Neighborhood Urban Environmental Quality Conditions Are Likely to Drive Malaria and Diarrhea Mortality in Accra, Ghana

Background. Urbanization is a process which alters the structure and function of urban environments. The alteration in the quality of urban environmental conditions has significant implications for health. This applies both to the ecology of insect vectors that may transmit diseases and the burden of disease. Study Objectives. To investigate the relationship between malaria and infectious diarrhea mortality and spatially varied neighborhood environmental quality conditions in a low-income economy. Design. A one time point spatial analysis of cluster-level environmental conditions and mortality data using principal component analysis (PCA), one-way analysis of variance (ANOVA) and generalized linear models (GLMs). Methods. Environmental variables were extracted from the Ghana Census 2000 database while mortality data were obtained from the Ghana Births and Deaths Registry in Accra over the period 1998–2002. Results. Whereas there was a strong evidence of a difference in relative mortality of malaria across urban environmental zones of differing neighborhood environmental conditions, no such evidence of mortality differentials was observed for diarrhea. In addition, whereas bivariate analyses showed a weak to strong evidence of association between the environmental variables and malaria mortality, no evidence of association was found between diarrhea mortality and environmental variables. Conclusion. We conclude that environmental management initiatives intended for infectious disease control might substantially reduce the risk of urban malaria mortality and to a less extent that for urban diarrhea mortality in rapidly urbanizing areas in a low-income setting

Health seeking behaviours among electronic waste workers in Ghana

Abstract Background Electronic waste workers are prone to various illnesses and injuries from numerous hazards thus the need for them to seek health care. The aim of this study was to describe health-seeking behavior, and social and other factors affecting this behavior, among electronic waste workers at Agbogbloshie, Accra, Ghana. Methods In-depth interviews were conducted and analyzed qualitatively from a grounded theory perspective. Results Workers experienced various kinds of ailments. These included physical injuries, chest and respiratory tract associated symptoms, malaria, headaches, body pains and stomach discomfort. They reported seeking health care from multiple sources, and the main determinants of health seeking behaviour were severity of illness, perceived benefit of treatment, accessibility of service, quality of service, ease of communication with service provider and cost of health care. Conclusion Multiple sources of health care were used by the e-waste workers. As cost was a major barrier to accessing formal health care, most of the workers did not subscribe to health insurance. Since enrollment in health insurance is low amongst the workers, education campaigns on the need to register with the National Health Insurance Scheme would facilitate access to formal health care and could result in improved health outcomes among e-waste workers.http://deepblue.lib.umich.edu/bitstream/2027.42/115463/1/12889_2015_Article_2376.pd

Pollution de l’air et comportement à risque des employés de boulangerie à Abidjan (Côte d’Ivoire)

Dans le secteur de la boulangerie, les employés sont régulièrement exposés à la poussière de farine qui est nocive pour la santé. Cependant, les employés de boulangeries à Abidjan ne prennent pas assez de précautions à leurs postes de travail afin de réduire les risques auxquels ils sont exposés.  L’objectif de cette étude est de mettre en exergue le comportement à risque des employés de boulangeries dans l’exercice de leurs activités à Abidjan. A travers une approche mixte, cette recherche s’est appuyée sur des techniques aussi bien quantitatives que qualitatives. Des entretiens semi-directifs et des questionnaires ont été réalisés avec les employés au sein de la boulangerie. À ces techniques, une observation directe a été effectuée au sein de la boulangerie sur le cadre de travail et le port des équipements de protection. La qualité de l’air a été mesurée à l’aide   du Quest 3M EVM-7. Les résultats montrent que 35 boulangeries (87,5%) sur les 40 investiguées utilisent le gaz butane comme combustible. Les mesures de PM2,5 donnent des valeurs moyennes de 280 µg/m3 et 260 µg/m3   respectivement en zone de production et de vente. Ces mesures correspondent respectivement à 11 et à 10 fois la norme de l’OMS. Dans ce cadre de travail, (374/599, 62,4%) des employés pensent que ne pas porter les équipements de protection individuelle ne constitue pas un risque pour leur santé. De plus ces boulangeries adoptent un système de nettoyage qui met en suspension la poussière de farine, impactant ainsi la qualité de l’air.  La sensibilisation sur les risques sanitaires liés à la pollution de l’air dans les boulangeries est indispensable à l’adoption de bonnes pratiques professionnelles par les employés de ces structures.   In the bakery sector, employees are regularly exposed to flour dust which is harmful to health. However, bakery workers in Abidjan do not take enough precautions at their workstations to reduce the risks to which they are exposed. The objective of this study is to highlight the risky behaviour of bakery workers in the exercise of their activities in Abidjan. Using a mixed-methods approach, this research relied on both quantitative and qualitative techniques. Semi-structured interviews and questionnaires were conducted with employees in the bakery. In addition to these techniques, direct observation was carried out in the bakery on the working environment and the wearing of protective equipment. Air quality was measured using the Quest 3M EVM-7. The results show that 35 bakeries (87.5%) out of the 40 investigated use butane gas as fuel. The PM2.5 measurements gave average values of 280 µg/m3 and 260 µg/m3 in the production and sales areas respectively. These measurements correspond to 11 and 10 times the WHO standard respectively. In this work environment, (374/599, 62.4%) of the employees believe that not wearing personal protective equipment does not constitute a risk to their health. In addition, these bakeries adopt a cleaning system that suspends flour dust, thus impacting air quality.  Raising awareness of the health risks associated with air pollution in bakeries is essential for the adoption of good working practices by the employees of these facilities

Assessing the Relationship between Socioeconomic Conditions and Urban Environmental Quality in Accra, Ghana

The influence of socioeconomic status (SES) on health inequalities is widely known, but there is still poor understanding of the precise relationship between area-based socioeconomic conditions and neighborhood environmental quality. This study aimed to investigate the socioeconomic conditions which predict urban neighbourhood environmental quality. The results showed wide variation in levels of association between the socioeconomic variables and environmental conditions, with strong evidence of a real difference in environmental quality across the five socioeconomic classes with respect to total waste generation (p < 0.001), waste collection rate (p < 0.001), sewer disposal rate (p < 0.001), non-sewer disposal (p < 0.003), the proportion of households using public toilets (p = 0.005). Socioeconomic conditions are therefore important drivers of change in environmental quality and urban environmental interventions aimed at infectious disease prevention and control if they should be effective could benefit from simultaneous implementation with other social interventions

A review of the structure and function of vital registration system in Ghana: towards improvement in mortality data quality for health policy analysis

Fobil JN, Aryee E, Bilson F, May J, Krämer A. A review of the structure and function of vital registration system in Ghana: towards improvement in mortality data quality for health policy analysis. Journal of Public Health in Africa. 2011;2(1):e5

Feasibility of Electronic Health Information and Surveillance System (eHISS) for disease symptom monitoring: A case of rural Ghana.

The current surge of mobile phone use in many African countries creates the opportunity to provide caregivers with limited access to the health care system with vital health recommendations. At the same time such communication system can be utilised to collect tempero-spatial data on disease symptoms

Prediction of Antibiotic Susceptibility Profiles of Vibrio cholerae Isolates From Whole Genome Illumina and Nanopore Sequencing Data: CholerAegon

During the last decades, antimicrobial resistance (AMR) has become a global public health concern. Nowadays multi-drug resistance is commonly observed in strains of Vibrio cholerae, the etiological agent of cholera. In order to limit the spread of pathogenic drug-resistant bacteria and to maintain treatment options the analysis of clinical samples and their AMR profiles are essential. Particularly, in low-resource settings a timely analysis of AMR profiles is often impaired due to lengthy culturing procedures for antibiotic susceptibility testing or lack of laboratory capacity. In this study, we explore the applicability of whole genome sequencing for the prediction of AMR profiles of V. cholerae. We developed the pipeline CholerAegon for the in silico prediction of AMR profiles of 82 V. cholerae genomes assembled from long and short sequencing reads. By correlating the predicted profiles with results from phenotypic antibiotic susceptibility testing we show that the prediction can replace in vitro susceptibility testing for five of seven antibiotics. Because of the relatively low costs, possibility for real-time data analyses, and portability, the Oxford Nanopore Technologies MinION sequencing platform-especially in light of an upcoming less error-prone technology for the platform-appears to be well suited for pathogen genomic analyses such as the one described here. Together with CholerAegon, it can leverage pathogen genomics to improve disease surveillance and to control further spread of antimicrobial resistance.We thank Dr. Daniel Cadar and Heike Baum from the NGS core facility of the Bernhard Nocht Institute for Tropical Medicine for technical support. We thank the Carl-Zeiss-Stiftung (FKZ 0563-2.8/738/2), TWMMG DigLeben (5575/10-9), and DFG iDIV (FZT 118, 202548816) for financial support. Figures were finalized with Inkscape v1.0.2.S

a cross-sectional study on the association between urbanicity and the acquisition of immunity

Background Malaria incidence has declined considerably over the last decade. This is partly due to a scale-up of control measures but is also attributed to increasing urbanization. This study aimed to analyse the association between malaria and urbanization and the effect of urbanicity on the acquisition of semi-immunity. Methods In 2012, children with fever presenting to St Michael’s Hospital Pramso/Ghana were recruited. The malaria-positive-fraction (MPF) of fever cases was calculated on community-level to approximate the malaria risk. The mean age of malaria cases was calculated for each community to estimate the acquisition of semi-immunity. The level of urbanicity for the communities was calculated and associations between MPF, urbanicity and immunity were modelled using linear regression. Results Twenty-six villages were included into the study with a mean MPF of 35 %. A linear decrease of 5 % (95 % CI: 4–6 %) in MPF with every ten-point increase in urbanicity was identified. The mean age of malaria patients increased by 2.9 months (95 % CI: 1.0–4.8) with every ten-point increase in urbanicity. Discussion The results confirm an association between an increase in urbanicity and declining malaria risk and demonstrate that the acquisition of semi-immunity is heterogeneous on a micro- epidemiological scale and is associated with urbanicity

Evidence of recent dengue exposure among malaria parasite-positive children in three urban centers in Ghana.

Blood samples of 218 children ages 2-14 years old with confirmed malaria in hospitals across Ghana were tested for dengue virus exposure. We detected dengue-specific immunoglobulin M (IgM) antibodies in 3.2% of the children, indicating possible coinfection, and IgG antibodies in 21.6% of them, which suggests previous exposure. Correlates of exposure are discussed