CDC in Sierra Leone

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Two case surveillance officers walk to the local clinic in the remote village of Tongo Walla, Sierra Leone, to assess surveillance practices in 2016. Credit: Luis Eduardo Torrens/CDC

The Centers for Disease Control and Prevention (CDC) began working in Sierra Leone in the 1970’s, focusing on Lassa fever. In 2008, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC began supporting Sierra Leone’s HIV response. A CDC country office was established in Sierra Leone in 2015, focusing on global health security and Ebola response. CDC works closely with Sierra Leone on strengthening laboratory, surveillance, emergency management, and workforce capacity to respond to disease outbreaks. 

As new health threats emerge (e.g., COVID-19) CDC and national partners are well-placed to leverage past successful initiatives and rapidly respond to new public health challenges. 

Download Sierra Leone Factsheet pdf icon[PDF – 376 KB]

CDC Impact in Sierra Leone 

COVID-19

Global health security  investments and decades of global cooperation and support to respond to outbreaks, control HIV, TB, and malaria, eradicate polio, and prepare for influenza and other pandemic diseases have built strong foundations upon which to attack the coronavirus pandemic. In Sierra Leone, CDC is supporting response coordination, surveillance, diagnostic capacity, quarantine management, case investigation, infection prevention and control, and risk communication activities, as follows: 

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CDC has supported adaptation of a system for electronic data capture in the field (case investigation, contact monitoring, etc.)

Field Epidemiology Training Program 

CDC supports Sierra Leone through the establishment of a Field Epidemiology Training Program (FETP), which provides field epidemiologists—or disease detectives— the necessary skills to collect, analyze and interpret data that contributes to evidence-based decisions. Three levels of training—advanced, intermediate, and frontline—develop national and local surveillance capabilities to investigate outbreaks before they become epidemics.  

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More than 215 graduated from the Intermediate and Frontline FETP courses 

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Trained 42 FETP graduates as contact tracing supervisors

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Trained 410 Community Health Workers  and volunteers to conduct contact tracing 

Global Health Security

In today’s connected world, disease threats can spread faster and more unpredictably than ever before. CDC helped Sierra Leone reach the targets outlined in the Global Health Security Agenda (GHSA), a global partnership launched in 2014 to help make the world safer from infectious disease threats.  

Working closely with the Ministry of Health and Sanitation (MOHS) and other partners, CDC provides expertise and support across the 11 technical areas, including disease surveillance, laboratory systems, workforce development, and emergency management, as well as immunization, and antimicrobial resistance. Additionally, CDC supports the establishment of a national public health institute that will serve as a central structure for public health functions.  

Sierra Leone was among the first countries in Africa to undergo the Joint External Evaluation (JEE) process. This  helped partners more clearly understand the country’s  needs and provided guidance for external resources to address these gaps. Shifting focus to Sierra Leone’s priorities for health security helps the government  align domestic resources to continue to build and sustain capacity.      

Sierra Leone has the highest maternal mortality rate in the world, as well as one of the highest mortality rates for children under age five. CDC is partnering with the Bill Melinda Gates Foundation and the MOHS to stand up the Child Health and Mortality Prevention Surveillance (CHAMPS) network to better identify, understand and prevent the causes of death in children under age 5.  

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In 2018, worked with partners to develop National Action Plan for Health Security and JEE assessment Update

Ebola

The 2014-2016 Ebola outbreak, was the largest  in history and Sierra Leone suffered the highest number of deaths. CDC provided technical and strategic support in epidemiology, infection prevention and control, case management, health promotion, laboratory diagnostics and systems strengthening, emergency management, border health, and research, including the Sierra Leone Trial to Introduce a Vaccine Against Ebola (STRIVE). CDC supported the establishment of the Sierra Leone Ebola/Epidemiological Database (SLED), used to describe and better understand morbidity and mortality from Ebola, and risk factors that contributed to the epidemic.

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SLED helps people in Sierra Leone find the graves of loved ones who died during the Ebola epidemic

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More than 700 CDC staff served on over 1,000 deployments to Sierra Leone

Capacity Building in Public Health Management and Leadership 

CDC supported the MOHS to launch the Community Health Officer Management and Leadership Training Program in 2016. Modeled after FETP, the six-month program includes classes and field assignments.

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As of August 2020, 185 community health officers across 14 districts have graduated, as well as nine participants in the training-of-trainers program

Infection Prevention and Control

CDC began training healthcare workers in infection prevention and control (IPC) during the Ebola epidemic. IPC is key to combating antimicrobial resistance. CDC assisted the MOHS in establishing a national IPC program and a national IPC certificate course. Sierra Leone now has a national IPC policy and guidelines, and CDC helped start a national IPC certificate course. CDC continues to strengthen capacity and sustainability of IPC as a key component of combating antimicrobial resistance.

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25 hospitals and 14 districts are prepared to implement the national IPC guidelines

Laboratory Systems Strengthening

CDC helps strengthen Sierra Leone’s laboratory network through investments in the Central Public Health Reference Laboratory and workforce development of laboratory technicians.

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10 key epidemic-prone diseases, like COVID-19, Ebola, yellow fever, cholera, and influenza, can now be detected through laboratory diagnostic testing

HIV and Tuberculosis

For the past 10 years CDC, as an implementing partner of the U.S. President’s Emergency Plan for AIDS (PEPFAR) in Sierra Leone, has helped improve the quality of HIV/AIDS and tuberculosis (TB) services. CDC has helped build high-quality laboratory systems to support HIV and TB testing, such as HIV viral load and early infant diagnosis and TB drug susceptibility testing. 

Sierra Leone became an official PEPFAR country in FY 2021. PEPFAR has increased its investment in Sierra Leone to support the National HIV Response.

Malaria

Malaria remains one of the highest burden diseases in Sierra Leone. The U.S. President’s Malaria Initiative (PMI) is led by USAID and co-implemented with CDC in 24 countries in Africa, including Sierra Leone. A CDC resident advisor provides technical advice to the National Malaria Control Program to enhance the implementation of malaria interventions, including entomologic surveillance, insecticide resistance testing, and improved data monitoring and usage. CDC supported the roll-out and evaluation of preventive treatment to reduce infant morbidity. 

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Trained 50 laboratory technicians in expert malaria microscopy

CDC Staff in Sierra Leone
  • 4 U.S. Assignees
  • 12 Locally Employed
Sierra Leone at a Glance
  • Population: > 7,813,215
  • Per capita income: > $1,580
  • Life expectancy: F 56 / M 54 years
  • Infant mortality rate: 75/1,000 live births

Sources: World Bank 2019, Population Reference Bureau

Sierra Leone Top 10 Causes of Death
  1. Malaria
  2. Lower respiratory infections
  3. Neonatal disorders
  4. Ischemic heart disease 
  5. Diarrheal diseases
  6. Stroke
  7. HIV/AIDS
  8. Congenital defects
  9. Tuberculosis
  10. Meningitis

Source: GBD Compare 2018, Sierra Leone

Page last reviewed: February 26, 2021
Content source: Global Health