Assessing Municipal Solid Waste Management Practices and Challenges in the Techiman Municipality, Ghana

Managing waste efficiently is essential for building sustainable, livable and healthy communities but this remains a challenge for many municipal governments due to limited municipal budget and other logistical challenges. Such challenges result in ineffective waste collection and disposal. However, identifying the challenges associated with municipal solid waste management often lead to developing solutions to mitigate the problem. This paper assesses the waste management practices and challenges within the Techiman municipality, the regional capital of the Bono East Region. By sampling residents’ perceptions and experiences it was observed that households and patrons were dissatisfied with Techiman’s Municipal Solid Waste Management (MSWM). Statistically the per capita per day rate of waste generation was 0.48kg/ per capita/per day, being higher than Ghana’s municipal waste generation of 0.40 kg/per capita/per day. Lack of collection of waste from the transfer stations to the landfill sites has resulted in about 67 heaps of uncollected waste in the municipality. The results show that lack of source separation and recycling, broken down trucks, low participation of private sector in waste collection, non-compliance of by-laws, poor road infrastructure leading to the landfill site, and inefficient landfill site have contributed to the waste problem in the municipality. Resorting to source separation, educating the public on waste management bye laws, increasing private sector participation and establishing engineered landfill sites can substantially contribute to sustainable Municipal Waste Management in the Techiman Municipality

Trends in extrapulmonary TB cases at three teaching hospitals in Ghana, 2008-2017

SETTING: Three teaching hospitals in Ghana. OBJECTIVE: To elucidate trends in demographics, clinical characteristics and treatment outcomes in extrapulmonary TB (EPTB) patients. DESIGN: This was a retrospective study involving the review and comparison of EPTB and pulmonary TB (PTB) data from 1 January 2008 to 31 December 2017 in TB registers and treatment cards. RESULTS: Of 15,392 TB cases, 4607 (30%) were EPTB, including 4477/4607 (97%) new cases. There were 2,679/4607 (58%) males and the age range was 0.3 to 96 years. Pleural TB (1021/4607, 22%) was the most common. Treatment success rates for EPTB and PTB were respectively 72% and 84%. HIV positivity was high among patients with disseminated/miliary TB (429/779, 55%) and TB meningitis (242/526, 46%). To note, disseminated/miliary TB (chi(2) = 33.53, P < 0.0001) increased, whereas TB meningitis (chi(2) = 19.43, P < 0.0001) decreased over the 10-year period. Mortality among EPTB patients was associated with increasing age (25 years), disseminated/miliary TB, TB meningitis and HIV positivity. CONCLUSIONS: There is male preponderance for both EPTB and PTB in Ghana. Increasing age, disseminated/ miliary TB, TB meningitis and HIV are risk factors for mortality among EPTB patients. This emphasises the need for public education on the risk factors for EPTB and preventive strategies

Prevalence of parasitic infections on cultured Nile tilapia, Oreochromis niloticus (Linnaeus, 1758) In Bong County, Liberia

This study investigated the prevalence rate, relative abundance and mean intensity of par­asites infecting cultured Nile tilapia Oreochromis niloticus L. in three fish farms, Gbarnga, Warta and CARI in Bong County, Liberia. Organs from thirty fish samples were exam­ined from September 2016 to February 2017, along with water quality parameters. Results showed the occurrence of seven parasites including protozoans, monogeneans, digeneans, cestodes, hirudineans, nematodes and crustaceans which were organ specific in terms of infection. The prevalence of the parasites varied seasonally, with the highest numbers oc­curring in November-January. The low prevalence rate, relative abundance and mean in­tensity of the parasites showed no threat to fish farmers in Liberia. All the water quality parameters were at desirable levels for the culture of the fish except nitrite, which was beyond the threshold for sustainable fish culture. It is therefore concluded that although parasitic infections in the three farms in the Bong County were low, best farm management practices are essential

Predictors of anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project.

Background: A lack of information on the etiology of anemia has hampered the design and monitoring of anemia-control efforts.Objective: We aimed to evaluate predictors of anemia in preschool children (PSC) (age range: 6-59 mo) by country and infection-burden category.Design: Cross-sectional data from 16 surveys (n = 29,293) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed separately and pooled by category of infection burden. We assessed relations between anemia (hemoglobin concentration &lt;110 g/L) and severe anemia (hemoglobin concentration &lt;70 g/L) and individual-level (age, anthropometric measures, micronutrient deficiencies, malaria, and inflammation) and household-level predictors; we also examined the proportion of anemia with concomitant iron deficiency (defined as an inflammation-adjusted ferritin concentration &lt;12 μg/L). Countries were grouped into 4 categories on the basis of risk and burden of infectious disease, and a pooled multivariable logistic regression analysis was conducted for each group.Results: Iron deficiency, malaria, breastfeeding, stunting, underweight, inflammation, low socioeconomic status, and poor sanitation were each associated with anemia in &gt;50% of surveys. Associations between breastfeeding and anemia were attenuated by controlling for child age, which was negatively associated with anemia. The most consistent predictors of severe anemia were malaria, poor sanitation, and underweight. In multivariable pooled models, child age, iron deficiency, and stunting independently predicted anemia and severe anemia. Inflammation was generally associated with anemia in the high- and very high-infection groups but not in the low- and medium-infection groups. In PSC with anemia, 50%, 30%, 55%, and 58% of children had concomitant iron deficiency in low-, medium-, high-, and very high-infection categories, respectively.Conclusions: Although causal inference is limited by cross-sectional survey data, results suggest anemia-control programs should address both iron deficiency and infections. The relative importance of factors that are associated with anemia varies by setting, and thus, country-specific data are needed to guide programs

Intraindividual double burden of overweight and micronutrient deficiencies or anemia among preschool children

Background: Child overweight prevalence is increasing globally, but micronutrient deficiencies persist. Objectives: We aimed to 1) describe the prevalence and distribution of intraindividual double burden of malnutrition (DBM), defined as coexistence of overweight or obesity (OWOB) and either micronutrient deficiencies or anemia, among preschool children; 2) assess the independence of DBM components, e.g., whether the prevalence of DBM is greater than what would be expected by chance; and 3) identify predictors of intraindividual DBM, to guide intervention targeting. Methods: We analyzed data from 24 population-based surveys from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project (separately by survey; n = 226 to n = 7166). We defined intraindividual DBM as coexisting OWOB and ≥1 micronutrient deficiency [e.g., Micronutrient Deficiency Index (MDI) \u3e 0; DBM-MDI] or anemia (DBM-Anemia). We assessed independence of DBM components with the Rao–Scott chi-square test and examined predictors of DBM and its components with logistic regression. Results: DBM prevalence ranged from 0% to 9.7% (median: 2.5%, DBM-MDI; 1.4%, DBM-Anemia), reflecting a lower prevalence of OWOB (range: 0%–19.5%) than of micronutrient deficiencies and anemia, which exceeded 20% in most surveys. OWOB was generally not significantly associated with micronutrient deficiencies or anemia. In more than half of surveys, children 6–23 mo of age, compared with ≥24 mo, had greater adjusted odds of DBM-Anemia, anemia, and micronutrient deficiencies. Child sex and household socioeconomic status, urban location, and caregiver education did not consistently predict DBM or its components. Conclusions: Intraindividual DBM among preschool children was low but might increase as child OWOB increases. The analysis does not support the hypothesis that DBM components cluster within individuals, suggesting that population-level DBM may be addressed by programs to reduce DBM components without targeting individuals with DBM

Determinants of antibody persistence across doses and continents after single-dose rVSV-ZEBOV vaccination for Ebola virus disease: an observational cohort study.

BACKGROUND: The recombinant vesicular stomatitis virus (rVSV) vaccine expressing the Zaire Ebola virus (ZEBOV) glycoprotein is efficacious in the weeks following single-dose injection, but duration of immunity is unknown. We aimed to assess antibody persistence at 1 and 2 years in volunteers who received single-dose rVSV-ZEBOV in three previous trials. METHODS: In this observational cohort study, we prospectively followed-up participants from the African and European phase 1 rVSV-ZEBOV trials, who were vaccinated once in 2014-15 with 300 000 (low dose) or 10-50 million (high dose) plaque-forming units (pfu) of rVSV-ZEBOV vaccine to assess ZEBOV glycoprotein (IgG) antibody persistence. The primary outcome was ZEBOV glycoprotein-specific IgG geometric mean concentrations (GMCs) measured yearly by ELISA compared with 1 month (ie, 28 days) after immunisation. We report GMCs up to 2 years (Geneva, Switzerland, including neutralising antibodies up to 6 months) and 1 year (Lambaréné, Gabon; Kilifi, Kenya) after vaccination and factors associated with higher antibody persistence beyond 6 months, according to multivariable analyses. Trials and the observational study were registered at ClinicalTrials.gov (Geneva: NCT02287480 and NCT02933931; Kilifi: NCT02296983) and the Pan-African Clinical Trials Registry (Lambaréné PACTR201411000919191). FINDINGS: Of 217 vaccinees from the original studies (102 from the Geneva study, 75 from the Lambaréné study, and 40 from the Kilifi study), 197 returned and provided samples at 1 year (95 from the Geneva study, 63 from the Lambaréné, and 39 from the Kilifi study) and 90 at 2 years (all from the Geneva study). In the Geneva group, 44 (100%) of 44 participants who had been given a high dose (ie, 10-50 million pfu) of vaccine and who were seropositive at day 28 remained seropositive at 2 years, whereas 33 (89%) of 37 who had been given the low dose (ie, 300 000 pfu) remained seropositive for 2 years (p=0·042). In participants who had received a high dose, ZEBOV glycoprotein IgG GMCs decreased significantly between their peak (at 1-3 months) and month 6 after vaccination in Geneva (p0·05). Neutralising antibodies seem to be less durable, with seropositivity dropping from 64-71% at 28 days to 27-31% at 6 months in participants from the Geneva study. INTERPRETATION: Antibody responses to single-dose rVSV-ZEBOV vaccination are sustained across dose ranges and settings, a key criterion in countries where booster vaccinations would be impractical. FUNDING: The Wellcome Trust and Innovative Medicines Initiative 2 Joint Undertaking

Preliminary Evaluation of Indoor Radon Exposure Levels in Students&apos; Halls of Residence at the Northern Campus (New Site) of the University of Cape Coast, Ghana

Abstract: The study seeks to present Radon exposure levels in some rooms within halls of residence at the New Site of the University of Cape Coast, Ghana determined using LR-115 TypeII Solid State Nuclear Track Detector (SSNTD) and E-PERM detecting systems. Pieces of the plastic LR-115 detectors were covered with aluminium foil and fixed in plastic holder such that the active part (coated part) of the detector was exposed (bare), facing downwards and together with the E-PERM were placed at a location in each of the selected rooms in the halls of residence for 30 days. The voltages of the E-PERMs were taken using the SPER-1 Reader whilst the LR-115 was chemically etched to reveal the alpha tracks. The mean radon exposure level for LR-115 was 6.8 mSv (range: 3.1-9.1 mSv) whiles the mean exposure for the E-PERM was 3.6 mSv (range: 1.7-5.3 mSv). The results obtained also indicated that the exposure levels measured by both the E-PERM and the LR-115 detectors were generally below the Environmental Protection Agency (US-EPA) guideline limit of 8 mSv. However, some rooms had their exposure levels (measured with the LR-115 detector) above the remedial guideline limit of 8 mSv, but far below the immediate action limit of 20 mSv. Most of a student time is spent indoors. There is therefore the need to have a fair idea the radon concentration and exposure levels in rooms since radon has been identified as a carcinogenic gas

Socioeconomic differentials in the immediate mortality effects of the national Irish smoking ban

This article has been made available through the Brunel Open Access Publishing Fund.Background: Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Methods: Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000–2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results: Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Conclusions: Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring that a differentiated analytical approach aided in understanding the complexities in which structural and material factors influence mortality

Assessment of Water Quality and Heavy Metal Levels in Water and Bottom Sediment Samples from Mokwé Lagoon, Accra, Ghana

Abstract: The current study deals with the physicochemical characteristics of water samples from the Mokwé Lagoon in addition to trace heavy metals (Cd, Cr, Ni, Pb and Zn) in the lagoon water and bottom sediments. The results indicated relatively high ionic content which was reflected in high conductivity, total dissolved Solids, alkalinity, hardness and chloride levels; and low nutrient content. The trace heavy metal levels in the lagoon water were found within good range of international guideline limits for natural waters. In contrast, the metallic levels in the sediment were high. The levels of metal contamination and distribution in the sediment samples were assessed using geoaccumulation index, enrichment factor, contamination factor and pollution load factor. The metal index analysis indicated high enrichment of the metals (especially Cr and Ni) which reflected anthropogenic effects of contamination attributable to several sources. The study calls for constant environmental monitoring to forestall any heavy metal hazard which could be detrimental to the aquatic ecosystem of the lagoon

Evaluation of sesamum gum as an excipient in matrix tablets

In developing countries modern medicines are often beyond the affordability of the majority of the population. This is due to the reliance on expensive imported raw materials despite the abundance of natural resources which could provide an equivalent or even an improved function. The aim of this study was to investigate the potential of sesamum gum (SG) extracted from the leaves of Sesamum radiatum (readily cultivated in sub-Saharan Africa) as a matrix former. Directly compressed matrix tablets were prepared from the extract and compared with similar matrices of HPMC (K4M) using theophylline as a model water soluble drug. The compaction, swelling, erosion and drug release from the matrices were studied in deionized water, 0.1 N HCl (pH 1.2) and phosphate buffer (pH 6.8) using USP apparatus II. The data from the swelling, erosion and drug release studies were also fitted into the respective mathematical models. Results showed that the matrices underwent a combination of swelling and erosion, with the swelling action being controlled by the rate of hydration in the medium. SG also controlled the release of theophylline similar to the HPMC and therefore may have use as an alternative excipient in regions where Sesamum radiatum can be easily cultivated