Sachet drinking water in accra: the potential threats of transmission of enteric pathogenic protozoan organisms

Background: The recent introduction of sachet water to consumers was to provide safe, hygienic and affordable instant drinking water to the public. Although this is a laudable idea current trends seem to suggest that sachet drinking water could be a route of transmission of enteric pathogens. Objective: To assess the safety of sachet drinkingwater. Materials and Methods: Twenty seven different brands of 500ml sachet water samples randomly selected and purchased from various vendors in Accra were subjected to microscopic examinations to determine the presence of parasitic protozoa. The study was carried out between January and May 2005. Results: Seventy-seven percent of the samples contained infective stages of pathogenic parasitic organisms. Common pathogens identified include, Microsporidia sp 14/27 (51.2%), Cryptosporidium parvum 17/27 (63.0%), Cyclospora cayetenensis16/27 (59.3%), Sarcocystis sp. 18/27 (66.7%). Rotifers 5/27 (18.5%), and Charcoat Leyden crystals 12/27 (44.4%). Ninety-three percent of the samples contained unidentified impurities/artifacts.29.6% of the samples contained at least one type of parasite, 14.8% contained at least 2 types of parasites, 25.9% contained at least three types of parasites, while 29.6% contained four types of parasites. Conclusion: The study indicated the presence of contaminants of feacal and zoonotic origin in some of the sachet water examined. This has grim public health implications as the organisms identified can cause water related diseases which have serious complications in children and adults particularly immunocompromised individuals. Sachet watershould be constantly monitored for its microbial quality

Trichomonas vaginalis infection in Southern Ghana: As sociated risk factors, clinical

Trichomonas vaginalis is the causative agent for the most prevalent nonviral sexually transmitted infection (STI) among women and the infection is associated with varied clinical presentations and outcomes. We conducted a cross-sectional study on 479 women visiting gynaecological and STI clinics in Southern Ghana between January and April 2016 to assess the risk factors associated with T. vaginalis and clinically characterize the infected groups. Vaginal samples were analysed using wet preparation microscopy and polymerase chain reaction (PCR). Of the 479 women, 63 (13.2%; 95% CI 9.5-17.6) and 78 (16.8%; 95% CI 12.2-21.1) had T. vaginalis infection based on wet preparation and PCR respectively, and diagnosis by PCR was significantly more sensitive (P < 0.0001). Univariate analyses found that Trichomonas vaginalis infection was significantly associated with vaginal itch (OR = 1.38, P = 0.04), oral sex (OR = 1.10, P = 0.04) and a prior history of stillbirth (OR = 3.62, P = 0.04). We used a model averaging approach to examine the relationship between T. vaginalis infection and predictor variables for clinical signs and risk factors. Vaginal itch was ranked highest in variable importance for clinical signs, occurring in 62% of the top eight models; discharge colour and discharge consistency were other variables also occurring in the top set of models. Scores were assigned based on the presenting clinical signs to categorise the pathogenicity levels of T. vaginalis into four groups; 6 (6.7%) corresponded to non-pathogenic group, 21 (23.6%) to the very low pathogenic, 39 (43.8%) to the low pathogenic and 12 (13.5%) to the high pathogenic group. A history of engaging in oral sex was ranked highest in variable importance for risk factors, occurring in 72% of the top-ranked models; cleaning material used after toileting and educational level also appeared in more than 50% of the top-ranked models. The varied clinically characterized groups suggest the existence of genetic polymorphism in the T. vaginalis infecting these individuals

Trichomonas vaginalis infection in southern Ghana: Clinical signs associated with the infection

Trichomonas vaginalis is the causative agent for the most prevalent non-viral sexually transmitted infection (STI) among women of child-bearing age. In Ghana, although the infection is prevalent, there is a dearth of data on the risk factors and symptoms associated with T. vaginalis infection. This study was conducted on 492 women visiting gynaecological and STI clinics in the Volta Region (VR) and Greater Accra Region (GAR) in southern Ghana. Wet mount microscopy and polymerase chain reaction (PCR) were used to diagnose T. vaginalis infection. Infection prevalence was 13.2% and 18.1% by WMM and PCR, respectively. Diagnosis by PCR was significantly more sensitive (McNemar’s test, p=0.0003). The regional prevalence of T. vaginalis infection by PCR was 21.7% in the VR and 12.8% in the GAR. There was a significant difference in prevalence between the two regions (Fisher’s exact test, p=0.02). T. vaginalis infection was associated with vaginal itch (odds ratio [OR]=1.71, p=0.04) and a history of engaging in oral sex (OR 1.90, p=0.04). A high prevalence of T. vaginalis infection was recorded among women visiting gynaecological and STI clinics in southern Ghana. There was no consistent association of infection with any recorded clinical signs and no clear risk factors for infection were identified