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Papers by Joseph B Koroma

Research paper thumbnail of No Evidence for Lymphatic Filariasis Transmission in Big Cities Affected by Conflict Related Rural-Urban Migration in Sierra Leone and Liberia

PLoS Neglected Tropical Diseases, 2014

Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles spec... more Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles species with Culex species playing only a minor role in transmission, if any. Being a predominantly rural disease, the question remains whether conflict-related migration of rural populations into urban areas would be sufficient for active transmission of the parasite.

Research paper thumbnail of Managing the Fight against Onchocerciasis in Africa: APOC Experience

PLOS Neglected Tropical Diseases, 2015

Research paper thumbnail of Mapping, monitoring, and surveillance of neglected tropical diseases: towards a policy framework

The Lancet, 2010

As national programmes respond to the new opportunities presented for scaling up preventive chemo... more As national programmes respond to the new opportunities presented for scaling up preventive chemotherapy programmes for the coadministration of drugs to target lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma, possible synergies between existing disease-specific policies and protocols need to be examined. In this report we compare present policies for mapping, monitoring, and surveillance for these diseases, drawing attention to both the challenges and opportunities for integration. Although full integration of all elements of mapping, monitoring, and surveillance strategies might not be feasible for the diseases targeted through the preventive chemotherapy approach, there are opportunities for integration, and we present examples of integrated strategies. Finally, if advantage is to be taken of scaled up interventions to address neglected tropical diseases, efforts to develop rapid, inexpensive, and easy-to-use methods, whether disease-specific or integrated, should be increased. We present a framework for development of an integrated monitoring and evaluation system that combines both integrated and disease-specific strategies.

Research paper thumbnail of Combined Spatial Prediction of Schistosomiasis and Soil-Transmitted Helminthiasis in Sierra Leone: A Tool for Integrated Disease Control

PLoS Neglected Tropical Diseases, 2012

Background: A national mapping of Schistosoma haematobium was conducted in Sierra Leone before th... more Background: A national mapping of Schistosoma haematobium was conducted in Sierra Leone before the mass drug administration (MDA) with praziquantel. Together with the separate mapping of S. mansoni and soil-transmitted helminths, the national control programme was able to plan the MDA strategies according to the World Health Organization guidelines for preventive chemotherapy for these diseases.

Research paper thumbnail of Impact of Three Rounds of Mass Drug Administration on Lymphatic Filariasis in Areas Previously Treated for Onchocerciasis in Sierra Leone

PLoS Neglected Tropical Diseases, 2013

The results show that mf prevalence decreased to ,1.0% in all but one of the 12 districts after t... more The results show that mf prevalence decreased to ,1.0% in all but one of the 12 districts after three MDAs. Overall mf density reduced by 65.0% among mf-positive individuals, and 95.8% for the entire population.

Research paper thumbnail of High coverage of mass drug administration for lymphatic filariasis in rural and non-rural settings in the Western Area, Sierra Leone

Parasites & Vectors, 2010

Background: Lymphatic filariasis elimination programs are based upon preventative chemotherapy an... more Background: Lymphatic filariasis elimination programs are based upon preventative chemotherapy annually in populations with prevalence more than or equal to 1%. The goal is to treat 80% of the eligible, at risk population yearly, for at least 5 years, in order to interrupt transmission and prevent children from becoming infected. This level of coverage has been a challenge in urban settings. Assessing the coverage in a rapidly growing urban/nonrural setting with inadequate population data is also problematic. In Sierra Leone, a 5-day preventative chemotherapy campaign was carried out in the Western Area including the capital: Freetown. An intensive, social mobilization strategy combined traditional and modern communication channels. To aid dissemination of appropriate information Frequently Asked Questions were developed and widely circulated. The population of the Western Area has grown faster than projected by the 2004 National Census due to the post-war settlement of internally displaced persons. As a reliable denominator was not available, independent monitoring was adapted and performed "in process" to aid program performance and "end process" to assess final coverage.

Research paper thumbnail of Lymphatic filariasis mapping by Immunochromatographic Test cards and baseline microfilaria survey prior to mass drug administration in Sierra Leone

Parasites & Vectors, 2012

Background: National mapping of lymphatic filariasis (LF) was conducted using Immunochromatograph... more Background: National mapping of lymphatic filariasis (LF) was conducted using Immunochromatographic tests (ICT) in 2005 to determine endemicity and geographic spread of the disease. A baseline microfilaria survey was then conducted to determine LF prevalence and microfilaria intensity. Methods: In 2005 1,982 persons of 15 years and over from 14 health districts were selected and fingertip blood samples were tested with ICT cards. In 2007-8 blood samples were taken between 10 p.m. and 2 a.m. and examined for microfilaria (mf) from 9,288 persons from 16 sentinel sites representing each district and 2 additional sites for districts with populations over 500,000 (Bo and Kenema).

Research paper thumbnail of The Epidemiology of Trachoma in the Five Northern Districts of Sierra Leone

Ophthalmic Epidemiology, 2011

In 2008, a trachoma prevalence survey was conducted in the five northern districts of Sierra Leon... more In 2008, a trachoma prevalence survey was conducted in the five northern districts of Sierra Leone to determine if and where specific components of the SAFE strategy (Surgery, Antibiotics, Face washing, Environmental change) should be initiated. A cross-sectional survey at district level was implemented using two-stage random cluster sampling: probability proportionate sampling was used to select villages in the first stage and compact segment sampling of households in the second stage. Both eyes of 16,780 individuals were examined using the World Health Organization simplified trachoma grading system. Data were also collected on village- and household-level behavior and environmental factors related to trachoma. Prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years was highest in Kambia at 3.52% (95% Confidence Interval (CI): 2.28-4.75%), while the prevalence of trachomatous trichiasis (TT) in persons over 15 years of age was highest in Port Loko at 0.27% (95% CI: 0.03-0.50%). Across all districts, the percentage of households reporting washing children's faces less than once per day was very low, while latrine coverage and accessible and safe water sources were not highly prevalent. In all districts but Koinadugu, TT prevalence was greater than the WHO elimination threshold, indicating the need for 1,016 TT surgeries to prevent blindness. District TF prevalence rates did not warrant mass antibiotic distribution. Although not required given the low prevalence of TF, we recommend the construction of 35,941 household latrines and provision of water sources within a 30-minute walk roundtrip for 17,551 households to bring Sierra Leone closer to reaching Millennium Development Goal 7.

Research paper thumbnail of Neglected tropical disease control in post-war Sierra Leone using the Onchocerciasis Control Programme as a platform

International Health, 2011

Strategic investments in the control of neglected tropical diseases (NTD) spearheaded by the US G... more Strategic investments in the control of neglected tropical diseases (NTD) spearheaded by the US Government, the British Government and other bilateral donors such as foundations and key pharmaceutical partners have enabled the treatment of millions of people for the five targeted debilitating diseases (lymphatic filariasis, onchocerciasis, schistosomiasis, soiltransmitted helminthiasis and trachoma), paving the way for the potential elimination as public health problems of some of these diseases. Like many other countries, Sierra Leone has a high burden of these major NTDs. Despite the fragile infrastructure of a health system emerging from a devastating 10-year civil war, the country has successfully implemented the National NTD Control Programme, reaching national coverage in 2010. The NTD Control Programme uses the existing Onchocerciasis Control Programme as a platform and involves primary health workers. The programme has provided extensive training opportunities to health workers at national, district and community levels. The country currently has 31 161 trained community volunteers treating a population of five million people. It is shown that the investments in NTD control are not only to control NTDs but also to strengthen health systems, particularly at the primary level, through extensive capacity building of frontline health workers and community-directed distributors.

Research paper thumbnail of Geographical Distribution of Intestinal Schistosomiasis and Soil-Transmitted Helminthiasis and Preventive Chemotherapy Strategies in Sierra Leone

Background: A national baseline mapping of schistosomiasis and soil-transmitted helminthiasis (ST... more Background: A national baseline mapping of schistosomiasis and soil-transmitted helminthiasis (STH) was performed in Sierra Leone. The aim was to provide necessary tools for the Ministry of Health and Sanitation to plan the intervention strategies in the national integrated control program on neglected tropical diseases according to the World Health Organization (WHO) guidelines for preventative chemotherapy (PCT) and for future monitoring and evaluation.

Research paper thumbnail of No Evidence for Lymphatic Filariasis Transmission in Big Cities Affected by Conflict Related Rural-Urban Migration in Sierra Leone and Liberia

PLoS Neglected Tropical Diseases, 2014

Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles spec... more Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles species with Culex species playing only a minor role in transmission, if any. Being a predominantly rural disease, the question remains whether conflict-related migration of rural populations into urban areas would be sufficient for active transmission of the parasite.

Research paper thumbnail of No Evidence for Lymphatic Filariasis Transmission in Big Cities Affected by Conflict Related Rural-Urban Migration in Sierra Leone and Liberia

PLoS Neglected Tropical Diseases, 2014

Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles spec... more Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles species with Culex species playing only a minor role in transmission, if any. Being a predominantly rural disease, the question remains whether conflict-related migration of rural populations into urban areas would be sufficient for active transmission of the parasite.

Research paper thumbnail of Managing the Fight against Onchocerciasis in Africa: APOC Experience

PLOS Neglected Tropical Diseases, 2015

Research paper thumbnail of Mapping, monitoring, and surveillance of neglected tropical diseases: towards a policy framework

The Lancet, 2010

As national programmes respond to the new opportunities presented for scaling up preventive chemo... more As national programmes respond to the new opportunities presented for scaling up preventive chemotherapy programmes for the coadministration of drugs to target lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma, possible synergies between existing disease-specific policies and protocols need to be examined. In this report we compare present policies for mapping, monitoring, and surveillance for these diseases, drawing attention to both the challenges and opportunities for integration. Although full integration of all elements of mapping, monitoring, and surveillance strategies might not be feasible for the diseases targeted through the preventive chemotherapy approach, there are opportunities for integration, and we present examples of integrated strategies. Finally, if advantage is to be taken of scaled up interventions to address neglected tropical diseases, efforts to develop rapid, inexpensive, and easy-to-use methods, whether disease-specific or integrated, should be increased. We present a framework for development of an integrated monitoring and evaluation system that combines both integrated and disease-specific strategies.

Research paper thumbnail of Combined Spatial Prediction of Schistosomiasis and Soil-Transmitted Helminthiasis in Sierra Leone: A Tool for Integrated Disease Control

PLoS Neglected Tropical Diseases, 2012

Background: A national mapping of Schistosoma haematobium was conducted in Sierra Leone before th... more Background: A national mapping of Schistosoma haematobium was conducted in Sierra Leone before the mass drug administration (MDA) with praziquantel. Together with the separate mapping of S. mansoni and soil-transmitted helminths, the national control programme was able to plan the MDA strategies according to the World Health Organization guidelines for preventive chemotherapy for these diseases.

Research paper thumbnail of Impact of Three Rounds of Mass Drug Administration on Lymphatic Filariasis in Areas Previously Treated for Onchocerciasis in Sierra Leone

PLoS Neglected Tropical Diseases, 2013

The results show that mf prevalence decreased to ,1.0% in all but one of the 12 districts after t... more The results show that mf prevalence decreased to ,1.0% in all but one of the 12 districts after three MDAs. Overall mf density reduced by 65.0% among mf-positive individuals, and 95.8% for the entire population.

Research paper thumbnail of High coverage of mass drug administration for lymphatic filariasis in rural and non-rural settings in the Western Area, Sierra Leone

Parasites & Vectors, 2010

Background: Lymphatic filariasis elimination programs are based upon preventative chemotherapy an... more Background: Lymphatic filariasis elimination programs are based upon preventative chemotherapy annually in populations with prevalence more than or equal to 1%. The goal is to treat 80% of the eligible, at risk population yearly, for at least 5 years, in order to interrupt transmission and prevent children from becoming infected. This level of coverage has been a challenge in urban settings. Assessing the coverage in a rapidly growing urban/nonrural setting with inadequate population data is also problematic. In Sierra Leone, a 5-day preventative chemotherapy campaign was carried out in the Western Area including the capital: Freetown. An intensive, social mobilization strategy combined traditional and modern communication channels. To aid dissemination of appropriate information Frequently Asked Questions were developed and widely circulated. The population of the Western Area has grown faster than projected by the 2004 National Census due to the post-war settlement of internally displaced persons. As a reliable denominator was not available, independent monitoring was adapted and performed "in process" to aid program performance and "end process" to assess final coverage.

Research paper thumbnail of Lymphatic filariasis mapping by Immunochromatographic Test cards and baseline microfilaria survey prior to mass drug administration in Sierra Leone

Parasites & Vectors, 2012

Background: National mapping of lymphatic filariasis (LF) was conducted using Immunochromatograph... more Background: National mapping of lymphatic filariasis (LF) was conducted using Immunochromatographic tests (ICT) in 2005 to determine endemicity and geographic spread of the disease. A baseline microfilaria survey was then conducted to determine LF prevalence and microfilaria intensity. Methods: In 2005 1,982 persons of 15 years and over from 14 health districts were selected and fingertip blood samples were tested with ICT cards. In 2007-8 blood samples were taken between 10 p.m. and 2 a.m. and examined for microfilaria (mf) from 9,288 persons from 16 sentinel sites representing each district and 2 additional sites for districts with populations over 500,000 (Bo and Kenema).

Research paper thumbnail of The Epidemiology of Trachoma in the Five Northern Districts of Sierra Leone

Ophthalmic Epidemiology, 2011

In 2008, a trachoma prevalence survey was conducted in the five northern districts of Sierra Leon... more In 2008, a trachoma prevalence survey was conducted in the five northern districts of Sierra Leone to determine if and where specific components of the SAFE strategy (Surgery, Antibiotics, Face washing, Environmental change) should be initiated. A cross-sectional survey at district level was implemented using two-stage random cluster sampling: probability proportionate sampling was used to select villages in the first stage and compact segment sampling of households in the second stage. Both eyes of 16,780 individuals were examined using the World Health Organization simplified trachoma grading system. Data were also collected on village- and household-level behavior and environmental factors related to trachoma. Prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years was highest in Kambia at 3.52% (95% Confidence Interval (CI): 2.28-4.75%), while the prevalence of trachomatous trichiasis (TT) in persons over 15 years of age was highest in Port Loko at 0.27% (95% CI: 0.03-0.50%). Across all districts, the percentage of households reporting washing children's faces less than once per day was very low, while latrine coverage and accessible and safe water sources were not highly prevalent. In all districts but Koinadugu, TT prevalence was greater than the WHO elimination threshold, indicating the need for 1,016 TT surgeries to prevent blindness. District TF prevalence rates did not warrant mass antibiotic distribution. Although not required given the low prevalence of TF, we recommend the construction of 35,941 household latrines and provision of water sources within a 30-minute walk roundtrip for 17,551 households to bring Sierra Leone closer to reaching Millennium Development Goal 7.

Research paper thumbnail of Neglected tropical disease control in post-war Sierra Leone using the Onchocerciasis Control Programme as a platform

International Health, 2011

Strategic investments in the control of neglected tropical diseases (NTD) spearheaded by the US G... more Strategic investments in the control of neglected tropical diseases (NTD) spearheaded by the US Government, the British Government and other bilateral donors such as foundations and key pharmaceutical partners have enabled the treatment of millions of people for the five targeted debilitating diseases (lymphatic filariasis, onchocerciasis, schistosomiasis, soiltransmitted helminthiasis and trachoma), paving the way for the potential elimination as public health problems of some of these diseases. Like many other countries, Sierra Leone has a high burden of these major NTDs. Despite the fragile infrastructure of a health system emerging from a devastating 10-year civil war, the country has successfully implemented the National NTD Control Programme, reaching national coverage in 2010. The NTD Control Programme uses the existing Onchocerciasis Control Programme as a platform and involves primary health workers. The programme has provided extensive training opportunities to health workers at national, district and community levels. The country currently has 31 161 trained community volunteers treating a population of five million people. It is shown that the investments in NTD control are not only to control NTDs but also to strengthen health systems, particularly at the primary level, through extensive capacity building of frontline health workers and community-directed distributors.

Research paper thumbnail of Geographical Distribution of Intestinal Schistosomiasis and Soil-Transmitted Helminthiasis and Preventive Chemotherapy Strategies in Sierra Leone

Background: A national baseline mapping of schistosomiasis and soil-transmitted helminthiasis (ST... more Background: A national baseline mapping of schistosomiasis and soil-transmitted helminthiasis (STH) was performed in Sierra Leone. The aim was to provide necessary tools for the Ministry of Health and Sanitation to plan the intervention strategies in the national integrated control program on neglected tropical diseases according to the World Health Organization (WHO) guidelines for preventative chemotherapy (PCT) and for future monitoring and evaluation.

Research paper thumbnail of No Evidence for Lymphatic Filariasis Transmission in Big Cities Affected by Conflict Related Rural-Urban Migration in Sierra Leone and Liberia

PLoS Neglected Tropical Diseases, 2014

Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles spec... more Background: In West Africa, the principal vectors of lymphatic filariasis (LF) are Anopheles species with Culex species playing only a minor role in transmission, if any. Being a predominantly rural disease, the question remains whether conflict-related migration of rural populations into urban areas would be sufficient for active transmission of the parasite.