LITURGICAL CHANGES IN THE REPERTORY OF THE METHODIST CHURCH GHANA

……………………………………………………………………………………………………… Abstract: The growth of Christianity in Ghana has led to the proliferation of liturgical changes leading to conflict of religious ideologies within the traditional (orthodox) and the modern (charismatic) churches. These liturgical modifications are seen not only in their worship, prayers and offerings but also in their music. This paper explores the changes that have taken place in the musical liturgy of the Methodist Church, Ghana. Through qualitative data collection, the paper investigates the factors leading to these changes and brings out the impact made in the Methodist church in general. It uses two epistemological frameworks: The separatism and the syncretism. The former looks at the liturgy in retrospect whereas the latter dwells on the changes culminating different beliefs as a result of the different movements in the Christendom in Ghana. To satisfy the varied congregational taste in this modern world, it is important that the shift in the musical liturgy of the Methodist church is well embraced by all

Multicentre studies of insecticide-treated durable wall lining in Africa and South-East Asia: entomological efficacy and household acceptability during one year of field use.

BACKGROUND: Indoor residual spraying (IRS) is a primary method of malaria vector control, but its potential impact is constrained by several inherent limitations: spraying must be repeated when insecticide residues decay, householders can tire of the annual imposition and campaign costs are recurrent. Durable lining (DL) can be considered an advanced form of long-lasting IRS where insecticide is gradually released from an aesthetically attractive wall lining material to provide vector control for several years. A multicentre trial was carried out in Equatorial Guinea, Ghana, Mali, South Africa and Vietnam to assess the feasibility, durability, bioefficacy and household acceptability of DL, compared to conventional IRS or insecticide-treated curtains (LLITCs), in a variety of operational settings. METHODS: This study was conducted in 220 households in traditional rural villages over 12-15 months. In all sites, rolls of DL were cut to fit house dimensions and fixed to interior wall surfaces (usually with nails and caps) by trained teams. Acceptability was assessed using a standardized questionnaire covering such topics as installation, exposure reactions, entomology, indoor environment, aesthetics and durability. Bioefficacy of interventions was evaluated using WHO cone bioassay tests at regular intervals throughout the year. RESULTS: The deltamethrin DL demonstrated little to no decline in bioefficacy over 12-15 months, supported by minimal loss of insecticide content. By contrast, IRS displayed a significant decrease in bioactivity by 6 months and full loss after 12 months. The majority of participants in DL households perceived reductions in mosquito density (93%) and biting (82%), but no changes in indoor temperature (83%). Among those households that wanted to retain the DL, 73% cited protective reasons, 20% expressed a desire to keep theirs for decoration and 7% valued both qualities equally. In Equatorial Guinea, when offered a choice of vector control product at the end of the trial (DL, IRS or LLITCs), DL consistently emerged as the most popular intervention regardless of the earlier household allocation. CONCLUSIONS: Just as long-lasting insecticidal nets overcame several of the technical and logistical constraints associated with conventionally treated nets and then went to scale, this study demonstrates the potential of DL to sustain user compliance and overcome the operational challenges associated with IRS

Safety and Immunogenicity of EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-Immune Adults: A Phase 1, Double-Blinded Placebo Controlled Dosage Escalation Study

<div><p>The erythrocyte binding antigen region II (EBA-175 RII) is a <i>Plasmodium falciparum</i> ligand that mediates erythrocyte invasion and is considered an important malaria vaccine candidate. A phase Ia trial in malaria naïve adults living in the United States found the recombinant non-glycosylated vaccine antigen, EBA-175 RII-NG adjuvanted with aluminium phosphate to be safe, immunogenic and capable of inducing biologically active antibodies that can inhibit parasite growth <i>in vitro</i>. The aim of the current study was to assess the safety and immunogenicity of this vaccine in malaria exposed semi-immune healthy adults living in a malaria endemic country, Ghana. In this double-blinded, placebo controlled, dose escalation phase I trial, eighteen subjects per group received ascending dose concentrations (5 μg, 20 μg or 80 μg) of the vaccine intramuscularly at 0, 1 and 6 months, while 6 subjects received placebo (normal saline). The primary end point was the number of subjects experiencing Grade 3 systemic or local adverse events within 14 days post-vaccination. Serious adverse events were assessed throughout the study period. Blood samples for immunological analyses were collected at days 0, 14, 28, 42, 180 and 194. A total of 52 subjects received three doses of the vaccine in the respective groups. No serious adverse events were reported. The majority of all adverse events reported were mild to moderate in severity, with local pain and tenderness being the most common. All adverse events, irrespective of severity, resolved without any sequelae. Subjects who received any of the EBA-175 RII-NG doses had high immunoglobulin G levels which moderately inhibited <i>P</i>. <i>falciparum</i> growth <i>in vitro</i>, compared to those in the placebo group. In conclusion, the EBA-175 RII-NG vaccine was safe, well tolerated and immunogenic in malaria semi-immune Ghanaian adults. Its further development is recommended.</p><p>Trial registration</p><p>ClinicalTrials.gov. Identifier: <a href="https://clinicaltrials.gov/ct2/show/NCT01026246" target="_blank">NCT01026246</a></p></div

Proportion of subjects with 4-fold increase from baseline in anti-EBA175 antibody response.

<p>Proportion of subjects with 4-fold increase from baseline in anti-EBA175 antibody response.</p

Trial profile.

<p>^a Vaccination was discontinued in one subject due to blood phobia. ^b One subject was excluded from further vaccinations due to severe anemia. ^c One subject migrated out of the country without prior notification. ^d One subject voluntarily withdrew to relocate to another town. ^e One subject discontinued the study and was lost to follow up for safety evaluation after receiving all three vaccinations. All attempts to find this subject failed. Abbreviation: EBA-175 RII-NG–Erythrocyte binding antigen 175 region II non-glycosylated.</p

Observed laboratory adverse events for all dose escalation groups.

<p><b>Panel A</b> is for screening prior to enrolment; <b>Panels B</b> and <b>C</b> are for vaccination 1, Day 0 and Day 14 respectively; <b>Panels D</b> and <b>E</b> are for vaccination 2, Day 0 and Day 14 respectively and <b>Panels F, G</b> and <b>H</b> are for vaccination 3, Day 0, Day 14 and Day 28 respectively. Abbreviations: ALT—Alanine Transaminase; AST—Alanine Aminotransferase; CR–Creatinine; BG–Blood glucose; K–Potassium; Na–Sodium; Hb–Hemoglobin; PLT–Platelets; WBC–White Blood Cells.</p

Demographic and baseline characteristics by dose of study population.

<p>Demographic and baseline characteristics by dose of study population.</p

Adverse events by severity vaccine dose and frequency of vaccinations.

<p>Adverse events by severity vaccine dose and frequency of vaccinations.</p

Anti-EBA-175 RII-NG IgG antibody levels (ELISA units) and growth inhibition activity against <i>P</i>. <i>falciparum</i> 3D7 parasite.

<p><b>Panel A:</b> Geometric mean IgG antibody levels (ELISA units) to the vaccine antigen EBA-175 RII-NG measured in each treatment group on different days (D0 to D194) post vaccination. <b>Panel B:</b> The left y-axis represents mean percentage <i>P</i>. <i>falciparum</i> 3D7 parasite growth inhibition measured for each treatment group on the different days post vaccination plotted as vertical bars. The right y-axis represents mean EBA175 ELISA units (on log 10 scale) used per growth inhibition assay well for each treatment group on the different days post vaccination plotted as lines. One subject in the placebo group recorded the highest anti-EBA-175 RII-NG IgG levels at baseline which persisted throughout the study. Both the high mean EBA 175 ELISA units/GIA well and mean GIA values observed in the placebo group were largely due to this subject. One ELISA unit is the reciprocal of the dilution required to give an optical density = 1 in the standardized assay. Any data point less than the minimal detectable level was assigned as 5 ELISA units in the growth inhibition assay well in the analysis. Vaccinations occurred on Days 0, 28 and 180. Blood samples were drawn for immunogenicity prior to vaccination. Abbreviations: EBA-175 RII-NG–Erythrocyte binding antigen 175 region II non-glycosylated; IgG–Immunoglobulin G; GIA–Growth inhibition assay.</p