Rapid Assessment as an Evaluation Tool for Polio National Immunisation Days in Brong Ahafo Region, Ghana

Background: Despite reported high coverage of National Immunization Days (NIDs) campaign in many countries children are still being missed during these campaigns. This is a study of a rapid assessment done to determine OPV coverage during an immunization campaign. Methods: In this descriptive cross-sectional study, regional supervisors in Brong Ahafo region of Ghana visited randomly selected houses during the first round of the Polio NIDs in October 2004 to identify under-5 children that were reached with OPV vaccines in the households and those missed during the campaign. Results: In the 13 districts a 1607 houses visited by regional supervisors for rapid assessment, volunteers did not visit 4 (0.24%) houses. There were 3737 under five in all the houses visited by the supervisors for rapid assessment out which 42 (1.2%) were missed and unvaccinated and the reason was that the children were not at home. The assessment showed that the main sources of information to mothers / caretakers on NIDs were Gong-gong and radio. The assessment provided opportunities to identify proportion of children missed and ensure necessary intervention to reach them. Conclusion: Rapid assessment is a valuable tool for evaluation of NIDs; it enables timely intervention in covering missed children and helps in careful interpretation of the usual over 100% coverage often recorded during NIDs. It is recommended that this be practiced widely to improve quality of NIDs for early global eradication of poliomyelitis.Contexte : Malgr\ue9 la haute couverte rapport\ue9e lors des campagnes nationales d'immunisation, dans plusieurs pays des enfants sont toujours rat\ue9s par ces campagnes. Nous proposons une estimation rapide de la couverture durant une campagne d'immunisation. M\ue9thodes : Dans cette \ue9tude descriptive sur un \ue9chantillon repr\ue9sentatif, des maisons choisies au hasard ont \ue9t\ue9 visit\ue9 par les superviseurs r\ue9gionaux de la r\ue9gion de Brong Ahafo, Ghana lors du premier passage des journ\ue9es nationales d'immunisation contre la Polio en Octobre 2004. Il s'agissait d'identifier les enfants de moins de 5 ans ayant re\ue7u le vaccin dans ces maisons et d'identifier ceux qui n'ont pas \ue9t\ue9 vaccin\ue9s dans cette campagne. R\ue9sultats : Dans 13 districts, un total de 1607 maisons visit\ue9es par les superviseurs r\ue9gionaux, pour estimation rapide. Quatre maisons (0,24%) n'avaient pas \ue9t\ue9 visit\ue9es par les volontaires. Il y'avaient 3737 enfants de moins de 5 ans dans l'ensemble des maisons visit\ue9es par les superviseurs, parmi eux 42 (1,2%) n'avaient pas \ue9t\ue9 vaccin\ue9s et la raison \ue9taient que ces enfants \ue9taient absents de la maison. L'\ue9valuation avait montr\ue9 que les principales sources d'information des mamans/gardiens lors des journ\ue9es nationales d'immunisation \ue9taient les Gong-gong et la radio. L'estimation avait donn\ue9 des opportunit\ue9s pour la d\ue9termination de la proportion d'enfants non vaccin\ue9s et des interventions \ue0 faire afin d'atteindre ces enfants. Conclusion : L'estimation rapide est un instrument important pour l'\ue9valuation des journ\ue9es nationales d'immunisation, elle permet des interventions opportunes pour couvrir les enfants manqu\ue9s. Elle permet aussi de faire une interpr\ue9tation prudente du taux de couverture de 100% habituellement rapport\ue9 durant ces journ\ue9es nationales d'immunisation. Il est recommand\ue9 de vulgariser cette v\ue9rification afin d'am\ue9liorer la qualit\ue9 de ces journ\ue9es nationales d'immunisation pour une \ue9radication globale de la poliomy\ue9lite

Near-threshold electron transfer in anion-nucleobase clusters : Does the identity of the anion matter?

Laser dissociation spectroscopy of I − ·adenine (I − ·A) and H 2 PO − 3 ·adenine (H 2 PO − 3 ·A) has been utilised for the first time to explore how the anion identity impacts on the excited states. Despite strong photodepletion, ionic photofragmentation is weak for both clusters, revealing that they decay predominantly by electron detachment. The spectra of I − ·A display a prominent dipole-bound excited state in the region of the detachment energy which relaxes to produce deprotonated adenine. In contrast, near-threshold photoexcitation of H 2 PO − 3 ·A does not access a dipole-bound state, but instead displays photofragmentation properties associated with ultrafast decay of an adenine-localised π→π* transition. Notably, the experimental electron detachment onset of H 2 PO − 3 ·A is around 4.7 eV, which is substantially lower than the expected detachment energy of an ion-dipole complex. The low value for H 2 PO − 3 ·A can be traced to initial ionisation of the adenine followed by significant geometric rearrangement on the neutral surface. We conclude that these dynamics quench access to a dipole-bound excited state for H 2 PO − 3 ·A and subsequent electron transfer. H 2 PO − 3 ·A represents an important new example of an ionic cluster where ionisation occurs from the neutral cluster component and where photodetachment initiates intra-molecular hydrogen atom transfer

Prenatal chromosomal diversification of leukemia in monozygotic twins

Previous studies on concordant acute lymphoblastic leukemia (ALL) in identical twins have identified the leukemia as monoclonal with MLL or ETV6-RUNX1 gene fusion as early or initiating events in utero. In the latter case, postnatal latency is associated with secondary genetic events such as ETV6 deletion. We describe here a pair of infant twins with concordant acute monoblastic leukemia (AML). They are a unique pair in that their leukemia blasts display extensive intraclonal chromosomal diversity. Comparison of the leukemic cells between the two twins by karyotype and fluorescence in situ hybridization identifies a common or shared stem line and extensive subclonal diversity for which the twins\u27 leukemic populations are divergent. This case of leukemia illustrates in utero initiation with early imposition of chromosomal instability, the progressively divergent evolution of which can be mapped in the twins into pre- and postnatal periods

The Costs of Implementing Vaccination With the RTS,S Malaria Vaccine in Five Sub-Saharan African Countries.

Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of the expanded program on immunization at all levels in each country were interviewed on the resources required for implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach setting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the countries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions. This study provides relevant information for donors and decision makers about the cost of implementing RTS,S. Variations within and across countries are important and the unknown future price per dose and wastage rate for this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation

Inhibition of the glycaemic response by onion : a comparison between lactose-tolerant and lactose-intolerant adults

This document is the Accepted Manuscript of the following article: R Hoffman, G Ranjbar and A M Madden, ‘Inhibition of the glycaemic response by onion: a comparison between lactose-tolerant and lactose-intolerant adults’, European Journal of Clinical Nutritin, (2016), 70: 1089-1091. The Version of Record is available online at doi: 10.1038/ejcn.2016.44.This pilot study compared inhibition of the glycaemic response to glucose by a dietary source of quercetin glucosides (onion) in lactose-tolerant adults (n = 12) and lactose-intolerant adults (n = 12). We hypothesised that lactose-intolerant people (who do not express lactase) will retain intact quercetin glucosides that can inhibit glucose uptake via the glucose transporter SGLT1 whereas lactose-tolerant people (who do express lactase) will hydrolyse quercetin glucosides to free quercetin which does not inhibit glucose uptake. In a glucose tolerance test, reduction of peak glucose levels by an onion meal was higher in lactose-intolerant people than lactose-tolerant people (44.2% versus 19.3%, p = 0.04). Incremental area under the blood glucose curve was reduced more in lactose-intolerant people, but was not statistically significantly (54.5% versus 42.1%, p = 0.42). A diet containing quercetin glucosides may be of greater benefit for glycaemic control in lactose-intolerant people than in lactose-tolerant people.Peer reviewedFinal Accepted Versio

Black Soldier Fly (Hermitia illucens) Larvae Meal as Alternative Protein in Broiler Production in Ghana

Feed cost has been a major challenge to the competitiveness of the poultry industry of Ghana due mainly to high cost of proteins. Insect larvae meals seem convenient alternatives however their use on commercial scale is unknown in Ghana. Three 8-week feeding trial using three isonitrogenous, isocaloric diets in a three-phase feeding strategy involving 1320 broiler DOCs was conducted. BSFLM was used as replacement for fishmeal and as partial replacement for soybean meal to determine its effect on broiler productivity, profitability and carcass measurements. The results indicated that replacing fishmeal with BSFLM significantly improved weight gain, feed conversion efficiency and production efficiency factor (PEF). No detrimental effect was observed on carcass and specific organ measurements. Using the partial budgeting approach on a 500-bird estimation an increase of one thousand, one hundred and eleven Ghana cedis (GH₵1,111.00) was obtained when the fishmeal was replaced with BSFLM. Also, an increase of four hundred and sixty-seven Ghana cedis (GH₵467.00) was estimated when soybean meal was partially replaced with BSFLM. It was concluded that BSFLM can be used to improve the productivity and profitability of broiler production

Expression of aldehyde dehydrogenase 1 as a marker of mammary stem cells in benign and malignant breast lesions of Ghanaian women

BACKGROUND: Breast cancers that are negative for the estrogen receptor (ER), the progesterone receptor (PR), and the HER2 (human epidermal growth factor receptor 2) marker are more prevalent among African women, and the biologically aggressive nature of these triple‐negative breast cancers (TNBCs) may be attributed to their mammary stem cell features. Little is known about expression of the mammary stem cell marker aldehyde dehydrogenase 1 (ALDH1) in African women. Novel data are reported regarding ALDH1 expression in benign and cancerous breast tissue of Ghanaian women. METHODS: Formalin‐fixed, paraffin‐embedded specimens were transported from the Komfo Anoyke Teaching Hospital in Kumasi, Ghana to the University of Michigan for centralized histopathology study. Expression of ER, PR, HER2, and ALDH1 was assessed by immunohistochemistry. ALDH1 staining was further characterized by its presence in stromal versus epithelial and/or tumor components of tissue. RESULTS: A total of 173 women contributed to this study: 69 with benign breast conditions, mean age 24 years, and 104 with breast cancer, mean age 49 years. The proportion of benign breast conditions expressing stromal ALDH1 (n = 40, 58%) was significantly higher than those with cancer (n = 44, 42.3%) ( P = .043). Among the cancers, TNBC had the highest prevalence of ALDH1 expression, either in stroma or in epithelial cells. More than 2‐fold higher likelihood of ALDH1 expression was observed in TNBC cases compared with other breast cancer subtypes (odds ratio = 2.38, 95% confidence interval 1.03‐5.52, P = .042). CONCLUSIONS: ALDH1 expression was higher in stromal components of benign compared with cancerous lesions. Of the ER‐, PR‐, and HER2‐defined subtypes of breast cancer, expression of ALDH1 was highest in TNBC. Cancer 2013. © 2012 American Cancer Society. Mammary stem cells, as identified by cells expressing the marker aldehyde dehydrogenase 1 (ALDH1), appear to be correlated with malignant transformation and progression of breast tissue into biologically aggressive phenotypes. This study reveals increased expression of ALDH1 in benign and malignant tissue of women from the western sub‐Saharan African nation of Ghana, a population known to have higher frequency of triple‐negative breast cancer, and ALDH1 expression in the malignant specimens was found to be associated with risk of triple‐negative breast cancer.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96403/1/27737_ftp.pd

Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases

BACKGROUND: Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. METHODS: Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. RESULTS: A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANY(r)); 16.8% (50/298) were isoniazid-mono-resistant (INH(r)), 16.8% (50/298) were rifampicin-mono-resistant (RIF(r)), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANY(r) were additionally resistant to at least one second line drug: 7.4% (2 RIF(r), 1 INH(r), and 10 MDR samples) resistant to only FQs and 2.3% (2 RIF(r), 1 INH(r), and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIF(r) and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INH(r) and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. CONCLUSION: The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance