Physical distancing and risk of COVID-19 in small-scale fisheries: a remote sensing assessment in coastal Ghana

The novel coronavirus is predicted to have dire implications on global food systems including fisheries value chains due to restrictions imposed on human movements in many countries. In Ghana, food production, both agriculture and fisheries, is exempted from restrictions as an essential service. The enforcement of COVID-19 prevention protocols, particularly social distancing, has been widely reported in Ghana's agricultural markets whereas casual observations and media reports on fish landing sites suggest no such enforcements are in place. This study aimed to provide sound scientific evidence as a basis for informed policy direction and intervention for the artisanal fishing sector in these challenging times. We employed an unmanned aerial vehicle in assessing the risk of artisanal fishers to the pandemic using physical distancing as a proxy. From analysis of cumulative distribution function (G-function) of the nearest-neighbour distances, this study underscored crowding at all surveyed fish landing beaches, and identified potential "hotspots" for disease transmission. Aerial measurements taken at times of peak landing beach activity indicated that the highest proportion of people, representing 56%, 48%, 39% and 78% in Elmina, Winneba, Apam and Mumford respectively, were located at distances of less than one metre from their nearest neighbour. Risk of crowding was independent of the population at the landing beaches, suggesting that all categories of fish landing sites along the coast would require equal urgency and measured attention towards preventing and mitigating the spread of the disease

A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio- demographic factors. In this Ghanaian population (age range, 14.4–15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38–52%), for malnutrition 50% (43–57%) and for CRFs 16% (11–21%). Infectious diseases and malnutrition frequently co-existed (28%; 21–34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2–9%) or with malnutrition (7%; 3–11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted

High prevalence of multidrug-resistant tuberculosis among patients with rifampicin resistance using GeneXpert Mycobacterium tuberculosis/rifampicin in Ghana

AbstractObjective/BackgroundDrug-resistant strains of tuberculosis (TB) represent a major threat to global TB control. In low- and middle-income countries, resource constraints make it difficult to identify and monitor cases of resistance using drug susceptibility testing and culture. Molecular assays such as the GeneXpert Mycobacterium tuberculosis/rifampicin may prove to be a cost-effective solution to this problem in these settings. The objective of this study is to evaluate the use of GeneXpert in the diagnosis of pulmonary TB since it was introduced into two tertiary hospitals in Ghana in 2013.MethodsA 2-year retrospective audit of clinical cases involving patients who presented with clinically suspected TB or documented TB not improving on standard therapy and had samples sent for GeneXpert testing.ResultsGeneXpert identified 169 cases of TB, including 17 cases of rifampicin-resistant TB. Of the seven cases with final culture and drug susceptibility testing results, six demonstrated further drug resistance and five of these were multidrug-resistant TB.ConclusionThese findings call for a scale-up of TB control in Ghana and provide evidence that the expansion of GeneXpert may be an optimal means to improve case finding and guide treatment of drug-resistant TB in this setting

Adolescent health in rural Ghana: A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors.

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio-demographic factors. In this Ghanaian population (age range, 14.4-15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38-52%), for malnutrition 50% (43-57%) and for CRFs 16% (11-21%). Infectious diseases and malnutrition frequently co-existed (28%; 21-34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2-9%) or with malnutrition (7%; 3-11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted

Clinical and anthropometric characteristics of 188 rural Ghanaian adolescents.

<p>Clinical and anthropometric characteristics of 188 rural Ghanaian adolescents.</p

Venn diagram for the co-occurrences of infectious diseases, malnutrition and cardio-metabolic risk factors in 188 adolescents in rural Ghana.

<p>Data are presented as proportions of the total study population. Infectious diseases comprise malarial infection <i>plus</i> diagnoses of and symptoms compatible with another infectious disease; malnutrition comprises underweight, stunting, iron deficiency and vitamin A deficiency; cardio-metabolic risk factors comprise overweight, obesity, impaired fasting glucose and hypertension.</p

Socio-demographic characteristics of 188 rural Ghanaian adolescents.

<p>Socio-demographic characteristics of 188 rural Ghanaian adolescents.</p

Proportions of infectious diseases, malnutrition and cardio-metabolic risk factors in 188 adolescents in rural Ghana.

<p>Error bars indicate 95% confidence intervals. dark grey = infectious diseases, comprise malarial infection <i>plus</i> diagnoses of and symptoms compatible with another infectious disease; light grey = malnutrition, comprises underweight, stunting, iron deficiency and vitamin A deficiency; white = cardio-metabolic risk factors, comprise overweight, obesity, impaired fasting glucose and hypertension.</p

Associations of demographic, socio-economic and medical factors with infectious diseases, malnutrition and CRFs.

<p>Associations of demographic, socio-economic and medical factors with infectious diseases, malnutrition and CRFs.</p