Much of the disease burden in our region hides behind a single symptom: fever. In Sierra Leone, an estimated 65% of acute febrile illnesses test positive for malaria (SL DHS 2019) — but that leaves a large share of fevers undiagnosed, caused by viruses, bacteria, parasites or fungi that routine testing never identifies. Our work in this area builds the laboratory, surveillance and research capacity to find out what is actually making people sick, and to detect emerging and epidemic pathogens early — before they become outbreaks.
Climate change, urbanisation and mobility make West Africa increasingly prone to emerging and re-emerging outbreaks — Ebola, Lassa, arboviruses and more.
Arboviral infections are underreported and often confused with malaria, so their true burden — and their risk — is poorly understood.
We strengthen in-country clinical, laboratory and genomic capacity so that detection and response can be led from within the region.
This study identifies and diagnoses the causes of undiagnosed fevers — fevers of unknown origin (FUO) — among patients attending designated sentinel health facilities in Freetown. Acute febrile illness can be driven by a wide range of pathogens, including dengue, typhoid, chikungunya, leptospirosis, influenza and many others, which frequently go unidentified when testing focuses on malaria alone.
Working with the Directorate of Health Security & Emergencies of the Ministry of Health and Sanitation, the study develops a mechanism to determine the etiologies of undiagnosed fevers, informing public-health programmes and strengthening the capacity to identify, monitor and assess pathogens of potential public-health importance — part of a global early-warning system for pandemic threats.
Objectives
West Africa is emerging as a potential hotspot for arboviral disease — dengue (DENV), Zika (ZIKV) and chikungunya (CHIKV), all transmitted by Aedes mosquitoes. Following the 2014 Ebola epidemic and the COVID-19 pandemic, the region continues to experience arboviral outbreaks that remain understudied, underreported, and easily confused with malaria.
SC-GRA is a prospective, observational, longitudinal study across five countries of the West African Consortium for Clinical Research on Epidemic Pathogens (WACCREP) — Mali, Côte d’Ivoire, Sierra Leone, Guinea and Liberia. Its principal aim is to advance sub-regional epidemic preparedness and response through integrated, collaborative clinical research and training, generating the evidence needed for surveillance and control of epidemic pathogens.
A population-based seroconversion survey estimating the seroprevalence and annual incidence of arboviral infection in the general population.
Febrile-illness surveillance measuring the prevalence and distribution of DENV, ZIKV and CHIKV among febrile patients, and the risk factors for severe disease.
Specific objectives
We welcome partners, students and collaborators interested in infectious-disease surveillance, diagnostics and genomic research in West Africa.
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