Food Insecurity as a Risk Factor for Outcomes Related to Ebola Virus Disease in Kono District, Sierra Leone: A Cross-Sectional Study

Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cros...

Full description

Saved in:
Bibliographic Details
Published inThe American journal of tropical medicine and hygiene Vol. 98; no. 5; pp. 1484 - 1488
Main Authors Kelly, J Daniel, Richardson, Eugene T, Drasher, Michael, Barrie, M Bailor, Karku, Sahr, Kamara, Mohamed, Hann, Katrina, Dierberg, Kerry, Hubbard, Allan, Lindan, Christina P, Farmer, Paul E, Rutherford, George W, Weiser, Sheri D
Format Journal Article
LanguageEnglish
Published United States Institute of Tropical Medicine 01.01.2018
The American Society of Tropical Medicine and Hygiene
Subjects
Online AccessGet full text

Cover

Loading…
Abstract Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cross-sectional study in two Ebola-affected communities in Kono district, Sierra Leone, from November 2015 to September 2016. We enrolled persons who were determined to have been exposed to Ebola virus. We assessed the association of food insecurity, using an adapted version of the Household Food Insecurity Access Scale, a nine-item scale well validated across Africa, with having been diagnosed with EVD and having died of EVD, using logistic regression models with cluster-adjusted standard errors. We interviewed 326 persons who were exposed to Ebola virus; 61 (19%) were diagnosed with EVD and 45/61 (74%) died. We found high levels (87%) of food insecurity, but there was no association between food insecurity and having been diagnosed with EVD. Among EVD cases, those who were food insecure had 18.3 times the adjusted odds of death than those who were food secure ( = 0.03). This is the first study to demonstrate a potential relationship between food insecurity and having died of EVD, although larger prospective studies are needed to confirm these findings.
AbstractList Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cross-sectional study in two Ebola-affected communities in Kono district, Sierra Leone, from November 2015 to September 2016. We enrolled persons who were determined to have been exposed to Ebola virus. We assessed the association of food insecurity, using an adapted version of the Household Food Insecurity Access Scale, a nine-item scale well validated across Africa, with having been diagnosed with EVD and having died of EVD, using logistic regression models with cluster-adjusted standard errors. We interviewed 326 persons who were exposed to Ebola virus; 61 (19%) were diagnosed with EVD and 45/61 (74%) died. We found high levels (87%) of food insecurity, but there was no association between food insecurity and having been diagnosed with EVD. Among EVD cases, those who were food insecure had 18.3 times the adjusted odds of death than those who were food secure ( P = 0.03). This is the first study to demonstrate a potential relationship between food insecurity and having died of EVD, although larger prospective studies are needed to confirm these findings.
Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cross-sectional study in two Ebola-affected communities in Kono district, Sierra Leone, from November 2015 to September 2016. We enrolled persons who were determined to have been exposed to Ebola virus. We assessed the association of food insecurity, using an adapted version of the Household Food Insecurity Access Scale, a nine-item scale well validated across Africa, with having been diagnosed with EVD and having died of EVD, using logistic regression models with cluster-adjusted standard errors. We interviewed 326 persons who were exposed to Ebola virus; 61 (19%) were diagnosed with EVD and 45/61 (74%) died. We found high levels (87%) of food insecurity, but there was no association between food insecurity and having been diagnosed with EVD. Among EVD cases, those who were food insecure had 18.3 times the adjusted odds of death than those who were food secure ( = 0.03). This is the first study to demonstrate a potential relationship between food insecurity and having died of EVD, although larger prospective studies are needed to confirm these findings.
Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes. No study, however, has examined the association between food insecurity and outcomes related to Ebola virus disease (EVD). We conducted a cross-sectional study in two Ebola-affected communities in Kono district, Sierra Leone, from November 2015 to September 2016. We enrolled persons who were determined to have been exposed to Ebola virus. We assessed the association of food insecurity, using an adapted version of the Household Food Insecurity Access Scale, a nine-item scale well validated across Africa, with having been diagnosed with EVD and having died of EVD, using logistic regression models with cluster-adjusted standard errors. We interviewed 326 persons who were exposed to Ebola virus; 61 (19%) were diagnosed with EVD and 45/61 (74%) died. We found high levels (87%) of food insecurity, but there was no association between food insecurity and having been diagnosed with EVD. Among EVD cases, those who were food insecure had 18.3 times the adjusted odds of death than those who were food secure ( P = 0.03). This is the first study to demonstrate a potential relationship between food insecurity and having died of EVD, although larger prospective studies are needed to confirm these findings.
Author Farmer, Paul E
Dierberg, Kerry
Rutherford, George W
Weiser, Sheri D
Hann, Katrina
Barrie, M Bailor
Richardson, Eugene T
Lindan, Christina P
Kelly, J Daniel
Karku, Sahr
Drasher, Michael
Hubbard, Allan
Kamara, Mohamed
Author_xml – sequence: 1
  givenname: J Daniel
  surname: Kelly
  fullname: Kelly, J Daniel
  organization: Department of Medicine, University of California, San Francisco, San Francisco, California
– sequence: 2
  givenname: Eugene T
  surname: Richardson
  fullname: Richardson, Eugene T
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 3
  givenname: Michael
  surname: Drasher
  fullname: Drasher, Michael
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 4
  givenname: M Bailor
  surname: Barrie
  fullname: Barrie, M Bailor
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 5
  givenname: Sahr
  surname: Karku
  fullname: Karku, Sahr
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 6
  givenname: Mohamed
  surname: Kamara
  fullname: Kamara, Mohamed
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 7
  givenname: Katrina
  surname: Hann
  fullname: Hann, Katrina
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 8
  givenname: Kerry
  surname: Dierberg
  fullname: Dierberg, Kerry
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 9
  givenname: Allan
  surname: Hubbard
  fullname: Hubbard, Allan
  organization: Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California
– sequence: 10
  givenname: Christina P
  surname: Lindan
  fullname: Lindan, Christina P
  organization: Institute for Global Health Sciences, University of California, San Francisco, California
– sequence: 11
  givenname: Paul E
  surname: Farmer
  fullname: Farmer, Paul E
  organization: Partners In Health, Freetown, Sierra Leone
– sequence: 12
  givenname: George W
  surname: Rutherford
  fullname: Rutherford, George W
  organization: Institute for Global Health Sciences, University of California, San Francisco, California
– sequence: 13
  givenname: Sheri D
  surname: Weiser
  fullname: Weiser, Sheri D
  organization: Department of Medicine, University of California, San Francisco, San Francisco, California
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29557329$$D View this record in MEDLINE/PubMed
BookMark eNpdkc1v1DAQxS1URLeFI1dkiQsHUvyZxBwqVUsXKlaq1AWu1sSZUC_ZuNgO0t75w5u0pQIOo9FofnqaN--IHAxhQEJecnaiRGnewTbvrk94VbBasCdkwVVVFrxU-oAsGGOiMKWsDslRSlvGeC04f0YOhdG6ksIsyO9VCC29GBK6Mfq8p5Ao0CufftAVuBwi7aa6HLMLO0z0CnvI2NIc6HkTeqDffBwT_eATQkLqB_o5DGGec_Quv6UbjzECXeN09Xt6RpcxpFRs0GUfBujpJo_t_jl52kGf8MVDPyZfV-dflp-K9eXHi-XZunCK61x0xkHrWN00ujWlNl0pqobVChrQTLFaohR1C5pzgaJpsUMuDWopFQh0nZbH5PRe92Zsdtg6HHKE3t5Ev4O4twG8_Xcz-Gv7Pfyy2kwqtZwE3jwIxPBzxJTtzieHfQ8DhjFZwbiu1fT9GX39H7oNY5wsTxTnUhvFlJqo4p5y818ido_HcGbnfO1dvpZXds534l_97eCR_hOovAW3UqSe
CitedBy_id crossref_primary_10_1371_journal_pgph_0000770
crossref_primary_10_1007_s10389_023_01867_8
crossref_primary_10_22490_25392786_4959
crossref_primary_10_3389_fsufs_2022_987924
crossref_primary_10_1097_COH_0000000000000659
crossref_primary_10_1016_j_gfs_2021_100594
crossref_primary_10_1093_ofid_ofac052
crossref_primary_10_1016_j_jclepro_2020_124537
crossref_primary_10_1186_s12937_023_00836_x
crossref_primary_10_1093_ofid_ofac593
crossref_primary_10_1371_journal_pone_0255392
crossref_primary_10_1093_infdis_jiac359
ContentType Journal Article
Copyright Copyright Institute of Tropical Medicine 2018
The American Society of Tropical Medicine and Hygiene 2018
Copyright_xml – notice: Copyright Institute of Tropical Medicine 2018
– notice: The American Society of Tropical Medicine and Hygiene 2018
DBID NPM
AAYXX
CITATION
7X8
5PM
DOI 10.4269/ajtmh.17-0820
DatabaseName PubMed
CrossRef
MEDLINE - Academic
PubMed Central (Full Participant titles)
DatabaseTitle PubMed
CrossRef
MEDLINE - Academic
DatabaseTitleList CrossRef

PubMed
MEDLINE - Academic

Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1476-1645
EndPage 1488
ExternalDocumentID 10_4269_ajtmh_17_0820
29557329
Genre Journal Article
GeographicLocations Sierra Leone
GeographicLocations_xml – name: Sierra Leone
GrantInformation_xml – fundername: NCATS NIH HHS
  grantid: KL2 TR001100
– fundername: NIMH NIH HHS
  grantid: T32 MH019105
GroupedDBID ---
.55
.GJ
1CY
23M
2WC
34G
36B
3O-
53G
5GY
5RE
5VS
6J9
ABCQX
ABPPZ
ABTNK
ACGFO
ADBBV
ADTPD
AENEX
AFFNX
AGCDD
AI.
AIAGR
ALMA_UNASSIGNED_HOLDINGS
AOIJS
BAWUL
BTFSW
DIK
E3Z
EBD
EBS
EJD
EMB
EMOBN
F5P
GX1
H13
HYE
K-O
KQ8
L7B
MV1
NEJ
NPM
OHT
OK1
P2P
PQQKQ
RHF
RHI
RPM
SV3
TR2
TST
UPT
VH1
W8F
WH7
WOQ
WOW
X7M
XOL
ZGI
ZKB
ZXP
~KM
AAYXX
CITATION
7X8
5PM
ID FETCH-LOGICAL-c415t-f9cadc08bb5d9659f627b084aba504083e328da5112e2bdefe139e5334a2ecf53
IEDL.DBID RPM
ISSN 0002-9637
IngestDate Tue Sep 17 21:24:59 EDT 2024
Fri Oct 25 01:22:57 EDT 2024
Thu Oct 10 17:50:43 EDT 2024
Fri Dec 06 08:48:32 EST 2024
Wed Oct 16 00:50:59 EDT 2024
IsDoiOpenAccess false
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 5
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c415t-f9cadc08bb5d9659f627b084aba504083e328da5112e2bdefe139e5334a2ecf53
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Authors’ addresses: J. Daniel Kelly, Department of Medicine, University of California, San Francisco, San Francisco, CA, and Partners In Health, Freetown, Sierra Leone, E-mail: dan.kelly@ucsf.edu. Eugene T. Richardson, Partners In Health, Freetown, Sierra Leone, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, and Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, E-mail: erichardson@bwh.harvard.edu. Michael Drasher, Sahr Karku, Mohamed Kamara, Katrina Hann, and Kerry Dierberg, Partners In Health, Freetown, Sierra Leone, E-mails: drasher003@gmail.com, sahrlukarku@gmail.com, kamaram04@gmail.com, hann.katrina@gmail.com, and kdierberg@gmail.com. M. Bailor Barrie and Paul E. Farmer, Partners In Health, Freetown, Sierra Leone, and Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, E-mails: bailor@wellbodyalliance.org and paul.e.farmer@gmail.com. Allan Hubbard, Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, E-mail: hubbard@berkeley.edu. Christina P. Lindan and George W. Rutherford, Institute for Global Health Sciences, University of California, San Francisco, CA, E-mails: krysia.lindan@ucsf.edu and george.rutherford@ucsf.edu. Sheri D. Weiser, Department of Medicine, University of California, San Francisco, San Francisco, CA, E-mail: sheri.weiser@ucsf.edu.
Financial support: This work was supported by UC Office of the President Global Food Initiative, UCSF Global Health Sciences, and Partners In Health—Sierra Leone.
OpenAccessLink http://www.ajtmh.org/deliver/fulltext/14761645/98/5/tpmd170820.pdf?itemId=%2Fcontent%2Fjournals%2F10.4269%2Fajtmh.17-0820&mimeType=pdf&containerItemId=content/journals/14761645
PMID 29557329
PQID 2113594044
PQPubID 105381
PageCount 5
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_5953383
proquest_miscellaneous_2015841643
proquest_journals_2113594044
crossref_primary_10_4269_ajtmh_17_0820
pubmed_primary_29557329
PublicationCentury 2000
PublicationDate 2018-01-01
PublicationDateYYYYMMDD 2018-01-01
PublicationDate_xml – month: 01
  year: 2018
  text: 2018-01-01
  day: 01
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
– name: Deerfield, Illinois
PublicationTitle The American journal of tropical medicine and hygiene
PublicationTitleAlternate Am J Trop Med Hyg
PublicationYear 2018
Publisher Institute of Tropical Medicine
The American Society of Tropical Medicine and Hygiene
Publisher_xml – name: Institute of Tropical Medicine
– name: The American Society of Tropical Medicine and Hygiene
References Richardson (b1) 2016; 18
Kelly (b26) 2018
Lindblade (b24) 2016; 22
Smit (b36) 2017; 64
Yamanis (b39) 2016; 10
Weiser (b6) 2011; 94
Seligman (b14) 2010; 21
Richardson (b27) 2016; 10
Richardson (b3) 2017; 195
Ferme (b28) 2001
Asiimwe (b15) 2015; 34
Rosenke (b42) 2016; 63
Waxman (b41) 2017; 17
Weiser (b5) 2014; 28
Leroy (b21) 2000; 355
Reid (b16) 2017; 75
The World Bank (b4) 2018
Qian (b18) 2017; 2017
Whittle (b23) 2016; 170
Coates (b29) 2007
World Health Organization (b31) 2014
Radimer (b7) 1990; 120
Kelly (b38) 2014; 513
Huang (b19) 2017; 63
Stehling-Ariza (b35) 2016; 16
Hamelin (b8) 1999; 129
World Food Programme (b11) 2014
Harthill (b17) 2011; 143
Baize (b20) 2002; 128
Richardson (b2) 2017; 5
Ballard (b30) 2011
Bharmal (b40) 2000; 50
Bickel (b32) 2000
Wilken (b33) 2017; 32
Burke (b13) 2014; 9
Theocharopoulos (b25) 2017; 12
Weiser (b22) 2012; 26
Palar (b12) 2016; 30
World Food Programme, Republic of Sierra Leone (b9) 2011
Cancedda (b34) 2016; 214
Dhillon (b37) 2015; 373
Wirth (b10) 2016; 11
References_xml – year: 2014
  ident: b11
  contributor:
    fullname: World Food Programme
– year: 2011
  ident: b30
  contributor:
    fullname: Ballard
– volume: 120
  start-page: 1544
  year: 1990
  ident: b7
  article-title: Development of indicators to assess hunger
  contributor:
    fullname: Radimer
– volume: 11
  start-page: e0155031
  year: 2016
  ident: b10
  article-title: Anemia, micronutrient deficiencies, and malaria in children and women in Sierra Leone prior to the Ebola outbreak–findings of a cross-sectional study
  contributor:
    fullname: Wirth
– volume: 170
  start-page: 228
  year: 2016
  ident: b23
  article-title: How food insecurity contributes to poor HIV health outcomes: qualitative evidence from the San Francisco Bay Area
  contributor:
    fullname: Whittle
– volume: 143
  start-page: 1325
  year: 2011
  ident: b17
  article-title: Review: micronutrient selenium deficiency influences evolution of some viral infectious diseases
  contributor:
    fullname: Harthill
– volume: 94
  start-page: 1729S
  year: 2011
  ident: b6
  article-title: Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS
  contributor:
    fullname: Weiser
– volume: 214
  start-page: S153
  year: 2016
  ident: b34
  article-title: Strengthening health systems while responding to a health crisis: lessons learned by a nongovernmental organization during the Ebola virus disease epidemic in Sierra Leone
  contributor:
    fullname: Cancedda
– year: 2001
  ident: b28
  contributor:
    fullname: Ferme
– volume: 5
  start-page: e254
  year: 2017
  ident: b2
  article-title: The Ebola suspect’s dilemma
  contributor:
    fullname: Richardson
– volume: 12
  start-page: e0176692
  year: 2017
  ident: b25
  article-title: Ebola management centre proximity associated with reduced delays of healthcare of Ebola virus disease (EVD) patients, Tonkolili, Sierra Leone, 2014–15
  contributor:
    fullname: Theocharopoulos
– volume: 2017
  start-page: 2197975
  year: 2017
  ident: b18
  article-title: Effects of vitamin B6 deficiency on the composition and functional potential of T cell populations
  contributor:
    fullname: Qian
– volume: 50
  start-page: 273
  year: 2000
  ident: b40
  article-title: Inequity and health. Is malnutrition really caused by poor nutrition?
  contributor:
    fullname: Bharmal
– volume: 17
  start-page: 654
  year: 2017
  ident: b41
  article-title: Characteristics and survival of patients with Ebola virus infection, malaria, or both in Sierra Leone: a retrospective cohort study
  contributor:
    fullname: Waxman
– volume: 16
  start-page: 611
  year: 2016
  ident: b35
  article-title: The impact of active surveillance and health education on an Ebola virus disease cluster–Kono district, Sierra Leone, 2014–2015
  contributor:
    fullname: Stehling-Ariza
– volume: 63
  start-page: 1
  year: 2017
  ident: b19
  article-title: Age-related vitamin D deficiency is associated with the immune response in children with community-acquired pneumonia
  contributor:
    fullname: Huang
– volume: 9
  start-page: e83387
  year: 2014
  ident: b13
  article-title: Increased incidence of tuberculosis in Zimbabwe, in association with food insecurity, and economic collapse: an ecological analysis
  contributor:
    fullname: Burke
– volume: 513
  start-page: 145
  year: 2014
  ident: b38
  article-title: Make diagnostic centres a priority for Ebola crisis
  contributor:
    fullname: Kelly
– volume: 63
  start-page: 1026
  year: 2016
  ident: b42
  article-title: Plasmodium parasitemia associated with increased survival in Ebola virus-infected patients
  contributor:
    fullname: Rosenke
– volume: 129
  start-page: 525S
  year: 1999
  ident: b8
  article-title: Food insecurity: consequences for the household and broader social implications
  contributor:
    fullname: Hamelin
– volume: 30
  start-page: 1457
  year: 2016
  ident: b12
  article-title: Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States
  contributor:
    fullname: Palar
– volume: 373
  start-page: 787
  year: 2015
  ident: b37
  article-title: Community trust and the Ebola endgame
  contributor:
    fullname: Dhillon
– volume: 10
  start-page: e0005077
  year: 2016
  ident: b39
  article-title: Fears and misperceptions of the Ebola response system during the 2014–2015 outbreak in Sierra Leone
  contributor:
    fullname: Yamanis
– volume: 10
  start-page: e0005087
  year: 2016
  ident: b27
  article-title: Minimally symptomatic infection in an Ebola ‘hotspot’: a cross-sectional serosurvey
  contributor:
    fullname: Richardson
– volume: 128
  start-page: 163
  year: 2002
  ident: b20
  article-title: Inflammatory responses in Ebola virus-infected patients
  contributor:
    fullname: Baize
– volume: 28
  start-page: 115
  year: 2014
  ident: b5
  article-title: Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda
  contributor:
    fullname: Weiser
– year: 2011
  ident: b9
  contributor:
    fullname: World Food Programme, Republic of Sierra Leone
– volume: 21
  start-page: 1227
  year: 2010
  ident: b14
  article-title: Food insecurity is associated with hypoglycemia and poor diabetes self-management in a low-income sample with diabetes
  contributor:
    fullname: Seligman
– year: 2014
  ident: b31
  contributor:
    fullname: World Health Organization
– volume: 32
  start-page: 673
  year: 2017
  ident: b33
  article-title: Knowledge, attitudes, and practices among members of households actively monitored or quarantined to prevent transmission of Ebola virus disease–Margibi County, Liberia: February–March 2015
  contributor:
    fullname: Wilken
– volume: 195
  start-page: 77
  year: 2017
  ident: b3
  article-title: The symbolic violence of ‘outbreak’: a mixed methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing
  contributor:
    fullname: Richardson
– volume: 355
  start-page: 2210
  year: 2000
  ident: b21
  article-title: Human asymptomatic Ebola infection and strong inflammatory response
  contributor:
    fullname: Leroy
– year: 2018
  ident: b4
  contributor:
    fullname: The World Bank
– volume: 18
  start-page: 167
  year: 2016
  ident: b1
  article-title: Biosocial approaches to the 2013–2016 Ebola pandemic
  contributor:
    fullname: Richardson
– volume: 22
  start-page: 1653
  year: 2016
  ident: b24
  article-title: Secondary infections with Ebola virus in rural communities, Liberia and Guinea, 2014–2015
  contributor:
    fullname: Lindblade
– year: 2000
  ident: b32
  contributor:
    fullname: Bickel
– volume: 64
  start-page: 243
  year: 2017
  ident: b36
  article-title: Characteristics and outcomes of pediatric patients with Ebola virus disease admitted to treatment units in Liberia and Sierra Leone: a retrospective cohort study
  contributor:
    fullname: Smit
– year: 2007
  ident: b29
  contributor:
    fullname: Coates
– volume: 34
  start-page: 252
  year: 2015
  ident: b15
  article-title: Bedside measures of malnutrition and association with mortality in hospitalized adults
  contributor:
    fullname: Asiimwe
– volume: 75
  start-page: e132
  year: 2017
  ident: b16
  article-title: Higher body mass index is associated with greater proportions of effector CD8+ T cells expressing CD57 in women living with HIV
  contributor:
    fullname: Reid
– volume: 26
  start-page: 67
  year: 2012
  ident: b22
  article-title: Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting
  contributor:
    fullname: Weiser
– year: 2018
  ident: b26
  article-title: Anatomy of a hotspot: chain and seroepidemiology of Ebola virus transmission, Sukudu, Sierra Leone, 2015-16
  contributor:
    fullname: Kelly
SSID ssj0018211
Score 2.3605554
Snippet Studies have shown that people suffering from food insecurity are at higher risk for infectious and noncommunicable diseases and have poorer health outcomes....
SourceID pubmedcentral
proquest
crossref
pubmed
SourceType Open Access Repository
Aggregation Database
Index Database
StartPage 1484
SubjectTerms Cross-sectional studies
Ebola virus
Food
Food security
Health risk assessment
Title Food Insecurity as a Risk Factor for Outcomes Related to Ebola Virus Disease in Kono District, Sierra Leone: A Cross-Sectional Study
URI https://www.ncbi.nlm.nih.gov/pubmed/29557329
https://www.proquest.com/docview/2113594044
https://search.proquest.com/docview/2015841643
https://pubmed.ncbi.nlm.nih.gov/PMC5953383
Volume 98
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwEB51e0BcEG9CSzVIiBPZ3Ty8cbhVS5fyWECUor1FduKoga5TbbIH7vxwZpxk1cKNWyI7spMZZ77xzHwGeEFKJHMtmGbflOSgmMhPZUBXSob5rIjDJOAC5-Wn2el5_H4lVnsghloYl7Sf62psL9djW1243MqrdT4Z8sQmX5ZzwTmRMpqMYETmd3DR-9CBDINgwLykXUlHrMkVmxP1o11fjOm3zHaPaYBTIZLIoctrNukfoPl3vuQ1A7S4C3d65IjH3QzvwZ6x9-HWso-NP4Dfi7ou8J1t-hPpUDWo8GvV_MSFO1QHCZ_i521LOmYadFlwpsC2xhNN_i1-rzbbBt90ARusLH6obc33zOHfvsIzMqAbhR9Nbc1rPMY5v4t_5lK5eGKckfjrIZwvTr7NT_3-jAU_J9Pd-mWaqyKfSq1FwdyC5SxM9FTGSitB61tGJgploRiWmVAXpjQEGQ3X76rQ5KWIHsG-pXGfABqTFrEuo4L3J8NEKKkJvxDgzEOhjNYevBy-cnbVUWlk5IKwZDInmSxIMpaMB4eDDLJ-RTUZSTUSaTyNYw-e75ppLXCAQ1lTb6kPYRsOo8aRB487ke1GGmTtQXJDmLsOzLN9s4XUz_Ft9-r29L-fPIDbNDXZ7dwcwn672ZpnhGVafQSjt6vgyGnwH_wl9cs
link.rule.ids 230,314,727,780,784,885,27924,27925,53791,53793
linkProvider National Library of Medicine
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwEB6VIgEXVF4l0JZBQpzI7iaONw63atvVlu4WRFvUW2Qnjhpgk2qTPXDnhzOTx6qFG7dEdmQnM85845n5DPCOlEglRjLNvs3IQbHCjZRHV1r5yTgN_NDjAufF2Xh2GXy6kldbIPtamCZpPzH5oPi5HBT5dZNbebNMhn2e2PDLYiI5J1KJ4T24L0UYeb2T3gUPlO95Peol_Qpbak2u2Rzq7_XyekA_ZrZ8TAQcSRmKBl_eskr_QM2_MyZvmaDpDjzusCMetnN8Alu2eAoPFl10_Bn8npZliidF1Z1Jh7pCjV_z6gdOm2N1kBAqfl7XpGW2wiYPzqZYl3hsyMPFb_lqXeFRG7LBvMDTsij5nln86w94TiZ0pXFuy8J-xEOc8Lu4500yF0-McxJ_PYfL6fHFZOZ2pyy4CRnv2s2iRKfJSBkjU2YXzMZ-aEYq0EZLWuFKWOGrVDMws75JbWYJNFqu4NW-TTIpXsB2QeO-BLQ2SgOTiZR3KP1QamUIwRDkTHyprTEOvO-_cnzTkmnE5ISwZOJGMrEXxiwZB_Z6GcTdmqpikqqQUTAKAgfebpppNXCIQxe2XFMfQjccSA2EA7utyDYj9bJ2ILwjzE0HZtq-20IK2DBudwr36r-ffAMPZxeLeTw_OTt9DY9omqrdx9mD7Xq1tvuEbGpz0OjxH0K--C8
linkToPdf http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELagSBUXxLtpCwwS4kQ2mzjeONyqbaOWdktFKeotsmNHDbDJapM9cO8P70weqy3cuCWyIzuZceYbz_gbxj6gEslMC6LZtzk6KJa7sfTxSskgm5gwiHw64Dw7nxxfhV-uxfVGqa82aT_Txaj8PR-VxU2bW7mYZ96QJ-ZdzKaCciIl9xYm9x6yR4Kjkg2Oeh9AkIHvD8gXdSzq6DXp3KanfjbzmxH-nMn6ERlwLETEW4y5YZn-gZt_Z01umKHkKXvS40c46Ob5jD2w5XO2Pesj5C_YbVJVBk7Kuq9LB6oGBd-K-hckbWkdQJQKX1cNapqtoc2FswaaCo40ernwo1iuajjswjZQlHBalRXdE5N_8wku0YwuFZzZqrSf4QCm9C7uZZvQRROjvMQ_L9lVcvR9euz2lRbcDA144-Zxpkw2lloLQwyD-SSI9FiGSiuBq1xyywNpFIEzG2hjc4vA0dIpXhXYLBf8FdsqcdwdBtbGJtQ5N7RLGURCSY0oBmFnFghltXbYx-Erp4uOUCNFR4Qkk7aSSf0oJck4bH-QQdqvqzpFqXIRh-MwdNj7dTOuCApzqNJWK-yDCIeCqSF32OtOZOuRBlk7LLonzHUHYtu-34JK2LJu90q3-99PvmPbF4dJenZyfrrHHuMsZbeVs8-2muXKvkFw0-i3rRrfAdKt-UI
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Food+Insecurity+as+a+Risk+Factor+for+Outcomes+Related+to+Ebola+Virus+Disease+in+Kono+District%2C+Sierra+Leone%3A+A+Cross-Sectional+Study&rft.jtitle=The+American+journal+of+tropical+medicine+and+hygiene&rft.au=Kelly%2C+J+Daniel&rft.au=Richardson%2C+Eugene+T&rft.au=Drasher%2C+Michael&rft.au=Barrie%2C+M+Bailor&rft.date=2018-01-01&rft.eissn=1476-1645&rft.volume=98&rft.issue=5&rft.spage=1484&rft.epage=1488&rft_id=info:doi/10.4269%2Fajtmh.17-0820&rft.externalDBID=NO_FULL_TEXT
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0002-9637&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0002-9637&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0002-9637&client=summon