Background Evidence of how social factors affect the health-related quality of life (HRQoL) of Ebola virus disease (EVD) survivors is limited. Our study explores the association between socio-demographic, health-related and psycho-social (stigma) factors and EVD survivors' health-related quality of life (HRQoL) in Sierra Leone. Methods We conducted a nationwide cross-sectional study among 358 EVD survivors between January and August 2018. We used a multistage sampling method to recruit EVD survivors, and the RAND 36-Item Health Survey item was used to assess the HRQoL. Data were analysed using descriptive statistics and multiple linear regression. Results When comparing by each dimension in relation to their respective summary scores, role limitation physical [0.00 (50.00)] and role limitation emotional [0.00 (33.33)] were the most affected physical health and mental health domains among EVD survivors respectively. EVD survivors who were older (β = − 3.90, 95% CI − 6.47 to − 1.32, p = 0.003), had no formal education (β = − 2.80, 95% CI − 5.16 to − 0.43, p = 0.021), experienced a unit increase in the number of post-Ebola symptoms (β = − 1.08, 95% CI − 1.74 to − 0.43, p < 0.001) and experienced a unit increase in enacted stigma (β = − 2.61, 95% CI − 4.02 to − 1.20, p < 0.001) were more likely to report a decreased level of physical health. EVD survivors who experienced a unit increase in the time spent in the Ebola treatment centre (β = − 0.60, 95% CI − 0.103 to − 0.18, p = 0.006) and those who experienced a unit increase in enacted Stigma were more likely to report decreased levels of mental health (β = − 1.50, 95% CI − 2.67 to − 0.33, p = 0.012). Conclusion Sociodemographic, health-related, and psycho-social factors were significantly associated with decrease levels of HRQoL. Our findings improve our understanding of the factors that might influence the HRQoL and suggest the need for EVD survivors to be provided with a comprehensive healthcare package that caters for their physical and mental health needs.

With an estimated population of 8.3 million, Sierra Leone has no existing pharmaceutical manufacturing company at present. The recent COVID-19 pandemic brought to the limelight the fragility and weakness of the Sierra Leonean pharmaceutical industry as it resulted in severe drug shortages and medicine insecurity in the country due to the restrictions imposed on importations, which validates the uncertainties if the country can sufficiently meet its local pharmaceutical needs and health demands. In this paper, we highlight the current situation of the Sierra Leonean pharmaceutical sector and provide recommendations for the country towards building a functional pharmaceutical industry based on lessons learnt from the COVID-19 pandemic.

Objective: This study evaluates the registration status and the quality of nine brands of Vitamin C sold in Freetown, Sierra Leone, using official and non-official methods of analysis. Methods: The parameters taken into consideration during the study include non-official methods (friability and disintegration) and the official methods (identification test, uniformity of dosage unit, and assay by titrimetric and colorimetric tests). The different brands of vitamin C were selected and classified as registered and unregistered based on the data derived from the National Medicines Regulatory Authority. Results: One vitamin C product collected was unregistered at the National medicines regulatory authority (Pharmacy Board of Sierra Leone). All nine vitamin C products met the requirements for uniformity of dosage unit. The vitamin C products also conformed to the BP specification for friability and identification test (retention factor). The identification test showed that each brand contained vitamin C (ascorbic acid). The disintegration test was not applicable for chewable tablets. Three of the four non-chewable vitamin C products complied with the BP specification for disintegration, while one failed and did not meet the requirement. The assay results for ascorbic acid using titration and colourimetric method were comparable and appropriate for determining vitamin C. Out of a total of nine samples; seven met the requirement for BP specification (Passed) for assay. In contrast, one product did not meet the BP requirement (failed), and one sample had more vitamin C than the Pharmacopoeia limit. Conclusion: Periodic quality evaluation and routine checks for pharmaceutical products can ascertain the quality of products, their storage conditions and identify potential counterfeit medications.

IntroductionTobacco use is a global health threat associated with a high disease burden and deaths. Studies concerning current tobacco use and susceptibility to using tobacco products among adolescents who are potential adult tobacco users in Sierra Leone have not been explored. We aimed to estimate the prevalence and correlates of current tobacco use and tobacco non-users susceptibility to using tobacco amongst Sierra Leonean high-school students.MethodWe used data obtained from the 2017 Sierra Leone Global Youth Tobacco Survey (GYTS), which presented information collected from 6680 students aged 11-17years nationwide. Gender-based correlates of current use and susceptibility to using tobacco among non-tobacco users were determined by complex sample logistic regression analyses. Adjusted odds ratios (AOR) and respective 95% confidence intervals (CIs) were reported. p-values less than 0.005 were considered significant.ResultsThe prevalence of current tobacco use among high school adolescents in Sierra Leone was 24.6% and was higher in males (27.9%) than in females (18.6%). Male [AOR=1.50 (95%CI: 1.18-1.91)], parental smoking [AOR=1.73(95%CI:1.32-2.26)] exposure to household secondhand smoke [AOR=1.82(95%CI:1.27-2.62)], having peers who smoke [AOR=2.24(1.51-3.31)] were more likely to be currently using tobacco. On the other hand, adolescents exposed to antismoking media messages were less likely to be current tobacco users [AOR=0.67(95%CI: 0.52-0.85)]. The overall tobacco non-users susceptibility to using tobacco among adolescents in Sierra Leone was 18.2% [male (18.0%), female (18.5%)]. Exposure to tobacco promotion [AOR =1.50(95%CI:1.06-2.10)] and non-exposure to antismoking education [AOR =1.39(95%CI:1.05-1.86)] were significantly associated with tobacco non-users’ susceptibility to using tobacco.ConclusionOur study suggests that one-in-four school-going adolescents currently use tobacco, with nearly one in five non-users susceptible to using tobacco. Given the high prevalence of tobacco product use among Sierra Leonean adults, our findings highlight the need for policies and interventions to prevent tobacco use behaviour among adolescents aimed at averting tobacco use in adulthood.

INTRODUCTION Tobacco use is a global health threat associated with a high disease burden and death. Current tobacco use and susceptibility to using tobacco products among adolescents who are potential adult tobacco users have not been explored in Sierra Leone. Thus, we aimed to estimate the prevalence and correlates of current tobacco use and tobacco non-users susceptibility to using tobacco amongst high school students in Sierra Leone. METHODS We used data obtained from the 2017 Sierra Leone Global Youth Tobacco Survey (GYTS), which presented information collected from 6680 students aged 11-17 years nationwide. Gender-based correlates of current use and susceptibility to using tobacco among non-tobacco users were determined by complex sample logistic regression analyses. Adjusted odds ratios (AOR) and respective 95% confidence intervals (CIs) are reported. A p<0.05 was considered significant. RESULTS The prevalence of current tobacco use among high school adolescents in Sierra Leone was 24.6%, higher in males (27.9%) than in females (18.6%). Male (AOR=1.50; 95% CI: 1.18-1.91), parental smoking (AOR=1.73; 95% CI: 1.32-2.26) exposure to household secondhand smoke (AOR=1.82; 95% CI: 1.27-2.62), having peers who smoke (AOR=2.24; 95% CI: 1.51-3.31) were more likely to be currently using tobacco. The overall tobacco non-users susceptibility to using tobacco among adolescents in Sierra Leone was 18.2% (males 18.0%, females 18.5%). Exposure to tobacco promotion (AOR=1.50; 95% CI: 1.06-2.10) and non-exposure to anti-smoking education (AOR=1.39; 95% CI: 1.05-1.86) were significantly associated with tobacco non-users' susceptibility to using tobacco. CONCLUSIONS Our study suggests that one in four school-going adolescents currently uses tobacco, with nearly one in five non-users susceptible to using tobacco. Given the high prevalence of tobacco product use among adults in Sierra Leone, our findings highlight the need for policies and interventions to prevent tobacco use behavior among adolescents, aimed at averting tobacco use in adulthood.