Food and its preparation conditions in hotels in Accra, Ghana: A concern for food safety

Although a lot of work has been done on the safety of street foods in most  developing countries, not much has been done with regards to the hotel industry. A pilot study to investigate food and its preparation conditions in ten selected hotels in Accra, the capital of Ghana with respect to food safety was therefore initiated in 2005/2006. A total of 184 samples; 105 swabs of kitchen working surfaces, cutlery and plates; 29, 30, and 20 samples of food, water and fruit juice  respectively were taken for microbial analysis from ten highly patronized hotels between December 2005 and June 2006. Standard microbiological methods were used for isolation, enumeration, and identification of bacteria. Thirty Seven (37) of the swab samples showed the presence of coliforms while Escherichia coli was absent in all the 105 samples. The total count of aerobic bacteria was high in the swabs from the working surfaces and cutting boards (> 103 cfu/ml). All the food samples tested negative for Salmonella, Staphylococcus and E. coli. Coliforms and E. coli were not detected in any of the 30 water samples tested, Ten of the fruit juice samples tested positive for coliforms although E. coli was absent in all the 20  samples. Most of the swabs that registered the presence of coliforms were from  chopping boards, pastry and working tables suggesting that the method of cleaning these surfaces should be improved. The microbial quality of all the food samples tested was satisfactory with aerobic colony counts of less than 104 cfu/g and no pathogens detected in 25g of food sample, which is the standard for ready to eat foods. The water samples also met the  satisfactory criteria of no coliforms detected in 100mls of water. No pathogens were detected in the fruit juice samples, but with the exception of ginger juice, all were contaminated with coliforms which suggests that, stringent measures be applied in the preparation and handling of these juices. As a result of this study staff and management of these hotels are now  implementing Good Hygienic Practices (GHP) and Hazard Analysis and Critical Control Points (HACCP).Key words: Food, Coliforms, Salmonella, Staphylococcu

Use of a molecular bacterial load assay to distinguish between active TB and post-TB lung disease

Authors acknowledge financial support from the EDCTP2 programme supported by the European Union project (grant #: TMA2016SF-1463-REMODELTZ) and DELTAS Africa Initiative (Afrique One-ASPIRE /DEL-15-008). The Afrique One-ASPIRE is funded by a consortium of donors including the African Academy of Sciences, Alliance for Accelerating Excellence in Science in Africa, the New Partnership for Africa's Development Planning and Coordinating Agency, the Wellcome Trust (107753/A/15/Z), and the UK Government. PMM, SKH and SGM were also supported by NIH U01AI115594.Publisher PDFPeer reviewe

Comparative efficacy of low-dose versus standard-dose azithromycin for patients with yaws: a randomised non-inferiority trial in Ghana and Papua New Guinea

Background: A dose of 30 mg/kg of azithromycin is recommended for treatment of yaws, a disease targeted for global eradication. Treatment with 20 mg/kg of azithromycin is recommended for the elimination of trachoma as a public health problem. In some settings, these diseases are co-endemic. We aimed to determine the efficacy of 20 mg/kg of azithromycin compared with 30 mg/kg azithromycin for the treatment of active and latent yaws. Methods: We did a non-inferiority, open-label, randomised controlled trial in children aged 6–15 years who were recruited from schools in Ghana and schools and the community in Papua New Guinea. Participants were enrolled based on the presence of a clinical lesion that was consistent with infectious primary or secondary yaws and a positive rapid diagnostic test for treponemal and non-treponemal antibodies. Participants were randomly assigned (1:1) to receive either standard-dose (30 mg/kg) or low-dose (20 mg/kg) azithromycin by a computer-generated random number sequence. Health-care workers assessing clinical outcomes in the field were not blinded to the patient's treatment, but investigators involved in statistical or laboratory analyses and the participants were blinded to treatment group. We followed up participants at 4 weeks and 6 months. The primary outcome was cure at 6 months, defined as lesion healing at 4 weeks in patients with active yaws and at least a four-fold decrease in rapid plasma reagin titre from baseline to 6 months in patients with active and latent yaws. Active yaws was defined as a skin lesion that was positive for Treponema pallidum ssp pertenue in PCR testing. We used a non-inferiority margin of 10%. This trial was registered with ClinicalTrials.gov, number NCT02344628. Findings: Between June 12, 2015, and July 2, 2016, 583 (65·1%) of 895 children screened were enrolled; 292 patients were assigned a low dose of azithromycin and 291 patients were assigned a standard dose of azithromycin. 191 participants had active yaws and 392 had presumed latent yaws. Complete follow-up to 6 months was available for 157 (82·2%) of 191 patients with active yaws. In cases of active yaws, cure was achieved in 61 (80·3%) of 76 patients in the low-dose group and in 68 (84·0%) of 81 patients in the standard-dose group (difference 3·7%; 95% CI −8·4 to 15·7%; this result did not meet the non-inferiority criterion). There were no serious adverse events reported in response to treatment in either group. The most commonly reported adverse event at 4 weeks was gastrointestinal upset, with eight (2·7%) participants in each group reporting this symptom. Interpretation: In this study, low-dose azithromycin did not meet the prespecified non-inferiority margin compared with standard-dose azithromycin in achieving clinical and serological cure in PCR-confirmed active yaws. Only a single participant (with presumed latent yaws) had definitive serological failure. This work suggests that 20 mg/kg of azithromycin is probably effective against yaws, but further data are needed

Impact of dietary patterns, individual and workplace characteristics on blood pressure status among civil servants in Bida and Wushishi communities of Niger State, Nigeria

The global burden estimate of hypertension is alarming and results in several million deaths annually. A high incidence of sudden deaths from cardiovascular diseases in the civil workforce in Nigeria is often reported. However, the associations between Dietary Patterns (DPs), individual, and workplace characteristics of hypertension among this workforce have not been fully explored. This study aimed to identify DP in the Bida and Wushishi Communities of Niger State and establish its relationship with hypertension along with other individual and workplace characteristics. Factor analysis was used to establish DP, Chi-square test to identify their relationships with hypertension, and logistic regression to determine the predictor risk factors. The prevalence of hypertension was 43.7%; mean weight, height, and body fat were: 72.8±15 kg, 166±8.9 mm and 30.4%, respectively. Three DPs: “Efficient Diet,” “Local diet,” and “Energy Boost Diet” were identified. The factor loading scores for these factors were divided into quintiles Q1–Q5; none of them had a significant effect on hypertension status. Conversely, increase in age, the Ministry, Department, and Agency (MDA) of employment, frequency of eating in restaurants, and obesity were identified as significant risk factors. After adjusting for confounders (age, body mass index, MDA, and eating habits), a high score (Q5) in “efficient diet pattern” was significantly related to a lower likelihood of hypertension than a low score (Q1). The prevalence of hypertension among the participants was relatively very high. An increase in age and working in educational sector were risk factors associated with hypertension. Therefore, it is recommended that civil servants engage in frequent exercise and undergo regular medical checkups, especially as they get older. These findings highlight the need for large-scale assessment of the impact of variables considered in this study on hypertension, among the civil workforce across Niger state and Nigeria

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Volume 7 No. 5 2007 FOOD AND ITS PREPARATION CONDITIONS IN HOTELS IN ACCRA, GHANA: A CONCERN FOR FOOD SAFETY

ABSTRACT Although a lot of work has been done on the safety of street foods in most developing countries, not much has been done with regards to the hotel industry. A pilot study to investigate food and its preparation conditions in ten selected hotels in Accra, the capital of Ghana with respect to food safety was therefore initiated in 2005/2006. A total of 184 samples; 105 swabs of kitchen working surfaces, cutlery and plates; 29, 30, and 20 samples of food, water and fruit juice respectively were taken for microbial analysis from ten highly patronized hotels between December 2005 and June 2006. Standard microbiological methods were used for isolation, enumeration, and identification of bacteria. Thirty Seven (37) of the swab samples showed the presence of coliforms while Escherichia coli was absent in all the 105 samples. The total count of aerobic bacteria was high in the swabs from the working surfaces and cutting boards (> 10 3 cfu/ml). All the food samples tested negative for Salmonella, Staphylococcus and E. coli. Coliforms and E. coli were not detected in any of the 30 water samples tested, Ten of the fruit juice samples tested positive for coliforms although E. coli was absent in all the 20 samples. Most of the swabs that registered the presence of coliforms were from chopping boards, pastry and working tables suggesting that the method of cleaning these surfaces should be improved. The microbial quality of all the food samples tested was satisfactory with aerobic colony counts of less than 10 4 cfu/g and no pathogens detected in 25g of food sample, which is the standard for ready to eat foods. The water samples also met the satisfactory criteria of no coliforms detected in 100mls of water. No pathogens were detected in the fruit juice samples, but with the exception of ginger juice, all were contaminated with coliforms which suggests that, stringent measures be applied in the preparation and handling of these juices. As a result of this study staff and management of these hotels are now implementing Good Hygienic Practices (GHP) and Hazard Analysis and Critical Control Points (HACCP)

Prevalence of Multidrug-Resistant Escherichia coli Isolated from Drinking Water Sources

The control of infectious diseases is badly endangered by the rise in the number of microorganisms that are resistant to antimicrobial agents. This is because infections caused by resistant microorganisms often fail to respond to conventional treatment, resulting in prolonged illness and greater risk of death. Antimicrobial-resistant bacteria are also present in various water sources. This study therefore sought to document the microbiological quality and antibiograms of bacterial isolates (E. coli strains) from six different water sources in order to determine their safety for human consumption and to provide updated antibiotic data for pragmatic treatment of patients. Bacteria isolation and identification was done using API and conventional methods. Antibiotic susceptibility testing was conducted using the Kirby–Bauer method. Results obtained indicated that all the water sources tested were of poor quality. Bacteria isolated included E. coli, Enterobacter spp., Klebsiella spp., Salmonella typhi, Streptococcus spp., Proteus vulgaris, Vibrio cholera, Shigella spp., Pseudomonas aeruginosa, and Enterococcus faecalis. The prevalence of multidrug-resistant E. coli was 49.48%. E. coli isolates showed high resistance patterns to the tested antibiotics. They were most resistant to penicillin (32.99%), cefuroxime (28.87%), erythromycin (23.71%), and tetracycline (21.45%). In contrast, they were susceptible to nitrofurantoin (93.8%), cefotaxime and amikacin (91.75%), gentamicin (90.7%), nalidixic acid (89.65%), ciprofloxacin (74.2%), chloramphenicol (69.07%), pipemidic acid (65.97%), and cefuroxime (52.58%). Sixty-three percent (63%) of the multidrug-resistant E. coli strains recorded a multiple antibiotic resistance (MAR) index value >0.2. The susceptible antibiotics, especially the nitrofurantoin, are hence recommended in the practical treatment of waterborne bacterial diseases

Prevalence and Antibiotic Susceptibility Profile of Methicillin Resistant Staphylococcus aureus in Accra, Ghana

Over the last four decades, methicillin-resistant Staphylococcus aureus (MRSA) has spread throughout the world and become highly endemic in many geographical areas. This pathogen causes severe morbidity and mortality in hospitals worldwide. MRSA is also considered a major community acquired pathogen throughout the world. MRSA is implicated in serious clinical conditions such as bacteremia, pneumonia, and intra-abdominal infection. The objective of this study was to determine the prevalence of MRSA in Accra, Ghana, and also to determine its antibiotic susceptibility profile. Two hundred and fifty Staphylococcus aureus isolates from routine microbiological specimens were collected from five hospitals in Accra. MRSA screening assay was used to screen for MRSA. Disc diffusion method (Kirby-Bauer) was used to determine the susceptibility of the MRSA. The MRSA screening assay, which is very close to the polymerase chain reaction in terms of specificity and sensitivity, showed that 84 of the 250 isolates were MRSA, giving a prevalence rate of 33.6%. MRSA strains were susceptible to erythromycin; 63 out of the 84 MRSA isolates were susceptible representing 75%. This was followed by gentamicin 46 (54.7%), cotrimoxazole 35 (49%), cefuroxime 33 (38%), flucloxacillin 24 (28.6%), and ampicillin 13 (15.5%). Penicillin 4 (4.8%) and tetracycline 6 (7.1%) were the least susceptible. The findings from this study emphasize the need for continual surveillance of MRSA and of antibiotic resistance in general