An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities. In this article, we first describe how the international NGO Partners In Health (PIH) partnered with the Government of Sierra Leone and Wellbody Alliance (a local NGO) to respond to the EVD epidemic in 4 of the country's most Ebola-affected districts. We then describe how, in the aftermath of the epidemic, PIH is partnering with the public sector to strengthen the health system and resume delivery of regular health services. PIH's experience in Sierra Leone is one of multiple partnerships with different stakeholders. It is also one of rapid deployment of expatriate clinicians and logistics personnel in health facilities largely deprived of health professionals, medical supplies, and physical infrastructure required to deliver health services effectively and safely. Lessons learned by PIH and its partners in Sierra Leone can contribute to the ongoing discussion within the international community on how to ensure emergency preparedness and build resilient health systems in settings without either.

We investigated the prevalence and incidence of dementing disorders in the city of Pylea, Greece, using a door-to-door three-phase approach, and explored the relationship between age and gender. From the initial cohort of 704-subjects, 112-subjects (15.9 percent) were excluded because they had moved out of town or could not be traced, 102-subjects (14.4 percent) died before the time of actual contact, and 110-subjects (15.6 percent) refused to be contacted. We were able to visit and examine 380-subjects (54 percent); each of them were administered the MMSE by one of three nurses and the CAMCOG by one of three physicians. We selected January 1, 1993, as the study prevalence day. Using specified diagnostic criteria, NINCDS-ADRDA and DSM-III-R, the study neurologists extensively investigated 118 from 380-subjects, who screened positive on MMSE (MMSE < 23) and CAMCOG (< 65). We found 35-subjects affected by dementia, 20 had Alzheimer's disease (AD), 11 had vascular or mixed dementia and four had secondary dementia (one Parkinson's disease, one Vitamin B12 deficiency, and two had Tumors). The estimated annual incidence rate for all forms of dementia, after correction for ageing of the samples was 57/1,000 persons aged > 70, made up of dementia of Alzheimer type (39.9/1,000), vascular dementia (13.9/1,000) and other forms (3.5/1,000). The prevalence of both dementia and AD increased steeply with advancing age and was consistently higher in women. The incidence of dementia increases with age, even in the oldest age groups and women have a higher risk of developing dementia than men. AD was the most common type of dementia. Our prevalence and incidence figures for dementia and AD are almost similar to those previously reported in Europe, the United States and Canada.

No abstract