Social Mobilization for Ebola Virus Clinical Trials During a Public Health Crisis in Liberia.

BACKGROUND: At the invitation of the Liberia Ministry of Health and Social Welfare (LMOHSW), the U.S. Department of Health and Human Services joined the LMOHSW in establishing the Partnership for Research on Ebola Virus in Liberia (PREVAIL) to develop treatment and prevention strategies for Ebola virus disease (EVD). Social mobilization was a vital element of PREVAIL in a country with limited history of clinical research. OBJECTIVES: To innovate a social mobilization program for clinical trials during the Liberian EVD outbreak. METHODS: PREVAIL's social mobilization included 1) advocacy for support from leaders, 2) engagement with communities to build trust, and 3) collaboration with media for quality communications.Lessons Learned and Conclusions: Social mobilization can support clinical trials. Trusted leaders and peer to peer communication are essential for sharing reliable information and countering mistrust. Real time monitoring of media can inform timely, specific messaging. Expert evaluation resources are essential for evidence-based effectiveness assessments.

Adult and paediatric haematology and clinical chemistry laboratory reference limits for Liberia.

BACKGROUND: As more research is conducted in Liberia, there is a need for laboratory reference limits for common chemistry and haematology values based on a healthy population. Reference limits from the United States may not be applicable. OBJECTIVE: The aim of this study was to present laboratory reference ranges from a Liberian population and compare them to United States ranges. METHODS: Serum chemistry and haematology values from 2529 adults and 694 children and adolescents obtained from two studies conducted in Liberia between 2015 to 2017 were used to determine reference limits. After removing outliers, the reference limits defined by the 2.5th and 97.5th percentiles were determined by sex in three age groups (6-11, 12-17, and 18+ years). RESULTS: The median (interquartile range) of adults was 29 (23, 37) years; 44% were female. The median (interquartile range) for children and adolescents was 12 (9, 15) years; 53% were female. Several reference ranges determined using Liberian participants differed from those in the US. For chemistries, a high percentage of both adults and children/adolescents had high serum chloride levels based on United States ranges. For haematology, a high percentage of Liberian participants had haemoglobin and related assays below the lower limit of United States ranges. CONCLUSION: Chemistry and haematology reference intervals determined for a Liberian population of healthy individuals should be considered for establishing eligibility criteria and monitoring of laboratory adverse events for clinical trials as well as for use in clinical settings in Liberia and perhaps for other countries in Western Africa.