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Nine months after the start of the Ebola outbreak in Sierra Leone in May 2014, communities in Port Loko continued to engage in high-risk practices; many remained unwilling to seek treatment. In the face of such behaviors, Oxfam Community Outreach teams conducted qualitative research using in-depth interviews, focus groups, and questionnaires to better understand the barriers and enablers affecting treatment-seeking behavior. Analysis of their results highlights 3 primary barriers to treatment seeking: fear and limited information, concern about unknown outsiders, and the often prohibitive distance and limited accessibility of treatment. Communities were asked to provide suggestions on how to address these barriers. Their recommendations fell into 4 main categories: providing information and better communication, including community members in decisions, providing closer treatment facilities with opportunities to learn how they operate, and using survivors to inspire hope for other sufferers. This research highlights the need for social mobilization programs to invest early in understanding the underlying causes of risky behaviors in order to develop programs that address them.

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Background: Chlamydia trachomatis can cause a sexually transmitted infection, which, untreated, may result in considerable morbidity. Methods: A prevalence study was conducted for C trachomatis using nucleic acid amplification technology in asymptomatic women, and certain risk factors that may be used to direct future screening strategies were assessed. Results: The study population comprised 945 asymptomatic women, of whom 783 were attending antenatal clinics, 91 were attending infertility clinics and 71 were attending family planning clinics. An overall C trachomatis prevalence of 3.7% (35/945) was found, with the highest prevalence of 11.2% (22/ 196) in Irish single women aged ,25 years. Logistic regression analysis showed that single status and age ,25 years were independent, statistically significant predictors of C trachomatis infection. Conclusion: These results support routine screening of asymptomatic women who are sexually active and aged ,25 years. An opportunist active screening of all sexually active women independent of age should be additionally considered if resources permit.

Background Patients who are HIV positive have an increased risk of developing a malignancy, most notably Kaposi's sarcoma (KS) and Non-Hodgkin's Lymphoma (NHL).Objective To assess the incidence of malignancy in a HIV positive cohort in Ireland. Methods We relrospectiveiy reviewed al] case notes of 784 HIV positive patients attending a GUM elinic of whom 340 had Stage IV disease.Results There were 43 diagnoses of malignancy in 41 patients, the majority of whom were homosexual. There were 25 cases of KS, seven cases of primary cerebral lymphoma. seven cases of systemic NHL and four other malignancies. The overall incidence of malignancy was 12.l^r of all patients with AIDS (i.e. 41/340 patients).Comment The incidence is lower than previously reported studies, but represents signiticant morbidity. The lower incidence may be explained by our patient demographic profile. In addition, malignancies may occur at a stage when patients are too ill to pursue investigation and post mortem examination tnay he refused. The need for close monitoring of high risk groups, such as HIV positive women with cervical dysplasia, has been confirmed. © 1997 Elsevier Science B.V.