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. (+info)
Thalassaemia in northern Liberia. A survey in the Mount Nimba area.
A population survey in northern Liberia showed an average incidence of 9 percent of beta-thalassaemia trait. There was considerable tribal variation, the highest rates being mainly found in tribes having a low incidence of Hb S. A single example of deltabeta-thalassaemia trait was also found; the incidence of delta-chain variants was 1.8 percent. The effect of malaria on Hb A2 levels was investigated but appeared to be negligible. The problems of beta-thalassaemia and Hb S occurring in the same population are discussed. It is considered that, although made on a local sample, the results of this survey indicate a high incidence of beta-thalassaemia trait elsewhere in Liberia and that this is a suitable are for investigations of linkage at beta- and delta-chain loci. No conclusion is at present possible from the data on the presence of alpha-thalassaemia although 10 percent of neonates were found to have increased levels of Hb Barts. (+info)
Homozygous beta thalassaemia in Liberia.
The clinical and haematological findings in 19 Liberians probably homozygous for beta thalassaemia are described. The haemoglobin patterns were similar with Hb F levels in the 30-50% range and a raised level of Hb A2 and, although the clinical severity varied widely, over half the cases were symptomless and even the more severely affected ones showed a milder picture than that found in Mediterranean races. Haemoglobin-synthesis studies carried out on three homozygotes and two heterozygotes indicated a variable degree of globin-chain imbalance. The reasons for the mild course of the disease in Liberians and other African races are discussed; it is likely that the beta-thalassaemia genes in these populations are different from those in other racial groups. It is noted that all persons in this study belong to tribes which have a low incidence of the sickle-cell gene. (+info)
Cholera epidemic after increased civil conflict--Monrovia, Liberia, June-September 2003.
Since 1989, civil war in Liberia has resulted in the displacement of hundreds of thousands of persons. In June 2003, as rebel forces approached the capital city of Monrovia (2003 estimated population: one million), an estimated 300,000 internally displaced persons (IDPs) settled in private homes with family members, public buildings, and other sites. Because of fighting during June-July, the normal collection of health data by the Liberian Ministry of Health (MoH) was interrupted. In June, cases of cholera were confirmed by international nongovernment organizations. To estimate the magnitude of the outbreak, in August, the World Health Organization (WHO) conducted a retrospective review of data collected by health organizations during June--August 2003 but not reported to MoH. Additional data were collected from an emergency surveillance system that began operation on August 25. This report summarizes the results of that analysis, which indicated that as of September 22, a cholera epidemic was ongoing in Monrovia. During the week ending October 20, a total of 1,252 cases of suspected cholera were reported (WHO, MoH, unpublished data, 2003). As of November 12, the epidemic was continuing. The epidemic began in June and was associated temporally with increased fighting and the movement of IDPs. Because cholera transmission was probably attributable to an acute shortage of clean water, poor sanitation, and crowded living conditions, international and Liberian organizations attempted to supply IDP settlements with sufficient potable water and began chlorinating wells. To stop cholera transmission and avoid additional illness and death, further preventive measures are needed. (+info)
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. (+info)
Genetic regulation of human anti-malarial antibodies in twins.
Immune responses to defined antigens may differ between individuals in a population as the reflection of differences in genetic regulation. In experimental animals, variation in responsiveness to a given epitope may be due to major histocompatibility complex (HLA, in humans) class II restrictions, implying serious limitations for the development of subunit vaccines. For human populations, knowledge of the relative importance of genetic as opposed to environmental factors affecting the immune response is scarce. We have compared antibody levels after immunization through repeated infections to a major malarial antigen (Pf155/RESA) in monozygotic twins with those in dizygotic twins, siblings, or unrelated controls. Antibody responses to the intact antigen and to some of its immunodominant epitopes were found to be more concordant within monozygotic twin pairs than in dizygotic pairs or age- and sex-matched siblings living under similar environmental conditions. The results support the conclusion that the antibody responses were genetically regulated. When the responses were assessed for possible associations with different HLA class II DRB, DQA, and DQB alleles had haplotypes, no associations were found. This suggests that the regulation of the Pf155/RESA antibody responses seen in this study reflects the impact of factors encoded by genes outside the HLA class II regions. (+info)
Consequences of vector behavior in epidemiology of onchocerciasis on the Firestone Rubber Plantation in Liberia.
In the current study, we have assessed the distribution of black fly vectors and the occurrence of onchocerciasis among residents of the Firestone Rubber Plantation (FRP) in Liberia. The degree of endemicity of onchocerciasis on the FRP is correlated with the breeding of Simulium yahense on the Du River and Simulium soubrense on the Farmington River, as well as with the feeding behavior of these black fly vectors. S. yahense is highly anthropophilic and highly susceptible to Onchocerca volvulus, thus, it is apparently the primary vector of O. volvulus on the plantation. S. soubrense is predominantly zoophilic; consequently, it has a low capacity for transmitting of O. volvulus to humans. The prevalence of the disease is hyperendemic in the divisional camps near the Du River, affecting 77.6% to 94.4% of males and 64.9% to 88.9% of females. In the camps along the Farmington River, the disease is hypoendemic, affecting 26.1% to 49.2% of males and 25.6% to 35.1% of females. The mean intensity of infection in the camps near the Du River was 14.1 microfilariae (mf)/mg of skin in males and 13.7 mf/mg of skin in females. The density of microfilariae in people in the camps along the Farmington River was 4.8 mf/mg of skin in males and 1.9 mf/mg of skin in females. The age-specific infection in camps along both rivers substantially increased after the ages 21-30, reaching a maximum at ages 41-50. The mean density of mf/mg of skin in three anatomic locations (calf, hip, and shoulder) was 28.0, 24.5, and 14.1 mf/mg of skin, respectively, for those living on the Du River, and 10.2, 7.6, and 5.8 mf/mg of skin, respectively, for those on the Farmington River. (+info)
Point-of-use water treatment and diarrhoea reduction in the emergency context: an effectiveness trial in Liberia.
Communicable diseases are of particular concern in conflict and disaster-affected populations that reside in camp settings. In the acute emergency phase, diarrhoeal diseases have accounted for more than 40% of deaths among camp residents. Clear limitations exist in current water treatment technologies, and few products are capable of treating turbid water. We describe the findings of a 12-week effectiveness study of point-of-use water treatment with a flocculant-disinfectant among 400 households in camps for displaced populations in Monrovia, Liberia. In intervention households, point-of-use water treatment with the flocculant-disinfectant plus improved storage reduced diarrhoea incidence by 90% and prevalence by 83%, when compared with control households with improved water storage alone. Among the intervention group, residual chlorine levels met or exceeded Sphere standards in 85% (95% CI: 83.1-86.8) of observations with a 95% compliance rate. (+info)