Water Handling And Hygiene Practices On The Transmission Of Diarrhoeal Diseases And Soil Transmitted Helminthic Infections In Communities In Rural Ghana

In Ghana, diarrhoeal diseases have been identified as the second commonest health problem treated in outpatient clinics. In this study, the relevance of water handling and hygienic practices on the transmission of diarrhoeal diseases and soil-transmitted helminthic infections in three communities in Ghana was evaluated. Specifically, the research looked at physico-chemical qualities of household water, the incidence of diarrhoeal diseases and soil-transmitted helminthic infections. Thirty households were selected by the systematic random sampling technique from the three communities namely Mayera, Ashongman village and Tetegu. Within each household, domestic water was collected and transported to the laboratory for physico-chemical testing. Standardized questionnaires were also administered. The questionnaires addressed issues such as water storage, treatment and hygienic practices among households. The incidence of diarrhoeal diseases and soil transmitted helminthic (STH) infections among households were also assessed. The commonest water sources included pipe-borne water, borehole, rainwater and water from rivers. Most households in the three communities did not treat their water before use. The commonest water storage containers included barrels without lids, pots and plastic containers. There was no significant correlation between STH and diarrhoeal diseases at both Mayera and the Ashongman communities (R=0.279, p=0.136 for Mayera; R=0.311, p=0.094 for Ashongman). However, there existed a weak significantly positive correlation between the incidences of diarrhoeal diseases and the incidence of STH at the Tetegu community (R=0.384, p=0.036). Health education in the aspect of proper hand washing with soap under running water should be intensified in the three communities. Keywords: diarrhoeal disease, water handling, hygiene, soil transmitted helminth, water qualit

Insecticide resistance profiles for malaria vectors in the Kassena-Nankana district of Ghana

BACKGROUND: Malaria is a major public health problem in Ghana. The current strategy of the National Malaria Control Programme is based on effective case management and the use of insecticide treated bed nets among vulnerable groups such as children under-five years of age and pregnant women. Resistance to pyrethroids by Anopheles gambiae s.l. and Anopheles funestus has been reported in several African countries including neighbouring Burkina Faso. METHODS: Indoor resting Anopheles mosquitoes were collected. Blood-fed and gravid females were allowed to oviposit, eggs hatched and larvae reared to 1-3 days old adults and tested against permethrin 0.75%, deltamethrin 0.05%, cyfluthrin 0.15%, lambdacyhalothrin 0.1% and DDT 4%, based on WHO methodology. PCR analyses were carried out on a sub-sample of 192 of the An. gambiae for sibling species complex determination. Resistance to pyrethroids and DDT was determined by genotyping the knock-down resistance kdr gene mutations in the study area. RESULTS: A total of 9,749 1-3 days-old F1 female Anopheles mosquitoes were exposed to the insecticides. Among the pyrethroids, permethrin, 0.75% had the least knockdown effect, whilst cyfluthrin 0.15%, had the highest knock-down effect. Overall, no difference in susceptibility between An. gambiae 93.3% (95% CI: 92.5-94.1) and An. funestus 94.5% (95% CI: 93.7-95.3) was observed when exposed to the pyrethroids. Similarly, there was no difference in susceptibility between the two vector species (An. gambiae = 79.1% (95% CI: 76.6-81.8) and An. funestus = 83.5% (95% CI: 80.2-86.4) when exposed to DDT. Overall susceptibility to the insecticides was between 80% and 98%, suggesting that there is some level of resistance, except for cyfluthrin 0.15%. The kdr PCR assay however, did not reveal any kdr mutations. The analysis also revealed only the molecular M (Mopti) form. CONCLUSION: The findings in this study show that An. gambiae and An. funestus, the main malaria vector mosquitoes in the Kassena-Nankana district are susceptible to the insecticides being used in the treatment of bed nets in the malaria control programme. There is however, the need for continuous monitoring of the pyrethroids as the efficacy is not very high

Associations between red cell polymorphisms and Plasmodium falciparum infection in the middle belt of Ghana.

BACKGROUND: Red blood cell (RBC) polymorphisms are common in malaria endemic regions and are known to protect against severe forms of the disease. Therefore, it is important to screen for these polymorphisms in drugs or vaccines efficacy trials. This study was undertaken to evaluate associations between clinical malaria and RBC polymorphisms to assess biological interactions that may be necessary for consideration when designing clinical trials. METHOD: In a cross-sectional study of 341 febrile children less than five years of age, associations between clinical malaria and common RBC polymorphisms including the sickle cell gene and G6PD deficiency was evaluated between November 2008 and June 2009 in the middle belt of Ghana, Kintampo. G6PD deficiency was determined by quantitative methods whiles haemoglobin variants were determined by haemoglobin titan gel electrophoresis. Blood smears were stained with Giemsa and parasite densities were determined microscopically. RESULTS: The prevalence of clinical malarial among the enrolled children was 31.9%. The frequency of G6PD deficiency was 19.0% and that for the haemoglobin variants were 74.7%, 14.7%, 9.1%, 0.9% respectively for HbAA, HbAC, HbAS and HbSS. In Multivariate regression analysis, children with the HbAS genotype had 79% lower risk of malaria infection compared to those with the HbAA genotypes (OR = 0.21, 95% CI: 0.06-0.73, p = 0.01). HbAC genotype was not significantly associated with malaria infection relative to the HbAA genotype (OR = 0.70, 95% CI: 0.35-1.42, p = 0.33). G6PD deficient subgroup had a marginally increased risk of malaria infection compared to the G6PD normal subgroup (OR = 1.76, 95% CI: 0.98-3.16, p = 0.06). CONCLUSION: These results confirm previous findings showing a protective effect of sickle cell trait on clinical malaria infection. However, G6PD deficiency was associated with a marginal increase in susceptibility to clinical malaria compared to children without G6PD deficiency

Potential of Lanistes varicus in limiting the population of Bulinus truncatus

Abstract Objective To determine the ability of the Ampullariid, Lanistes varicus to prey on egg masses and juveniles of Bulinus truncatus snails, an intermediate host of urogenital schistosomiasis in West Africa. Results Lanistes varicus was found to feed voraciously on egg masses and juveniles of Bulinus truncatus, consuming all egg masses (20 –25) exposed to it within 24 h. Also, 95–100% of 1–2 days old B. truncatus snails exposed to a single L. varicus snail was consumed within 4 days. The presence of L. varicus snails greatly increased mortality in B. truncatus with mortality increasing with increase in the number of L. varicus snails in the mixture of the two snail species. The current study has demonstrated under laboratory conditions that the Ghanaian strain of L. varicus has the potential of limiting the population of B. truncatus snails, and contribute to the control of urogenital schistosomiasis in West Africa

MOESM1 of Potential of Lanistes varicus in limiting the population of Bulinus truncatus

Additional file 1. Arrangement of B. truncatus and L. varicus in snail population control experiments

Evaluation of field recognizable morbidity indicators of Schistosoma haematobium infection among primary school children in Ghana

Aim - This study was a retrospective evaluation of morbidity indicators and the use of questionnaire in decisions that relate to Schistosoma haematobium infection control among primary school children in Ghana. Materials and Methods — In all, 417 pupils in three primary schools (Kasseh sub-District, Dangme East District, Ghana), provided urine samples, which were examined for S. haematobium ova. The study utilized a structured questionnaire, the Urit 10V multi-stick urine reagent strips and the filtration method. Results — Overall, prevalence by microscopy was 20.9% (requires targeted treatment once every two years), and was higher (14.0%) among the 10-15 years age group (χ2=22.44, p<0.001). The lowest prevalence was among the <6 (0.5%, 2/417) and ≥19 (1.4%, 6/417) years age groups. There was no significant difference in prevalence among females (7.9%, 33/417) and males (12.9%, 54/417) (χ2=2.58, p=0.108). Self-reported haematuria was 43.2% (targeted treatment once a year). There was a significant difference between female (16.1%, 67/417) and male (27.1%, 113/417) responses to self-reported haematuria (χ2=4.170, p<0.001). A lower consolidated mean prevalence of 11.7% was estimated among pupils who had ova in their urine and also exhibited three morbidity indicators (haematuria, leucocyturia and proteinuria). Combined and averaged sensitivity and specificity estimations (sensitivity = 55.4%, specificity = 67.8%, Positive Predictive Value (PPV) = 53.4%, Negative Predictive Value (NPV) = 64.2%) of these morbidity indicators, was insufficient in equalizing the reliability of ova quantification. With the exception of leucocyturia, which was common among all pupils, 28.75% (25/87) of the infected individuals did not have any form of haematuria or proteinuria. Out of these, one pupil had heavy ova intensity (80 eggs/10ml of urine) while the remaining 24 had low ova intensity infection (1-44 eggs/10ml of urine). Questionnaire correctly identified 56.3% of pupils with S. haematobium ova in their urine, also reporting bloody urine (PPV=27.2%; NPV=84.0%). It also identified 49.4% of pupils with ova, reporting painful urination (PPV=26.1%, NPV=82.5%). Conclusion — This study emphasizes the relevance of evaluating the criteria for interpretation of morbidity indicators, prior to their field application. Questionnaire use remains key for surveillance purposes, to determine the presence of the infection in an area. Future studies should consolidate similar data elsewhere in Ghana for a better understanding of morbidity indicators and questionnaire use for decisions that relates to control strategies

MOESM3 of Potential of Lanistes varicus in limiting the population of Bulinus truncatus

Additional file 3. Weight measurement data

Integrated value-chain and risk assessment of Pig-Related Zoonoses in Ghana.

The marked increase in the pig-trade in Ghana has raised concerns about increased transmission of related zoonotic diseases. A study on pig-related zoonoses along the pork value-chain was conducted in Greater Accra and Upper East Regions of Ghana. Results showed significant taenia (60%) and trichinella (8%) seroprevalence in pigs in Upper East with little evidence of transmission to humans. Sero-prevalence of HEV was high in both pigs (85%) and humans (37%). Sero-prevalence rates were significantly higher in Upper East than Greater Accra. Pig handlers in Accra had significantly higher sero-prevalence rates (58%) than other community members (18%) but there was no such association in the Upper East. Given the high rates of mortality, miscarriage and stillbirth associated with HEV in pregnancy, it is a cause for concern that 31% women of child-bearing age tested sero-positive for HEV

An Evaluation of Treatment Outcomes in a Cohort of Clients on the DOTS Strategy, 2012–2016

We present, for the first time, an evaluation of treatment outcomes in a cohort at a TB referral centre in the Central Region of Ghana. Of the 213 clients placed on DOTS, 59.2% (126/213) were sputum smear-positive. An overall cure rate of 90.2% (51.6% cured + 37.6% completed) and a death rate of 8.5% (18/213) were estimated. Of the number of clients who died, 5.7% (12/213) were males (χ2 = 2.891, p=0.699; LR = 3.004, p=0.699). Deaths were only recorded among clients who were > 19 years old (χ2 = 40.319, p=0.099; LR = 41.244, p=0.083). Also, 0.9% (2/213) was lost to follow-up, while 1.4% (3/213) had treatment failure. In total, 13.6% (7.0%, 15/213 males, and 6.6%, 14/213 females) of clients who were placed on DOTS were HIV seropositive. Ages of 40–49 years had the highest number, 13/213 (6.1%), infected with HIV, though the difference among the remaining age groups was not statistically significant (χ2 = 9.621, p=0.142). Furthermore, 7.0% (15/213) had TB/HIV coinfection. Out of them, 9 were cured and 5 died at home, while 1 had treatment failure. Tuberculosis/HIV infection prevention advocacy and interventions that address sociodemographic determinants of unfavourable treatment outcomes are urgently required to augment national efforts towards control

Impact of an Irrigation Dam on the Transmission and Diversity of Plasmodium falciparum in a Seasonal Malaria Transmission Area of Northern Ghana

Water bodies such as dams are known to alter the local transmission patterns of a number of infectious diseases, especially those transmitted by insects and other arthropod vectors. The impact of an irrigation dam on submicroscopic asexual parasite carriage in individuals living in a seasonal malaria transmission area of northern Ghana was investigated. A total of 288 archived DNA samples from two cross-sectional surveys in two communities in the Bongo District of Northern Ghana were analysed. Parasite density was determined by light microscopy and PCR, and parasite diversity was assessed by genotyping of the polymorphic Plasmodium falciparum msp2 block-3 region. Submicroscopic parasitaemia was estimated as the proportional difference between positive samples identified by PCR and microscopy. Dry season submicroscopic parasite prevalence was significantly higher (71.0%, p=0.013) at the dam site compared with the nondam site (49.2%). Similarly, wet season submicroscopic parasite prevalence was significantly higher at the dam site (54.5%, p=0.008) compared with the nondam site (33.0%). There was no difference in parasite density between sites in the dry season (p=0.90) and in the wet season (p=0.85). Multiplicity of infection (MOI) based on PCR data was significantly higher at the dam site compared with the nondam site during the dry season (p<0.0001) but similar between sites during the wet season. MOI at the nondam site was significantly higher in the wet season than in the dry season (2.49, 1.26, p<0.0001) but similar between seasons at the dam site. Multivariate analysis showed higher odds of carrying submicroscopic parasites at the dam site in both dry season (OR = 7.46, 95% CI = 3.07–18.15) and in wet season (OR = 1.73, 95% CI = 1.04–2.86). The study findings suggest that large water bodies impact year-round carriage of submicroscopic parasites and sustain Plasmodium transmission