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PubMed1987

Pediatric Lassa fever: a review of 33 Liberian cases.

Thirty-three cases of pediatric Lassa fever were identified at Curran Lutheran Hospital and Phebe Hospital in Liberia between January 1980 and March 1984. All 18 fetal cases died and the case-fatality rate for 15 childhood cases was 27%. We identified four clinical presentations according to age, including a case of congenital Lassa fever, a condition not reported previously. Two cases of Lassa fever were found serologically during a one-month survey of all pediatric admissions at Curran Lutheran Hospital, 2.4% of those children who had serum pairs collected. We also identified a "swollen baby syndrome" consisting of widespread edema, abdominal distention, and bleeding. This distinctive clinical presentation of Lassa fever ended in death in three of four cases and was present in three of the four childhood deaths in this series. Its absence seems to be a good prognostic indicator in children.

Adult↗
PubMed1976

[Treatment of schistosomiasis haematobium with metritionate in OPD-patients (author's transl)].

40 patients--5 to 50 years of age--voiding eggs of Schistosoma haematobium in their urine--underwent treatment with Metrifonate at the OPD of Bong Mine Hospital, Liberia. The patients received 10 mg/kg body weight 3 times at a fortnight's interval. The drug was swallowed under medical supervision. 27 patients no longer passed eggs after the 1. dose of Metrifonate, 37 no longer voided eggs after the 2. administration. 1 patient did not show up for control after the 3. dose. Theoretically he may not be healed. 1 other patient who came for control after 12 months had been exposed to reinfection and again voided eggs in her urine. She had been negative after the 2. treatment. Reinfection may have happened. Patients could be controlled over a period of 6-14 months. Thus, Metrifonate seems to be an effective drug in the treatment of urinary schistosomiasis. Side-effects (nausea, abdominal pains, and--very rare--vomiting) were mild and disappeared spontaneously within less than 24 hours after medication. Patients did not have to interrupt school, daily activities, and treatment. Statistically, Metrifonate did not show any influence on transaminase SGOT, SGPT, and LDH during and after the course of treatment. The same evaluation applies to eosinophilia. There is no increase or decrease of this particular type of cell during and after treatment 7 patients showed alterations of their ECG curves. There were changes of the T-wave in V1-4. In adults traces were normal again several months after completion of treatment. It seems to be difficult to interpret ECGs in West African youngsters. X-ray photos of the lungs never revealed any pathological findings which could be connected to the course of treatment. Metrifonate seems to be a valuable drug in treatment of Schistosoma haematobium-infection. The drug is well tolerated if the treatment scheme--mentioned above--is used.

Administration, Oral↗
PubMedDate not supplied

Population needs identified for assistance in some ECA member states.

The U.N. Fund for Population Activities (UNPFA) has conducted Needs Assessment Missions in many developing countries as a means of identifying population and related areas in which individual countries would need assistance to achieve self-reliance in formulating and implementing population policies and programs. This exercise is still going on in some of the countries. In ECA member States these needs missions have been conducted in the following countries: Burundi, Cameroon, Comoros, Ethiopia, the Gambia, Guinea, Ivory Coast, Liberia, Madagascar, Malawi, Mauritania, Morocco, Niger, Rwanda, Sierra Leone, Senegal, Somalia, Sudan, Swaziland, Tanzania, Zambia, and Zimbabwe. The areas identified for assistance vary from country to country, however, in some cases the needs are similar. Data collection and analysis is still 1 of population needs for which many countries require assistance. This includes conducting of national population censuses and demographic surveys and establishing or improving the civil registration systems on vital events. Training of nationals in data collection and analysis is another area in which ECA member States need assistance. It was identified that there is lack of integration of population variables in socioeconomic development planning. The various missions recommended assistance to help ECA member States to integrate population variables in development planning. Creation of Population units in ministries of planning and/or other departments was recommended as a means to help this integration. The various missions also identified the need to create or to enhance the awareness of the interrelationship between population and sociodevelopment and their implications. To this end the missions on needs assessment recommended assistance in population information and communication activities, including the introduction of population education in formal and nonformal education, conducting of seminars and workshops on population and development etc. To help formulation of population policies, the establishment of National Population Commissions at the highest level was recommended. Such commissions would examine population issues in detail and formulate suggestions for policy decisions and measures. Other common population related areas which require greater assistance include health programs of maternal and child health care, health education activities, and family planning activities. Last but not least is the need to improve the role and status of women in Africa so that they can be integrated to take a more active part in the various economic and social activities in national development.

Burundi↗
PubMed1976

The hydro-chemical and physical conditions of the environment of the immature stages of some species of the simulium (Edwardsellum) damnosum complex (Diptera).

Water samples were collected from breeding sites of species of the Simulium (Edwardsellum) damnoslm complex in Upper Volta, Liberia and Cameroon during the dry season; and in Tanzania and Kenya at various seasons during a period of two years. The following 20 factors were analysed at 45 breeding sites: water temperature, current velocity, pH value, conductivity free carbon dioxide, oxygen content, calcium, magnesium, potassium, sodium, alkalinity, chloride, sulphate, nitrite, nitrate, ammonium, phosphate, silicate, total iron and organic substance (consumption of potassium permanganate). A number of notable differences in the chemical composition of the water of the breeding sites of 13 S. damnosum complex species were found, particularly with regard to the pH and conductivity. On the basis of these differences the various species can be divided into three main groups: Group I: 3 species (S. sanctipauli, S. yahense, "Menge"); breeding in sites with pH values always below 7 and conductivity values below 50 mumhos. Group II: 8 species (S. sirbanum, S. sudanense, S. damnosum s.s., S. squamosum, "Sanje", "Nkusi", "Nyamagasani", "Jovi"); breeding in watercourses with neutral, weakly acid or weakly alkaline reactions and conductivity values ranging from 50 to 150 mumhos. Group III: 2 species ("Kibwezi", "Kisiwani"); breeding in watercourses characterized by highly alkaline reactions with pH values between 7.7 and 10 and by conductivity values between 400 and 950 mumhos. The vectors of Onchocerca volvulus are included in group I and II only.

Animals↗
PubMed1965

PRIMITIVE AFRICAN MEDICAL LORE AND WITCHCRAFT.

This article presents a comprehensive study of the methods, practices, equipment, and paraphernalia of African witch doctors in carrying out primitive medical practices. The chief tribes studied are the Azandes of the Sudan, the Manos of Liberia, the Congo tribes, the Bundas of Angola, and the Zulus and other Bantu tribes of South Africa. Primitive beliefs and customs are discussed only insofar as they have a direct bearing on medical practices. The medical practices considered deal mainly with the application of general remedies for ailments and diseases, but certain specialized fields such as obstetrics, surgery, treatment for fractures, and dentistry are also included. Primitive medicaments are presented with reference to their application for various illnesses. An alphabetical list of these medicaments is given at the end of the article.

Africa↗
PubMed1962

A serological survey of antibodies to selected enteroviruses.

SERA FROM VARIOUS POPULATION GROUPS IN LIBERIA, COLOMBIA, PERU AND SOUTHERN LOUISIANA, USA, HAVE BEEN STUDIED FOR THE PRESENCE OF NEUTRALIZING ANTIBODIES TO THE FOLLOWING ENTEROVIRUSES: poliovirus type 1, Coxsackie viruses B5 and A9, and ECHO viruses E6 and E9. The results obtained indicate that these viruses are world-wide in distribution and that infection (though not necessarily disease) occurs at an early age. Variations in antibody patterns occur, most notably with Coxsackie B5 virus. Environmental conditions apparently influence the spread of virus, but other factors, as yet unknown, may also play an important role in the dissemination of an organism. It is suggested that surveys such as these might be useful to indicate populations in need of particular vaccines.

Antibodies↗
PubMed1992

Extreme mortality in nineteenth-century Africa: the case of Liberian immigrants.

Several studies have examined the mortality of immigrants from Europe to Africa in the nineteenth century. This paper examines the level of mortality in Liberia of Africans who emigrated there from the United States. A life table is estimated from data collected by the American Colonization Society from 1820 to 1843. The analysis reflects the mortality experience of a population that is transplanted from one disease environment to another, more exacting, disease environment. The results of this analysis show that these Liberian immigrants experienced the highest mortality rates in accurately recorded human history.

Adolescent↗
PubMed1992

Professional nursing and Operation Smile International.

Operation Smile International (OSI) has a commitment to make a difference in the quality of life for people in third world countries by performing reconstructive surgeries on patients with birth defects and other deformities. Faculty members from the Hampton University School of Nursing and a graduate student were volunteers on two African medical missions. This article focuses on two of these faculty members as they provided nursing care services during reconstructive surgeries in Monrovia, Liberia and as they conducted lecture series, surveys, a research study and a day-long scientific symposium. Additionally, a model for human resource development was established in Monrovia, in conjunction with OSI, to upgrade the level of nursing education for Liberian.

Education, Nursing↗
PubMed1991

Fine structure of microfilariae in the skin of onchocerciasis patients after exposure to amocarzine.

Transmission electron microscopy was used to demonstrate the effects of amocarzine (CGP 6140) on the fine structure of Onchocerca volvulus microfilariae (mf) in skin biopsies from patients treated orally in Guatemala or transepidermally exposed in Liberia. After 6-10 hours exposure to the drug most mf did not show any alterations and only a few mf contained increased numbers of vacuoles in the cytoplasm and clefts between cuticle and hypodermis. At 20-48 hours after treatment most of the mf showed distinct signs of damage. Most frequently seen was disintegration of the cytoplasm of the afibrillar portion of the muscle cells. Some mf showed also disintegration of the myofilaments and of the internal structure of the mitochondria in the muscle cells. Other signs were progressive separation of the cuticle from the hypodermis, increase of intracellular vacuoles and clefts and in some mf condensation of the cytoplasm. The type and the site of the morphological alterations were the same after both forms of amocarzine administration. The degree of morphological changes increased with the length of time of exposure to the drug. Microfilariae with morphological alterations were nearly always surrounded by adherent host cells, mostly eosinophils and macrophages.

Administration, Cutaneous↗
PubMed1991

Health and nutritional status of Liberian refugee children--Guinea, 1990.

Since December 1989, civil strife in Liberia has caused mass displacement of persons to neighboring Guinea and Ivory Coast (Figure 1). Liberian refugees initially settled in the Forest Region of Guinea and shared food and shelter with members of the same ethnic groups (mainly Gio and Mano) already residing in the area. The number of refugees overwhelmed the capacity of affected villages to provide basic needs, and camp-like settlements were established that received substantial external relief. In May 1990, to determine appropriate priorities for relief assistance, the health and nutritional status of Liberian refugees in the Forest Region of Guinea was assessed by CDC for the U.S. Department of State's Bureau for Refugee Programs. In May, an estimated 80,000 refugees were in the area; by December the number had increased to an estimated 400,000. This report summarizes findings of the health and nutritional assessment of Liberian refugee children.

Africa, Western↗
PubMed1989

Community-based treatment of onchocerciasis with ivermectin: acceptability and early adverse reactions.

A study of community-based treatment of onchocerciasis with ivermectin was undertaken in a rain forest area of Liberia to investigate the possible occurrence of serious adverse effects. The total population was 13,704, the microfilarial load was 5.35 mf/mg skin, and the prevalence of Onchocerca volvulus infection was 50% at 9 years of age and over 80% among those aged 15 years and older. Certain groups (like pregnant women and young children) were excluded from treatment. Out of the 7956 people eligible for treatment, 7699 (97%) accepted the ivermectin. Data on possible adverse reactions were collected by four different methods, including systematic house-by-house follow-up visits three days after treatment, biweekly population surveillance, and monitoring of both mobile clinic records and hospital records. No severe adverse reactions were noted, and no deaths could be related to ivermectin treatment; only 1.3% of the persons treated had a moderate adverse reaction of the Mazzotti type, presumably related to the killing of microfilariae. The study showed good acceptance by the population, and that mass treatment campaigns with ivermectin are feasible.

Adolescent↗
PubMed1988

Histological examination of onchocercomata after therapy with ivermectin.

During chemotherapy trials in hyperendemic onchocerciasis areas in West Africa 15 adult nodule carriers in Liberia and 24 patients in Mali received single doses of ivermectin (150 or 200 micrograms/kg). Nodules were extirpated two, six and ten months after therapy and examined histologically. No macrofilaricidal effect of ivermectin was observed. Two months after therapy, in 93% of all female worms with intrauterine stretched microfilariae nearly all microfilariae were degenerated. The percentage was lower after ten months but still significantly higher than in untreated control groups. Ivermectin did not cause degeneration of the intrauterine coiled microfilariae. But the percentage of the female worms with coiled microfilariae was significantly lower two and ten months after therapy than that in the placebo or untreated control groups. Correspondingly, the percentage of nodules with intact microfilariae in the nodule tissue was also significantly lower throughout the examination period than that of the untreated control groups. There was not observed any effect on the spermatogenesis and spermatozoa were found frequently in the uteri of female worms. Using the method of histology, the long lasting inhibitory effect of a single dose of ivermectin on the intrauterine production of microfilariae could clearly be demonstrated. This proves the value of histology for the assessment of drug effects on adult O. volvulus.

Animals↗
PubMed1978

A standardization of microfilarial densities for epidemiological comparisons in periodic bancroftian filariasis.

Microfilarial density in the peripheral blood changes with time. The average concentration in a population can only be calculated if the influence of circadian periodicity is eliminated from individual measurements. A transformation of the harmonic wave formula, describing the time dependent changes in density allows to calculate the number of microfilariae at the peak of the curve from the number observed at the time of examination. The equation was tested for strains of Wuchereria bancrofti from Liberia.

Blood↗
PubMedDate not supplied

Sexual behavior, contraceptive practice, and reproductive health among Liberian adolescents.

This paper reports on a survey that was aimed at obtaining information for use in designing programs to reduce the incidence of adolescent pregnancy in Liberia. The sample of 1,488 never-married adolescents aged 14-21 was divided into subgroups based on age, sex, student status, and (for non-students) level of education. Although 57-93 percent of respondents claimed to have received information on reproductive health, only 2-21 percent could identify the monthly fertile period. Thirty to 49 percent of females ages 14-17 years have sexual relations at least once a month; over 80 percent of female non-students ages 18-21 years are sexually active. Highest levels of current contraceptive use were reported for 18-21-year-old female students (51 percent). Never-use of contraception among sexually active respondents was 97 percent for 14-17-year-old non-student females with a low educational level. Insufficient information about family planning methods and inaccessibility were the main reasons cited for non-use. Half of females ages 14-21 years who are currently attending school have been pregnant, as have 67 percent of those not in school. These results indicate a substantial unmet need on the part of Liberian adolescents with respect to reproductive health knowledge, information, and access to contraceptive methods.

Abortion, Induced↗
PubMed1986

Pancreatic fibrosis calcification and situs inversus in a Liberian female; a case report.

We report the first case of the Pancreatic fibrosis calcification syndrome (PFCS) in a Liberian. The patient presented with the classical features of the syndrome - a history of recurrent abdominal pain, diabetes mellitus, malabsorption and pancreatic calcification on plain abdominal X-ray. The patient also has situs inversus; we believe that this combination is a casual one. Since describing this case, five more cases have been diagnosed; we believe that this condition is not rare in Liberia.

Adolescent↗
PubMed1979

Notes on nematode larvae others than microfilariae found on filter membranes in blood surveys for bancroftian filariasis.

Among 741 people examined in a rural area in Liberia for microfilariae of Wuchereria bancrofti 39 (5,3%) were found to be infected with nematode larvae others than microfilariae. These larvae had more developed inner structures than microfilariae and could be classified into two different types, differing in length and shape. The larvae have not been identified yet, but it is believed that they have to be associated to parasitic nematodes of the intestine.

Adolescent↗
PubMed1972

Human monkeypox.

Between October 1970 and May 1971, six cases of human infection with monkeypox virus were identified in Liberia, Nigeria, and Sierra Leone. Four of the cases were confirmed by virus isolation and two were diagnosed on the basis of epidemiological and serological investigations. All the cases occurred in unvaccinated individuals.Post-infection serological studies showed high haemagglutination-inhibition and neutralizing titres to pox group virus in four of the cases. Repeated challenge vaccination of all cases with potent smallpox vaccine resulted in equivocal reactions.In all, 24 susceptible household contacts were exposed to the infected cases, but none developed disease. All the contacts subsequently responded to vaccination with a primary reaction, thus confirming their susceptibility and ruling out asymptomatic infection.

Adult↗
PubMed1984

Infections with the hepatitis B virus associated delta agent in an isolated West-African community.

The occurrence of delta agent (delta) infection in the native population of the isolated Gbawein and Wroughbarh Clan region of Grand Bassa County, Liberia was studied. Sera of 97 patients with epilepsy, 73 non-epileptic relatives, and 31 non-epileptic control subjects were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs) and antibody to delta antigen (anti-delta). Of the 201 individuals tested 76 (37.8%) were HBsAg positive; the overall infection rate (HBsAg and anti-HBs positives) was 68.7%. No correlation with clinical disease could be established. Markers of delta infection were detected in seven index cases. All subjects with anti-delta were HBsAg positive except one, who was anti-HBs positive with a low titre of anti-delta (less than 1:10(2)), which is indicative of a recent delta infection. Mothers of six delta infected index cases were available for testing, one was found HBsAg and anti-delta positive, while the other five were anti-HBs positive and anti-delta negative. No delta infections occurred in children of HBV negative mothers. Presence of delta markers varied significantly (P less than 0.02) among HBsAg carriers of the Kpelle (18%) and the Bassa (2%) language group. A comparable difference in delta markers was observed among HBsAg carriers of the Gbawein (17%) and the Wroughbarh (4%) clans.

Adolescent↗