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CDC in Sierra Leone

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Sierra Leone at a Glance

  • Population: 6,242,140
  • Per capita income: $1,360
  • Life expectancy at birth women/men: 45/45 yrs
  • Infant mortality rate: 128/1000 live births
Source: Population Reference Bureau World Population Data Sheet, 2013

Map of Sierra LeoneThe Centers for Disease Control and Prevention (CDC) began working in Sierra Leone in 2008 through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). CDC supports laboratory and surveillance capacity building activities for HIV and other infectious diseases. CDC also supports training to build basic disease detection and response capacity in the workforce. With no permanent in-country presence, CDC coordinates activities from its Atlanta headquarters through site visits and with the assistance of implementing partners in-country, the Association of Public Health Laboratories and the Africa Field Epidemiology Network.  

National Public Health Laboratory

CDC and PEPFAR partners assisted in establishing the Central Public Health Reference Laboratory (CPHRL) in 2011. The CPHRL offers serology, molecular, and microbiology public health services. Through Atlanta-based technical assistance, CDC assists the National AIDS Commission to institute and promote lab safety, quality control, and quality assurance in HIV/AIDS laboratory methods; supports the development of a laboratory information network protocol for HIV and related opportunistic infections; installs laboratory HIV diagnostic equipment; trains staff on current HIV diagnostic methods; and provides guidance to institute a phased national HIV proficiency testing program with support from WHO.

Monitoring and Evaluation

CDC conducted a pre-pilot evaluation to assess infrastructure, systems, and potentials for integration into the existing maternal and child health program and will develop guidelines to conduct an expanded pilot.
CDC provided a national review, assessments, and technical assistance to the NAS and partners to address gaps in pediatric HIV services.  CDC also established an in-country prevention of mother-to-child pediatric technical work group to harmonize activities in early infant diagnosis services.


Impact in Sierra Leone

  • Laboratory capacity expanded by converting the National HIV Reference Laboratory into a national infectious diseases public health laboratory, which offers a much broader range of services including serology, molecular diagnostics, and microbiology
  • Support of the global polio eradication initiative contributed to zero polio cases identified in since 2010

CDC provided support and technical expertise in the expansion of the antenatal surveillance survey from 13 to 20 sentinel sites.


CDC's development of strong partnerships with NAS, MoHS, WHO, UNICEF, the Department of Defense, and the United States Agency for International Development has led to the establishment of  an MoHS-led laboratory and surveillance technical workgroup, the development of a national laboratory strategic plan, and an MoHS-approved national laboratory policy.


The focus of CDC-supported polio eradication activities is to increase the immunity of the population through immunization campaigns, to strengthen surveillance, to prevent re-importation of wild poliovirus, and to minimize the consequences of further international spread of virus into West Africa. CDC deployed 27 public health professionals to work in Sierra Leone on immunization activities through the Stop the Transmission of Polio program since the program began in 1999.  CDC also co-founded the Measles & Rubella Initiative partnership that is working to eliminate measles and rubella in Sierra Leone as well as in the other parts of the world.


In early 2009, the joint CDC/ Naval Medical Research Unit No.3 team conducted an assessment in Sierra Leone to determine the country’s capacity and willingness to set up an influenza sentinel surveillance system. Since then an influenza reference laboratory has been established in Lakka, staff attended a regional influenza surveillance training organized by CDC, and a laboratory technician was trained on techniques to isolate influenza virus, as well as on the management of an influenza sentinel surveillance system.  With support from the Sierra Leone Ministry of Health, as well as the World Health Organization, an influenza surveillance system was established and now has grown to 8 sites.  With CDC-provided diagnostic materials and equipment, the Sierra Leone Influenza Reference Laboratory will take over testing all specimens that need to be tested for influenza.

Global Health Initiative (GHI)

The Global Health Initiative (GHI) is an approach to instituting integrated, coordinated and results-driven global health investments.  It supports all U.S. Government agencies to work as one.  With the support of CDC and other partners, the PMTCT program in Sierra Leone is working toward integration within the maternal child health program, thereby significantly increasing access to care. It is also working with the Integrated Disease Surveillance and Response (IDSR) program to leverage surveillance systems as a vehicle for referral of specimens for diagnosis toward elimination of mother-to-child HIV transmission.

Top 10 Causes of Death

Source: GBD Compare , 2010
  1. Malaria 17%
  2. Lower respiratory infections 9%
  3. Protein-Energy Malnutrition 9%
  4. Pre-Term Birth Complications 5%
  5. Diarrheal disease 5%
  1. HIV 4%
  2. Cancer 4%
  3. Stroke 4%
  4. Tuberculosis 4%
  5. Ischemic Heart Disease 2%


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  • Page last reviewed: August 5, 2014
  • Page last updated: August 5, 2014
  • Content source: Global Health
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