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Sierra Leone continues to review and make public all mining and lease agreements, retaining its Extractive Industries Transparency Initiative EITI compliance designation. It is up for review in Numerous independent newspapers circulate freely, and there are dozens of public and private radio and television outlets.

However, public officials continue to employ the country's libel and sedition laws to target journalists, particularly those reporting on high-level corruption. In September , three reporters from the Salone Times and New Age publications who had criticized a potential increase in telecommunications prices appeared in court after being charged with libel. Academic freedom is generally upheld, but resource strains within the university system have led to strikes by professors.

In March , in the city of Bo, one student from Njala University was killed and several were injured during protests against a faculty strike over unpaid salaries and other benefits.

Private discussion remains largely open. In September , the head of the National Telecommunications Commission NATCOM , while speaking to the Sierra Leone Association of Journalists, announced that some monitoring of social media would be conducted during the elections, but no outright ban. While freedom of assembly is constitutionally guaranteed, the police violently cracked down on several protests and demonstrations in In March, police fired tear gas into a students' demonstration in front of President Koroma's home and arrested 16 students.

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Nongovernmental organizations NGOs and civic groups operate freely, though a law requires NGOs to submit annual activity reports and renew registration every two years. While workers have the right to join independent trade unions, there are no laws preventing discrimination against union members or prohibiting employers from interfering in the formation of unions. While the constitution provides for an independent judiciary, in practice the judiciary is prone to interference from the executive branch, particularly in corruption cases.

A lack of clear procedures for appointing and dismissing judges makes these processes vulnerable to abuse. Corruption, poor salaries, and a lack of resources impede judicial effectiveness. Resource constraints and a lack of lawyers outside of Freetown hinder access to legal counsel. Although the constitution guarantees a fair trial, this right is sometimes limited in practice, largely due to corruption.

Because of resource constraints, the average defendant spends between three and five years in detention awaiting trial. In May , the judiciary developed new bail and sentencing guidelines to limit the amount of time prisoners spend in pretrial detention facilities. Detention facilities are under strain, with occupancy levels at percent of official capacity as of September Prisons and detention facilities fail to meet basic standards of health and hygiene, and infectious disease is prevalent. Extrajudicial killings by the police remained a problem in , particularly against people peacefully engaged in protests.

Police are rarely held accountable for abuses and killings. Members of the LGBT lesbian, gay, bisexual, and transgender community face discrimination in employment and access to healthcare, and the population is vulnerable to violence. Discrimination against LGBT people is not explicitly prohibited by the constitution. Women experience discrimination in employment, education, and access to credit. Employers frequently fire women who become pregnant during their first year on the job.

Sierra Leoneans generally enjoy freedom of movement after restrictions from the Ebola Virus epidemic were lifted in However, petty corruption is common and parents often have to pay bribes to register their children in primary and secondary school. Property rights are constitutionally guaranteed, but the laws on the books do not effectively protect those rights. Sierra Leone does not have a land titling system.

LGBT rights in Sierra Leone

Outside of Freetown, land falls under customary law and its use is determined by chiefs. The government has often failed to regulate the activities of international investors, exacerbating threats to property rights.

Laws passed in grant women the right to inherit property, but many women have little power to contest land issues within the customary legal system. In , Sierra Leone reduced the cost of registering a new business. The law prohibits domestic violence, but gender-based violence remained a serious problem in Reports of rape and domestic violence rarely result in conviction, and the police unit responsible for investigating and prosecuting these crimes remains underfunded and understaffed.

Women experience discrimination in marriage and divorce laws. Customary law guides many of these issues, and women are often conferred inferior status — women are often considered equal to children under customary law, and also considered the property of their husbands. Female genital mutilation is not prohibited by law, and the practice remains widespread. The government's ban on 'visibly pregnant' girls from attending school remained in effect in In , President Koroma rejected a bill passed unanimously by Parliament that would have legalized abortion at up to 12 weeks of pregnancy under any circumstances and up to 24 weeks under special circumstances.

Child marriage remains a problem, with almost half of all girls married before the age of Reports of economic exploitation of workers in the natural resource sector are common. Barriers to access remain for individuals who wish to seek redress for economic exploitation. While it is not common for individuals to take such cases to the formal legal system, there is little data on how such issues are handled. Child trafficking remained a problem in Through August , cases of sexual exploitation of children were reported, and only were referred for prosecution.

Child labor is prevalent, despite laws limiting it. Log in. Remember Me. Forgot password? Email this document Printable version. UNHCR is not responsible for, nor does it necessarily endorse, its content. Search Refworld. Clear Search. Advanced Search Search Tips.

Phone numbers of Freetown Gay Sierra Leone

Sierra Leone. Late stage HIV diagnosis has been associated with higher morbidity and mortality [ 25 , 26 ] and escalated treatment costs in an already overburdened healthcare system [ 27 ]. In our study however, mortality was not associated with late-stage HIV presentation, likely due to the sample size of the study.

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Other factors significantly associated with in-hospitality were, most prominently, the presence of neurological symptoms—i. The etiologies of jaundice in HIV disease span a broad spectrum of conditions. In hyper-endemic countries such as Sierra Leone, jaundice is most often associated with malaria or acute HBV infection, but may also be a prominent clinical feature of alcoholic liver disease, drug-induced hepatotoxicity, tuberculosis-associated granulomatous hepatitis, AIDS cholangiopathy, hepatocellular carcinoma, schistosomiasis, hemangioma, and hepatic adenoma [ 28 , 29 ].

Several observational studies have shown that HIV coinfection with HBV can lead to rapid more progression to AIDS [ 30 , 31 ], adverse complications such as the immune reconstitution syndrome on ART initiation [ 32 , 33 ], and faster onset of cirrhotic liver disease and hepatocellular carcinoma [ 33 , 34 ].

Of note, we recently observed a high prevalence of serological markers of chronic HBV infection, i. In another cohort of HIV infected patients, we also recorded a high prevalence of pretreatment HIV drug resistance Our study had several limitations, including the small sample size, potentially making the findings not readily generalizable. There was potential selection bias in this study, as patients at the national referral health center would be expected to more severely ill and therefore possibly at higher risk of mortality.

Determining admission diagnoses and causes of death were major challenges, given that advanced diagnostic tools which are not readily available in resource-limited settings are needed to determine the etiology of certain infections and AIDS-defining conditions and thus, most diagnoses were presumptive. Incompleteness of the CD4 cell count data was another limitation; this is because the study relied on the availability of point-of-care testing data per standard of care.

Furthermore, the study did not track patients in non-medical wards, which may have underestimated the true prevalence of HIV—related admissions.

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Nonetheless, we believe that our study is significant because it offers insight into the morbidity and mortality patterns of hospitalized HIV-infected patients at the main referral tertiary healthcare facility in Sierra Leone and further provides on update on this important public health topic in the West Africa region.

In the era of widespread ART availability globally, a high burden of HIV-related admissions and in-hospital mortality were observed at Connaught Hospital in Freetown, the main referral hospital in Sierra Leone. All data and material generated or analyzed during this study are included in this manuscript.

Raw de-identified study data are available from the corresponding author upon reasonable request. Google Scholar. Region: west and Central Africa. Causes of death and factors associated with early mortality of HIV-infected adults admitted to Korle-Bu teaching hospital. Pan Afr Med J. Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa: a multicountry survey in the antiretroviral treatment era. AIDS Rev. Country Sierra Leone Open Forum Infect Dis.

PLoS One. A framework for the development and interpretation of different sepsis.

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