Two cases of Pentalogy of Cantrell diagnosed antenatally at Korle Bu Teaching Hospital, Accra

Pentalogy of Cantrell is a rare congenital malformation syndrome that may be associated with other congenital anomalies. The syndrome is said to affect males and females in equal numbers and the prognosis is generally poor. We report two cases of Cantrell’s Pentalogy diagnosed antenatally at the Korle Bu teaching Hospital. The 2 cases described in this report demonstrate the complete and incomplete variant of the syndrome. The cases were referred as an omphalocoele and a detailed anomaly scan confirmed the diagnosis of Pentalogy of Cantrell. Both cases were females and neither survived beyond 24 hours. Although this condition is associated with a poor prognosis, there have been some reported cases of survival in the literature. Thus, accurate prenatal diagnosis and a multidisciplinary approach to the management may offer improved outcomes.Keywords: Foetal Anomaly, Ventral wall defect, Obstetric ultrasound, Prenatal diagnosis, Thoraco-abdominalsyndrom

Incipient bifenthrin-resistance in field populations of cocoa mirids, Distantiella theobroma (Dist.) and Sahlbergella singularis Hagl. (Hemiptera: Miridae)

Bifenthrin is one of the insecticides approved by the Ghana Cocoa Board (COCOBOD) for the control of cocoa mirids. Bifenthrin-resistance levels of D. theobroma and S. singularis collected from different locations in the Eastern Region (ER), Volta Region (VR) and Central Region (CR) were determined by calculating their resistance ratios (RRs). The highest RRs for S. singularis were recorded from New Tafo in the ER and Logba Alikpati in the VR, which displayed 6-fold and 6.2- fold bifenthrin-resistance, respectively. Populations of S. singularis from Pankese in the ER and Likpe in the VR also displayed 3.6-fold and 3.9-fold bifenthrin-resistance, respectively. The D. theobroma population that displayed the highest bifenthrin-resistance of 3.7-fold was from New Tafo. The results show incipient bifenthrin-resistance in field populations of D. theobroma and S. singularis, which requires the implementation of effective resistance management strategies to prevent full-blown resistance in the cocoa mirids

INSECTICIDE HANDLING IN COCOA PRODUCTION IN FOUR REGIONS IN GHANA

Management of insect pests of cocoa (Theobroma cacao L.) using insecticides began in 1950 and has since gone through various programmes with concomitant challenges and successes. Presently Imidacloprid (Confidor®), Bifenthrin (Akatemaster®) and Thiamethoxam (Actara®)are recommended by Ghana Cocoa Board (COCOBOD) for the management of insect pests. A survey was conducted in the Ashanti, Eastern, Volta and Western Regions of Ghana using questionnaires and farm visits of 147 cocoa farmers’ fields to gather information on the characteristics of the farmers and insecticide handling and use by respondents. The survey showed that males dominated cocoa farming (72.7%) and most of them aged between 50 and 60 years. About 44% have had basic education whilst 37.5% of them belonged to farmer based organizations. About 52.8% of the farmers own motorized mistblower but 47.2% of the farmers use knapsack in the absence of a mistblower. About 44.8% do their own spray application whereas 55.2% hire labour. About 60.9% of the population across the regions read the label on the insecticides before application. A few (31.6 %) of the respondents put on the full personal protective costume during insecticide application and 21.9% do not use any protection. There was a positive correlation between farmers’ membership of farmer-based organisation and the costume-wearing farmers in the Ashanti, Eastern and Volta Regions and it was significant in the Ashanti region. It isrecommended that training and monitoring programmes be organized for farmers on the need to handle pesticides properly for personal and environmental safety and consumer benefit.Keywords: Insecticides; pest management; cocoa farmers; safet

Decentralized Solid Waste Management in Rural Ghana: A Case Study of Assin Kushea Community in Assin North Municipality

Management of solid waste continues to be a major developmental challenge for developing countries like Ghana. The current focus and attention have been on the collection and dumping of waste in urban communities where generation rate is high to the detriment of rural communities. In this study, a pilot waste management scheme was undertaken in Assin Kushea, a rural community in the Assin North Municipality, to determine the willingness of the community to sort their waste at source, the quantity of waste generated by the community, and the characteristics of the waste to inform the treatment or disposal options suitable for the community. The results of the study showed that the community generates approximately 20 to 40 kg waste per day which comprises about 77% biological municipal waste (BMW) and 23% of residual waste. Laboratory analysis of the waste showed that the moisture content of the waste was about 68%. The percentage volatile solid was about 85.45%, leaving an ash content of approximately 14.55% all by weight of the waste materials. More than 50% of the sampled population achieved 100% source separation efficiency. Given the composition and characteristics of the waste, and the willingness of the community to sort their waste at source, composting or anaerobic fermentation of the organic waste fraction is recommended as the best waste treatment option for the organic component of the waste for the community

Factors contributing to late presentation of breast cancer in Africa: a systematic literature review

Background: Over 50% of people diagnosed with breast cancer in most African countries present late and report to the hospital with advanced stage III and IV disease, a major reason for the poor survival rate. This study reviewed studies focusing on patient-related factors or reasons contributing to the late presentation or delayed diagnosis of breast cancer in Africa. Method: A rigorous literature search was conducted with search terms “Breast Neoplasms” AND “Late Presentation” OR “Delayed Diagnosis” AND “Africa” OR “the name of any of the African countries” within CINAHL, African Index Medicus, MEDLINE, Web of Science and PsycINFO electronic databases. Additional hand searching of reference lists of included articles was conducted. A thematic synthesis was conducted. Result: Of the eighty-two studies identified, nine were eligible and included in the review. Studies included were conducted in Egypt, Nigeria, Ghana, Kenya and Libya. The factors identified as contributing to late presentation of breast cancer among most African women were negative symptom interpretation, fear, belief in alternative medicine, social relations and networks, lack of trust and confidence in orthodox medicine, and access to healthcare. Conclusion: A complex matrix of factors were identified that contribute to the late presentation or delayed diagnosis of breast cancer among most African women. The orthodox medical system in most African countries is gradually losing their relationship and credibility because of false reassurance, frequent misdiagnosis and strike actions, which is leading to late presentation of breast cancer

The perception and management of risk in UK office property development

Risk is an ever-present aspect of business, and risk taking is necessary for profit and economic progress. Speculative property development is popularly perceived as a 'risky business' yet, like other entrepreneurs, developers have opportunities to manage the risks they face; techniques include phasing and joint ventures. The associated areas of investment portfolio risk, development risk analysis and construction risk management have all been addressed by research. This article presents new knowledge about how developers perceive risks and the means they subsequently adopt to manage them. The developers of office projects across the UK were sent questionnaires by post. Respondents were asked about their perceptions of risks at the first appraisal stage and currently and about the risk management techniques that they had adopted. In-depth interviews with a selection of respondents were then used to discuss and augment the findings. Developers were most concerned about market-based risks at both stages. Concern about production-orientated risks was lower and fell significantly between the two stages. A fixed price contract was the most common risk management technique. Risk management techniques were used more often outside London and the South East. Developer type affects both the perception and management of risk. While developers do manage risk, decisions are made on the basis of professional and business experience. These findings should help development companies manage risk in a more objective and analytical way

Facilitators and Barriers to Uptake of an Extended Seasonal Malaria Chemoprevention Programme in Ghana: A Qualitative Study of Caregivers and Community Health Workers.

BACKGROUND: Seasonal Malaria Chemoprevention (SMC) is currently recommended for children under five in areas where malaria transmission is highly seasonal. We explored children's caregivers' and community health workers' (CHWs) responses to an extended 5-month SMC programme. METHODS: Thirteen in-depth interviews and eight focus group discussions explored optimal and suboptimal 'uptake' of SMC to examine facilitators and barriers to caregivers' uptake. RESULTS: There did not appear to be major differences between caregivers of children with optimal and sub-optimal SMC uptake in terms of their knowledge of malaria, their perceptions of the effect of SMC on a child's health, nor their understanding of chemoprevention. Caregivers experienced difficulty in prioritising SMC for well children, perceiving medication being for treatment rather than prevention. Prior to the study, caregivers had become accustomed to rapid diagnostic testing (RDT) for malaria, and therefore blood testing for malaria during the baseline survey at the start of the SMC programme may have positively influenced uptake. Facilitators of uptake included caregivers' trust in and respect for administrators of SMC (including CHWs), access to medication and supportive (family) networks. Barriers to uptake related to poor communication of timings of community gatherings, travel distances, absence during SMC home deliveries, and limited demand for SMC due to lack of previous experience. Future delivery of SMC by trained CHWs would be acceptable to caregivers. CONCLUSION: A combination of caregivers' physical access to SMC medication, the drug regimen, trust in the medical profession and perceived norms around malaria prevention all likely influenced caregivers' level of uptake. SMC programmes need to consider: 1) developing supportive, accessible and flexible modes of drug administration including home delivery and village community kiosks; 2) improving demand for preventive medication including the harnessing of learnt trust; and 3) developing community-based networks for users to support optimal uptake of SMC