THE EVALUATION OF DOMESTIC DUCKS AS POTENTIAL RESERVOIR OF AVIAN INFLUENZA VIRUS IN POST HPAI H5N1 OUTBREAK AREA, SUNYANI MUNICIPALITY, BRONG AHAFO REGION OF GHANA

Background: Avian influenza (AI) is an important zoonotic disease responsible for significant losses in most sub-Saharan countries. However, the role of poultry other than chicken in the epidemiology of the disease, especially after the first AI outbreak in Ghana, has not been fully elucidated. The objective of this study is to determine whether the AI virus infection that was reported in the area in May 2007 was circulating silently in ducks in nine randomly selected farms in the Sunyani Municipality, Ghana. Materials and Methods: The sample size was calculated using Epi info version 3.4.1 at 95% confidence level, absolute precision of 5% and assuming 0.5 prevalence of Avian Influenza A virus in ducks. Samples collection was done simultaneously with questionnaire administration to farmers. A total of 526 samples made up of 384 cloacal swabs and 142 feather tissues from ducks from a commercial duck farm, seven backyard holdings and one live birds market in six randomly selected communities in the Sunyani Municipality, Brong Ahafo region of Ghana. The samples were processed and subjected to Influenza Type A Matrix Gene analysis using RRT-PCR. Results: All the 526 samples subjected to Influenza Type A Matrix Gene analysis using RRT-PCR were negative for Influenza Type A viruses. However, it was observed that bio-security practices which are keys to reintroduction of the virus in the area were not adhered to in 89 % of the sites investigated. Our finding also revealed that only the commercial farm investigated in this study complied with fifteen (78.9%) of the nineteen different farm practices observed. Conclusion: Though AI was not detected in the ducks sampled, there is the need for continuous surveillance and education of stakeholders on standard bio-security and farm management practices in the area

Repurposing an integrated national influenza platform for genomic surveillance of SARS-CoV-2 in Ghana: a molecular epidemiological analysis

Background Genomic surveillance of SARS-CoV-2 is crucial for monitoring the spread of COVID-19 and guiding public health decisions, but the capacity for SARS-CoV-2 testing and sequencing in Africa is low. We integrated SARS-CoV-2 surveillance into an existing influenza surveillance network with the aim of providing insights into SARS-CoV-2 transmission and genomics in Ghana. Methods In this molecular epidemiological analysis, which is part of a wider multifaceted prospective observational study, we collected national SARS-CoV-2 test data from 35 sites across 16 regions in Ghana from Sept 1, 2020, to Nov 30, 2021, via the Ghanaian integrated influenza and SARS-CoV-2 surveillance network. SARS-CoV-2-positive samples collected through this integrated national influenza surveillance network and from international travellers arriving in Accra were sequenced with Oxford Nanopore Technology sequencing and the ARTIC tiled amplicon method. The sequence lineages were typed with pangolin and the phylogenetic analysis was conducted with IQ-Tree2 and TreeTime. Findings During the study period, 5495 samples were submitted for diagnostic testing through the national influenza surveillance network (2121 [46·1%] of 4021 samples with complete demographic data were from female individuals and 2479 [53·9%] of 4021 samples were from male individuals). We also obtained 2289 samples from travellers who arrived in Accra and had a positive lateral flow test, of whom 1626 (71·0%, 95% CI 69·1–72·9) were confirmed to be SARS-CoV-2 positive. Co-circulation of influenza and SARS-CoV-2 in Ghana was detected, with increased cases of influenza in November, 2020, November, 2021, and January and June, 2021. In 4124 samples from individuals with influenza-like illness, SARS-CoV-2 was identified in 583 (14·1%, 95% CI 13·1–15·2) samples and influenza in 356 (8·6%, 7·8–9·5). Conversely, in 476 samples from individuals with of severe acute respiratory illness, SARS-CoV-2 was detected in 58 (12·2%, 9·5–15·5) samples and influenza in 95 (19·9%, 16·5–23·9). We detected four waves of SARS-CoV-2 infections in Ghana; each wave was driven by a different variant: B.1 and B.1.1 were the most prevalent lineages in wave 1, alpha (B.1.1.7) was responsible for wave 2, delta (B.1.617.2) and its sublineages (closely related to delta genomes from India) were responsible for wave 3, and omicron variants were responsible for wave 4. We detected omicron variants among 47 (32%) of 145 samples from travellers during the start of the omicron spread in Ghana (wave 4). Interpretation This study shows the value of repurposing existing influenza surveillance platforms to monitor SARS-CoV-2. Influenza continued to circulate in Ghana in 2020 and 2021, and remained a major cause of severe acute respiratory illness. We detected importations of SARS-CoV-2 variants into Ghana, including those that did or did not lead to onward community transmission. Investment in strengthening national influenza surveillance platforms in low-income and middle-income countries has potential for ongoing monitoring of SARS-CoV-2 and future pandemics. Funding The EDCTP2 programme supported by the EU

Factors associated with suboptimal intake of some important nutrients among HIV-positive pregnant adolescents from two Ghanaian districts

This study determined the daily intakes of some important nutrients and factors associated with the suboptimal intakes of these nutrients among young HIV-positive (HIV+) pregnant women from two Ghanaian districts. Eighty-five of such women after informed consent were recruited from three hospitals and were interviewed using a structured questionnaire. Dietary intake was quantified using the 24-hour recall technique. Total intake, calculated based on dietary recall, and adequacy of intake, calculated based on intake levels compared to the RDA, were assessed. Factors potentially associated with intake were tested using the Mann Whitney U test. The median daily intakes of the nutrients of interest were as follows: Protein (63.1 g), Vitamin C (106 mg), Zinc (11.7 mg), Iron (22.2 mg), and Selenium (1.4 &mu;g). The prevalence of inadequacy of these nutrients were: Vitamin C (35.3%), Protein (39.7%), Iron (72.9%), Selenium (97.6%), and Zinc (100%). HIV + women with nausea, vomiting, and oral lesions had significantly lower intakes of Protein, Iron and Zinc (p < 0.05). Inadequacy of dietary intake is very prevalent among this group of pregnant women particularly among those with nausea, vomiting, and oral lesions. These conditions could be significant contributors to the burden of nutrient deficiencies among women infected with HIV in this setting. Since deficiencies of these nutrients during pregnancy could lead to adverse pregnancy outcomes, emphasis on the dietary sources of these nutrients such as fish, peas, nuts, kontomire, whole grain cereals, seafood, onions, milk, garlic, alfalfa, mushrooms, and banana should be made during antenatal counseling

Strengthening the influenza vaccine virus selection and development process: Report of the 3rd WHO Informal Consultation for Improving Influenza Vaccine Virus Selection held at WHO headquarters, Geneva, Switzerland, 1-3 April 2014

Contains fulltext : 152749.pdf (publisher's version ) (Open Access)Despite long-recognized challenges and constraints associated with their updating and manufacture, influenza vaccines remain at the heart of public health preparedness and response efforts against both seasonal and potentially pandemic influenza viruses. Globally coordinated virological and epidemiological surveillance is the foundation of the influenza vaccine virus selection and development process. Although national influenza surveillance and reporting capabilities are being strengthened and expanded, sustaining and building upon recent gains has become a major challenge. Strengthening the vaccine virus selection process additionally requires the continuation of initiatives to improve the timeliness and representativeness of influenza viruses shared by countries for detailed analysis by the WHO Global Influenza Surveillance and Response System (GISRS). Efforts are also continuing at the national, regional, and global levels to better understand the dynamics of influenza transmission in both temperate and tropical regions. Improved understanding of the degree of influenza seasonality in tropical countries of the world should allow for the strengthening of national vaccination policies and use of the most appropriate available vaccines. There remain a number of limitations and difficulties associated with the use of HAI assays for the antigenic characterization and selection of influenza vaccine viruses by WHOCCs. Current approaches to improving the situation include the more-optimal use of HAI and other assays; improved understanding of the data produced by neutralization assays; and increased standardization of serological testing methods. A number of new technologies and associated tools have the potential to revolutionize influenza surveillance and response activities. These include the increasingly routine use of whole genome next-generation sequencing and other high-throughput approaches. Such approaches could not only become key elements in outbreak investigations but could drive a new surveillance paradigm. However, despite the advances made, significant challenges will need to be addressed before next-generation technologies become routine, particularly in low-resource settings. Emerging approaches and techniques such as synthetic genomics, systems genetics, systems biology and mathematical modelling are capable of generating potentially huge volumes of highly complex and diverse datasets. Harnessing the currently theoretical benefits of such bioinformatics ("big data") concepts for the influenza vaccine virus selection and development process will depend upon further advances in data generation, integration, analysis and dissemination. Over the last decade, growing awareness of influenza as an important global public health issue has been coupled to ever-increasing demands from the global community for more-equitable access to effective and affordable influenza vaccines. The current influenza vaccine landscape continues to be dominated by egg-based inactivated and live attenuated vaccines, with a small number of cell-based and recombinant vaccines. Successfully completing each step in the annual influenza vaccine manufacturing cycle will continue to rely upon timely and regular communication between the WHO GISRS, manufacturers and regulatory authorities. While the pipeline of influenza vaccines appears to be moving towards a variety of niche products in the near term, it is apparent that the ultimate aim remains the development of effective "universal" influenza vaccines that offer longer-lasting immunity against a broad range of influenza A subtypes

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

The past 2 years, during which waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants swept the globe, have starkly highlighted health disparities across nations. Tegally et al. show how the coordinated efforts of talented African scientists have in a short time made great contributions to pandemic surveillance and data gathering. Their efforts and initiatives have provided early warning that has likely benefited wealthier countries more than their own. Genomic surveillance identified the emergence of the highly transmissible Beta and Omicron variants and now the appearance of Omicron sublineages in Africa. However, it is imperative that technology transfer for diagnostics and vaccines, as well the logistic wherewithal to produce and deploy them, match the data-gathering effort