I'm trained pharmacy professional, academician and health researcher with a decade experience in drug regulation, pharmacovigilance, pharmacy practice and education, drug discovery, public health and complementary and alternative medicine research and practice. I'm current doing my PhD at the Australian research centre in complementary and Integrative medicine(ARCCIM), University of Technology Sydney
Public Health Association of Australia (PHAA)
Commonwealth Pharmacist Association CPA
Pharmaceutical Society of Society of Sierra Leone
Complementary and Integrative Medicine
Maternal and childhealth
Pharmacy Education and practice
Global health and infectious diseases
Jalloh, MB, Bah, AJ, James, PB, Sevalie, S, Hann, K & Shmueli, A 2019, 'Impact of the free healthcare initiative on wealth-related inequity in the utilization of maternal & child health services in Sierra Leone.', BMC health services research, vol. 19, no. 1.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:As a result of financial barriers to the utilization of Maternal and Child Health (MCH) services, the Government of Sierra Leone launched the Free Health Care Initiative (FHCI) in 2010. This study aimed to examine the impact of the FHCI on wealth related inequity in the utilization of three MCH services. METHODS:We analysed data from 2008 to 2013 Sierra Leone Demographic Health Surveys (SLDHS) using 2008 SLDHS as a baseline. Seven thousand three hundred seventy-four and 16,658 women of reproductive age were interviewed in the 2008 and 2013 SLDHS respectively. We employed a binomial logistic regression to evaluate wealth related inequity in the utilization of institutional delivery. Concentration curves and indices were used to measure the inequity in the utilization of antenatal care (ANC) visits and postnatal care (PNC) reviews. Test of significance was performed for the difference in odds and concentration indexes obtained for the 2008 and 2013 SLDHS. RESULTS:There was an overall improvement in the utilization of MCH services following the FHCI with a 30% increase in institutional delivery rate, 24% increment in more than four focused ANC visits and 33% increment in complete PNC reviews. Wealth related inequity in institutional delivery has increased but to the advantage of the rich, highly educated, and urban residents. Results of the inequity statistics demonstrate that PNC reviews were more equally distributed in 2008 than ANC visits, and, in 2013, the poorest respondents ranked by wealth index utilized more PNC reviews than their richest counterparts. For ANC visits, the change in concentration index was from 0.008331[95% CI (0.008188, 0.008474)] in 2008 to - 0.002263 [95% CI (- 0.002322, - 0.002204)] in 2013. The change in concentration index for PNC reviews was from - 0.001732 [95% CI (- 0.001746, - 0.001718)] in 2008 to - 0.001771 [95% CI (- 0.001779, - 0.001763)] in 2013. All changes were significant (p value < 0.001). CONCLUSION:The FHCI app...
James, PB, Wardle, J, Steel, A & Adams, J 2019, 'Pattern of health care utilization and traditional and complementary medicine use among Ebola survivors in Sierra Leone.', PLoS One, vol. 14, no. 9, p. e0223068.View/Download from: Publisher's site
BACKGROUND: It is well established that Ebola Survivors experience a myriad of physical and psychological sequelae. However, little is known about how they seek care to address their health needs. Our study determines the current healthcare seeking behaviour among Ebola survivors and determines the prevalence, pattern of use and correlates of traditional and complementary medicine (T&CM) use among Ebola survivors in Sierra Leone. METHODS: We conducted a nationwide questionnaire survey among a cross-sectional sample of Ebola Survivors in Sierra Leone between January and August 2018. We employed descriptive statistics, chi-square test, Fisher exact two-tailed test and backward stepwise binary regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. RESULTS: Ebola Survivors who participated in our study (n = 358), visited a healthcare provider (n = 308, 86.0%), self-medicated with conventional medicines (n = 255, 71.2%) and visited a private pharmacy outlet (n = 141, 39.4%). Survivors also self-medicated with T&CM products (n = 107, 29.9%), concurrently self-medicated with conventional and T&CM products (n = 62, 17.3%), and visited a T&CM practitioner (n = 41, 11.5%). Almost half of (n = 163, 45.5%) Ebola survivors reported using T&CM treatments for post ebola related symptoms and non-Ebola related symptoms since their discharge from an Ebola treatment centre. Ebola survivors who considered their health to be fair or poor (AOR = 4.08; 95%CI: 2.22-7.50; p<0.01), presented with arthralgia (AOR = 2.52; 95%CI: 1.11-5.69, p = 0.026) and were discharged three years or less (AOR = 3.14; 95%CI: 1.13-8.73, p = 0.028) were more likely to use T&CM. Family (n = 101,62.0%) and friends (n = 38,23.3%) were the common sources of T&CM information. Abdominal pain (n = 49, 30.1%) followed by joint pain (n = 46, 28.2%) and back pain (n = 43, 26.4%) were the most cited post-Ebola indications for T&CM use. More than three-quarters of T&CM ...
James, PB, Kaikai, AI, Bah, AJ, Steel, A & Wardle, J 2019, 'Herbal medicine use during breastfeeding: a cross-sectional study among mothers visiting public health facilities in the Western area of Sierra Leone.', BMC complementary and alternative medicine, vol. 19, no. 1.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:The use of medications, including herbal medicines during breastfeeding is always a concern among women. Currently, there is no published evidence on whether Sierra Leonean women use herbal medicine during breastfeeding. This study investigates the prevalence, correlates and pattern of herbal medicine use during breastfeeding. METHODOLOGY:We conducted a cross-sectional study among 378 current breastfeeding mothers visiting public healthcare facilities within the Western area of Sierra Leone. Descriptive statistics and logistic regression analysis were used for data analysis. RESULTS:Over a third of mothers (n = 140, 37.0%) used herbal medicine during breastfeeding. However, very few herbal medicine users (2.1%, n = 3) used herbal medicine to augment breastfeeding. Dietary changes were the most common method used to increase breast milk supply (93.9%, n = 355) with cassava leaves sauce and tubers being the most common dietary addition. Mothers with children more than six months old were more likely to use herbal medicine than mothers with younger children (OR:1.8; CI:1.13-2.85,p = 0.013). Among herbal medicine users, only 11.4% (n = 16) disclosed their herbal medicine use to their conventional healthcare providers. CONCLUSION:The use of herbal medicine among breastfeeding mothers attending public health facilities in the Western area of Sierra Leone is common. Whilst this use is not usually specific to increasing breast milk supply, our study indicates that herbal medicines may be used to 'cleanse' initial breast milk.
James, PB, Wardle, J, Steel, A & Adams, J 2019, 'Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review.', Tropical medicine & international health : TM & IH, vol. 24, no. 6, pp. 671-691.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:A myriad of physical and psychosocial sequelae have been reported among Ebola survivors from previous Ebola virus disease (EVD) outbreaks, including the most recent in West Africa. This review examines the various forms of psychological distress experienced by EVD survivors, family and community reactions to EVD survivors and EVD survivors' coping mechanisms. METHODS:We conducted a literature search of original articles employing Medline (Ovid), PubMed, Web of Science, Scopus, CINAHL, EBSCO host academic search complete, PsycINFO (EBSCO) and Embase databases. RESULTS:Our search identified 1890 articles of which 24 met our inclusion criteria. Various forms of psychological distress were prevalent among EVD survivors including depression, anxiety, anger, grief, guilt, flashbacks, sadness, worthlessness, substance addiction, suicidal tendencies and self-stigmatisation. Family and community responses to EVD survivors ranged from acceptance to rejection, isolation, stigmatisation and discrimination. EVD survivors' coping strategies included engagement with religious faith, EVD survivors associations and involvement in EVD prevention and control interventions. CONCLUSION:Psychological distress, including that resulting from family and community stigma and discrimination, appears common among EVD survivors. Community-based mental health and psychosocial interventions integrated within a broader package of care for EVD survivors that also recognises the physical health challenges are required. Well-designed longitudinal studies can provide clear insights on the nature and trajectory of the psychosocial issues currently experienced by EVD survivors.
James, PB, Wardle, J, Steel, A & Adams, J 2019, 'Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone.', Medicina (Kaunas, Lithuania), vol. 55, no. 7.View/Download from: UTS OPUS or Publisher's site
Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors' attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57-9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92-13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10-30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74-9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors' attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner-survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for tr...
James, PB, Taidy-Leigh, L, Bah, AJ, Kanu, JS, Kangbai, JB & Sevalie, S 2018, 'Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone', EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE.View/Download from: UTS OPUS or Publisher's site
Guo, H, Adah, D, James, PB, Liu, Q, Li, G, Ahmadu, P, Chai, L, Wang, S, Liu, Y & Hu, L 2018, 'Xueshuantong Injection (Lyophilized) Attenuates Cerebral Ischemia/Reperfusion Injury by the Activation of Nrf2-VEGF Pathway', NEUROCHEMICAL RESEARCH, vol. 43, no. 5, pp. 1096-1103.View/Download from: UTS OPUS or Publisher's site
James, PB, Bah, AJ, Margao, EK, Hanson, C, Kabba, JA & Jamshed, SQ 2018, 'Exploring the Knowledge and Perception of Generic Medicines among Final Year Undergraduate Medical, Pharmacy, and Nursing Students in Sierra Leone: A Comparative Cross-Sectional Approach.', Pharmacy (Basel, Switzerland), vol. 6, no. 1.View/Download from: UTS OPUS or Publisher's site
Most low-income nations have national medicine policy that emphasized the use of generic medicines in the public health sector. However, the use of generics is often debatable as there are concerns over its efficacy, quality, and safety compared to their branded counterparts. This study was conducted to compare the knowledge and perception of generic medicines among final year undergraduate medical, pharmacy, and nursing students in Sierra Leone. We conducted a questionnaire-based cross-sectional study among these students at the College of Medicine and Allied Health Sciences University of Sierra Leone. Out of the 62 students, only two (2/62, 3.2%) knew about the acceptable bioequivalence limit. At least half of respondents in all three groups agreed that all generics are therapeutically equivalent to their innovator brand. At least half of the medicine (21/42, 50%) and nursing (6/9, 66.6%) students, compared to pharmacy students (5/11, 45.5%), believed that higher safety standards are required for proprietary medicines than for generic medicines. Most of them agreed that they need more information on the safety, quality, and efficacy aspects of generics (59/62, 95.2%). All three groups of healthcare students, despite variations in their responses, demonstrated a deficiency in knowledge and misconception regarding generic medicines. Training on issues surrounding generic drugs in healthcare training institutions is highly needed among future healthcare providers in Sierra Leone.
James, P, Jamshed, S, Elkalmi, R, AlShami, A, Nor, A, Kabir, F, Sumali, I, Zubair, A & Shamsudin, S 2018, 'Causes of Stress and Management Approaches Among Undergraduate Pharmacy Students: Findings From a Malaysian Public University', Archives of Pharmacy Practice, vol. 0, no. 0, pp. 0-0.View/Download from: UTS OPUS or Publisher's site
James, PB, Bah, AJ, Tommy, MS, Wardle, J & Steel, A 2018, 'Herbal medicines use during pregnancy in Sierra Leone: An exploratory cross-sectional study', Women and Birth.View/Download from: UTS OPUS or Publisher's site
© 2017 Australian College of Midwives. Background: The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care. Aim: This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone. Methods: A cross-sectional study was conducted among pregnant women (n = 134) who were at least 18 years of age and who have had at least one previous pregnancy, using face to face interview. Descriptive statistics, univariate and multivariate logistic regression analysis were used for data analysis. Results: The response rate was 82.7%. Nearly two-thirds of pregnant women reported using herbal medicine (62.7%). Herbal medicine users were more likely to be Muslim than Christian. Luffa acutangula (L.) Roxb was the most cited herbal medicine used and was mostly indicated for urinary tract infection and pedal oedema. Perceived effectiveness and safety over conventional medicine (70.2%) was key driver for use, and majority did not disclose their use of herbs to their maternal health professional (95.2%). Conclusion: Herbal medicine use among pregnant women in this study was widespread. Maternal health providers should be aware of this relatively common practice and routinely discuss and educate pregnant women on the potential risks and benefits associated with the use of herbs.
James, PB, Kamara, H, Bah, AJ, Steel, A & Wardle, J 2018, 'Herbal medicine use among hypertensive patients attending public and private health facilities in Freetown Sierra Leone.', Complementary therapies in clinical practice, vol. 31, pp. 7-15.View/Download from: UTS OPUS or Publisher's site
This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown.We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant.Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider.There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes.
James, PB, Wardle, J, Steel, A & Adams, J 2018, 'Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review.', BMJ global health, vol. 3, no. 5, pp. e000895-e000895.View/Download from: UTS OPUS or Publisher's site
Background:The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region. Methods:We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken. Results:Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%-100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers' negative attitude and a lack of enquiry about TCAM use from healthcare providers. Conclusion:TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.
James, PB, Rehman, IU, Bah, AJ, Lahai, M, Cole, CP & Khan, TM 2017, 'An assessment of healthcare professionals' knowledge about and attitude towards influenza vaccination in Freetown Sierra Leone: a cross-sectional study', BMC PUBLIC HEALTH, vol. 17.View/Download from: UTS OPUS or Publisher's site
Kassim, SA, James, PB, Alolga, RN, Assanhou, AG, Kassim, SM, Bacar, A, Silai, R, Tian, L, Li, H & Ma, A 2016, 'Major decline in malaria morbidity and mortality in the union of comoros between 2010 and 2014: The effect of a combination of prevention and control measures', South African Medical Journal, vol. 106, no. 7, pp. 709-714.View/Download from: Publisher's site
© 2016, South African Medical Association. All rights reserved. Background. Malaria remains a public health challenge in sub-Saharan Africa. In response to this, many countries are working towards achieving the World Health Assembly and Roll Back Malaria Partnership target of a 75% decline in malaria incidence. Objective. To assess trends in malaria morbidity and mortality in the three islands of the Comoros Archipelago from 2010 to 2014. Methods. This was a retrospective study in which all confirmed malaria cases and deaths recorded between 2010 and 2014 were accessed from the national malaria control database. Trends and comparisons in malaria incidence and case fatality rates for all age groups, including under-5 children and pregnant women, were analysed using Microsoft Excel and SPSS version 16. Results. A substantial decline in malaria incidence was observed for each island between 2010 and 2014; from 75.98 cases per 1 000 population in 2010 to 0.14 in 2014 in Moheli, 60.60 to 0.02 in Anjouan and 235.36 to 5.47 in Grand Comoro. Additionally, a general reduction in malaria case fatalities was observed. In Moheli, there were no case fatalities between 2010 and 2014, while there was a decline in the case fatality rate in Anjouan (from 1.20 fatalities per 1 000 cases to 0) and Grand Comoros (0.51 to 0). There were also significant differences (p<0.05) in malaria incidence and case fatalities between the three islands. A similar trend was observed for pregnant women and under-5 children. Conclusion. Our study indicates a significant decline in malaria morbidity and mortality in the islands of Moheli, Anjouan and Grand Comoro from 2010 to 2014. This considerable reduction is attributed to a combination of malaria prevention and control interventions implemented during the study period.
James, PB, Jamshed, SQ & Patel, I 2016, 'Ebola virus disease: How can African pharmacists respond to future outbreaks?', Asian Pacific Journal of Tropical Disease, vol. 6, no. 5, pp. 337-338.View/Download from: Publisher's site
© 2016 Asian Pacific Tropical Medicine Press. In its forty years history (1976-2016), the West African region has recorded the most devastating form of the Ebola virus disease. The sparse knowledge of healthcare professionals and general public combined with lesser responses from international community are major factors for the dissemination of the disease. In the context of this outbreak, there is a need to highlight the roles and responsibilities of pharmacists, especially in the African healthcare setting. Moreover, the prerequisite of diagnostic kits for the timely detection of the infection as well as pharmacists' awareness of the current therapeutic regimen are recommended.
James, PB, Bah, AJ & Kondorvoh, IM 2016, 'Exploring self-use, attitude and interest to study complementary and alternative medicine (CAM) among final year undergraduate medical, pharmacy and nursing students in Sierra Leone: a comparative study', BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE, vol. 16.View/Download from: UTS OPUS or Publisher's site
James, PB & Cole, CP 2016, 'Intern pharmacists' perceived preparedness for practice, their extent of involvement in pharmacy related activities and future career choices in sierra leone: A baseline descriptive survey', Pharmacy Education, vol. 16, no. 1, pp. 26-32.
© 2015 FIP. Objective: To assess intern pharmacists' perceived preparedness for practice, document the extent of their involvement in selected pharmacy related activities during the internship period, as well as determine their future career path. Methodology: A descriptive cross-sectional study was conducted among intern pharmacists using an eight item questionnaire. Simple descriptive statistics were used to calculate frequency counts and percentages with regard to respondent demographics and Likert scale responses. Results: Eighty-five percent of the 20 respondents perceived that they are prepared to perform dispensing and retail, and patient care activities with only half of them in multidisciplinary team care but not pharmaceutical business management (13, 65%). Close to two-thirds of respondents were often involved in patient care (13, 65%). Only six (30%) were often part of a multidisciplinary health care team. Nearly all (18, 90%) want to work in an environment with more patient contact. Conclusion: This study suggests that intern pharmacists in Sierra Leone perceived to a large extent they are prepared for and were involved in most pharmacy related activities considered in this study except for multidisciplinary team care which seems to be limited; although they would prefer to work in a clinical setting in the future.
Cole, CP, James, PB & Kargbo, AT 2015, 'An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone.', Journal of basic and clinical pharmacy, vol. 6, no. 4, pp. 109-114.View/Download from: Publisher's site
There is limited information on pediatric prescribing in Sierra Leone. This study evaluated prescribing patterns for under-five patients at Ola During Children's Hospital (ODCH) and assessed the extent of rational prescribing.A descriptive, cross-sectional, retrospective study of 294 prescriptions, selected by systematic random sampling was conducted at the outpatient department of ODCH. The World Health Organisation prescribing indicators were analyzed using the SPSS package 16.0. The index of rational drug prescribing (IRDP) was calculated to assess rational prescribing.The average number of medicines per prescription was 3.77. The percentage of medicines prescribed by generic names was 71.0%, while 74.8% and 21.1% of prescriptions had an antibiotic and injection, respectively. The percentage of medicines prescribed from the national essential medicines list was 70.6%. The most commonly prescribed pharmacological groups of medicines were vitamins (85.37%) and antibiotics (82.99%). The IRDP was 2.71, instead of the ideal value of 5.Pediatric prescribing patterns at the outpatient department of ODCH cannot be said to be entirely rational, especially with regards to antibiotic and injection prescribing.
James, PB & Bah, AJ 2014, 'Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: a descriptive cross-sectional survey', BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE, vol. 14.View/Download from: UTS OPUS or Publisher's site