Malaria vaccine deployment in Africa: focus on Ghana

The announcement by the Ghana Health Service /Ministry of Health at the beginning of May to begin the pilot implementation of the malaria vaccine – RTS,S/AS01 (Mosquirix®) – manufactured by GSK Biologicals was greeted with rumours about conspiracy theories of secretagenda to depopulate Africa through the use of vaccines and all the other stories that are often propagated by the anti vaxxers. This was not unlike the fear and panic spread throughout the country that prevented investigators from conducting clinical trials on new vaccines against the Ebola virus disease a few years ago

Estimating the Extent of Degradation in the Bounfum Forest Reserve, Ghana, Using Historical Remotely Sensed Data and Landscape Fragmentation Indices

Land use and land cover changes, especially deforestation and forest degradation and its driving factors, are key factors hindering sustainable forest management. Currently, there is limited knowledge concerning the detection of the extent and interpretation of the spatial and temporal pattern of forest cover dynamics in the Bounfum Forest Reserve, which when available will inform sustainable policies. Using the Landsat TM image of 1986, Landsat ETM+ image of 2002 and Landsat 8 OLI image of 2014, the study identified and quantified the forest cover dynamics in the Bounfum Forest Reserve from 1986 to 2014. The ERDAS maximum likelihood classification algorithm was used to classify the pixels into five major land cover classes namely, bare/built areas, farmlands, closed forest, open forest and shrub/grassland. The Kappa coefficients of 0.83 (1986), 0.72 (2002) and 0.75 (2014) respectively were obtained for the classified images. The findings showed that the closed forests decreased by 3.5% (563.90 ha) per annum whilst the open forests and farm lands increased by 19.5% (385.60 ha) and 2.9% (65.00 ha) per annum within the 28-year period. This implies that the Bounfum forest reserve has been highly degraded over the past 28 years, evident through the trends of its patch densities and the number of patches. Collaborative forest management is required in the management of the forest reserve to conserve the socio-ecological and economic benefits derived from the resource on sustainable basis. Keywords: Land use and land cover change, Bounfum forest reserve, deforestation, forest degradation, remote sensing, sustainable forest managemen

Growth of wildtype and mutant E. coli strains in minimal media for optimal production of nucleic acids for preparing labeled nucleotides

Since RNAs lie at the center of most cellular processes, there is a need for synthesizing large amounts of RNAs made from stable isotope-labeled nucleotides to advance the study of their structure and dynamics by nuclear magnetic resonance (NMR) spectroscopy. A particularly effective means of obtaining labeled nucleotides is to harvest these nucleotides from bacteria grown in defined minimal media supplemented with 15NH4Cl and various carbon sources. Given the high cost of carbon precursors required for labeling nucleic acids for NMR studies, it becomes important to evaluate the optimal growth for commonly used strains under standard minimal media conditions. Such information is lacking. In this study, we characterize the growth for Escherichia coli strains K12, K10zwf, and DL323 in three minimal media with isotopic-labeled carbon sources of acetate, glycerol, and glycerol combined with formate. Of the three media, the LeMaster-Richards and the Studier media outperform the commonly used M9 media and both support optimal growth of E. coli for the production of nucleotides. However, the growth of all three E. coli strains in acetate is reduced almost twofold compared to growth in glycerol. Analysis of the metabolic pathway and previous gene array studies help to explain this differential growth in glycerol and acetate. These studies should benefit efforts to make selective 13C-15N isotopic-labeled nucleotides for synthesizing biologically important RNAs

Health seeking behaviours among electronic waste workers in Ghana

Abstract Background Electronic waste workers are prone to various illnesses and injuries from numerous hazards thus the need for them to seek health care. The aim of this study was to describe health-seeking behavior, and social and other factors affecting this behavior, among electronic waste workers at Agbogbloshie, Accra, Ghana. Methods In-depth interviews were conducted and analyzed qualitatively from a grounded theory perspective. Results Workers experienced various kinds of ailments. These included physical injuries, chest and respiratory tract associated symptoms, malaria, headaches, body pains and stomach discomfort. They reported seeking health care from multiple sources, and the main determinants of health seeking behaviour were severity of illness, perceived benefit of treatment, accessibility of service, quality of service, ease of communication with service provider and cost of health care. Conclusion Multiple sources of health care were used by the e-waste workers. As cost was a major barrier to accessing formal health care, most of the workers did not subscribe to health insurance. Since enrollment in health insurance is low amongst the workers, education campaigns on the need to register with the National Health Insurance Scheme would facilitate access to formal health care and could result in improved health outcomes among e-waste workers.http://deepblue.lib.umich.edu/bitstream/2027.42/115463/1/12889_2015_Article_2376.pd

Efficacy of RTS,S malaria vaccines: individual-participant pooled analysis of phase 2 data.

BACKGROUND: The efficacy of RTS,S/AS01 as a vaccine for malaria is being tested in a phase 3 clinical trial. Early results show significant, albeit partial, protection against clinical malaria and severe malaria. To ascertain variations in vaccine efficacy according to covariates such as transmission intensity, choice of adjuvant, age at vaccination, and bednet use, we did an individual-participant pooled analysis of phase 2 clinical data. METHODS: We analysed data from 11 different sites in Africa, including 4453 participants. We measured heterogeneity in vaccine efficacy by estimating the interactions between covariates and vaccination in pooled multivariable Cox regression and Poisson regression analyses. Endpoints for measurement of vaccine efficacy were infection, clinical malaria, severe malaria, and death. We defined transmission intensity levels according to the estimated local parasite prevalence in children aged 2-10 years (PrP₂₋₁₀), ranging from 5% to 80%. Choice of adjuvant was either AS01 or AS02. FINDINGS: Vaccine efficacy against all episodes of clinical malaria varied by transmission intensity (p=0·001). At low transmission (PrP₂₋₁₀ 10%) vaccine efficacy was 60% (95% CI 54 to 67), at moderate transmission (PrP₂₋₁₀ 20%) it was 41% (21 to 57), and at high transmission (PrP₂₋₁₀ 70%) the efficacy was 4% (-10 to 22). Vaccine efficacy also varied by adjuvant choice (p<0·0001)--eg, at low transmission (PrP₂₋₁₀ 10%), efficacy varied from 60% (95% CI 54 to 67) for AS01 to 47% (14 to 75) for AS02. Variations in efficacy by age at vaccination were of borderline significance (p=0·038), and bednet use and sex were not significant covariates. Vaccine efficacy (pooled across adjuvant choice and transmission intensity) varied significantly (p<0·0001) according to time since vaccination, from 36% efficacy (95% CI 24 to 45) at time of vaccination to 0% (-38 to 38) after 3 years. INTERPRETATION: Vaccine efficacy against clinical disease was of limited duration and was not detectable 3 years after vaccination. Furthermore, efficacy fell with increasing transmission intensity. Outcomes after vaccination cannot be gauged accurately on the basis of one pooled efficacy figure. However, predictions of public-health outcomes of vaccination will need to take account of variations in efficacy by transmission intensity and by time since vaccination. FUNDING: Medical Research Council (UK); Bill & Melinda Gates Foundation Vaccine Modelling Initiative; Wellcome Trust

Prevalence and Associated Risk Factors of Symptomatic Dry Eye in Ghana: A cross-sectional population-based study

Purpose This study sought to estimate the prevalence and associated risk factors of symptomatic dry eye in the general non-clinical Ghanaian population. Methods This was a cross-sectional population-based study conducted from November 2019 to February 2020. A stratified, multistage, random sampling technique was used to select participants aged 18 years and above from the capital cities of eight administrative regions in Ghana. Symptomatic dry eye was assessed using the Ocular Surface Disease Index questionnaire (OSDI). A study specific structured questionnaire was administered to collect information on participants’ demographics and self-reported risk factors of dry eye disease such as smoking, diabetes, hypertension, arthritis, ocular allergies, pregnancy, contact lens wear, use of topical glaucoma medication and multivitamin supplement. Multiple linear regression analysis was used to explore associations between symptomatic dry eye and participant characteristics. A p-value of 0.05 was considered statistically significant

Safety of intravitreal ziv-aflibercept in choroido-retinal vascular diseases: A randomised double-blind intervention study

AIM:To evaluate the safety of 1.25mg and 2mg intravitreal ziv-aflibercept (IVZ) in Ghanaian eyes with choroido-retinal vascular diseases. DESIGN:Prospective, randomised, double blind, interventional study. METHODS:Twenty patients with centre involving macular oedema in diabetic retinopathy, retinal vein occlusion, and neovascular age-related macular degeneration were assigned to 2 groups receiving 3 doses of 1.25mg/0.05ml (group 1) and 2mg/0.08ml IVZ (Group 2) at 4 weekly intervals. Safety data was collected after 30 minutes, 1 and 7 days, and 4, 8 and 12 weeks after injection. Changes in continuous variables were compared using paired t-test and categorical variables were compared using chi-square test of proportions. Repeated-Measures ANOVA with nesting test was used to compare variations in continuous variables by IVZ dose over time. Primary outcome measures were ocular and systemic adverse events at 4 weeks. RESULTS:Eleven females and nine males, with mean age of 63.2± 7.3 years were included. Ocular adverse events included subconjunctival haemorrhage in 1 eye, intraocular pressure (IOP) >21mmHg at 30 minutes in 6 eyes and mild pain in 3 eyes at 1-day. There was no significant difference in IOP rise between the 2 groups at 30 minutes (p = 0.21). No other ocular or systemic adverse events were observed. There was significant improvement in the best corrected visual acuity (LogMAR) from 0.95±0.6 to 0.6±0.4 (p<0.01) and 0.47±0.3 (p<0.01), reduction in central subfield foveal thickness from 405.9±140 um at baseline to 255.6±75 um (p<0.01) and 238±88 um (p<0.01) at 4 and 12 weeks respectively, although no difference was observed between the 2 groups (p = 0.34). CONCLUSION:IVZ at 1.25mg and 2mg had similar safety profiles, and did not have any major unexpected adverse events. Further studies with larger cohorts are required to confirm efficacy

Seeking treatment for uncomplicated malaria: experiences from the Kintampo districts of Ghana.

BACKGROUND: Malaria accounts for many deaths and illnesses, mostly among young children and pregnant women in sub-Saharan Africa. An integrated approach is recommended to ensure effective malaria control. Socio-cultural factors continue to serve as determinants of malaria health-seeking behaviour. An INDEPTH effectiveness and safety study platform was established to unearth issues around the use of licensed and nationally recommended anti-malarials in real life settings. This study reports on treatment-seeking behaviour for uncomplicated malaria among community members. METHODS: A qualitative study was conducted in the dry and rainy seasons in purposively selected communities in Kintampo north and south districts. This was based on distances to a health facility, ethnicity and availability of medicines at the sale outlets. Twenty-four focus group discussions were conducted among adult men, women care-takers of children less than 5 years and pregnant women. Ten INDEPTH interviews were also conducted among operators of medicine sale outlets and managers of health facilities. Fifty-one illnesses narrative interviews were conducted among adult men, women, women caretakers of children less than 5 years and pregnant women. Transcripts were transferred into Nvivo 8 software for data management and analysis. RESULTS: The artemisinin-based combinations that were commonly known and used were artesunate-amodiaquine and artemether-lumefantrine. Use of herbal preparation to treat diseases including uncomplicated malaria is rife in the communities. Drug stores were not the main source of artemisinin-based combination sales at time of the study. Monotherapies, pain killers and other medicines were purchased from these shops for malaria treatment. Dizziness, general body weakness and sleepiness were noted among respondents who used artemisinin-based combination therapy (ACT) in the past. CONCLUSION: There is no clear cut trajectory for management of uncomplicated malaria in the study area. Different approaches are adopted when treating malaria. There is need for community education to influence behaviour on the management of malaria to achieve real gains from ACT use

Enrichment of maize and triticale bran with recombinant Aspergillus tubingensis ferulic acid esterase

Ferulic acid is a natural antioxidant found in various plants and serves as a precursor for various fine chemicals, including the flavouring agent vanillin. However, expensive extraction methods have limited the commercial application of ferulic acid, in particular for the enrichment of food substrates. A recombinant Aspergillus tubingensis ferulic acid esterase Type A (FAEA) was expressed in Aspergillus niger D15#26 and purified with anion-exchange chromatography (3487 U/mg, Km = 0.43 mM, Kcat = 0.48/min on methyl ferulate). The 36-kDa AtFAEA protein showed maximum ferulic acid esterase activity at 50 C and pH 6, suggesting potential application in industrial processes. A crude AtFAEA preparation extracted 26.56 and 8.86 mg/g ferulic acid from maize bran and triticale bran, respectively, and also significantly increased the levels of p-coumaric and caffeic acid from triticale bran. The cost-effective production of AtFAEA could therefore allow for the enrichment of brans generally used as food and fodder, or for the production of fine chemicals (such as ferulic and p-coumaric acid) from plant substrates. The potential for larger-scale production of AtFAEA was demonstrated with the A. niger D15[AtfaeA] strain yielding a higher enzyme activity (185.14 vs.83.48 U/ml) and volumetric productivity (3.86 vs. 1.74 U/ml/h) in fed-batch than batch fermentation.In part by the National Research Foundation of South Africa (Grant 76597 to MVB and Grant 86423 to WHvZ).http://link.springer.com/journal/131972018-03-31hb2017Food Scienc