Morphometric characterization of three Tsetse Fly Species - Glossina M. Morsitans, G. P. Palpalis and G. Tachinoides (Diptera: Glossinidae) from Ghana

Tsetse flies (Diptera: Glossinidae) are the main vectors of Human African Trypanosomiasis (HAT), or sleeping sickness and Animal African Trypanosomiasis, (AAT) or Nagana in Sub Saharan Africa. In Ghana, whilst HAT is no longer a major public health issue, AAT is still widely reported and causes considerable losses in the livestock sector resulting in major impacts on agricultural production, livelihoods and food security in the country. Application of morphometric techniques can reveal the existing level of population differentiation in tsetse flies, providing guidance on the distribution of genetically defined subpopulations. Morphometric techniques were used to compare size and shape of three tsetse fly species- G. m. morsitans, G. p. palpalis and G. tachinoides of Ghana, and also compare populations of G. p. palpalis collected from three geographical regions (Northern, Eastern and Western) of Ghana. Flies were sampled from four sites in the Western, one site in the Eastern and three sites in the Northern Region using standard un-baited biconical traps. Right wings and right hind legs of selected flies from different collection sites were removed and mounted on microscope slides using glycerin as the mounting medium. Images of the prepared slides were captured under a Leica EZ4 D microscope with an inbuilt camera connected to a laptop. Linear and proportions of wing and hind tibia measurements were arcsine-root transformed before analyzing with a general linear model in analysis of variance (ANOVA). Multivariate statistical analyses were used to detect any possible variations. Results of the GLM analyses of linear and ratio data revealed that different linear combinations can be used to characterize tsetse species of different populations. The ratio value hind tibia/wing length (th/at) significantly distinguished fly populations into four groups, Northern, Eastern, Western and the lab colony; this is an indication that hind tibia/wing length is a good morphometric feature which can be used to discriminate flies from different regions of Ghana. The principal components and canonical variates as well as Mahalanobis squared distances confirmed linear and ratio separations. Therefore based on these differences in morphometric characters observed, the three tsetse species were distinguished from each other. Similar work on morphometrics needs to be done to include more regions and many other body parts such as proboscis length, antennal length, thorax and abdomen length and width in order to establish stronger morphometric tools for discriminating different tsetse fly species

Foodborne illness among school children in Ga east, Accra

Background: A food borne illness was reported in Ga- East district of Greater Accra Region among school children in May, 2007 after eating food provided at school. The objective of the investigation was to determine the source, mode of contamination and the causative agent.Methods: A case-control study was conducted, cases were schoolchildren with abdominal symptoms and controls were children of the same sex and class without any symptom during the same period. The school children were selected by systematic sampling. Food handlers and the children were interviewed by a structured questionnaire. Food handlers were physically examined and their stools and blood examined. The kitchen for food preparation was inspected. Risks of food borne infection from the foods eaten were determined using attack rates .Results: The minimum, peak and maximum incubation periods were 2, 11 and 61 hours respectively. The source was rice and groundnut soup (with the highest attack rate difference). Stool and blood samples of food handlers were not infective. Storage facility for food items was poor. No food samples were available for organism isolation. A protocol to prevent such outbreaks was nonexistent.Conclusion: The short incubation period and symptoms presented suggest an infective origin. The storage of the meat may potentially have been the point of contamination. The study showed that the schoolchildren ate contaminated food although the investigation could not determine the causative agent. Protocols to prevent such outbreaks need to be developed for the schools.Keywords: Food borne, illness, contaminated food, school children, Accr

Clinical features of COVID-19 in Ghana: symptomatology, illness severity and comorbid non-communicable diseases

Objective: This analysis described the clinical features of COVID-19 in the early phase of the pandemic in Ghana.Methods: Data were extracted from two national COVID-19 treatment centers in Ghana for over 11 weeks(from March to May 2020). Descriptive and inferential statistics were performed. Modified Ordered Logistic and Negative Binomial Regression analysis were applied to establish factors associated with illness severity and Non-communicable Disease (NCDs) counts respectively. All analysis was conducted at the 95% confidence level (p-value ≤ 0.05) using Stata 16.Results: Among the 275 patients, the average age was 40.7±16.4, with a preponderance of males (54.5%). The three commonest symptoms presented were cough (21.3%), headache (15.7%), and sore throat (11.7%). Only 7.6% of the patients had a history of fever. Most patients were asymptomatic (51.65). Approximately 38.9% have an underlying co-morbid NCDs, with Hypertension (32.1%), Diabetes (9.9%), and Asthma (5.2%) being the three commonest. The odds of Moderate/severe (MoS) was significantly higher for those with unknown exposures to similar illness [aOR(95%CI) = 4.27(1.12-10.2)] compared with non-exposure to similar illness. An increased unit of NCD’s count significantly increased the odds of COVID-19 MoS illness by 26%[cOR(95%CI) =1.26(1.09-1.84)] and 67% (adjusting for age) [aOR(95%CI)=1.67(1.13-2.49)].Conclusion: The presence of cardiovascular co-morbidities dictated the frequency of reported symptoms and severity of COVID-19 infection in this sample of Ghanaians. Physicians should be aware of the presence of co-morbid NCDs and prepare to manage effectively among COVID-19 patients

Steroid-induced dysglycaemia in patients with haematological disorders a ten-year review in a tertiary hospital in Ghana

Background: Glucocorticoids (steroids) play a key role in the management of multiple medical conditions including haematological disorders. This study looked at the prevalence of steroid induced dysglycaemia in patients with haematological disorders receiving steroids as part of their treatment with the view of modifying its use and selection of patients where necessary.Methods: A retrospective review of haematology patients on treatment regimens including steroids. Information extracted included, demographic characteristics, clinical information such as age, gender, haematological disorder, type of steroid, daily and cumulative dose of steroid, duration of therapy, family history of diabetes and alcohol use.Results: The case records of 351 haematology patients were reviewed. However, eight patients with dysglycaemia before therapy were excluded. The median age of patients was 51.0 ± 26.0(IQR: Interquartile Range) years, with an age range of 13 to 87 years, and a female: male ratio of 1.2: 1 (p= 0.778). The prevalence of Steroid-Induced Dysglycaemia(SID) was 3.79% with a mean diagnosis interval of 8.8 + 2.1 months. Overall, 245 (71.4%) patients were on continuous steroids. Among the 13 patients who developed SID, 11 (84.6%) were on continuous steroids. In the majority of the patients (97.1%) there was no family history of diabetes in a first degree relative. Significant differences were found between patients with normoglycaemia and those with dysglycaemia with respect to age (p=0.049) and duration of steroid therapy (p=0.024).Conclusion: The prevalence of steroid-induced dysglycaemia is relatively low among Ghanaian patients with haematological disorders on steroid based chemotherapy.Keywords: steroids, haematological disorders, dysglycaemia, Ghana, risk factors.Funding: None declare

Sex differences in perceived risk and testing experience of HIV in an urban fishing setting in Ghana

The concept of neighborhood remains important in criminology but there is an increasing academic interest in the potential impact of the Modifiable Areal Unit Problem (MAUP) on neighborhood based studies. In the present study data over arson from the Swedish rescue services 2007-2012 have been employed to analyze MAUP in the city of Malmö, Sweden. The city has been divided into 50*50 meter pixels as micro-places (n=64540) which have been assigned a value for arson from frequency of arson within the pixel. The analysis is based on a comparison of two types of administrative geographical units alongside 40 randomly generated sets of thiessen polygon geographical units. Empty two-level hierarchical regression models with the micro-places as level 1 unit have been used to calculate Intra-Class Correlations (ICC) separately with each of the 42 different geographical units of analysis as level 2 units. The analysis is repeated with two alternative methods, kernel density and euclidian distance, to calculate a value for each micro-place. Results show that administrative geographical units of analysis in some cases just are marginally better than geographical units with random boundaries if the basic urban structure is taken into account

Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana

Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors.Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done.Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significantResults: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value< 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher prevalence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia.Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensified to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key

COVID-19 pandemic and dental practice in Ghana

With the advent of the COVID-19 pandemic, healthcare systems and their provision of care has globally been challenged, including the delivery of Oral healthcare. In Ghana, it has become imperative that healthcare delivery including the practice of Dentistry and its sub-specialties be re-oriented in our peculiar setting to ensure minimal risk of spread of the infection. This article discusses the impact of COVID-19 on the practice of Dentistry in the country

Emerging challenges in innate immunity: Staphylococcus aureus and healthcare-associated infection

Staphylococcus aureus, a prominent human pathogen, exhibits a remarkable ability to interact with host proteins involved in crucial physiological pathways, such as the complement system, coagulation cascade, and fibrinolysis cascade. This paper explores the ability of this notable bacteria to successfully manipulate and evade the host innate system, expatiating on the strategies that enhance its pathogenicity leading to implications on the healthcare system such as the propagation of diverse nosocomial infections. The investigation focuses on key S. aureus proteins, including Coagulase (Coa), von Willebrand factor-binding protein (vWbp), and Staphylokinase (SAK), which play pivotal roles in blood coagulation, fibrinolysis, and evasion of host antibacterial peptides. Notably, these proteins contribute to the formation of fibrin networks, protecting the bacterium from immune clearance and promoting lethal bloodstream infections in murine models. Additionally, the debate surrounding the role of SAK as a critical virulence factor is addressed, emphasizing its impact on biofilm formation, invasion of internal organs, and bacterial loads in sepsis studies. Furthermore, the interaction of S. aureus with matrix metalloproteinases and the secretion of superantigen-like proteins (SSL1 and SSL5) are explored as additional mechanisms employed by the bacterium to impede immune responses. In addressing emerging challenges in innate immunity, the paper discusses the escalating antibiotic resistance in S. aureus, with a specific focus on methicillin-resistant strains (MRSA) and its capacity to instigate healthcare-associated infections as an effect

Non-communicable diseases among children in Ghana: health and social concerns of parent/caregivers.

Background: Globally, there is a progressive rise in the burden of non-communicable diseases (NCDs). This paper examined the health and social concerns of parents/caregivers on in-patient care for children with NCDs in Ghana. Methods: This was a cross-sectional study in three large health facilities in Ghana (the largest in the South, the largest in the North and the largest in the Eastern part of Ghana. Data was collected with a structured questionnaire among 225 caregivers ( 6518 years) of 149 children with NCDs in health facilities in the three regions. Data was analyzed with simple descriptive statistics. Results: Most caregivers 169(75.0%) were women, relatively young (median age 35years), mostly married and resided in urban areas. Sickle cell disease was the commonest NCD among the children. All 169(75.0%) caregivers believed children suffer NCDs because of sins of parents/ancestors, 29(12.9%) believed herbalists/spiritualists have insights into treating NCDs and 73(32.6%) have previously used herbs/traditional medicine for child's illness. NCD in children was a burden and caused financial difficulties for families. Most caregivers (>96.0%) indicated NCDs in children should be included in national health insurance benefits package and a comprehensive national NCD policy is needed. Conclusion: Absence of national NCD policy for children is a major challenge. The burden of care rests mainly on the parents/ caregivers. A national strategic intervention on the importance of awareness generation on the causes, risk factors, prevention and treatment of NCDs for families and communities is essential. Government support through national health and social policy initiatives are essential

Sociodemographic and clinical characteristics of the first cohort of COVID-19 recoveries at two national treatment centres in Accra, Ghana

Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical features are still evolving, new tests are being developed with inherent challenges regarding interpretation of tests results. There is generally, a gap in knowledge on the virus globally as the pandemic evolves and in Ghana, there is dearth of information and documentation on the clinical characteristics of the virus. With these in mind, we set out to profile the initial cohort of COVID-19 patients who recovered in Ghana. Methods: We reviewed clinical records of all confirmed cases of COVID-19 who had recovered from the two main treatment centres in Accra, Ghana. Descriptive data analysis was employed and presented in simple and relational tables. Independent t-test and ANOVA were used to determine differences in the mean age of the sexes and the number of days taken for the first and second retesting to be done per selected patient characteristics. Results: Of the 146 records reviewed, 54% were male; mean age of patients was 41.9 ± 17.5 years, nearly half were asymptomatic, with 9% being severely ill. The commonest presenting symptoms were cough (22.6%), headache (13%) and sore throat (11%) while the commonest co-morbidities were hypertension (25.3%), diabetes mellitus (14%) and heart disease (3.4%). Conclusion: COVID-19 affected more males than females; nearly half of those infected were asymptomatic. Cough, headache and sore throat were the commonest symptoms and mean duration from case confirmation to full recovery was 19 days. Further research is required as pandemic evolve