The Impact of Migration on the Welfare of Households Left Behind in Rural Ghana: A Quasi-Experimental Impact Evaluation

Using panel data collected in 2015 and 2018, this paper employs econometric techniques to evaluate the impact of migration on the welfare of households left behind in rural Ghana. We find that poverty is an important driver of migration. Households with lower baseline food and nonfood consumption are more likely to have a member migrating over the three-year period of the study. Specifically, households with migrants had a lower level of consumption at baseline compared to non-migrant households. Using both propensity score matching (PSM) and difference-in-differences (DID) estimation approaches to explore migration’s welfare impact, we find no significant differences between treated and control households once initial baseline differences in consumption are accounted for. Our results suggest that migration has helped to bridge the gap in welfare between disadvantaged (low consumption) and advantaged (higher consumption) households in rural Ghana.DFI

Association of MYH9-rs3752462 polymorphisms with chronic kidney disease among clinically diagnosed hypertensive patients: a case-control study in a Ghanaian population

Background: Chronic kidney disease (CKD) is a significant comorbidity among hypertensive patients. Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) have been demonstrated to be significantly associated with CKD, among African- and European-derived populations. We investigated the spectrum of MYH9-associated CKD among Ghanaian hypertensive patients. Methods: The study constituted a total of 264 hypertensive patients. Hypertensive patients with glomerular filtration rate (eGFR) \u3c 60 ml/min/1.73m (CKD-EPI formula) or clinically diagnosed were defined as case subjects ( = 132) while those with eGFR ≥60 ml/min/1.73m were classified as control subjects ( = 132). Demographic data were obtained with a questionnaire and anthropometric measurements were taken. Five (5) millilitres (ml) of venous blood was drawn from study subjects into gel and EDTA vacutainer tubes. Two (2) mL of EDTA anticoagulated blood was used for genomic DNA extraction while three (3) mL of blood was processed to obtain serum for biochemical measurements. Genotyping of MYH9 polymorphisms (rs3752462) was done employing Tetra primer Amplification Refractory Mutation System (T-ARMS) polymerase chain reaction (PCR). Spot urine samples were also collected for urinalysis. Hardy-Weinberg population was assessed. Logistic regression models were used to assess the associations between single nucleotide polymorphisms and CKD. Results: The cases and control participants differed in terms of age, sex, family history, and duration of CKD (-value \u3c 0.001). The minor allele frequencies of rs3752462 SNP were 0.820 and 0.567 respectively among the control and case subjects. Patients with the heterozygote genotype of rs3752462 (CT) were more likely to develop CKD [aOR = 7.82 (3.81-16.04)] whereas those with homozygote recessive variant (TT) were protective [aOR = 0.12 (0.06-0.25)]. Single nucleotide polymorphism of rs3752462 (CT genotype) was associated with increased proteinuria, albuminuria, and reduced eGFR. Conclusions: We have demonstrated that MYH9 polymorphisms exist among Ghanaian hypertensive patients and rs3752462 polymorphism of MYH9 is associated with CKD. This baseline indicates that further longitudinal and multi-institutional studies in larger cohorts in Ghana are warranted to evaluate MYH9 SNP as an independent predictor of CKD among hypertensive patients in Ghana

Enhancing productivity of farmer-saved seed yam in Ghana: Positive selection and neem leaf powder factors

Recycling of diseased and pests infested seed yam ( Dioscorea spp.) has resulted in drastic yield reductions in yam production. The objective of this study was to determine the effect of positive selection on the quality of farmer-saved seed yam and also evaluate the effect of neem leaf powder in managing plant parasitic nematodes damage to yam. Two farming systems namely; Positive selection (PS) and Farmer practice (FP) and two soil amendment regimes; neem leaf powder at 20 g stand-1 (NA20) and no neem amendment (NA0) were tested on one variety of yam (Dente). A 2 x 2 x 1 factorial study, mounted on a randomised complete block design in a split plot arrangement was conducted in four replications. Positive selection occupied main plots; while Farmer practice occupied sub-plots. The study was conducted in eight communities located in two municipalities of Ghana, during 2015-2017. Parameters evaluated included Yam Mosaic Virus incidence and severity, incidence and severity of nematode cracks and galling on yam tubers, plant establishment and yield of yam. It was observed that Yam Mosaic Virus (YMV) disease incidence decreased from 38% in 2016 to 31% in 2017 in PS plots as a result of using virus-free planting materials. However, in FP plots, it increased from 67% in 2016 to 72% in 2017. Neem leaf powder amendment resulted in significantly (P< 0.05) low tuber galling (7%) compared with 40% in unamended plots. Similarly, PS plots yielded 7.7 t ha-1 compared to 5.9 t ha-1 in FP fields. In conclusion, Positive selection out-yielded FP by 30.5%; while PS-neem leaf powder interaction resulted in 38.5% over and above FP without neem amendment.Le recyclage des semences d\u2019igname ( Dioscorea spp.) contamin\ue9es par des maladies et des parasites a entra\ueen\ue9 une r\ue9duction drastique du rendement de la production d\u2019igname. L\u2019objectif de cette \ue9tude \ue9tait de d\ue9terminer l\u2019effet de la s\ue9lection positive sur la qualit\ue9 des semences d\u2019igname conserv\ue9es par les agriculteurs et \ue9galement d\u2019\ue9valuer l\u2019effet de la poudre de feuilles de neem dans la gestion des dommages caus\ue9s par les n\ue9matodes parasites des plantes. Deux syst\ue8mes agricoles \ue0 savoir; S\ue9lection positive (PS) et pratique paysanne (PF) et deux r\ue9gimes d\u2019amendement du sol; De la poudre de feuille de neem \ue0 20 g du stand-1 (NA20) et aucun amendement de neem (NA0) ont \ue9t\ue9 test\ue9s sur une vari\ue9t\ue9 d\u2019igname (Dente). Une \ue9tude factorielle de 2 x 2 x 1, mont\ue9e sur une dispositif en\ua0blocs al\ue9atoires complets dans un arrangement en parcelles divis\ue9es, a \ue9t\ue9 men\ue9e en quatre r\ue9p\ue9titions. S\ue9lection positive occup\ue9e parcelles principales; tandis que la pratique paysanne occupait des sous-parcelles. L\u2019\ue9tude a \ue9t\ue9 men\ue9e dans huit communaut\ue9s situ\ue9es dans deux municipalit\ue9s du Ghana en 2015-2017. Les param\ue8tres \ue9valu\ue9s comprenaient l\u2019incidence et la gravit\ue9 du virus de la mosa\uefque de l\u2019igname, l\u2019incidence et la gravit\ue9 des fissures de n\ue9matode et le grippage des tubercules de l\u2019igname, l\u2019\ue9tablissement de la plante et le rendement de l\u2019igname. Il a \ue9t\ue9 observ\ue9 que l\u2019incidence de la maladie caus\ue9e par le virus de la mosa\uefque \ue0 l\u2019igname (YMV) avait diminu\ue9 de 38% en 2016 \ue0 31% en 2017 dans les parcelles PS gr\ue2ce \ue0 l\u2019utilisation de mat\ue9riel de plantation d\ue9pourvu de virus. Cependant, dans les parcelles de PF, il est pass\ue9 de 67% en 2016 \ue0 72% en 2017. L\u2019amendement de poudre de feuille de Neem a entra\ueen\ue9 une r\ue9duction significative du galles des tubercules (P <0,05) (7%) par rapport \ue0 40% dans les parcelles non modifi\ue9es. De m\ueame, les parcelles de PS ont produit 7,7 t ha-1, contre 5,9 t ha-1 dans les champs de PF. En conclusion, la s\ue9lection positive a eu un rendement sup\ue9rieur de 30,5% \ue0 celui de la PF; tandis que l\u2019interaction de la poudre de feuille PS-neem a eu pour r\ue9sultat 38,5% de plus que FP sans amendement de nee

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries