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PubMed2006

Trauma healing in refugee camps in Guinea: a psychosocial program for Liberian and Sierra Leonean survivors of torture and war.

From 1999 to 2005, the Minneapolis-based Center for Victims of Torture (CVT) served Liberian and Sierra Leonean survivors of torture and war living in the refugee camps of Guinea. A psychosocial program was developed with 3 main goals: (a) to provide mental health care, (b) to train local refugee counselors, and (c) to raise community awareness about war trauma and mental health. Utilizing paraprofessional counselors under the close, on-site supervision of expatriate clinicians, the treatment model blended elements of Western and indigenous healing. The core component consisted of relationship-based supportive group counseling. Clinical interventions were guided by a 3-stage model of trauma recovery (safety, mourning, reconnection), which was adapted to the realities of the refugee camp setting. Over 4,000 clients were provided with counseling, and an additional 15,000 were provided with other supportive services. Results from follow-up assessments indicated significant reductions in trauma symptoms and increases in measures of daily functioning and social support during and after participation in groups. The treatment model developed in Guinea served as the basis for CVT's ongoing work with survivors in Sierra Leone and Liberia. ((c) 2006 APA, all rights reserved).

Guinea↗
PubMed1999

Dry supplementary feeding programmes: an effective short-term strategy in food crisis situations.

Malnutrition is frequently a predominant problem in disasters, and supplementary feeding programmes (SFPs) are often set up in food emergencies. This review analyses the effectiveness of such programmes in crisis situations in Liberia, Burundi and Goma (Congo), concluding that it is feasible to enrol large numbers of children in SFPs and achieve proportions of recovery above 75% if these programmes are implemented as a short-term measure in emergency situations. However, satisfactory SFP results do not necessarily indicate improved nutritional status of the whole population.

Burundi↗
PubMed1979

A pocket of controlled malaria in a holoendemic region of West Africa.

Yekepa, a mining town in northern Liberia, has been built entirely since 1960 and now has a population of 16 000 inhabitants including 1500 expatriates. Although situated in a holoendemic region with constant human movements in and out of the town, the mining company has succeeded in controlling malaria in Yekepa. Furthermore, there is a constant threat of the vector in the close surroundings to the town. Control is maintained by regular residual insecticide sprayings with DDT, regular larviciding with fuel oil and fortnightly issue of amodiaquine chemoprophylactic to all workers. A Malariometric survey showed that the spleen and parasite rates were 11% and 13% respectively in the controlled areas and 95% and 67% respectively in surrounding regions not subjected to control measures. The dominant malaria parasite in the area was Plasmodium falciparum. No adult vectors were found in the town. In the surrounding villages the average room density of adult vectors was 3.8 and the sporozoite rate in a village very close to the town was 9.2%. The dominant vector of the area was Anopheles gambiae with A. Funestusalso being present. The annual per capita cost, including all control activities, is about 4--5 US dollars.

Amodiaquine↗
PubMed1997

Identification of larval-stage-specific antigens of Onchocerca volvulus uniquely recognized by putative immune sera from humans and vaccination sera from animal models.

Immunity to Onchocerca volvulus is indicated by the existence of putative immune individuals (PI), who do not develop patent infections or clinical symptoms after living in endemic areas for extended periods of time. To gain insight into the nature of the humoral response of PI from Liberia and Ecuador, their sera and those of infected individuals were investigated and compared using western blots. The antigen preparations used were extracts of third- and fourth-stage larvae (L3 and L4, respectively), excretory-secretory proteins (ES-L3) and extracts of third-stage larvae (L3-day2) that had been cultured for 2 days, and extracts of nodular and skin microfilariae. Whereas some antigens were commonly recognized by all individuals, many stage-specific antigens (of 68, 60, 55, 46, 43, 42, 20 and 18 kDa in L3; 100, 88, 80, 50, 48, 45, 40 and 20 kDa in L3-day2; 110, 80 and 72 kDa in ES-L3; 48, 18, 16 and 14 kDa in L4; and 115, 60, 47, 43 and 17 kDa in skin and/or nodular microfilariae) were uniquely recognized by sera from PI. Some of the unique antigens were also recognized by sera from mice and a chimpanzee that were resistant to challenge after immunization with irradiated third-stage larvae. The results support the validity of the assumption that a unique status of immunity develops in certain individuals living in areas where onchocerciasis is endemic.

Animals↗
PubMedDate not supplied

The rehabilitation of child soldiers: defining needs and appropriate responses.

There is growing international concern that large numbers of children are being recruited to military forces in situations of conflict around the globe, despite the fact that there are principles established in international law specifically directed against the use of children as soldiers. It has been assumed that military experience will have negative psychological effects on children, and several projects aimed at the rehabilitation of such children have been developed. We have had opportunities to examine the situation of child soldiers in Uganda, Liberia and Sierra Leone. In this article we draw attention to some of the conceptual and practical problems involved in this rehabilitative work.

Adolescent↗
PubMed1991

Community-based treatment of onchocerciasis with ivermectin: safety, efficacy, and acceptability of yearly treatment.

The safety, acceptability, and efficacy of ivermectin during community-based mass treatment of onchocerciasis was assessed. Ivermectin was distributed three times, 1 year apart, to the population of a rubber plantation (14,000 people) in Liberia where greater than 80% of adults have Onchocerca volvulus infection. In a sample of adults, the microfilarial density was reduced by 84% after 2 years of treatment. Acceptance was as high as 98% during the third year. Adverse reactions occurred in 6-13 in 1000 people after first treatment and in only 3-4 in 1000 receiving their second or third annual dose of ivermectin; severe adverse reactions were not seen. These data show that community-based treatment with ivermectin is safe, well accepted, and effective in reducing microfilarial loads and suggest that ivermectin is the first practical drug suitable for mass treatment campaigns to control human onchocerciasis.

Adolescent↗
PubMed1994

Prevalence of hypertension in rural west Africa.

The prevalence of hypertension in rural African communities has been reported previously to be relatively low, with prevalence rates ranging between 2.5% and 10.9%. The authors obtained blood pressure recordings in 3,588 adult residents (age > 20 years) of the Liberian Agricultural Company rubber plantation, located in rural Liberia, West Africa. Blood pressures were obtained using automated digital blood pressure machines in a house-to-house survey. Individuals with a systolic blood pressure greater than 139 mm Hg or a diastolic blood pressure greater than 89 mm Hg were referred to a central site, where three subsequent blood pressure determinations were made, the mean of which was used to determine whether people were hypertensive. The overall prevalence of hypertension (blood pressure > 139/89 mm Hg) was 12.5%. Hypertension was most common in the older women (prevalence 5.7% in women age 20-24 years old, 50% in women older than 55). Using more stringent criteria for hypertension, systolic blood pressure greater than 159 mm Hg or diastolic blood pressure greater than 94 mm Hg, 20% of women between 50-54 had hypertension and 26% of the women older than 55 had hypertension. In some ethnic groups, the prevalence of hypertension was as high as 25%. Based on these results, the prevalence of hypertension in some rural African communities may be higher than reported previously, particularly in older women and among certain ethnic groups, possibly suggesting a strong hereditary component.

Adult↗
PubMed2002

Volunteer experience overseas.

Volunteer experience gained in separate 1-month rotations in three African countries is outlined. Each rotation was unique yet each shared much in common. The latter two rotations were sponsored by Orthopaedics Overseas and as such were more structured than the Liberia experience. Various patients were seen including those with congenital, tumor, traumatic, and developmental conditions. The opportunity to have a cultural exchange at the patient and peer level and to provide a needed service made volunteering a professionally rewarding experience.

Developing Countries↗
PubMed2004

Humanitarian action and military intervention: temptations and possibilities.

Although the war in Liberia in July 2003 claimed hundreds of lives, the international community was reluctant to intervene. In this article, the author debates the question: does international military intervention equal protection of populations? The role of humanitarian organisations in military intervention is considered. Aid organisations cannot call for deployment of a protection force without renouncing their autonomy or appealing to references outside their own practices. Such organisations provide victims with vital assistance and contribute to ensuring that their fate becomes a stake in political debate by exposing the violence that engulfs them, without substituting their own voices for those of the victims. The political content of humanitarian action is also outlined and military intervention in the context of genocide is discussed. The author concludes that the latter is one of the rare situations in which humanitarian actors can consider calling for an armed intervention without renouncing their own logic.

Altruism↗
PubMed1987

Tsetse ecology in a Liberian rain-forest focus of Gambian sleeping sickness.

Investigations on tsetse ecology were undertaken in Bong County of Liberia during the dry season, October 1981 to February 1982, around villages where the human infection rate with Trypanosoma brucei gambiense Dutton was about 2%. Most tsetse captured in biconical traps were Glossina palpalis Robineau-Desvoidy and G. pallicera Bigot, with relatively few G. fusca Walker and G. nigrofusca Newstead. Swamps and water-gathering places were predominant habitats of all four species, but tsetse were also found in coffee and cocoa plantations. Breeding-places of G. palpalis were found in the leaf axils of oilpalm trees (Elaeis guineensis Jacquin), especially beside paths where people would risk being bitten. Bloodmeals of twenty-nine wild-caught G. palpalis were identified as mostly from man (fifteen) and bushbuck (Tragelaphus scriptus (Pallas] or other wild ruminants (eleven), plus three from reptiles. It is concluded that man may be the principal host of tsetse in the area, while man or bushbuck could be the main reservoir to T.b. gambiense infection. Most of the activity of G. palpalis occurs in the early afternoon from noon to 16.00 hours. Mean life-span of G. palpalis and G. pallicera, estimated from wing-fray age-groups, was consistent with the females, and to a lesser degree the males, having vector potential.

Animals↗
PubMed1988

The tropical African latrine blowfly, Chrysomya putoria (Wiedemann).

The status of the tropical African latrine blowfly Chrysomya putoria (Wiedemann, 1830) is recognized as distinct from the sub-tropical African blowfly C.chloropyga (Wiedemann, 1818) (Diptera: Calliphoridae). The biology of C.putoria in laboratory culture is described briefly with emphasis on the differences in development found in three strains of this species from Tanzania, Liberia and Brazil. All three strains were reproductively compatible and there was no evidence of F1 hybrid sterility or hybrid breakdown in subsequent generations. Larval development was significantly faster in the Brazilian strain than in the strain from Tanzania. Sexual maturity was significantly faster in adults of the Liberian and Brazilian strains compared to that found in the strain from Tanzania. This latter strain was affected by the source of protein available as adult food. These differences between strains did not appear to be due to selection in laboratory culture, but rather evidence of the evolution of physiological divergence within a species occupying different geographical regions.

Animals↗
PubMed1995

Antigenicity and immunogenicity of recombinant glutamate-rich protein of Plasmodium falciparum expressed in Escherichia coli.

A recombinant Plasmodium falciparum glutamate-rich protein (GLURP) was produced in Escherichia coli as a nearly full-length protein. In order to map immunodominant regions on GLURP, the nonrepetitive amino-terminal region (R0) as well as the central repeat region (R1) and the carboxy-terminal repeat region (R2) were also produced as separate products. All four purified gene products reacted specifically with serum samples from adults living in an area of Liberia where malaria is holoendemic. It appears that the human immune response against GLURP is primarily directed against the R2 region because 94% of the serum samples reacted with this region in an immunoassay. Antibody reactivity against the R0 region was also observed in 75% of the serum samples, while the R1 region showed only weak antibody-binding activity. When the nearly full-length GLURP molecule was adsorbed to Al(OH)3 it was found to be immunogenic in mice. In these experiments, the antibody response was almost exclusively directed against the R2 region. When anti-GLURP sera were obtained from rabbits immunized with the three regions, R0, R1, and R2, respectively, they recognized in immunoprecipitation experiments authentic GLURP from P. falciparum grown in vitro. These results demonstrate that GLURP produced in E. coli can induce a humoral immune response against GLURP derived from blood-stage parasites.

Amino Acid Sequence↗
PubMed1981

Epidemiology of hepatitis B infection in Liberian infants.

To provide background for a hepatitis B vaccine efficacy trial, sera were collected from 0- to 4-year-old Liberian infants and their mothers, on two occasions an average of 14.75 months apart, and tested for serological markers of hepatitis B virus infection. The prevalence of the hepatitis B surface antigen (HBsAg) was 2.9% in the 0- to 6-month age group and 23% in infants 3 to 4 years of age. HBsAg persisted for the 14.75-month average follow-up period in 80.8% of the infants tested. The annual incidence of development of HBsAg was 18.9% for infants less than 1 year of age and 13.6% in infants 3 to 4 years of age. Infants born to HBsAg carrier mothers had significantly higher age-specific prevalence and incidence of hepatitis B virus infection. However, it was estimated that only a minor proportion of hepatitis B infections in Liberia are derived by vertical transmission from carrier mothers.

Adolescent↗
PubMed1986

Cryptosporidium spp., a frequent cause of diarrhea in Liberian children.

This report presents results from a sample survey designed to investigate the possible role of Cryptosporidium spp. in childhood diarrhea in a developing country, Liberia, West Africa. During the four months of January to April 1983, a house-to-house study was carried out in two geographically and socially different communities--an urban slum and three rural villages. Stool samples from 374 children, aged 6 to 59 months, were tested for Cryptosporidium spp. Among the children with diarrhea 8.4% were Cryptosporidium spp. positive compared with a prevalence rate of 5.9% in asymptomatic children. Of the children living in a household with a Cryptosporidium spp.-positive index child, 8.6% had a positive stool sample. Of all children attending a clinic because of diarrhea, 14.6% were Cryptosporidium spp. positive. Cryptosporidiosis was more frequent in younger children; 24 of the total of 29 positive cases (83%) were below 2.5 years old. Actual or previous bottle feeding (formula) was a risk factor, particularly in children below 18 months old. Of the bottle-fed children, 28% were Cryptosporidium spp. positive versus 9.1% of children never bottle fed. Crowding is another possible risk factor. The prevalence of cryptosporidiosis was 13.5% in big urban households with more than 10 children, whereas the prevalence in the small urban households was 6.1%. Ethnic and religious differences were particularly evident in the rural area. No Muslim households had cryptosporidiosis, whereas the prevalence in non-Muslim tribes was 9%. The general belief that cryptosporidiosis is primarily a zoonosis is questioned in this study, partly because many carriers and asymptomatic household contacts were found.

Age Factors↗
PubMed1998

Detection of Lassa virus antinucleoprotein immunoglobulin G (IgG) and IgM antibodies by a simple recombinant immunoblot assay for field use.

The nucleoprotein of Lassa virus, strain Josiah, was expressed in Escherichia coli as an N-terminally truncated, histidine-tagged recombinant protein. Following affinity purification the protein was completely denatured and spotted onto nitrocellulose membrane. A total of 1 microgram of protein was applied for detection of Lassa virus antibodies (LVA) in a simple immunoblot assay. Specific anti-Lassa immunoglobulin M (IgM) antibodies could be detected by increasing the amount of protein to 5 microgram. A panel of 913 serum specimens from regions in which Lassa virus was endemic and from regions in which Lassa virus was not endemic was used for evaluating the sensitivity and specificity of the LVA immunoblot in comparison to those of an indirect immunofluorescence (IIF) assay. The sera originated from field studies conducted in the Republic of Guinea (570 serum samples) and Liberia (99 serum samples), from inpatients of the clinical department of the Bernhard-Nocht-Institute, Hamburg, Germany (94 serum samples), and from healthy German blood donors (150 serum samples). In comparison to the IIF assay the LVA immunoblot assay had a specificity of 90.0 to 99.3%, depending on the origin of the specimens. The sensitivity was found to be highest for the Guinean samples (90.7%) and was lower for the Liberian samples (75%). Acute Lassa fever was diagnosed by PCR in 12 of 59 (20.3%) patients with fever of unknown origin (FUO) from the Republic of Guinea. On admission to the hospital, nine Lassa fever patients (75%) were reactive by the IgM immunoblot assay. One of the patients was infected with a new Lassa variant, which showed 10.4% variation on the amino acid level in comparison to the prototype strain of Lassa virus, Josiah. Seven PCR-negative patients were reactive by immunoblotting. The positive and negative predictive values of a single IgM immunoblot result for acute, PCR-confirmed Lassa fever were therefore 53.6 and 93.0%, respectively. Because of its high negative predictive value, a single IgM immunoblot result will be valuable for excluding acute Lassa fever for cases of FUO in areas where Lassa fever is endemic.

Amino Acid Sequence↗
PubMed1991

Ocular manifestations of onchocerciasis in a rain forest area of west Africa.

The epidemiology and natural history of onchocerciasis and its ocular complications in rain forest areas are poorly understood. The present study was conducted on a rubber plantation in a hyperendemic area in the rain forest of Liberia, West Africa, where 800 persons were examined. The prevalence of infection was 84% overall 29% had intraocular microfilariae, and 2.4% were blind in one or both eyes. Onchocerciasis was the cause of all binocular blindness and one-third of all visual impairment. Over half of the visual impairment caused by onchocerciasis was due to posterior segment diseases. Chorioretinal changes were present in 75% of people, and included intraretinal pigment clumping in 52% and retinal pigment epithelium atrophy in 32%. Atrophy of the retinal pigment epithelium was associated with increasing age and severity of infection. Intraretinal pigment was strongly associated with anterior uveitis. There was a strong correlation between uveitis and the inflammatory chorioretinal sequelae: retinitis, intraretinal pigment, subretinal fibrosis, and optic neuropathy. These findings indicate that considerable visual impairment associated with rain forest onchocerciasis is common and is due largely to chorioretinal disease.

Adolescent↗
PubMed1979

Immunologic response in onchocerciasis: relations to microfilaria density in the skin biopsy and to some frequent symptoms.

During physical and immunologic investigations on onchocerciasis in 1,298 persons in the Republic of Liberia, the following results were obtained. There is a significant correlation between immune response and Onchocerca volvulus infection detected by a microfilaria-positive skin biopsy. On the other hand, the immune response is not influenced by the number of parasites in the skin, and there is no correlation of the immune response with Onchocerca nodules and with pruritus. There is a high proportion of serologically false-positive and false-negative results, and thus a diagnosis cannot be made simply by establishing evidence for antibodies in one person.

Adolescent↗
PubMed1983

Successful treatment with praziquantel of six patients infected with the African lung fluke, Paragonimus uterobilateralis.

Six cases of human paragonimiasis (Paragonimus uterobilateralis) are documented from Liberia and Guinea. These are the first cases reported from these countries. Paragonimiasis should be considered in the differential diagnosis of any West African patient who presents with hemoptysis. Praziquantel was used successfully to treat these patients, and may be the drug of choice for P. uterobilateralis infections.

Adolescent↗