions increased significantly more in the area with high numbers of refugees than in the other two areas. INTERPRETATION: In areas with high numbers of refugees, the refugee-assistance programme improved the health system and transport infrastructure. The presence of refugees also led to economic changes and a "refugee-induced demand". The non-directive refugee policy in Guinea made such changes possible and may be a cost-effective alternative to camps.

Adult↗
PubMed1988

Morphological differences between Venezuelan and African microfilariae of Onchocerca volvulus.

Comparative morphological and biometric characteristics of microfilariae of Onchocerca gutturosa and O. volvulus from different geographical areas (Upper Orinoco, Venezuela; Togo; Liberia) were assessed. "Stepwise" discriminant analysis and Mahalanobis estimators were applied to measure distance between populations. The results indicate a strong similarity between the two strains from the Upper Orinoco (Venezuela) and the Togo strain, as well as a clear separation between these strains and that of O. gutturosa. The Liberian strain was easily distinguishable from microfilariae from Togo and Venezuela. Discriminant analysis showed the Liberian deme to be as different from the Venezuelan and Togo demes as these demes were from microfilariae of the reference species, O. gutturosa. Although it is necessary to confirm these data using formalin-fixed specimens obtained from the skin, the present findings suggest the existence of geographically-different strains of O. volvulus in America and Africa.

Animals↗