An Evaluation of Sustainability and Subsidy Dependence of Microfinance Institutions in Ghana

The research aims to explore the understanding of the relationship between sustainability of microfinance institutions (MFIs), subsidy dependence index (SDI) and operational self-sufficiency (OSS).The research study is based on initial exploratory study by analyzing data on 14 executive directors in qualitative interviews and 116 relationship executives in research questionnaires. The microfinance institutions identified were the Financial Non-Governmental Organizations (FNGOs), the Savings and Loans Companies (S&L), the Credit Unions (CUs), the Rural Banks (RBs) and the SUSU Companies. Multiple Regressions which allows for the testing of theories or models established a significant relationship between the Operational Self Sufficiency (OSS) and the predictors, especially the drop-out rate of clients and average loans. The Subsidy Dependence Index (SDI) was calculated for the various types of MFIs and the result was a high dependency ratio especially among the FNGOs. Though the dependency is on the decline, it is very slow indicating that most MFIs will depend on subsidies for a very long time to come. Key words: Subsidy dependence; Sustainability; Operational self-sufficiency; Viability; Microfinanc

Success of Microfinance Institutions: The Ghanaian Experience

Success in microfinance refers to measures which when adopted will significantly improve the life and operations of the institutions though many authors have different views on what constitute success. The following imperatives have been used to scan success of microfinance institutions (MFIs): acquiring more clients, effective and efficient loan processing, effective record keeping, increased savings, external and internal audits, level of staff remuneration and staff turnover rate. The research was based on both qualitative and quantitative approaches. First, interviews were held with selected CEOs from all the categories of MFIs in Ghana. This was followed by self-administered survey involving 130 microfinance institutions. The results indicated that all the perceived factors were significant in determining the success of MFIs. Key words: Success; Microfinance; Sustainability; Remuneratio

Repellency Potential, Chemical Constituents of Ocimum Plant Essential Oils, and Their Headspace Volatiles against Anopheles gambiae s. s., Malaria Vector

African malaria mosquitoes (Anopheles gambiae sensu stricto) transmit a malaria parasite (Plasmodium falciparum) to humans. The current control strategies for the vector have mainly focussed on synthetic products, which negatively impact the environment and human health. Given the potential use of environmentally friendly plant-derived volatiles as a control, this work aims to examine and compare the repellency potential of essential oils and headspace volatiles from Ocimum gratissimum, Ocimum tenuiflorum, and Ocimum basilicum and their chemical compositions. The repellency potential and chemical composition of the plants were achieved by using the protected arm-in-cage method and gas chromatography-mass spectrometry (GC-MS) analysis. Among the three Ocimum species, both the essential oils and the headspace volatiles from O. tenuiflorum achieved the longest repellency time lengths of 90–120 minutes. One hundred and one (101) chemical constituents were identified in the headspace volatiles of the three Ocimum spp. Nonetheless, (−)-camphor, (E)-γ-bisabolene, terpinolene, β-chamigrene, cubedol, (E)-farnesol, germacrene D-4-ol, viridiflorol, γ-eudesmol, tetracyclo [6.3.2.0 (2,5).0(1,8)] tridecan-9-ol, 4,4-dimethyl, α-eudesmol, isolongifolol, and endo-borneol were unique only to O. tenuiflorum headspace volatiles. Either essential oils or headspace volatiles from O. tenuiflorum could offer longer protection time length to humans against An. gambiae. Though field studies are needed to assess the complementarity between the chemical constituents in the headspace volatiles of O. tenuiflorum, our observations provide a foundation for developing effective repellents against An. gambiae

Onchocerciasis: The Pre-control Association between Prevalence of Palpable Nodules and Skin Microfilariae

*Background*: The prospect of eliminating onchocerciasis from Africa by mass treatment with ivermectin has been rejuvenated following recent successes in foci in Mali, Nigeria and Senegal. Elimination prospects depend strongly on local transmission conditions and therefore on pre-control infection levels. Pre-control infection levels in Africa have been mapped largely by means of nodule palpation of adult males, a relatively crude method for detecting infection. We investigated how informative pre-control nodule prevalence data are for estimating the pre-control prevalence of

Impact of long-term treatment of onchocerciasis with ivermectin in Kaduna State, Nigeria: first evidence of the potential for elimination in the operational area of the African Programme for Onchocerciasis Control.

BACKGROUND: Onchocerciasis can be effectively controlled as a public health problem by annual mass drug administration of ivermectin, but it was not known if ivermectin treatment in the long term would be able to achieve elimination of onchocerciasis infection and interruption of transmission in endemic areas in Africa. A recent study in Mali and Senegal has provided the first evidence of elimination after 15-17 years of treatment. Following this finding, the African Programme for Onchocerciasis Control (APOC) has started a systematic evaluation of the long-term impact of ivermectin treatment projects and the feasibility of elimination in APOC supported countries. This paper reports the first results for two onchocerciasis foci in Kaduna, Nigeria. METHODS: In 2008, an epidemiological evaluation using skin snip parasitological diagnostic method was carried out in two onchocerciasis foci, in Birnin Gwari Local Government Area (LGA), and in the Kauru and Lere LGAs of Kaduna State, Nigeria. The survey was undertaken in 26 villages and examined 3,703 people above the age of one year. The result was compared with the baseline survey undertaken in 1987. RESULTS: The communities had received 15 to 17 years of ivermectin treatment with more than 75% reported coverage. For each surveyed community, comparable baseline data were available. Before treatment, the community prevalence of O. volvulus microfilaria in the skin ranged from 23.1% to 84.9%, with a median prevalence of 52.0%. After 15 to 17 years of treatment, the prevalence had fallen to 0% in all communities and all 3,703 examined individuals were skin snip negative. CONCLUSIONS: The results of the surveys confirm the finding in Senegal and Mali that ivermectin treatment alone can eliminate onchocerciasis infection and probably disease transmission in endemic foci in Africa. It is the first of such evidence for the APOC operational area

A comparison of multiple Rosetta data sets and 3D model calculations of 67P/Churyumov-Gerasimenko coma around equinox (May 2015)

We have used the latest available shape model for gas and dust simulations of the inner coma of comet 67P/Churyumov-Gerasimenko for the period around May 2015 (equinox). We compare results from a purely insolation-driven model with a complementary set of observations made by ROSINA, VIRTIS, MIRO, and OSIRIS within the same period. The observations include - for the first time - inverted MIRO measurements of gas density, temperature and bulk velocity to constrain the model. The comparisons show that, as in November 2014 (Marschall et al., 2016), insolation-driven activity does not provide an adequate fit to the data. Both VIRTIS and MIRO observations indicate that emissions from the Hatmehit and Imhotep regions of the nucleus are strongly depleted in total gas, H2O, and dust emissions in this case. The MIRO inversion provides a challenging constraint to the models as a consequence of the terminator orbit and nucleus pointing of the spacecraft. Nonetheless a consistent picture with a dominance of outgassing from the Hapi region, even at equinox, is clearly evident. An inhomogeneous model consistent with models proposed for the November 2014 time-frame was constructed and provides a better fit to the data. As far as we are aware this is the first time comae data from four Rosetta instruments have been used to constrain within one self-contained model the emission distribution at the nucleus surface and study the dynamics of the gas and dust outflow

Macrofilaricidal Activity after Doxycycline Only Treatment of Onchocerca volvulus in an Area of Loa loa Co-Endemicity: A Randomized Controlled Trial

The control of onchocerciasis in Africa relies on the sustained delivery of ivermectin. In certain areas, annual treatments delivered with high population coverage for at least 15–17 years can break transmission. In other endemic settings this strategy alone is thought to be insufficient to eradicate the disease. One of the major limitations occurs in areas that are co-endemic with another filarial infection caused by Loa loa, due to the risk of a rare severe adverse event associated with the rapid killing of L. loa microfilariae in heavily parasitized individuals. There are also concerns over recent evidence of reduced efficacy of ivermectin and the possible development of resistance. An alternative approach is to target the Wolbachia bacterial endosymbionts of Onchocerca volvulus with the antibiotic, doxycycline. In an area of Cameroon co-endemic for onchocerciasis and loiasis we conducted a trial comparing doxycycline with or without ivermectin treatment to ivermectin treatment alone. A six-week course of doxycycline delivers macrofilaricidal and sterilizing activities, which is not dependent upon co-administration of ivermectin. Doxycycline is well tolerated in patients co-infected with moderate intensities of L. loa microfilariae. The trial indicates that anti-wolbachial therapy is a feasible alternative to ivermectin in communities co-endemic for onchocerciasis and loiasis

Genetic polymorphisms in MDR1, CYP3A4 and CYP3A5 genes in a Ghanaian population: a plausible explanation for altered metabolism of ivermectin in humans?

<p>Abstract</p> <p>Background</p> <p>Ivermectin, a substrate of multidrug resistance (MDR1) gene and cytochrome P450 (CYP) 3A4, has been used successfully in the treatment of onchocerciasis in Ghana. However, there have been reports of suboptimal response in some patients after repeated treatment. Polymorphisms in host MDR1 and CYP3A genes may explain the observed suboptimal response to ivermectin. We genotyped relevant functional polymorphisms of MDR1 and CYP3A in a random sample of healthy Ghanaians and compared the data with that of ivermectin-treated patients with a view to exploring the relationship between suboptimal response to ivermectin and MDR1 and CYP3A allelic frequencies.</p> <p>Methods</p> <p>Using PCR-RFLP, relevant polymorphic alleles of MDR1 and CYP3A4 genes were analysed in 204 randomly selected individuals and in 42 ivermectin treated patients.</p> <p>Results</p> <p>We recorded significantly higher MDR1 (3435T) variant allele frequency in suboptimal responders (21%) than in patients who responded to treatment (12%) or the random population sample (11%). <it>CYP3A4*1B</it>, <it>CYP3A5*3 </it>and <it>CYP3A5*6 </it>alleles were detected at varied frequencies for the sampled Ghanaian population, responders and suboptimal responders to ivermectin. <it>CYP3A5*1/CYP3A5*1 </it>and <it>CYP3A5*1/CYP3A5*3 </it>genotypes were also found to be significantly different for responders and suboptimal responders. Haplotype (*1/*1/*3/*1) was determined to be significantly different between responders and suboptimal responders indicating a possible role of these haplotypes in treatment response with ivermectin.</p> <p>Conclusion</p> <p>A profile of pharmacogenetically relevant variants for MDR1, CYP3A4 and CYP3A5 genes has been generated for a random population of 204 Ghanaians to address the scarcity of data within indigenous African populations. In 42 patients treated with ivermectin, difference in MDR1 variant allele frequency was observed between suboptimal responders and responders.</p

Metabolomics-Based Discovery of Diagnostic Biomarkers for Onchocerciasis

Onchocerciasis, caused by the filarial parasite Onchocerca volvulus, afflicts millions of people, causing such debilitating symptoms as blindness and acute dermatitis. There are no accurate, sensitive means of diagnosing O. volvulus infection. Clinical diagnostics are desperately needed in order to achieve the goals of controlling and eliminating onchocerciasis and neglected tropical diseases in general. In this study, a metabolomics approach is introduced for the discovery of small molecule biomarkers that can be used to diagnose O. volvulus infection. Blood samples from O. volvulus infected and uninfected individuals from different geographic regions were compared using liquid chromatography separation and mass spectrometry identification. Thousands of chromatographic mass features were statistically compared to discover 14 mass features that were significantly different between infected and uninfected individuals. Multivariate statistical analysis and machine learning algorithms demonstrated how these biomarkers could be used to differentiate between infected and uninfected individuals and indicate that the diagnostic may even be sensitive enough to assess the viability of worms. This study suggests a future potential of these biomarkers for use in a field-based onchocerciasis diagnostic and how such an approach could be expanded for the development of diagnostics for other neglected tropical diseases

Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study

In a randomized, placebo-controlled trial in Ghana, 67 onchocerciasis patients received 200-mg/day doxycycline for 4–6 weeks, followed by ivermectin (IVM) after 6 months. After 6–27 months, efficacy was evaluated by onchocercoma histology, PCR and microfilariae determination. Administration of doxycycline resulted in endobacteria depletion and female worm sterilization. The 6-week treatment was macrofilaricidal, with >60% of the female worms found dead, despite the presence of new, Wolbachia-containing worms acquired after the administration of doxycycline. Doxycycline may be developed as second-line drug for onchocerciasis, to be administered in areas without transmission, in foci with IVM resistance and in areas with Loa co-infections