Seven principles for effective firm management

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Cost-effectiveness of HIV screening of blood donations in Accra (Ghana)

AbstractObjectivesAreas with high HIV-incidence rates compared to the developed world may benefit from additional testing in blood banks and may show more favorable cost-effectiveness ratios. We evaluated the cost-effectiveness of adding p24 antigen, mini pool nucleic acid amplification testing (MP-NAT), or individual donation NAT (ID-NAT) to the HIV-antibody screening at the Korle Bu Teaching Hospital (Accra, Ghana), where currently only HIV-antibody screening is undertaken.MethodsThe residual risk of HIV transmission was derived from blood donations to the blood bank of the Korle Bu Teaching Hospital in 2004. Remaining life expectancies of patients receiving blood transfusion were estimated using the World Health Organization life expectancies. Cost-effectiveness ratios for adding the tests to HIV-antibody screening only were determined using a decision tree model and a Markov model for HIV.ResultsThe prevalence of HIV was estimated at 1.51% in 18,714 donations during 2004. The incremental cost per disability-adjusted life-year (DALY) averted was US$1237 for p24 antigen, US$3142 for MP-NAT and US$7695 compared to the next least expensive strategy. HIV-antibody screening itself was cost-saving compared to no screening at all, gaining US$73.85 and averting 0.86 DALY per transfused patient. Up to a willingness-to-pay of US$2736 per DALY averted, HIV-antibody screening without additional testing was the most cost-effective strategy. Over a willingness-to-pay of US$11,828 per DALY averted, ID-NAT was significantly more cost-effective than the other strategies.ConclusionsAdding p24 antigen, MP-NAT, or ID-NAT to the current antibody screening cannot be regarded as a cost-effective health-care intervention for Ghana

Unexpected elevated alanine aminotransferase, asparte aminotransferase levels and hepatitis E virus infection among persons who work with pigs in accra, ghana

<p>Abstract</p> <p>Background</p> <p>Several studies have suggested that elevated serum alanine aminotransferase (ALT) and asparte aminotransferase (AST) may be markers of hepatitis E virus (HEV) infection. Thus, individuals with elevated ALT and AST may have ongoing subclinical infection of HEV. We estimated the prevalence of anti-HEV antibodies and serum ALT and AST levels among persons who work with pigs in Accra, Ghana.</p> <p>Results</p> <p>Three hundred and fifty- persons who work with pigs provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV, ALT and AST levels. The median age of participants was 32.85 ± 11.38 years (range 15-70 years). HEV seroprevelance was 34.84%. Anti-HEV IgG was detected in 19.26% while anti-HEV IgM was detected in 15.58% of the persons who tested positive. On multivariate analysis, the independent determinants of HEV infection were, being employed on the farm for less than six months [odds ratio (OR) 8.96; 95% confidence interval (95% CI) 5.43-14.80], having piped water in the household and/or on the farm (OR 13.33; 95% CI 5.23-33.93) and consumption of alcohol (OR 4.91: 95% CI 2.65-9.10). Levels >3× the expected maximum were found for both ALT and AST among individuals who tested positive for anti-HEV IgG (ALT, 210.17 ± 11.64 U/L; AST, 127.18 ± 11.12 U/L) and anti-HEV IgM (ALT, 200.97 ± 10.76 U/L; AST, 120.00 ± 15.96 U/L).</p> <p>Conclusion</p> <p>Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection, ALT and AST values in pig handlers.</p

Sero-survey of rubella IgM antibodies among children in Jos, Nigeria

Sero-survey of rubella IgM antibodies was carried out among children aged 0-10 years in Jos, Nigeria. Blood samples were collected from the subjects and sera extracted. Of the 93(100%) assayed for the rubella IgM antibody, 42(45.2%) were seropositive for rubella IgM antibody while 51(54.8%) were seronegative. A breakdown of the seropositive subjects reveals that 14(15.1%) of the infected children were males while 28(30.1%) were females. Those subjects within the age groups of 1-2, 3-4 and 5-6 years had the highest prevalence of 8(8.6%) followed by those within the age groups of 7-8, 9-10 years with 7(7.5%). Blood transfusion as a risk factor did not show any significant influence on the status of the subjects. The demographic data of the mothers of the subjects were also linked with the seropositivity of the children

Arp2/3 Complex Regulates Asymmetric Division and Cytokinesis in Mouse Oocytes

Mammalian oocyte meiotic maturation involves oocyte polarization and a unique asymmetric division, but until now, the underlying mechanisms have been poorly understood. Arp2/3 complex has been shown to regulate actin nucleation and is widely involved in a diverse range of processes such as cell locomotion, phagocytosis and the establishment of cell polarity. Whether Arp2/3 complex participates in oocyte polarization and asymmetric division is unknown. The present study investigated the expression and functions of Arp2/3 complex during mouse oocyte meiotic maturation. Immunofluorescent staining showed that the Arp2/3 complex was restricted to the cortex, with a thickened cap above the meiotic apparatus, and that this localization pattern was depended on actin. Disruption of Arp2/3 complex by a newly-found specific inhibitor CK666, as well as by Arpc2 and Arpc3 RNAi, resulted in a range of effects. These included the failure of asymmetric division, spindle migration, and the formation and completion of oocyte cytokinesis. The formation of the actin cap and cortical granule-free domain (CGFD) was also disrupted, which further confirmed the disruption of spindle migration. Our data suggest that the Arp2/3 complex probably regulates oocyte polarization through its effect on spindle migration, asymmetric division and cytokinesis during mouse oocyte meiotic maturation

Investigation of the viability and cost effectiveness of solid fuel gasifiers close coupled to internal combustion engines for 200 kWe power generation. Technical progress report No. 9

The viability and cost effectiveness of a 200 kWe engine generator unit fueled by a direct coupled, solid fuel gasifier were studied. Recent literature describing gasifier technology was obtained and personal visits were made to test facility sites and engine manufacturing plants to discuss the subject with researchers and engineers. Two prototype units were inspected, one of which was in partial operation. This report presents a brief discussion of fuel and gasifier technology, gas treatment (clean up) for engine use, engine use technology, other uses for gasifiers, the viability of close coupled units, and an estimate of cost effectiveness. Present small experimental gasifier systems perform as expected and have served to demonstrate the technology. Typically they operate with fuel species which are present and collected on the site of a processing plant. Certain needed development efforts are discussed. Also, fuel must be available at low cost and even then electric power produced in this way is unlikely to be competitive economically where utility poles are available. (LTN

Seroprevalence of dengue virus infections in Ghana

Background: Dengue virus (DENV) causes febrile illness that may be misdiagnosed with other infectious diseases. This may contribute to the possibility of missing out DENV infections. Recent reports show seroepidemiologic evidence of DENV infections in Ghana, but the frequency of infection and the geographic dissemination are unknown.Objectives: To examine the seroprevalence, the geographical pattern and the age distribution of DENV infections in Ghana.Design: A cross sectional epidemiological study with sera (N = 417) from all 10 regions in Ghana. The sera were obtained during the national surveillance of suspected outbreak of yellow fever (YF) in 2014. The Panbio Dengue IgG Indirect ELISA kit was used for the detection of IgG antibodies.Results: The seroprevalence of dengue IgG was 29.7% among the suspected YF patients in Ghana. Seroprevalence of DENV IgG increased with age. It was 10.4% in the 0-9 year olds, 26.1% in children and adolescents from 10-19 years, 43.1% in the group of 20-29 year old young adults and 57.0% in the age group ≥ 30 years. The seroprevalence ranged from 18.2% in the Western region to 57.9% in the Upper East. The Upper East and the Volta region had a significantly higher seroprevalence than the overall seroprevalence in Ghana (p = 0.0094).Conclusion: The study shows low to moderate levels of dengue virus infection in Ghana and demonstrates that infections occur in all age group and differ between regions. Awareness of DENV infection should be created in the country in cases of undifferentiated fever