Immunization Coverage of Pregnant Women with Tetanus Toxoid Vaccine in Dormaa East District-Brong Adaro Region, Ghana

This paper examines the immunization coverage of Tetanus toxoid vaccine in the Dormaa East District and then assesses the reasons for the low coverage in the district as to whether it is as a result of the attitude of health staff, knowledge of beneficiaries on its importance or the accessibility of the health facilities. Our findings suggest that, most beneficiaries fail to get immunized due to the reasons that they are not treated well by health workers on their visit to the immunization Centres. The beneficiaries are also unaware of when to be immunized and do not see the relevance of being immunized. Getting access to the vaccination centre is another cause for dropping-out in the course of immunization. It is recommended to the stakeholders to design and implement appropriate and relevant immunization programmes that will serve to improve EPI service utilization in the Dormaa East District Health Administration by embarking on routine educational campaign at both antenatal and postnatal sessions and child welfare clinics. There is the need to stress on the total number of times mothers need to visit the clinic to complete the immunization and the importance of being immunized. Also mother’s immunization for tetanus toxoid vaccine should be given equal attention by all health workers just like the immunization for their children during antenatal care attendance. The health staffs should also try making the beneficiaries feel good when they appear for their service. Enough immunization service centers should be made available close to the various communities to enable the people get quick access to it. Keywords: maternal and neonatal tetanus, Tetanus Toxoid immunization and regression analysis

Clinical features of COVID-19 in Ghana: symptomatology, illness severity and comorbid non-communicable diseases

Objective: This analysis described the clinical features of COVID-19 in the early phase of the pandemic in Ghana.Methods: Data were extracted from two national COVID-19 treatment centers in Ghana for over 11 weeks(from March to May 2020). Descriptive and inferential statistics were performed. Modified Ordered Logistic and Negative Binomial Regression analysis were applied to establish factors associated with illness severity and Non-communicable Disease (NCDs) counts respectively. All analysis was conducted at the 95% confidence level (p-value ≤ 0.05) using Stata 16.Results: Among the 275 patients, the average age was 40.7±16.4, with a preponderance of males (54.5%). The three commonest symptoms presented were cough (21.3%), headache (15.7%), and sore throat (11.7%). Only 7.6% of the patients had a history of fever. Most patients were asymptomatic (51.65). Approximately 38.9% have an underlying co-morbid NCDs, with Hypertension (32.1%), Diabetes (9.9%), and Asthma (5.2%) being the three commonest. The odds of Moderate/severe (MoS) was significantly higher for those with unknown exposures to similar illness [aOR(95%CI) = 4.27(1.12-10.2)] compared with non-exposure to similar illness. An increased unit of NCD’s count significantly increased the odds of COVID-19 MoS illness by 26%[cOR(95%CI) =1.26(1.09-1.84)] and 67% (adjusting for age) [aOR(95%CI)=1.67(1.13-2.49)].Conclusion: The presence of cardiovascular co-morbidities dictated the frequency of reported symptoms and severity of COVID-19 infection in this sample of Ghanaians. Physicians should be aware of the presence of co-morbid NCDs and prepare to manage effectively among COVID-19 patients

Coronary arteriographic findings in black patients and risk markers for coronary artery disease

Coronary arteriographic results are reported in 1535 black patients: 751 men (mean age 57 +/- 11) and 784 women (mean age 59 +/- 11). Among the black men 19%, 15%, 21%, and 4% had single-, double-, and triple-vessel and left main disease, respectively. Among the black women there were 12%, 10%, 15%, and 3% with similar involvement. Logistic regression models showed that most of the recognized risk factors were positively correlated with significant (at least one artery with >/= 50% stenosis) coronary disease, but a history of hypertension was not a significant independent predictor in either sex. ECG evidence of previous infarction increased the odds of detecting significant coronary disease by the greatest amount when controlling for other significant risk markers in women. In men both previous infarction and atypical pain (negative) were equally important. This study confirms but does not explain previous reports that have revealed less than expected angiographic evidence of significant coronary artery disease in black compared with white persons

Mixed-sex Nile tilapia (Oreochromis niloticus) can perform competitively with mono-sex stocks in cage production

All-male tilapia stocks are widely used by farmers to supply both domestic and international markets with homogenous, large sized fish (500 g+). While a number of strategies are possible, hormonal treatment of fry with 17α-methyltestosterone (MT) is the most common method used by commercial farmers due to its low cost and ease of application. However, contrasting to its current widespread use the implications of MT in tilapia farming have raised concerns especially from public and environmental perspectives. Therefore, in this study we tested the impact of stocking a mixed-sex fast growing strain of Nile tilapia (Oreochromis niloticus) fry at high density and then grading out females at 4 or 8 weeks intervals during grow-out and compared final production with a standard MT-treated mono-sex system. From a production perspective, the strategies to remove females at 4 or 8 weeks were successful as no differences in harvest weight, survival and feed conversion rate were observed when compared to the MT-treated group. Similarly, no differences at harvest were obtained in terms of external appearance, Fulton's condition factor, gonadosomatic index, fillet yield, fat-somatic index and visceral-somatic index (%) between MT-monosex group and the groups where females were removed (4 or 8 weeks). However, a financial analysis of this approach showed that the additional costs (fry, feed and labour) involved in the mixed-sex strategy resulted in lower profits. This could be mitigated if a proportion of the removed females could be sold at a premium price as potential broodstock. In the model presented, sales of 13% of the removed females for broodfish at current Thai prices, or a premium of at least 8% for non-sex-reversed final product would be sufficient for the mixed-sex system to return a higher profit than the mono-sex system. The latter strategy could also enable further social licence through use of small fish in nutritional and outgrower initiatives.Output Status: Forthcoming/Available Onlin

Pharmaceutical screen identifies novel target processes for activation of autophagy with a broad translational potential

Autophagy is a conserved homeostatic process active in all human cells and affecting a spectrum of diseases. Here we use a pharmaceutical screen to discover new mechanisms for activation of autophagy. We identify a subset of pharmaceuticals inducing autophagic flux with effects in diverse cellular systems modelling specific stages of several human diseases such as HIV transmission and hyperphosphorylated tau accumulation in Alzheimer’s disease. One drug, flubendazole, is a potent inducer of autophagy initiation and flux by affecting acetylated and dynamic microtubules in a reciprocal way. Disruption of dynamic microtubules by flubendazole results in mTOR deactivation and dissociation from lysosomes leading to TFEB (transcription factor EB) nuclear translocation and activation of autophagy. By inducing microtubule acetylation, flubendazole activates JNK1 leading to Bcl-2 phosphorylation, causing release of Beclin1 from Bcl-2-Beclin1 complexes for autophagy induction, thus uncovering a new approach to inducing autophagic flux that may be applicable in disease treatment

Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation

CITATION: Bawua, A. et al. 2020. Establishing Ghanaian adult reference intervals for hematological parameters controlling for latent anemia and inflammation. International journal of laboratory hematology, 42(6):705–717. doi:10.1111/ijlh.13296The original publication is available at https://onlinelibrary.wiley.com/journal/1751553xBackground: In Ghana, diagnostic laboratories rely on reference intervals (RIs) provided by manufacturers of laboratory analyzers which may not be appropriate. This study aimed to establish RIs for hematological parameters in adult Ghanaian population. Methods: This cross-sectional study recruited 501 apparently healthy adults from two major urban areas in Ghana based on the protocol by IFCC Committee for Reference Intervals and Decision Limits. Whole blood was tested for complete blood count (CBC) by Sysmex XN-1000 analyzer, sera were tested for iron and ferritin by Beckman-Coulter/AU480, for transferrin, vitamin-B12, and folate was measured by Centaur-XP/Siemen. Partitioning of reference values by sex and age was guided by “effect size” of between-subgroup differences defined as standard deviation ratio (SDR) based on ANOVA. RIs were derived using parametric method with application of latent abnormal values exclusion method (LAVE), a multifaceted method of detecting subjects with abnormal results in related parameters. Results: Using SDR ≥ 0.4 as a threshold, RIs were partitioned by sex for platelet, erythrocyte parameters except mean corpuscular constants, and iron markers. Application of LAVE had prominent effect on RIs for majority of erythrocyte and iron parameters. Global comparison of Ghanaian RIs revealed lower-side shift of RIs for leukocyte and neutrophil counts, female hemoglobin and male platelet count, especially compared to non-African countries. Conclusion: The LAVE effect on many hematological RIs indicates the need for de-liberate secondary exclusion for proper derivation of RIs. Obvious differences in Ghanaian RIs compared to other countries underscore the importance of country-specific RIs for improved clinical decision-making.https://onlinelibrary.wiley.com/doi/10.1111/ijlh.13296Publishers versio

Coagulation factors and natural anticoagulants as surrogate markers of preeclampsia and its subtypes: A case-control study in a Ghanaian population

Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case-control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly (p \u3c .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 g/mL), PS (6.58 g/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥ 0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies

Within-Neighborhood Patterns and Sources of Particle Pollution: Mobile Monitoring and Geographic Information System Analysis in Four Communities in Accra, Ghana

BACKGROUND: Sources of air pollution in developing country cities include transportation and industrial pollution, biomass and coal fuel use, and resuspended dust from unpaved roads. OBJECTIVES: Our goal was to understand within-neighborhood spatial variability of particulate matter (PM) in communities of varying socioeconomic status (SES) in Accra, Ghana, and to quantify the effects of nearby sources on local PM concentration. METHODS: We conducted 1 week of morning and afternoon mobile and stationary air pollution measurements in four study neighborhoods. PM with aerodynamic diameters RESULTS: In our measurement campaign, the geometric means of PM2.5 and PM10 along the mobile monitoring path were 21 and 49 microg/m3, respectively, in the neighborhood with highest SES and 39 and 96 microg/m3, respectively, in the neighborhood with lowest SES and highest population density. PM2.5 and PM10 were as high as 200 and 400 microg/m3, respectively, in some segments of the path. After adjusting for other factors, the factors that had the largest effects on local PM pollution were nearby wood and charcoal stoves, congested and heavy traffic, loose dirt road surface, and trash burning. CONCLUSIONS: Biomass fuels, transportation, and unpaved roads may be important determinants of local PM variation in Accra neighborhoods. If confirmed by additional or supporting data, the results demonstrate the need for effective and equitable interventions and policies that reduce the impacts of traffic and biomass pollution

Cardiopulmonary Impact of Particulate Air Pollution in High-Risk Populations: JACC State-of-the-Art Review

Fine particulate air pollution <2.5 μm in diameter (PM(2.5)) is a major environmental threat to global public health. Multiple national and international medical and governmental organizations have recognized PM(2.5) as a risk factor for cardiopulmonary diseases. A growing body of evidence indicates that several personal-level approaches that reduce exposures to PM(2.5) can lead to improvements in health endpoints. Novel and forward-thinking strategies including randomized clinical trials are important to validate key aspects (e.g., feasibility, efficacy, health benefits, risks, burden, costs) of the various protective interventions, in particular among real-world susceptible and vulnerable populations. This paper summarizes the discussions and conclusions from an expert workshop, Reducing the Cardiopulmonary Impact of Particulate Matter Air Pollution in High Risk Populations, held on May 29 to 30, 2019, and convened by the National Institutes of Health, the U.S. Environmental Protection Agency, and the U.S. Centers for Disease Control and Prevention