Spatial dependency of V. cholera prevalence on open space refuse dumps in Kumasi, Ghana: a spatial statistical modelling

<p>Abstract</p> <p>Background</p> <p>Cholera has persisted in Ghana since its introduction in the early 70's. From 1999 to 2005, the Ghana Ministry of Health officially reported a total of 26,924 cases and 620 deaths to the WHO. Etiological studies suggest that the natural habitat of <it>V. cholera </it>is the aquatic environment. Its ability to survive within and outside the aquatic environment makes cholera a complex health problem to manage. Once the disease is introduced in a population, several environmental factors may lead to prolonged transmission and secondary cases. An important environmental factor that predisposes individuals to cholera infection is sanitation. In this study, we exploit the importance of two main spatial measures of sanitation in cholera transmission in an urban city, Kumasi. These are proximity and density of refuse dumps within a community.</p> <p>Results</p> <p>A spatial statistical modelling carried out to determine the spatial dependency of cholera prevalence on refuse dumps show that, there is a direct spatial relationship between cholera prevalence and density of refuse dumps, and an inverse spatial relationship between cholera prevalence and distance to refuse dumps. A spatial scan statistics also identified four significant spatial clusters of cholera; a primary cluster with greater than expected cholera prevalence, and three secondary clusters with lower than expected cholera prevalence. A GIS based buffer analysis also showed that the minimum distance within which refuse dumps should not be sited within community centres is 500 m.</p> <p>Conclusion</p> <p>The results suggest that proximity and density of open space refuse dumps play a contributory role in cholera infection in Kumasi.</p

Spatial and demographic patterns of Cholera in Ashanti region - Ghana

Abstract Background Cholera has claimed many lives throughout history and it continues to be a global threat, especially in countries in Africa. The disease is listed as one of three internationally quarantinable diseases by the World Health organization, along with plague and yellow fever. Between 1999 and 2005, Africa alone accounted for about 90% of over 1 million reported cholera cases worldwide. In Ghana, there have been over 27000 reported cases since 1999. In one of the affected regions in Ghana, Ashanti region, massive outbreaks and high incidences of cholera have predominated in urban and overcrowded communities. Results A GIS based spatial analysis and statistical analysis, carried out to determine clustering of cholera, showed that high cholera rates are clustered around Kumasi Metropolis (the central part of the region), with Moran's Index = 0.271 and P Chi square for trend analysis reflected a direct spatial relationship between cholera and urbanization (χ2 = 2995.5, P χ2 = 1757.2, P χ2 = 831.38, P Conclusion The results suggest that high urbanization, high overcrowding, and neighborhood with Kumasi Metropolis are the most important predictors of cholera in Ashanti region.</p

Spatial dependency of Buruli ulcer prevalence on arsenic-enriched domains in Amansie West District, Ghana: implications for arsenic mediation in Mycobacterium ulcerans infection

BACKGROUND: In 1998, the World Health Organization recognized Buruli ulcer (BU), a human skin disease caused by Mycobacterium ulcerans (MU), as the third most prevalent mycobacterial disease. In Ghana, there have been more than 2000 reported cases in the last ten years; outbreaks have occurred in at least 90 of its 110 administrative districts. In one of the worst affected districts, Amansie West, there are arsenic-enriched surface environments resulting from the oxidation of arsenic-bearing minerals, occurring naturally in mineral deposits. RESULTS: Proximity analysis, carried out to determine spatial relationships between BU-affected areas and arsenic-enriched farmlands and arsenic-enriched drainage channels in the Amansie West District, showed that mean BU prevalence in settlements along arsenic-enriched drainages and within arsenic-enriched farmlands is greater than elsewhere. Furthermore, mean BU prevalence is greater along arsenic-enriched drainages than within arsenic-enriched farmlands. CONCLUSION: The results suggest that arsenic in the environment may play a contributory role in MU infection

Adoption of Plantain within New Zealand Farming Systems

In New Zealand, plantain has been incorporated into the pasture forage base in three ways: as a short-term pure crop; as a major component in “herb mixes” that include clovers and chicory; and as a minor component in perennial grass-based swards. All types are typically grazed in-situ. Given the incentive to optimise the plantain proportion in livestock diet to mitigate nitrogen losses and the observed lack of persistence in grass-dominant pasture over time, there is a need to use various pasture types strategically across a farm system to ensure a long-term sustainable contribution of plantain to feed intake. The inclusion of plantain in the forage base should be relatively straightforward since farmers are already familiar with establishing and managing forage crops and mixed-species pastures. However, there are still technical questions to answer and incentives to implement before we can achieve the region-wide adoption necessary to result in a measurable impact on water quality. The Tararua District, on the east coast of the North Island of New Zealand, represents a useful case study of adoption in a strong dairy farming region. Some underpinning elements for successful adoption were in place: 1) national agronomic experience in using a plantain cultivar released in 1996; and 2) regulatory push in terms of reducing N leaching losses on farms. However, other initiatives were required to see meaningful progress: provision of data from local dairy farm systems, focused on the impact on forage supply/quality; a targeted extension program by a trusted sector leader agency (DairyNZ); individual farmer risk-taking and leadership in establishing and managing new crops and pastures. After three years, awareness is well embedded in the rural community and approximately 30% of dairy farms within the district have started to use plantain

Economic Valuation for Water Supply From Merapi Volcano National Park Case Study: Kali Kuning Sub Watershed

The Merapi Volcano National Park (MVNP) is developed based on particular considerations such as protecting ecosystem or preserving certain species. Management of national park will not succeed unless the communities surrounding park support the park itself. However, it will be challenging because the park was established through a ‘top-down' process. Therefore, it is important to ensure that the surrounding communities are able to derive benefit economically from the park, especially environmental services such as water supply. The goal of this study is to estimate the economic value for water supply from MVNP with Kali Kuning Sub Watershed as the study case. The economic valuation is estimated based on three different land use maps: 2015's (deforestation), 2025's (afforestation) and extreme condition which is grassland (without national park). The economic value is approached by market price for water use value. Lastly, cost and benefit analysis based on several scenarios (deforestation, afforestation and ‘without national park') is implemented. The study shows that afforestation scenario presents the highest economic value from water supply for the surrounding communities as well as the downstream communities

Landscape Diversity Related to Buruli Ulcer Disease in Côte d'Ivoire

Buruli ulcer (BU) is one of the most neglected but treatable tropical diseases. The causative organism, Mycobacterium ulcerans, is from the family of bacteria that causes tuberculosis and leprosy. This severe skin disease leads to long-term functional disability if not treated. BU has been reported in over 30 countries mainly with tropical and subtropical climates, but Côte d'Ivoire is one of the most affected countries. M. ulcerans is an environmental bacterium and its mode of transmission to humans is still unclear, such that the disease is often referred to as the “mysterious disease” or the “new leprosy”. Here, we explored the relationship between environmental and socioeconomic factors and BU cases on a nationwide scale. We found that irrigated rice field cultures areas, and, to a lesser extent, banana fields as well as areas in the vicinity of dams used for irrigation and aquaculture purposes, represent high risk zones for the human population to contract BU in Côte d'Ivoire. This work identifies high-risk areas for BU in Côte d'Ivoire and deserves to be extended to different countries. We need now to obtain a global vision and understanding of the route of transmission of M. ulcerans to humans in order to better implement control strategies

Characteristics and racial variations of polypoidal choroidal vasculopathy in tertiary centers in the United States and United Kingdom

PURPOSE: To evaluate the characteristics and racial variations amongst patients with polypoidal choroidal vasculopathy (PCV) in the United States and the United Kingdom. METHODS: Fundus photos and indocyanine green angiography images were evaluated in a multicenter retrospective study to establish the diagnosis of PCV. Visual acuity (VA) was recorded in ETDRS letter count. RESULTS: Eighty eyes of 71 PCV patients (average age of 69.4 ± 10.4 years) were included in the analysis. Of the total 71 subjects, 46 (65%) were women, 33 (46.5%) were Blacks, 16 (22.5%) were Whites, 19 (26.8%) were Asians and 3 (4.2%) belonged to other races. The Black subgroup had vision gain of 3.5 letters. The White and Asian subgroups had vision loss of 13.1 and 3.5 letters, respectively. There was female predominance in Blacks (67%), Whites (69%), and Asians (58%). PCV was found to be a bilateral disease in 14 patients (20%). There was significant decrease of 7 letters with every decade increase in age (p = 0.005). Final VA was worse in males when compared to females (p = 0.042), and worse in Whites when compared to Blacks (p = 0.005). For every 10 letters worse in initial VA upon diagnosis with PCV, the final VA was worse by 6 letters (p < 0.001). The location of the polypoidal lesion within the macula was associated with significant decrease of 14 letters in BCVA (p = 0.02). The length of follow up was significantly associated with worse visual outcome (p = 0.012). Final VA had no significant correlation with the lens status, or the different treatment modalities. CONCLUSIONS: Based on our cohort from tertiary centers in the United States and United Kingdom, PCV is a bilateral disease in one-fifth of patients. It features a variable female predominance based on ethnicity. Increased age, worse vision upon initial presentation, longer follow up and macular location of the polyp were associated with worse visual outcome

Healing Spaces: Feasibility of a Multisensory Experience for Older Adults with Advanced Dementia and their Caregivers

Healing Spaces proposes a new approach to multisensory interventions that show potential in ameliorating the behavioral and psychological symptoms of advanced dementia in older adults. Using smart technology, the project combines both digital and physical components to transform spaces and create unified, curated sensory experiences that provide meaningful context for interaction, and are easy for caregivers to deliver. A usability study was conducted for the Healing Spaces app followed by a feasibility evaluation of the full experience in a memory care facility recruiting caregivers, and residents in advanced stages of dementia. The feasibility evaluation successfully illuminated strengths as well as areas for improvement for the Healing Spaces experience in a memory care setting with older adults with advanced dementia. Caregivers and facility managers expressed interest in continuing to use Healing Spaces with the residents of the facility. Lessons learned about the technical and logistical implementation of Healing Spaces are discussed, as well as future directions for study design and potential therapeutic value of the experience.Comment: PETRA 20: Proceedings of the 13th ACM International Conference on PErvasive Technologies Related to Assistive Environments. June 2020. Article No 24. Pages 1 to