title: Changing patterns of health in communities impacted by a bioenergy project in northern Sierra Leone.
abstract: Large private sector investments in low- and middle-income countries are often critically evaluated with regards to their environmental, social, human rights, and health impacts. A health impact assessment, including a baseline health survey, was commissioned by the Addax Bioenergy Sierra Leone project in 2010. As part of the monitoring, a follow-up survey was conducted three years later. A set of health indicators was assessed at six impacted and two control sites. Most of these indices improved, particularly at the impacted sites. The prevalences of stunting, wasting, and Plasmodium falciparum in children under five years of age decreased significantly at impacted sites (all p < 0.05) and non-significantly at control sites. Anemia in children and in women of reproductive age (15-49 years) decreased significantly at impacted and control sites (p < 0.05 and p < 0.001, respectively). Health facility-based deliveries increased significantly at the impacted sites (p < 0.05). The prevalences of helminth infections in children aged 10-15 years remained approximately at the same levels, although focal increases at the impacted sites were noted. Access to improved sanitation decreased significantly (p < 0.05) at control and non-significantly at impacted sites. Water quality remained poor without significant changes. The epidemiologic monitoring of a bioenergy project provides a useful contribution for evidence-based decision-making.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland. astrid.knoblauch@unibas.ch.
authors.forename: Astrid M
authors.initials: AM
authors.lastname: Knoblauch
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. mhodges@hki.org.
authors.forename: Mary H
authors.initials: MH
authors.lastname: Hodges
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. mdbah@hki.org.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Bah
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. hkamara@hki.org.
authors.forename: Habib I
authors.initials: HI
authors.lastname: Kamara
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. akargbo@hki.org.
authors.forename: Anita
authors.initials: A
authors.lastname: Kargbo
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. jpaye@hki.org.
authors.forename: Jusufu
authors.initials: J
authors.lastname: Paye
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. thamid@hki.org.
authors.forename: Hamid
authors.initials: H
authors.lastname: Turay
authors.affiliation: Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone. enyorkor@hki.org.
authors.forename: Emmanuel D
authors.initials: ED
authors.lastname: Nyorkor
authors.affiliation: SHAPE Consulting Ltd., Pretoria 0062, South Africa. mdivall@shapeconsulting.org.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Divall
authors.affiliation: Helen Keller International, Regional Office for Africa, P.O. Box, Dakar, Senegal. yzhang@hki.org.
authors.forename: Yaobi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland. juerg.utzinger@unibas.ch.
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland. mirko.winkler@unibas.ch.
authors.forename: Mirko S
authors.initials: MS
authors.lastname: Winkler
mesh_terms: D000293:Adolescent; D000328:Adult; D056804:Biofuels; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D062489:Health Impact Assessment; D006801:Humans; D008297:Male; D012499:Sanitation; D012807:Sierra Leone; D055815:Young Adult
chemical_list: D056804:Biofuels