By Mabinty M. Kamara & Alpha Abu
Health authorities in Sierra Leone have been engaged in tackling Lassa fever, a disease that is prevalent in the Eastern Region and notably Kenema district, considered the epicentre.
Despite years of relentless efforts by medics to control the spread of the virus, challenges remain, exacerbated by the apparent ignorance of a reasonable part of the population on the real dangers associated with the zoonotic disease, caused by the Multimammate rat.
The Lassa Fever Programme located in Kenema has over the years received support from the United States, enabling the implementation of various initiatives.
Lack of proper education
Generally people in Sierra Leone have a fair knowledge about the fact that Lassa fever is caused by a rat, and they will tell you the rodent with an elongated mouth is responsible for transmitting the virus.
That apart, a greater percentage of the populace have very little idea on the virus’ mode of transmission or its symptoms on affected persons, not to talk about having any fair knowledge about the debilitating conditions some survivors may have to live with.
A random sampling of the views of Sierra Leoneans on lassa fever early this December mirrors those held by the general public about the disease. Mohamed Jalloh, a researcher and economist at the Sanusi Research and Consulting Firm said he has heard about Lassa fever and that it is caused by rat but admitted not to have any idea about its symptoms or seen a victim.
A young journalist in Freetown has absolutely no idea about the cause and mode of transmission of the virus.
And a young man who rides a commercial rickshaw in Freetown could tell people become infected through ingestion of food contaminated by the virus- carrying rat, but lacked knowledge about its symptoms on persons or its post-treatment effects on survivors.
The above examples give a mixed bag of conceptions about the zoonotic disease in Sierra Leone, posing to public health workers an even greater challenge in mitigating or preventing the spread of Lassa fever in the country.
Lassa fever according to expert is a highly contagious haemorrhagic disease which can be transmitted from a particular type of rat scientifically known as Mastomys Natalenses. It can also be transmitted from human to humans through body contacts.
In Sierra Leone like in other West Africa countries like Nigeria, Guinea and Liberia, Lassa fever has, over the years, been killing dozens of people while some have miraculously survived its virulence. Emmanuel Saidu a lecturer at the Njala University who doubles as a Research scientist and a team lead for Highly Consequence Pathogens Projects funded by the US Center for Disease Control said there is currently no specific treatment for the disease but that infected persons are supportive care and symptomatic treatment until they recover.
We could not get Sierra Leone’s minister of Health and Sanitation who is an experienced virologist to speak on some technical and policy issues in relation to the subject.
However, in an earlier interview with Politico, he assured that Ribavirin is an effective treatment for the disease.
Tackling Lassa Fever: An Organized Approach
The existential experience of public health workers devoted to the cause of combating the virus cannot go unnoticed. Years of commitment, research and networking with partners have created a concerted approach in curtailing the prospect of the disease becoming an epidemic.
Risk Communication Lead/Health Education Officer for Kenema District Health Management Team, Francis Suma said Lassa fever is one of the diseases under surveillance and that together with the district- based Lassa fever Control Programme and partners, they have been regularly monitoring the trend of incidence.
This he said has enabled them, health care providers, with the participation of communities to do continuous follow up and be able to detect cases and do immediate referrals to the Kenema Government Hospital ‘’for necessary action’’.
‘’So as we continue with those important healthcare interventions, we also promote preventive measures that can help toward reducing the burden of Lassa Fever cases, especially so in those communities or chiefdoms that have the potential to invariably record cases’’, Suma explains.
There are teams that conduct ‘Active case Search’ in chiefdoms in Kenema district considered as the ‘Lassa fever belt’ namely Nongowa, Lower Bambara, Small Bo, Dodo and Malegohun that have over the years been recording cases.
Controlling the spread of the virus
Communities where Lassa fever is said to be concentrated are closely knitted with similar ethnicity, tradition and shared values and traditions hence changing their perception about certain things can be very difficult. The tradition of hunting rats for food is quite common in rural settings of Sierra Leone and public health officials in Kenema district have been engaging locals and encouraging them to desist from the practice, telling them rats are likely to carry the virus.
Suma said they undertake preventive interventions, getting the people to understand the seriousness of the disease and for them to limit contact with rats in general.
Improved home and community hygiene and sanitation, and getting the people to comply with recommended measures are some of the undertakings of the health experts.
Early- care seeking is also encouraged in towns and villages along the Lassa fever belt, discouraging the practice of buying drugs from peddlers and treating themselves at home for ailments that are undiagnosed instead of going to hospitals.
Horrors of the disease and surviving it
Musa Momoh who lives in the town of Panguma in Kenema district was infected with lassa fever and survived. Sounding quite religious, he said it’s all in God’s hands and would not blame anyone for getting infected. Momoh claimed he complied with all the preventive measures against the disease, not eating slept- over food, kept his drinkable water well protected and had never touched or eaten rodents.
Momoh whose family line has a long terrorising history of Lassa fever infection, narrated how the virus was first detected on his niece decades ago, the beginning of what was to become a long and harrowing experience for him and his relations. She survived after she was taken to Segbwema Hospital in the nearby Kailahun district, and never complained of any complication.
Next to be infected was Momoh’s younger sister and then another sister’s husband, in quick succession. According to Momoh, the two were taken to the Kenema government hospital and were treated, with no underlying health problems, post-treatment. Soon after, his sister who was so concerned about her husband’s health months before also got infected and then her son, but the two were treated with no report of adverse condition after they were discharged from hospital.
‘’Our mother was also diagnosed with Lassa fever and survived after she was admitted at the Kenema hospital. Next to catch the virus was our father and he was taken to hospital but he didn’t survive. I was by his hospital bedside, wearing gloves, not allowed to touch him with bare hands. After he succumbed to the disease, he was placed in a body bag and buried by the hospital staff ’’, Momoh lamented.
He said three years after his father died, he was in Kenema when he started experiencing headache and flu, accompanied by fever. He said he became worried because of the not too hygienic surrounding he was staying at the time. He decided to travel to Panguma and upon reaching there he met his other sister also complaining of being unwell.
They were both taken to the Kenema hospital where they were diagnosed of having the virus and had to undergo treatment.
Momoh is all too conversant now with the early symptoms of Lassa fever: intense fever and cold even in the hottest period of the day, high body temperature, headache and tiredness.
He and his sister survived but claimed at some point when the drug Quinine was being administered intravenously, he complained to the nurse of experiencing a reverberating feeling in his eardrum. And according to health experts, some survivors suffer from hearing loss.
Momoh is now fully recovered but says there are many challenges facing people undergoing treatment for Lassa fever such as lacking the means to purchase supplementary drugs prescribed by the hospital, to go with those Lassa fever drugs offered free.
He said seeking early treatment is key for anyone to survive the disease and that ‘’Lassa fever is real’’.
Since his survival, Momoh said he has been engaged consistent awareness raising and sensitisation in his locality which has resulted in community action to stop the Spill over of the disease. “if you hear about Lassa fever case in Panguma, it must have come from the peripheral villages because everybody is now aware in Panguma and is making conscious effort to prevent the disease,” he said adding that one such preventive measure is by rearing cats as pest and constantly cleaning their environment and watching what they eat.
Other experts have also called for a one health approach which brings together the health sector, environment, food and agriculture in dealing with the disease in the country.
Mabinty Magdalene Kamara and Alpha Abu are Sierra Leonean Journalists working with Politico Newspaper.
This story was published with the support of Internews’s Earth Journalism Network.
Copyright © 2022 Politico Online (23/12/22)
