A practical community-based response strategy to interrupt Ebola transmission in sierra Leone, 2014-2015.

BACKGROUND: The Ebola virus disease spread rapidly in West Africa in 2014, leading to the loss of thousands of lives. Community engagement was one of the key strategies to interrupt Ebola transmission, and practical community level measures needed to be explored in the field and tailored to the specific context of communities. METHODS: First, community-level education on Ebola virus disease (EVD) prevention was launched for the community's social mobilizers in six districts in Sierra Leone beginning in November 2014. Then, from January to May of 2015, in three pilot communities, local trained community members were organized to engage in implementation of EVD prevention and transmission interruption measures, by involving them in alert case report, contact tracing, and social mobilization. The epidemiological indicators of transmission interruption in three study communities were evaluated. RESULTS: A total of 6 016 community social mobilizers from 185 wards were trained by holding 279 workshops in the six districts, and EVD message reached an estimated 631 680 residents. In three pilot communities, 72 EVD alert cases were reported, with 70.8 % of them detected by trained local community members, and 14 EVD cases were finally identified. Contact tracing detected 64.3 % of EVD cases. The median duration of community infectivity for the cases was 1 day. The secondary attack rate was 4.2 %, and no third generation of infection was triggered. No health worker was infected, and no unsafe burial and noncompliance to EVD control measures were recorded. The community-based measures were modeled to reduce 77 EVD cases, and the EVD-free goal was achieved four months earlier in study communities than whole country of Sierra Leone. CONCLUSIONS: The community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission in a country with weak health system. The successfully practical experience to reduce the risk of Ebola transmission in the community with poor resources would potentially be helpful for the global community to fight against the EVD and the other diseases in the future.

Rapid assessment of knowledge, attitudes, practices, and risk perception related to the prevention and control of Ebola virus disease in three communities of Sierra Leone.

BACKGROUND: The recent outbreak of the Ebola virus disease (EVD) in Sierra Leone has been characterized by the World Health Organization as one of the most challenging EVD outbreaks to date. The first confirmed case in Sierra Leone was a young woman who was admitted to a government hospital in Kenema following a miscarriage on 24 May 2014. On 5 January 2015, intensified training for an EVD response project was initiated at the medical university of Sierra Leone in Jui. To understand the knowledge, attitudes, practices, and perceived risk of EVD among the public, especially after this training, a rapid assessment was conducted from 10 to 16 March 2015. METHODS: Interviews were conducted with 466 participants based on questionnaires that were distributed from 10 to 16 March 2015 by cluster sampling in three adjacent communities, namely Jui, Grafton, and Kossoh Town, in the Western Area Rural District of Sierra Leone. RESULTS: It was found that knowledge about EVD was comprehensive and high. Positive attitude towards prevention was found to be satisfactory. Nearly all participants knew the reporting phone number 117 and had reported some change in behavior since learning about Ebola. More than half (62 %) of the participants had a history of travelling to urban areas, which increases the risk of infection. The multivariable logistic regression analysis showed that community and occupation were variables associated with perceived risk of EVD. CONCLUSIONS: Our study showed that community level social mobilization and community engagement were an effective strategy in the special context.

Knowledge and attitudes about Ebola vaccine among the general population in Sierra Leone.

BACKGROUND: Clinical trials of Ebola vaccine are ongoing. Before it becomes commercially available, understanding the Ebola vaccine-related knowledge and attitude of the general population is imperative to developing an effective vaccine coverage strategy. METHODS: We conducted a survey including 400 participants from general communities of the West Area Rural District, Sierra Leone. Knowledge and attitudes about Ebola vaccine were investigated, and the determinants of having knowledge and a positive attitude toward accepting vaccination were identified. RESULTS: Over half (55.8%) of the participants were aware of Ebola vaccine. About 60% of the participants were willing to be study subjects if the Ebola vaccine clinical trial were conducted in their communities. Most of the participants (72.5%) were willing to take Ebola vaccination if it was free of charge. Given that the vaccination was not free, the proportion willing to pay a fee to take the vaccination declined dramatically to 26.6%. Using a forward step-wise logistic model, monthly salary was identified as the single determinant (OR for every 100,000 Leones increase: 1.17, 95%CI: 1.04-1.31) for awareness of Ebola vaccine, which was identified as the determinant (OR: 1.88, 95%CI: 1.17-3.02) for free vaccination uptake willingness. The combination of monthly salary, monthly average income of family members and their interaction was found to be associated with charged vaccination uptake willingness. DISCUSSION: Measures are still needed to promote the Ebola vaccine awareness and knowledge updating. Free or low-priced vaccine could increase the vaccination acceptability of the general community population significantly.

Soil respiration and carbon loss relationship with temperature and land use conversion in freeze-thaw agricultural area.

Soil respiration (Rs) was hypothesized to have a special response pattern to soil temperature and land use conversion in the freeze-thaw area. The Rs differences of eight types of land use conversions during agricultural development were observed and the impacts of Rs on soil organic carbon (SOC) loss were assessed. The land use conversions during last three decades were categorized into eight types, and the 141 SOC sampling sites were grouped by conversion type. The typical soil sampling sites were subsequently selected for monitoring of soil temperature and Rs of each land use conversion types. The Rs correlations with temperature at difference depths and different conversion types were identified with statistical analysis. The empirical mean error model and the biophysical theoretical model with Arrhenius equation about the Rs sensitivity to temperature were both analyzed and shared the similar patterns. The temperature dependence of soil respiration (Q10) analysis further demonstrated that the averaged value of eight types of land use in this freeze-thaw agricultural area ranged from 1.15 to 1.73, which was lower than the other cold areas. The temperature dependence analysis demonstrated that the Rs in the top layer of natural land covers was more sensitive to temperature and experienced a large vertical difference. The natural land covers exhibited smaller Rs and the farmlands had the bigger value due to tillage practices. The positive relationships between SOC loss and Rs were identified, which demonstrated that Rs was the key chain for SOC loss during land use conversion. The spatial-vertical distributions of SOC concentration with the 1.5-km grid sampling showed that the more SOC loss in the farmland, which was coincided with the higher Rs in farmlands. The analysis of Rs dynamics provided an innovative explanation for SOC loss in the freeze-thaw agricultural area. The analysis of Rs dynamics provided an innovative explanation for SOC loss in the freeze-thaw agricultural area.

Effects of land use changes on the ecosystem service values of a reclamation farm in northeast China.

Intensive agricultural development can change land use, which can further affect regional ecosystem services and functions. With the rapid growth of the population and the national demand for food, the northeast of China, which is located in the high latitudes, has experienced four agricultural developments since the 1950s. The original wetlands of this area were developed for farmland. The evaluation of ecosystem services is conducted to reveal the ecosystem status and variable trends caused by land reclamation. The aim of this study is to provide scientific basis for environmental management and for the sustainable development of agriculture in Northeast China. With GIS-RS technology, a typical farm was chosen to analyze variations in the ecosystem service value in response to land use changes during the study period. The total ecosystem service value of the farm decreased from 7523.10 million Yuan in 1979 to 4023.59 million Yuan in 2009 with an annual rate of -1.6 % due to the decreasing areas of woodland and wetland. The increased areas of cropland, water area and grassland partly offset the loss of the total value, but the loss was still greater than the compensation. Waste treatment and climate regulation were the top two service functions with high service values, contributing to approximately 50 % of the total service value. The spatial difference of the ecosystem service value also was analyzed. The wetlands located in the central and northeastern sections of the farm changed significantly. From the aspect of ecosystem service value, the wetland and water area should be conserved, as they have the highest value coefficients. The accuracy of the value coefficient, however, needs to be studied further in future research.