Hiv/Aids prevalence at the accident & emergency centre of a tertiary and referral health institution in Ghana

Background: Ghana has an estimated HIV prevalence of 1.4%, but the HIV prevalence of patients presenting at emergency departments in Ghana is not well documented in published literature. This study evaluated the prevalence of HIV infection at the Accident & Emergency Department, Komfo Anokye Teaching Hospital (KATH A&E), Kumasi, Ghana.Methods: A descriptive cross-sectional survey was carried out on patients aged 18 and above presenting to KATH A&E. An opt-in testing approach was used; consenting patients were screened for HIV using rapid HIV finger-stick testing with HIV 1-2 STAT-PAK. Sero-positivity was confirmed by OraQuick HIV 1-2 test. Data was analysed using multivariate logistic regression.Results: 1125 patients presenting at the KATH A&E during the study period were offered the Rapid HIV test. 667 of these patients consented to have the test. HIV prevalence was 13.5% (90/667). 53 females (58.9%) were HIV positive compared to 37 males (41.1%). The age group 30-50 years had the highest risk of being HIV-positive. Other socio-demographic variables such as educational level and occupation were significantly associated with HIV-infection (Pvalue = 0.001 at 95% CI).Conclusion: This study shows that emergency department HIV testing in Ghana is feasible. The prevalence of HIV sero-positive patients presenting at KATH A&E was tenfold higher than national estimates. We conclude that this study showed a high prevalence among patients seeking emergency care in our setting. Testing in the emergency department could lead to early detection of HIV-infected patients for linkage to care.Keywords: HIV Infections; HIV Screening; Prevalence, Diagnosis, Emergency Departmen

Sustainable use of termite activity in agro-ecosystems with reference to earthworms. A review

International audienceAbstractSustainable agriculture and agro-ecology justify the need to study and understand the role played by ecological processes, and soil biodiversity in particular, in agro-ecosystem functioning. A large number of studies have focused on earthworms in temperate and humid tropical ecosystems and have demonstrated their importance for improving soil biological, physical, and chemical properties in agro-ecosystems. Their “success” is so essential that earthworms are widely considered key species and relevant indicators of soil health in temperate ecosystems. In arid and sub-arid ecosystems, the role of “soil engineer” is usually attributed to termites, and especially fungus-growing termites in Africa and Asia. However, despite this recognition, significant effort is spent eradicating them in plantations because of their pest status. In this review, we discuss the status of termites (“pests” vs. “soil engineers”) and question whether termites play similar roles to earthworms in arid- and sub-arid agroecosystems, with a focus on their influence on nutrient cycling and water dynamics. We argue that the dream of controlling natural interactions and ridding plantations of termites remains a costly legacy of the green revolution. We review the agricultural practices that have been used to reduce termite damage in plantations by restoring refuges to predators or by reorienting termite foraging activity towards organic amendments. Then, we show that the stimulation of termite activity can be used to improve key ecological functions in agro-ecosystems, such as increasing water availability to plants or producing fertility hot-spots. Finally, we suggest that more research on how termites can be used for improving ecosystem services, as is actually done with earthworms in temperate and humid tropical countries, could lead to a paradigm shift in our understanding of the impact of termites in tropical agro-ecosytems