Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR

Background: Most sexually transmitted infection (STI) management efforts focus on the syndromic approach to diagnose and treat patients. However, most women with STIs have been shown to be entirely asymptomatic, or if symptoms exist, are often missed when either clinical or conventional bacteriologic diagnostic tools are employed.Methods: We assessed the performance of a multiplex real time PCR assay to describe other potential pathogens that could be missed by conventional bacteriological techniques in 200 women attending a routine STI clinic in Kumasi, Ghana.Results: Although a total 78.00% of the women were asymptomatic, 77.1% of them tested positive for at least one bacterial STI pathogen. Mycoplasma genitalium was the most commonly detectable pathogen present in 67.5% of all women. Of those testing positive, 25.0% had single infections, while 38.0% and 19.5% had double and triple infections respectively. Altogether, 86.54% and 90.91% of the symptomatic and asymptomatic women respectively tested positive for at least one pathogen (p<0.05). There were no significant associations (p<0.05) between the clinical manifestations of the symptomatic women and the pathogens detected in their samples.Conclusions: Our study confirmed the importance of complementing the syndromic approach to STI management with pathogen detection and most importantly recognise that STIs in women are asymptomatic and regular empirical testing even for both symptomatic and asymptomatic patients is critical for complete clinical treatment.Funding: EOD (Ellis Owusu-Dabo Research working group, KCCR)Keywords: Etiology, Syndromic, Sexually Transmitted Infections, Multiplex real time PC

Effectiveness of artemisinin-based combination therapy used in the context of home management of malaria: A report from three study sites in sub-Saharan Africa

BACKGROUND: The use of artemisinin-based combination therapy (ACT) at the community level has been advocated as a means to increase access to effective antimalarial medicines by high risk groups living in underserved areas, mainly in sub-Saharan Africa. This strategy has been shown to be feasible and acceptable to the community. However, the parasitological effectiveness of ACT when dispensed by community medicine distributors (CMDs) within the context of home management of malaria (HMM) and used unsupervised by caregivers at home has not been evaluated. METHODS: In a sub-set of villages participating in a large-scale study on feasibility and acceptability of ACT use in areas of high malaria transmission in Ghana, Nigeria and Uganda, thick blood smears and blood spotted filter paper were prepared from finger prick blood samples collected from febrile children between six and 59 months of age reporting to trained CMDs for microscopy and PCR analysis. Presumptive antimalarial treatment with ACT (artesunate-amodiaquine in Ghana, artemether-lumefantrine in Nigeria and Uganda) was then initiated. Repeat finger prick blood samples were obtained 28 days later for children who were parasitaemic at baseline. For children who were parasitaemic at follow-up, PCR analyses were undertaken to distinguish recrudescence from re-infection. The extent to which ACTs had been correctly administered was assessed through separate household interviews with caregivers having had a child with fever in the previous two weeks. RESULTS: Over a period of 12 months, a total of 1,740 children presenting with fever were enrolled across the study sites. Patent parasitaemia at baseline was present in 1,189 children (68.3%) and varied from 60.1% in Uganda to 71.1% in Ghana. A total of 606 children (51% of infected children) reported for a repeat test 28 days after treatment. The crude parasitological failure rate varied from 3.7% in Uganda (C.I. 1.2%-6.2%) to 41.8% in Nigeria (C.I. 35%-49%). The PCR adjusted parasitological cure rate was greater than 90% in all sites, varying from 90.9% in Nigeria (C.I. 86%-95%) to 97.2% in Uganda (C.I. 95%-99%). Reported adherence to correct treatment in terms of dose and duration varied from 81% in Uganda (C.I. 67%-95%) to 97% in Ghana (C.I. 95%-99%) with an average of 94% (C.I. 91%-97%). CONCLUSION: While follow-up rates were low, this study provides encouraging data on parasitological outcomes of children treated with ACT in the context of HMM and adds to the evidence base for HMM as a public health strategy as well as for scaling-up implementation of HMM with ACTs

Bacterial Contaminants and Antibiogram of Ghana Paper Currency Notes in Circulation and Their Associated Health Risks in Asante-Mampong, Ghana

Transmission of pathogens through currency notes has become very relevant in today’s world due to COVID-19 pandemic. This study profiled microbial flora and their antibiotic activities from Ghana paper currency (GH¢) notes in circulation in Mampong Municipal of Ashanti Region, Ghana. The study employed a cross-sectional design to assess bacterial contaminants and their antibiotic activities from January to May 2019. A total of 70 GH¢ notes consisting of 15 each of GH¢1, GH¢2, and GH¢5; 10 each of GH¢10 and GH¢20; and 5 of GH¢50 were randomly sampled from persons at different shops, canteens, and commercial drivers. The surfaces of each GH¢ note were gently swabbed, and tenfold serial dilutions made were inoculated on plate count agar (PCA), MacConkey agar, mannitol salt agar, and deoxycholate citrate agar. The study used appropriate laboratory and biochemical tests for bacterial identification. SPSS-IBM version 16.0 was used to analyze the data. Of the 70 GH¢ notes studied, 97.1% were contaminated with one or more bacterial isolates. Mean counts on PCA ranged between 3.2 cfu/ml × 105 and 4.7 cfu/ml × 105 on GH¢ notes. Of 124 bacteria isolated, 34 (27.4%), 30 (24.2%), 22 (17.7%), 17 (13.7%), 13 (10.5%), and 8 (6.5%) were from GH¢1, GH¢2, GH¢10, GH¢5, GH¢20, and GH¢50, respectively (p<0.05). Bacterial isolates were Escherichia coli (28.23%), Staphylococcus aureus (16.94%), coagulase-negative Staphylococcus (16.13%), Klebsiella species (11.29%), Salmonella species (9.68%), Shigella species (8.87%), Pseudomonas aeruginosa (5.65%), and Proteus species (3.23%). GH¢ notes had 25.81%, 20.16%, 19.35%, 17.74%, and 16.94% from meat shops, commercial drivers, canteens, grocery shops, and vegetable shops, respectively. All bacteria were 100% resistant to erythromycin, 87.5% to tetracycline, chloramphenicol, and cotrimoxazole, 75% to vancomycin, while 87.50% sensitive to amikacin. The GH¢ notes were heavily colonized with potential pathogens, which are resistant to most commonly used antibiotics and could pose a health threat to users during commercial transactions

Antimicrobial activities of Hibiscus sabdariffa and Aspilia africana against clinical isolates of Salmonella typhi

Background: Plants hold prospects for novel drugs discovery against Salmonella typhi and its swift antibiotics resistance. This study aimed to determine the antimicrobial activities of Hibiscus sabdariffa and Aspilia africana extracts against clinical isolates of S. typhi. Methods: Active ingredients of plants were extracted using ethanol and constituted into Extracts I, II and III. Extract I is A. africana, Extract II is H. sabdariffa and Extract III is a combination of extracts of A. africana and H. sabdariffa. Phytochemical screening, antimicrobial sensitivity test (Agar Well Diffusion), Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) tests were conducted during this study. Results: Results on phytochemicals of H. sabdariffa and A. africana extracts showed phenols, saponins, tannins, reducing sugars, triterpenoids, coumarins, alkaloids and steroids. Antimicrobial sensitivity test showed that S. typhi was sensitive to all extracts indicating zones of inhibition of 29.0, 19.0 and 18.5 mm for Extract I, II and III respectively while resistant to lower concentrations of Extract I at 100, 50 and 25 mg/ml. Resistant S. typhi was sensitive to Extract I, II, and III (21.0, 19.0 and 19.0 mm) respectively at 200 mg/ml while resistant to both Extract I and II at (100, 50 and 25 mg/ml) and (50 and 25 mg/ml) respectively. MIC experiments showed 3.125, 6.25 and 3.125 mg/ml against sensitive S. typhi and 25, 12.5 and 12.5 mg/ml against resistant S. typhi for Extract I, II and III respectively. MBC values were 25, 12.5 and 12.5 mg/ml against sensitive S. typhi and 50, 25 and 25 mg/ml against resistant S. typhi for Extract I, II and III respectively. Plant extracts, when combined with ciprofloxacin (concentration), indicated MBCs of 0.19, 0.19, and 0.39 mg/ml against sensitive S. typhi compared with 0.19, 0.097 and 0.19 mg/ml against resistant S. typhi for Extract I, II and III respectively. Conclusion: These plant extracts showed great antimicrobial activities and therefore could be exploited and harnessed for future antibiotic drug discovery

Microbial Contamination, an Increasing Threat to the Consumption of Fresh Fruits and Vegetables in Today’s World

Microbes are found all over the globe with some few exceptions, including sterilized surfaces. They include normal flora that is nonpathogenic, which contribute to the larger percentage, and pathogenic species which are few. Hence, the activities of humans cannot be completely separated from microbes. Thus, many pathogenic microbes have found their way into fresh fruits and vegetables which are a great source of a healthy diet for humans. The growing demand for fresh fruits and vegetables has necessitated larger production. The larger production of vegetables within the shortest possible time to meet the growing demand has placed them at a higher risk of contamination with the pathogenic microbes, making the safety of consumers uncertain. Study of sources of contamination and type of pathogenic etiological agents isolated from fresh fruits and vegetables includes Bacillus cereus, Campylobacter jejuni, Clostridium botulinum, E. coli O157: H7, Listeria monocytogenes, Salmonella spp., Shigella, Staphylococcus, and Vibrio cholera. Several measures have proven to be effective in controlling contamination of microbes and they include the establishment of surveillance systems to monitor the production chain and thoroughly washing vegetables with vinegar water. Saltwater and other washing techniques are effective but caution should be taken to make sure one does not use one cycle of water for washing all vegetables. The consumption of fresh fruits and vegetables is still encouraged by this review but significant measures must be taken to check the safety of these products before consumption

Food milling machines are hosts to pathogenic bacteria: A cross-sectional study in the Asante Mampong Municipal, Ghana

Foodborne illnesses are a growing concern globally, with the food processing chain being implicated as the main culprit. However, the contribution of milling machines to these outbreaks in the Asante Mampong municipality is not well understood. This study evaluated the bacteriological quality of 55 food milling machines and assessed management practices and perceptions of operators towards microbial contamination. The study recorded a total mean count of 1.95523 × 105 (CFU/ml) and identified 82 bacteria in five genera, with Salmonella spp. and Shigella spp. being the most prevalent. The Fufu pounding machine recorded the highest total isolates, while the pepper/tomato machine had the highest Salmonella isolates. Compared to similar studies, this research offers novel findings on the extent of contamination and specific genera of bacteria found in food milling machines in the Asante Mampong municipality. The study highlights the need for regular and rigorous checks on milling machines to minimize contamination and foodborne outbreaks in the food milling industry. The study's findings offer solutions to reducing foodborne illnesses locally and nationally, including increased awareness and licensing of milling machine operators to ensure good hygiene practices and minimize contamination. This research contributes to new knowledge on management practices and perceptions of operators towards microbial contamination in milling machines. Additionally, the study's relevance to the global discourse on food safety can aid in achieving Sustainable Development Goal 3 (Good Health and Well-being) and the Africa Union's Agenda 2063 in promoting food safety and nutrition security on the continent

Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

Abstract Background The recent Ebola Virus Disease (EVD) epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to) any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS) regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hospital based cross sectional study involving 101 HCWs from two facilities in Kumasi, Ghana to assess the level of preparedness of HCWs to respond to any possible EVD. Methods We administered a face-to-face questionnaire using an adapted WHO (2015) and CDC (2014) Checklist for Ebola Preparedness and assessed overall knowledge gaps, and preparedness of the Ghanaian HCWs in selected health facilities of the Ashanti Region of Ghana from October to December 2015. Results A total 92 (91.09%) HCWs indicated they were not adequately trained to handle an EVD suspected case. Only 25.74% (n = 26) considered their facilities sufficiently equipped to handle and manage EVD patients. When asked which disinfectant to use after attending to and caring for a suspected patient with EVD, only 8.91% (n = 9) could correctly identify the right disinfectant (χ2 = 28.52, p = 0.001). Conclusion Our study demonstrates poor knowledge and ill preparedness and unwillingness of many HCWs to attend to EVD. Beyond knowledge acquisition, there is the need for more training from time to time to fully prepare HCWs to handle any possible EVD case