Risk factors for Buruli ulcer disease (Mycobacterium ulcerans infection):Results from a case-control study in Ghana

Background. Morbidity due to Buruli ulcer disease (BUD), a cutaneous infection caused by Mycobacterium ulcerans, has been increasingly recognized in rural West Africa. The source and mode of transmission remain unknown. Methods. To identify BUD risk factors, we conducted a case-control study in 3 BUD-endemic districts in Ghana. We enrolled case patients with clinically diagnosed BUD and obtained skin biopsy specimens. M. ulcerans infection was confirmed by at least I of the following diagnostic methods: histopathologic analysis, culture, polymerase chain reaction, and Ziehl-Neelsen staining of a lesion smear. We compared characteristics of case patients with confirmed BUD with those of age- and community-matched control subjects using conditional logistic regression analysis. Results. Among 121 case patients with confirmed BUD, leg lesions (49%) or arm lesions (36%) were common. Male case patients were significantly more likely than female case patients to have lesions on the trunk (25% vs. 6%; P = .009). Multivariable modeling among 116 matched case-control pairs identified wading in a river as a risk factor for BUD (odds ratio [OR], 2.69; 95% confidence interval [Cl], 1.27-5.68; P = .0096). Wearing a shirt while farming (OR, 0.27; 95% Cl, 0.11-0.70; P = .0071), sharing indoor living space with livestock (OR, 0.36; 95% Cl, 0.15-0.86; P = .022), and bathing with toilet soap (OR, 0.41; 95% Cl, 0.19-0.90; P = .026) appeared to be protective. BUD was not significantly associated with penetrating injuries (P = .14), insect bites near water bodies (P = .84), bacille Calmette-Guerin vaccination (P = .33), or human immunodeficiency virus infection (P = .99). Conclusions. BUD is an environmentally acquired infection strongly associated with exposure to river areas. Exposed skin may facilitate transmission. Until transmission is better defined, control strategies in BUD-endemic areas could include covering exposed skin

Preliminary findings from stimulated spontaneous reporting of adverse drug reactions during COVID-19 pandemic: an experience from Ghana

Background: The novel coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is limited information on the safety of drugs used for the treatment of COVID-19.Objective: Objective of this study is to describe the pattern of stimulated spontaneous adverse drug reaction (ADR) reports received from healthcare professionals for SARS-CoV-2 positive patients in Ghana and lessons learnt particularly for low- and middle-income countries.Methods: This is a study of individual case safety reports (ICSRs) received from healthcare professionals between 1st April 2020 to 31st July 2020 in SARS-CoV-2 positive patients in Ghana. The ICSRs were retrieved from the SafetyWatch System and descriptive statistics used to describe the ADRs by System Organ Classification and Preferred Term.Results: Information was received from 40 COVID-19 Treatment Centres across the country with 9 centres submitting a total of 53 ICSRs containing 101 ADRs; approximately two ADRs per ICSR. Females accounted for 29(54.7%) of the ICSRs and males 24(45.3%). Newly reported ADRs of interest were one report each of tremor for doxycycline; scrotal pain, dyspnoea, gait disturbances and dysgeusia for chloroquine; and dry throat, hyperhidrosis, restlessness and micturition frequency increased for hydroxychloroquine. A strong spontaneous system with the availability of focal persons at the Treatment Centres played a key role in reporting ADRs during the pandemic.Conclusion: This is the first experience with spontaneous reporting during COVID-19 pandemic in Ghana. The profile of most of the ADRs reported appears consistent with what is expected from the summary of product characteristics. A study with a larger sample size with well-defined denominator in future studies is paramount in determining the relative risk of these medications in SARS-CoV-2 positive patients

Beliefs and attitudes toward Buruli ulcer in Ghana

Buruli ulcer is a devastating emerging disease in tropical countries. Quantitative and qualitative data were obtained by interviewing patients with this disease and control subjects in Ghana. Common perceived causes were witchcraft and curses. Other reported causes were personal hygiene, environment, and close contact with a patient with this disease. Financial difficulties, fear of the mutilating aspects of treatment, and social stigma were the main reasons found for delay in obtaining treatment. Patients are reluctant to seek treatment outside their own community. Patients often expected medical treatment instead of surgery, and underestimated the duration of hospital admission. The stigma of the disease is huge, and is strongly associated with the mysterious nature of the condition, the lack of knowledge about its mode of transmission, and the lack of proper treatment. Stigma scores were higher in unaffected respondents and in a less endemic location. Education on the disease, usually propagated for early case detection, might be useful in reducing stigma

Beliefs and attitudes toward Buruli ulcer in Ghana

Buruli ulcer is a devastating emerging disease in tropical countries. Quantitative and qualitative data were obtained by interviewing patients with this disease and control subjects in Ghana. Common perceived causes were witchcraft and curses. Other reported causes were personal hygiene, environment, and close contact with a patient with this disease. Financial difficulties, fear of the mutilating aspects of treatment, and social stigma were the main reasons found for delay in obtaining treatment. Patients are reluctant to seek treatment outside their own community. Patients often expected medical treatment instead of surgery, and underestimated the duration of hospital admission. The stigma of the disease is huge, and is strongly associated with the mysterious nature of the condition, the lack of knowledge about its mode of transmission, and the lack of proper treatment. Stigma scores were higher in unaffected respondents and in a less endemic location. Education on the disease, usually propagated for early case detection, might be useful in reducing stigma

Various Factors Affecting Plasma Free Amino Acid Concentrations in the Horse

158 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1982.A series of trials was conducted to determine the effects of various factors including meal schedule, fasting, age and sex of the animal, protein level and quality, exercise, training, length of time on the diet and sample location, on the resulting plasma free amino acid (PFAA) concentrations in the horse. Six horses were individually fed a complete pelleted diet of 15.1% C.P. at a rate of 1.75% of body weight in either one, two or six meals daily. Horses receiving six meals had more constant level of PFAA than horses fed one or two meals. Feeding one or two meals per day produced large PFAA peaks at five and three h after beginning the meal, respectively. Following the absorptive peak at five h, PFAA declined to a constant level at 20-30 h, then rose to near absorptive levels when the fat was continued for 48 h. There was no plateau of PFAA, indicating that a steady state fasting level was not attained.When the effect of age on plasma arginine (ARG), lysine (LYS), histidine (HIS) and ornithine (ORN) was investigated in weanling, yearling and mature mares receiving a 16.8% C.P. diet, it was observed that PFAA were lower in weanlings than in the yearlings or mature mares. The yearlings were lower in ARG than the mature mares. There was no effect of sex on any of the PFAA except ORN which was higher in males.Although PFAA increased with age when horses were fed the 16.8% C.P. diet, there was no effect of age on PFAA when horses were fed the 8.5% C.P. diet. The higher amino acid/protein content of the 16.8% C.P. diet was reflected in higher PFAA in horses of all ages. On the first day following the change from the 8.5% C.P. diet to the 16.8% C.P. diet, plasma LYS, ARG and HIS levels were lower than on day four, eight or 12, indicating that one day is not time enough for the PFAA pool to adapt. There was no apparent effect of protein source on plasma LYS during hours one to four after eating the meal when weanlings were fed diets containing either soybean oil meal or cottonseed meal with crystalline lysine.The effects of an aerobic training program and a single exercise bout on PFAA were examined in six mature mares. PFAAs sampled at rest and while trotting were not different; however training increased plasma leucine and aspartic acid. Samples taken from the jugular vein, pulmonary artery and carotid artery were not different in their PFAA concentrations.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD