Onome Abiri - Academia.edu (original) (raw)

Papers by Onome Abiri

Tropical Medicine and Infectious Disease

Background: The quality of pharmacovigilance data is important for guiding medicine safety and cl... more Background: The quality of pharmacovigilance data is important for guiding medicine safety and clinical practice. In baseline and follow-up studies after introducing interventions to improve the quality of reporting of Individual Case Safety Reports (ICSRs) in Sierra Leone, we compared (a) timeliness and completeness of reporting and (b) patient outcomes classified as ‘recovering’. Methods: Baseline (January 2017–December 2021) and follow-up (June 2022–April 2023) studies of ICSRs in the national pharmacovigilance database. Interventions introduced following recommendations from the baseline study included: updating standard operating procedures and guidelines, setting performance targets follow-up of patient outcomes, and training. Results: There were 566 ICSRs in the baseline study and 59 in the follow-up study. Timelines (reporting < 30 days) improved by five-fold (10% at baseline to 47% in follow-up). For the completeness of variables in ICSRs (desired threshold ≥ 90%),this w...

The Journal of infection, 2017

Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), ... more Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), but less attention has been focused on it for treatment. We assessed the effectiveness of convalescent whole blood (CWB) in the treatment of consented EVD patients. We recruited 69 subjects in December 2014 up to April 2015, at the 34 Military Hospital in Wilberforce and the PTS 1 Ebola Treatment Unit in Hastings, Freetown. Forty-four were given CWB, and 25 who consented but preferred to be exempted from the CWB treatment were used to compare clinical outcomes. All were given routine treatment used at the Ebola Treatment Unit. One of 44 subjects treated with CWB dropped out of the study and 31 recovered while 12 succumbed to the disease with a case fatality rate of 27.9%. For the group that was given routine treatment without CWB, 11 died with a case fatality rate of 44%. There was a significant difference between admission viral load and viral load after the first 24 h of treatment with...

Despite the potential uses of Jatropha curcas ( JC), very little is known about its effects on th... more Despite the potential uses of Jatropha curcas ( JC), very little is known about its effects on the blood cells. The current study was therefore undertaken to investigate the effect of JC seed from Sierra Leone on different haematological parameters. Ethanol extract of JC was administered daily to adult male and female Wistar rats (120-200g) either intraperitoneally or orally for 3 days or 7 days respectively. For each treatment route the rats were divided into six sub-groups as follows: group 1 rats (control group) received 0.9 % physiological saline (i.p.) or de-ionised water (p.o.) at 10 ml/kg, while rats in groups 2, 3 and 4 received 50, 100 and 200 mg/kg dose of the extract respectively; and groups 5 and 6 rats received iron (5 mg/kg) and EDTA (40 mg/kg) respectively. The rats were weighed before and after the treatment period, and at the end of the treatment period blood samples were collected by cardiac puncture. The following haematological parameters were evaluated: RBC, WB...

Globalization and Health

Background A stable, well-functioning and integrated national medicines regulatory system is a co... more Background A stable, well-functioning and integrated national medicines regulatory system is a core component of health systems resilient against infectious disease outbreaks. In many low- and middle-income countries, however, sizable gaps exist in the emergency preparedness framework of national regulatory authorities (NRAs). RegTrain-VaccTrain is a project of Germany Ministry of Health’s Global Health Protection Programme that contributes to global efforts aimed at strengthening such regulatory systems by providing technical support and advice to partner NRAs. In this study, we probed the outputs of our capacity-strengthening activities for clinical trials oversight (CTO) to take stock of progress made and examine remaining priorities in order to provide specialized technical assistance in addressing them to improve operational readiness for emergencies. Method Data validated from NRA self-benchmarking results in 2017 and worksheet records of November 2021 were utilized to assess ...

Trials

Clinical trials during public health emergencies of novel medical products such as therapeutics a... more Clinical trials during public health emergencies of novel medical products such as therapeutics and vaccines in resource-limited settings are daunting due to the limited capacity for regulatory assessment. Regulating clinical trials during the Ebola outbreak in Sierra Leone required expedited evaluation to identify medical products that could be promptly introduced to combat the epidemic in the absence of approved treatment or prevention. This article explored the decisions taken by the Pharmacy Board of Sierra Leone through its Expert Committee on Medicine Safety and Clinical Trials regarding clinical trials oversight during the Ebola epidemic and the lessons learned. This independent expert committee assessed and provided scientific opinions to the Pharmacy Board of Sierra Leone to inform approval of all clinical trials within 10–15 working days. We also requested for assisted review from the African Vaccine Regulatory Forum and support from the US Food and Drug Administration thr...

Sierra Leone Journal of Biomedical Research, Dec 31, 2015

In spite of the myriad of ethno medical uses and agro-feed potential of Jatropha curcas (JC) seed... more In spite of the myriad of ethno medical uses and agro-feed potential of Jatropha curcas (JC) seeds and the potential for production of biodiesel, toxic properties have been adduced to the plant, especially the seeds. Thus, the current study was done with the aim of investigating the toxicity of the ethanol seed extract of JC in rats, mice and chicks; and also to use conventional antidotes to treat intoxication in rats due to JC poisoning. The LD50 of the ethanol extract of the JC seed was determined by the method initially described by Lorke. In addition, acute behavioral and CNS toxicity studies of JC including antidotal therapy against JC poisoning were done. The data was analysed using SPSS and results were expressed as mean ± SEM. p < 0.05 was considered significant. The LD50 of IP JC extract ranged from 177.48 to 288.53 mg/kg (moderately toxic) for the adult female rat, adult male mouse and young male rat. For the adult male rats the LD50 values were 565.69 mg/kg (IP, slightly toxic) and >5000 mg/kg (oral, slightly toxic) and the LD50 of the JC extract for the chicks was 28.28 mg/kg (IP, highly toxic). JC produced a fairly dose dependent behavioral and CNS depressant effects which were reduced by atropine, EDTA and a combination of atropine, sodium nitrite & sodium thiosulphate, and EDTA. Also these antidotes either singly or in combination reduced mortality among the rats by 25-50%. In conclusion, the ethanol extract of JC seeds produces behavioral changes in experimental animals possibly in part by CNS depression which were ameliorated by atropine or EDTA and a combination of antidotes. Thus, these antidotes particularly atropine, may be exploited in the management of JC poisoning.

International Journal of Environmental Research and Public Health, 2022

Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they c... more Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they can cause life-threatening illness, permanent disabilities, and death. We assessed country-wide ADR reporting on antimicrobials and their outcomes. Methods: A cross-sectional study was conducted using individual case safety reports (ICSRs) entered into the national pharmacovigilance database (VigiFlow) during 2017–2021. Results: Of 566 ICSRs, inconsistent reporting was seen, with the highest reporting in 2017 and 2019 (mass drug campaigns for deworming), zero reporting in 2018 (reasons unknown), and only a handful in 2020 and 2021 (since COVID-19). Of 566 ICSRs, 90% were for antiparasitics (actively reported during mass campaigns), while the rest (passive reporting from health facilities) included 8% antibiotics, 7% antivirals, and 0.2% antifungals. In total, 90% of the reports took >30 days to be entered (median = 165; range 2–420 days), while 44% had <75% of all variables filled i...

BMC Nephrology, May 2, 2022

Background: The burden of both acute kidney injury and chronic kidney disease is on the rise glob... more Background: The burden of both acute kidney injury and chronic kidney disease is on the rise globally. In sierra Leone, there has been no data on renal patients or admissions. This study intends to close this gap in knowledge and give preliminary data on the burden of renal disease in this country. Methods: The study was a retrospective review of the case notes of patients admitted at Connaught Hospital, Freetown over a 2 year period. Data extraction was done using a well-structured proforma. Results: A 2.7% renal admission burden was obtained; mean duration of hospital stay was 15.1 ± 14.7; mean age of patients was 47.2 ± 17.5 with a female preponderance. The common risk factors for chronic kidney disease were systemic hypertension (43%) and diabetes mellitus (24%). The common risk factors for acute kidney injury were sepsis (77%) and hypovolemia (15%). The in-hospital mortality rate was 47% and 73% were non-compliant with haemodialysis probably due to financial reasons. Conclusion: There is a significant burden of kidney disease in our environment, affecting mainly our young and middle-aged population. A rational approach is to embark on kidney disease prevention programs.

Tropical Medicine and Infectious Disease, 2021

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, curre... more Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access,...

Table S1. Result for the Pharmacy Board of Sierra Leone. Table S2. Result for health facilities. ... more Table S1. Result for the Pharmacy Board of Sierra Leone. Table S2. Result for health facilities. Table S3. Result for the public health programmes. (DOCX 40 kb)

Background: We described here a patient that developed gangrene of the hand and forearm few days ... more Background: We described here a patient that developed gangrene of the hand and forearm few days after ceftriaxone and ringer’s lactate infusion therapy. To the best of our knowledge, this is the first case of ceftriaxone and ringer’s lactate extravasation associated gangrene described in the literature. Case presentation: We report here a case of a 2-year-old child that was hospitalized because of high fever, cough, difficult breathing, anorexia and vomiting. He was given artesunate injection 2.4ml 12 hourly, ampicillin sodium injection 500mg 6 hourly and Gentamycin injection 25mg 6 hourly for three days due to suspected clinical malaria and later on ringer’s lactate intravenous infusion and ceftriaxone injection since he was not improving clinically. Prior to discharge, the boy’s right forearm and hand were swollen and painful. When the child was brought back to the hospital, parents were informed that the boy’s forearm and hand have become gangrenous. Conclusion: The causal relat...

Jatropha curcas (J. curcas) seeds have been exploited as a source of biodiesel and for its ethnom... more Jatropha curcas (J. curcas) seeds have been exploited as a source of biodiesel and for its ethnomedicinal uses and agro feed potential, however, toxic properties have been associated with the seeds. The study was aimed at determining the toxic constituents present in J. curcas fruits, seeds and kernels and ethanol seed extract. Standard methods were employed in the investigations, including those of the Association of Analytical Chemists and Trease and Evans. J. curcas fruits, seeds and kernels from Sierra Leone contained cyanogenic glycosides (in mg/100g) of 7.10, 5.10 and 16.96 while the corresponding values for the Nigeria samples were 11.60, 10.15 and 15.92; all greatly above the maximum permissible limits of 0.05-0.35. Similarly, the tannin contents of the fruits, seeds and kernels from Sierra Leone (1.66, 1.46, and 1.80) and of the seeds and kernels from Nigeria (1.40, 1.48) approximated the maximum permissible limits of 1.5 mg/100g or were higher. In contrast, the phytates an...

Tropical Medicine and Infectious Disease

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, curre... more Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access,...

Journal of Pharmaceutical Policy and Practice

Few low and middle-income countries (LMIC) have fully operational pharmacovigilance structures, s... more Few low and middle-income countries (LMIC) have fully operational pharmacovigilance structures, systems and legal framework to collect and collate safety data and evaluate the risks and benefits by active and passive approaches. However, in a LMIC such as Sierra Leone, the capacity to manage the risks by taking appropriate preventative actions to help inform therapeutic decisions, promote rational use of medicines, guide risk management and communications is gradually growing but yet to be fully optimized. This study sought to assess the current status of pharmacovigilance in Sierra Leone since it became the 87th member of the World Health Organisation International Drug Monitoring Programme. This study evaluated the pharmacovigilance system in Sierra Leone through a comprehensive and system-based approach that covered the national medicines regulatory authority, health facilities and public health programmes. A descriptive cross-sectional study design was employed. Using a convenience sampling method, 14 respondents from the national medicines regulatory authority, six health facilities and six public health programmes were interviewed. Data were collected using a validated metric instrument: Indicator-Based Pharmacovigilance Assessment Tool. A scoring system was used for the quantification of assessment results with a score greater than 60% indicating that an organization has structural and policy frameworks to collect and collate safety data in a national database and evaluate the risks and benefits by both active and passive approaches. The study findings showed that the national medicines regulatory authority scored 79% and thus met the standard requirements of pharmacovigilance. On the other hand, the health facilities and public health programmes scored less than 60% indicating the need to fully operationalise pharmacovigilance frameworks at these levels. The study further demonstrated that the national medicine regulatory authority which hosts the national pharmacovigilance centre had functional pharmacovigilance structures and processes with potential to providing leadership in the implementation of pharmacovigilance in Sierra Leone.

Tropical Medicine and Infectious Disease

Background: The quality of pharmacovigilance data is important for guiding medicine safety and cl... more Background: The quality of pharmacovigilance data is important for guiding medicine safety and clinical practice. In baseline and follow-up studies after introducing interventions to improve the quality of reporting of Individual Case Safety Reports (ICSRs) in Sierra Leone, we compared (a) timeliness and completeness of reporting and (b) patient outcomes classified as ‘recovering’. Methods: Baseline (January 2017–December 2021) and follow-up (June 2022–April 2023) studies of ICSRs in the national pharmacovigilance database. Interventions introduced following recommendations from the baseline study included: updating standard operating procedures and guidelines, setting performance targets follow-up of patient outcomes, and training. Results: There were 566 ICSRs in the baseline study and 59 in the follow-up study. Timelines (reporting < 30 days) improved by five-fold (10% at baseline to 47% in follow-up). For the completeness of variables in ICSRs (desired threshold ≥ 90%),this w...

The Journal of infection, 2017

Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), ... more Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), but less attention has been focused on it for treatment. We assessed the effectiveness of convalescent whole blood (CWB) in the treatment of consented EVD patients. We recruited 69 subjects in December 2014 up to April 2015, at the 34 Military Hospital in Wilberforce and the PTS 1 Ebola Treatment Unit in Hastings, Freetown. Forty-four were given CWB, and 25 who consented but preferred to be exempted from the CWB treatment were used to compare clinical outcomes. All were given routine treatment used at the Ebola Treatment Unit. One of 44 subjects treated with CWB dropped out of the study and 31 recovered while 12 succumbed to the disease with a case fatality rate of 27.9%. For the group that was given routine treatment without CWB, 11 died with a case fatality rate of 44%. There was a significant difference between admission viral load and viral load after the first 24 h of treatment with...

Despite the potential uses of Jatropha curcas ( JC), very little is known about its effects on th... more Despite the potential uses of Jatropha curcas ( JC), very little is known about its effects on the blood cells. The current study was therefore undertaken to investigate the effect of JC seed from Sierra Leone on different haematological parameters. Ethanol extract of JC was administered daily to adult male and female Wistar rats (120-200g) either intraperitoneally or orally for 3 days or 7 days respectively. For each treatment route the rats were divided into six sub-groups as follows: group 1 rats (control group) received 0.9 % physiological saline (i.p.) or de-ionised water (p.o.) at 10 ml/kg, while rats in groups 2, 3 and 4 received 50, 100 and 200 mg/kg dose of the extract respectively; and groups 5 and 6 rats received iron (5 mg/kg) and EDTA (40 mg/kg) respectively. The rats were weighed before and after the treatment period, and at the end of the treatment period blood samples were collected by cardiac puncture. The following haematological parameters were evaluated: RBC, WB...

Globalization and Health

Background A stable, well-functioning and integrated national medicines regulatory system is a co... more Background A stable, well-functioning and integrated national medicines regulatory system is a core component of health systems resilient against infectious disease outbreaks. In many low- and middle-income countries, however, sizable gaps exist in the emergency preparedness framework of national regulatory authorities (NRAs). RegTrain-VaccTrain is a project of Germany Ministry of Health’s Global Health Protection Programme that contributes to global efforts aimed at strengthening such regulatory systems by providing technical support and advice to partner NRAs. In this study, we probed the outputs of our capacity-strengthening activities for clinical trials oversight (CTO) to take stock of progress made and examine remaining priorities in order to provide specialized technical assistance in addressing them to improve operational readiness for emergencies. Method Data validated from NRA self-benchmarking results in 2017 and worksheet records of November 2021 were utilized to assess ...

Trials

Clinical trials during public health emergencies of novel medical products such as therapeutics a... more Clinical trials during public health emergencies of novel medical products such as therapeutics and vaccines in resource-limited settings are daunting due to the limited capacity for regulatory assessment. Regulating clinical trials during the Ebola outbreak in Sierra Leone required expedited evaluation to identify medical products that could be promptly introduced to combat the epidemic in the absence of approved treatment or prevention. This article explored the decisions taken by the Pharmacy Board of Sierra Leone through its Expert Committee on Medicine Safety and Clinical Trials regarding clinical trials oversight during the Ebola epidemic and the lessons learned. This independent expert committee assessed and provided scientific opinions to the Pharmacy Board of Sierra Leone to inform approval of all clinical trials within 10–15 working days. We also requested for assisted review from the African Vaccine Regulatory Forum and support from the US Food and Drug Administration thr...

Sierra Leone Journal of Biomedical Research, Dec 31, 2015

In spite of the myriad of ethno medical uses and agro-feed potential of Jatropha curcas (JC) seed... more In spite of the myriad of ethno medical uses and agro-feed potential of Jatropha curcas (JC) seeds and the potential for production of biodiesel, toxic properties have been adduced to the plant, especially the seeds. Thus, the current study was done with the aim of investigating the toxicity of the ethanol seed extract of JC in rats, mice and chicks; and also to use conventional antidotes to treat intoxication in rats due to JC poisoning. The LD50 of the ethanol extract of the JC seed was determined by the method initially described by Lorke. In addition, acute behavioral and CNS toxicity studies of JC including antidotal therapy against JC poisoning were done. The data was analysed using SPSS and results were expressed as mean ± SEM. p < 0.05 was considered significant. The LD50 of IP JC extract ranged from 177.48 to 288.53 mg/kg (moderately toxic) for the adult female rat, adult male mouse and young male rat. For the adult male rats the LD50 values were 565.69 mg/kg (IP, slightly toxic) and >5000 mg/kg (oral, slightly toxic) and the LD50 of the JC extract for the chicks was 28.28 mg/kg (IP, highly toxic). JC produced a fairly dose dependent behavioral and CNS depressant effects which were reduced by atropine, EDTA and a combination of atropine, sodium nitrite & sodium thiosulphate, and EDTA. Also these antidotes either singly or in combination reduced mortality among the rats by 25-50%. In conclusion, the ethanol extract of JC seeds produces behavioral changes in experimental animals possibly in part by CNS depression which were ameliorated by atropine or EDTA and a combination of antidotes. Thus, these antidotes particularly atropine, may be exploited in the management of JC poisoning.

International Journal of Environmental Research and Public Health, 2022

Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they c... more Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they can cause life-threatening illness, permanent disabilities, and death. We assessed country-wide ADR reporting on antimicrobials and their outcomes. Methods: A cross-sectional study was conducted using individual case safety reports (ICSRs) entered into the national pharmacovigilance database (VigiFlow) during 2017–2021. Results: Of 566 ICSRs, inconsistent reporting was seen, with the highest reporting in 2017 and 2019 (mass drug campaigns for deworming), zero reporting in 2018 (reasons unknown), and only a handful in 2020 and 2021 (since COVID-19). Of 566 ICSRs, 90% were for antiparasitics (actively reported during mass campaigns), while the rest (passive reporting from health facilities) included 8% antibiotics, 7% antivirals, and 0.2% antifungals. In total, 90% of the reports took >30 days to be entered (median = 165; range 2–420 days), while 44% had <75% of all variables filled i...

BMC Nephrology, May 2, 2022

Background: The burden of both acute kidney injury and chronic kidney disease is on the rise glob... more Background: The burden of both acute kidney injury and chronic kidney disease is on the rise globally. In sierra Leone, there has been no data on renal patients or admissions. This study intends to close this gap in knowledge and give preliminary data on the burden of renal disease in this country. Methods: The study was a retrospective review of the case notes of patients admitted at Connaught Hospital, Freetown over a 2 year period. Data extraction was done using a well-structured proforma. Results: A 2.7% renal admission burden was obtained; mean duration of hospital stay was 15.1 ± 14.7; mean age of patients was 47.2 ± 17.5 with a female preponderance. The common risk factors for chronic kidney disease were systemic hypertension (43%) and diabetes mellitus (24%). The common risk factors for acute kidney injury were sepsis (77%) and hypovolemia (15%). The in-hospital mortality rate was 47% and 73% were non-compliant with haemodialysis probably due to financial reasons. Conclusion: There is a significant burden of kidney disease in our environment, affecting mainly our young and middle-aged population. A rational approach is to embark on kidney disease prevention programs.

Tropical Medicine and Infectious Disease, 2021

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, curre... more Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access,...

Table S1. Result for the Pharmacy Board of Sierra Leone. Table S2. Result for health facilities. ... more Table S1. Result for the Pharmacy Board of Sierra Leone. Table S2. Result for health facilities. Table S3. Result for the public health programmes. (DOCX 40 kb)

Background: We described here a patient that developed gangrene of the hand and forearm few days ... more Background: We described here a patient that developed gangrene of the hand and forearm few days after ceftriaxone and ringer’s lactate infusion therapy. To the best of our knowledge, this is the first case of ceftriaxone and ringer’s lactate extravasation associated gangrene described in the literature. Case presentation: We report here a case of a 2-year-old child that was hospitalized because of high fever, cough, difficult breathing, anorexia and vomiting. He was given artesunate injection 2.4ml 12 hourly, ampicillin sodium injection 500mg 6 hourly and Gentamycin injection 25mg 6 hourly for three days due to suspected clinical malaria and later on ringer’s lactate intravenous infusion and ceftriaxone injection since he was not improving clinically. Prior to discharge, the boy’s right forearm and hand were swollen and painful. When the child was brought back to the hospital, parents were informed that the boy’s forearm and hand have become gangrenous. Conclusion: The causal relat...

Jatropha curcas (J. curcas) seeds have been exploited as a source of biodiesel and for its ethnom... more Jatropha curcas (J. curcas) seeds have been exploited as a source of biodiesel and for its ethnomedicinal uses and agro feed potential, however, toxic properties have been associated with the seeds. The study was aimed at determining the toxic constituents present in J. curcas fruits, seeds and kernels and ethanol seed extract. Standard methods were employed in the investigations, including those of the Association of Analytical Chemists and Trease and Evans. J. curcas fruits, seeds and kernels from Sierra Leone contained cyanogenic glycosides (in mg/100g) of 7.10, 5.10 and 16.96 while the corresponding values for the Nigeria samples were 11.60, 10.15 and 15.92; all greatly above the maximum permissible limits of 0.05-0.35. Similarly, the tannin contents of the fruits, seeds and kernels from Sierra Leone (1.66, 1.46, and 1.80) and of the seeds and kernels from Nigeria (1.40, 1.48) approximated the maximum permissible limits of 1.5 mg/100g or were higher. In contrast, the phytates an...

Tropical Medicine and Infectious Disease

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, curre... more Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access,...

Journal of Pharmaceutical Policy and Practice

Few low and middle-income countries (LMIC) have fully operational pharmacovigilance structures, s... more Few low and middle-income countries (LMIC) have fully operational pharmacovigilance structures, systems and legal framework to collect and collate safety data and evaluate the risks and benefits by active and passive approaches. However, in a LMIC such as Sierra Leone, the capacity to manage the risks by taking appropriate preventative actions to help inform therapeutic decisions, promote rational use of medicines, guide risk management and communications is gradually growing but yet to be fully optimized. This study sought to assess the current status of pharmacovigilance in Sierra Leone since it became the 87th member of the World Health Organisation International Drug Monitoring Programme. This study evaluated the pharmacovigilance system in Sierra Leone through a comprehensive and system-based approach that covered the national medicines regulatory authority, health facilities and public health programmes. A descriptive cross-sectional study design was employed. Using a convenience sampling method, 14 respondents from the national medicines regulatory authority, six health facilities and six public health programmes were interviewed. Data were collected using a validated metric instrument: Indicator-Based Pharmacovigilance Assessment Tool. A scoring system was used for the quantification of assessment results with a score greater than 60% indicating that an organization has structural and policy frameworks to collect and collate safety data in a national database and evaluate the risks and benefits by both active and passive approaches. The study findings showed that the national medicines regulatory authority scored 79% and thus met the standard requirements of pharmacovigilance. On the other hand, the health facilities and public health programmes scored less than 60% indicating the need to fully operationalise pharmacovigilance frameworks at these levels. The study further demonstrated that the national medicine regulatory authority which hosts the national pharmacovigilance centre had functional pharmacovigilance structures and processes with potential to providing leadership in the implementation of pharmacovigilance in Sierra Leone.