School Sanitation and Hygiene Education: A Focus on Rural Community Basic Schools in Ghana.

This study was conducted to examine the impact of School Sanitation and Hygiene Education (SSHE) on Basic schools pupils in the Akontombra district in the Sefwi Wiawso Municipality in Western Region of Ghana. It was in an attempt to find out how pupils practise sanitation. One hundred respondents made up of 50 boys and 50 girls drawn from the target population were sampled randomly and purposively. Data was gathered mainly with the aid of interviews and questionnaires. The study revealed that improving hygiene and sanitation of school children is a significant factor for achieving good educational outcomes. It was also realized in the ten schools where the study was conducted that school sanitation and hygiene education did not have any significant impact on the pupils in the area. Thus schools and stakeholders will have to emphasise the implementation of SSHE. It was recommended among others that the government, in collaboration with Ghana Education Service (GES) should organise workshops for school health coordinators and empower them with skills that will enable them handle issues related to hygiene and sanitation with confidence. Keywords: improving sanitation, hygiene, educational outcomes, practice, health

A Heuristic Approach to Locating a Landfill Site in the Sekondi- Takoradi Metropolis of Ghana

The rise in the urban population of developing countries in the past decade has brought the necessity to develop environmentally sustainable and efficient waste management systems. Sanitary landfill constitutes one of the primary methods of municipal solid waste disposal. Optimized siting has gained considerable importance in order to ensure minimum damage to the environment. Despite an increase in alternative techniques for disposing of waste, landfill site still remains the primary means of waste disposal. This study seeks to find the optimal location of a landfill site in the Sekondi -Takoradi metropolis. The problem was formulated as an Integer Programming model and the solution was presented through an ant colony based meta-heuristic for the Travelling Salesman Problem. The data on distances were taken from potential collection points and also Cartesian coordinates of the collection points were collected and used for each sub-metro. The optimal solutions were obtained with the aid of a MATLAB implementation codes. The Ant Colony results revealed that the best location for an additional landfill site is Apremedo with a route length of a 133.35miles. Keywords: Ant colony, Travelling Salesman Problem, Landfill site, Optimization and Integer Programming

What makes joint assessment procedures attractive to the innovative industry: successes, challenges, and proposed improvements

Regulatory harmonization and convergence have been identified as the key driver in promoting efficient evaluation of medicines, reducing workload, and supporting earlier access to medicines on the African continent. There has been great progress to date in enhancing regulatory harmonization and convergence on the African continent via the Regional Economic Communities (RECs) and with the establishment of the Africa Medicines Agency (AMA). In this article, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Africa Regulatory Network (ARN) presents its perspective based on the available literature review and results from a survey conducted with innovative biopharmaceutical companies to gather experiences using regional joint assessment procedures (JAPs) in Africa, such as the East African Community Medicines Regulatory Harmonization (EAC-MRH), the West African Medicines Regulatory Harmonization (WA-MRH), and the Southern African Development Community Medicines Regulatory Harmonization (SADC-MRH) initiative through the ZAZIBONA Collaborative Procedure for Medicines Registration (ZaZiBoNa), and provides best practices in this evolving landscape. The article also assesses other collaborative registration pathways available to facilitating registration of pharmaceutical products in African countries, such as WHO Collaborative Registration Procedures (CRP), Swissmedic’s Marketing Authorisation for Global Health Products (MAGHP) and EU Medicines for All (EU-M4ALL). Benefits and challenges of each of the existing pathways are discussed in this article. Main benefits include building more expert capacity and improved collaboration amongst experts, as well as shorter review timelines in some cases. Key challenges include the lack of predictability in the adherence to procedural timelines as defined per guidelines, lengthy timeline to achieve national marketing authorization following joint assessment, the lack of dedicated personnel, administrative issues during the submission process as well as additional country-specific requirements on top of JAP-specific requirements. Our recommendations for improvements include harmonization of requirements across countries and regions and with international standards, appropriate resource allocation for JAP activities to ensure adherence to timelines, use of JAPs throughout the entire product lifecycle and all product categories, adequate use of digital technologies, and improved communication and transparency with applicants. These improvements will allow industry to better plan their filing strategies for the region which will lead to overall improved usability of the JAPs in Africa and enable faster patient access

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Effect of Branding Gulf Oysters on Consumer’s Willingness to Pay

Within the East coast and West Coast oyster market, oysters are generally marketed using product attributes and brand name. However the Gulf oyster market does not involve branding. Using choice experiment method and online survey data, the study estimated the effect of branding Gulf oysters on Gulf and Non-Gulf consumers’ willingness to pay. Alternative-specific conditional logit, Nested logit and Alternative-specific multinomial probit methods of analysis were used to investigate the Independence of Irrelevant Alternative assumption made about consumers. Pooled and scaled models were used to analyze the identified data categories from which consumers were found to share the same oyster preferences. The results found that consumers on the average were willing to pay more for the oysters harvested from their own region relative to those harvested from outside their region. They were willing to pay a less for oysters harvested outside their region

INTERIOR POINT ALGORITHM FOR SOLVING FARM RESOURCE ALLOCATION PROBLEM

This paper introduces interior point algorithm as an alternative approach to simplex algorithm for solving farm resource allocation problem. The empirical result of interior point algorithm is compared with that of the simplex algorithm. It goes further to address a profit maximization problem. The result revealed several relevant patterns. Results of the interior point algorithm is similar to that of the simplex algorithm. Findings indicated that in both algorithms, the farm is to produce peppers, wheat which is irrigated and weeded manually, hire additional month of labour, and also purchase urea and muriate fertilizer to realize a similar amount of profit. Additionally, both algorithms suggested that practicing crop rotation where beans, if grown, should be altered with wheat cannot be possible since no beans will be grown. The Simplex algorithm saves 39 iterations over Interior Point algorithm in solving the farm resource allocation problem. The findings demonstrate that the interior point algorithm offers a useful alternative to the simplex algorithm when addressing farm resource allocation problem

Interior point algorithm for solving farm resource allocation problem

This paper introduces interior point algorithm as an alternative approach to simplex algorithm for solving farm resource allocation problem. The empirical result of interior point algorithm is compared with that of the simplex algorithm. It goes further to address a profit maximization problem. The result revealed several relevant patterns. Results of the interior point algorithm is similar to that of the simplex algorithm. Findings indicated that in both algorithms, the farm is to produce peppers, wheat which is irrigated and weeded manually, hire additional month of labour, and also purchase urea and muriate fertilizer to realize a similar amount of profit. Additionally, both algorithms suggested that practicing crop rotation where beans, if grown, should be altered with wheat cannot be possible since no beans will be grown. The Simplex algorithm saves 39 iterations over Interior Point algorithm in solving the farm resource allocation problem. The findings demonstrate that the interior point algorithm offers a useful alternative to the simplex algorithm when addressing farm resource allocation problem. JEL code: D24, D57, C61, C63, C6

Effect of branding Gulf oysters on consumers willingness to pay

Using a choice experiment this study found that raw oyster consumers are more likely to buy oysters harvested from their region over those harvested outside the region. Consumers are more likely to buy wild-caught oysters over cultivated oysters. Non-Gulf consumers are more likely to buy medium or large size oysters over small size