Prevalence of intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) use during pregnancy and other associated factors in Sekondi-Takoradi, Ghana

Background: Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) has been adopted as policy by most countries in sub-Saharan Africa. This cross-sectional study assessed the prevalence of IPTp-SP usage for prevention of malaria among pregnant women as well as evaluated factors associated with IPTp-SP use during pregnancy in Sekondi-Takoradi region of Ghana.Methods: Pregnant women attending their antenatal-care with either clinical/ultrasound evidence of pregnancy were recruited. Venous blood was screened for malaria using RAPID response antibody kit and Giemsa staining. Haemoglobin estimations were done by cyanmethemoglobin method while Human Immunodeficiency Virus (HIV) screening was performed by the national diagnostic algorithm of two rapid antibody test and western blot confirmation.Results: Of the 754 consented pregnant women interviewed in this study, 57.8% had received IPTp-SP while 42.2% had not at their first contact with the study personnel. Furthermore, 18.6% (81/436) of those that received IPTp-SP were malaria positive while 81.4% (355/436) were malaria negative. The results also indicated that 47.7% (51/107) of the pregnant women in their third trimester who were meant to have received at least two-doses of SP had received ≥2 doses while 35.5% (38/107) had received 1 dose. In multivariable logistic regression analysis, pregnant women in their third trimester who received ≥2 doses of SP showed decreased likelihoods of malaria (adjusted OR, 0.042; 95% CI, 0.003-0.51; P = 0.013).Conclusion: IPTp-SP usage among pregnant women in Sekondi-Takoradi reduces malaria and its use for malaria prevention should be strengthened with proper dosage completion and coverage.Keywords: Malaria in pregnancy, IPTp-SP, anaemia, Ghan

Prevalence of intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) use during pregnancy and other associated factors in Sekondi-Takoradi, Ghana

Background: Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) has been adopted as policy by most countries in sub-Saharan Africa. This cross-sectional study assessed the prevalence of IPTp-SP usage for prevention of malaria among pregnant women as well as evaluated factors associated with IPTp-SP use during pregnancy in Sekondi-Takoradi region of Ghana. Methods: Pregnant women attending their antenatal-care with either clinical/ultrasound evidence of pregnancy were recruited. Venous blood was screened for malaria using RAPID response antibody kit and Giemsa staining. Haemoglobin estimations were done by cyanmethemoglobin method while Human Immunodeficiency Virus (HIV) screening was performed by the national diagnostic algorithm of two rapid antibody test and western blot confirmation. Results: Of the 754 consented pregnant women interviewed in this study, 57.8% had received IPTp-SP while 42.2% had not at their first contact with the study personnel. Furthermore, 18.6% (81/436) of those that received IPTp-SP were malaria positive while 81.4% (355/436) were malaria negative. The results also indicated that 47.7% (51/107) of the pregnant women in their third trimester who were meant to have received at least two-doses of SP had received 652 doses while 35.5% (38/107) had received 1 dose. In multivariable logistic regression analysis, pregnant women in their third trimester who received 652 doses of SP showed decreased likelihoods of malaria (adjusted OR, 0.042; 95% CI, 0.003-0.51; P = 0.013). Conclusion: IPTp-SP usage among pregnant women in Sekondi-Takoradi reduces malaria and its use for malaria prevention should be strengthened with proper dosage completion and coverage

Escalating pyrethroid resistance in two major malaria vectors Anopheles funestus and Anopheles gambiae (s.l.) in Atatam, Southern Ghana

Background: Aggravation of insecticide resistance in malaria vectors is threatening the efforts to control malaria by reducing the efficacy of insecticide-based interventions hence needs to be closely monitored. This study investigated the intensity of insecticide resistance of two major malaria vectors An. funestus sensu stricto (s.s.) and An. gambiae sensu lato (s.l.) collected in southern Ghana and assessed the bio-efficacy of several long-lasting insecticidal nets (LLINs) against these mosquito populations. Methods: The insecticide susceptibility profiles of Anopheles funestus s.s. and Anopheles gambiae s.l. populations from Obuasi region (Atatam), southern Ghana were characterized and the bio-efficacy of some LLINs was assessed to determine the impact of insecticide resistance on the effectiveness of these tools. Furthermore, molecular markers associated with insecticide resistance in both species were characterized in the F0 and F1 populations using PCR and qPCR methods. Results: Anopheles funestus s.s. was the predominant species and was resistant to pyrethroids, organochlorine and carbamate insecticides, but fully susceptible to organophosphates. An. gambiae s.l. was resistant to all four insecticide classes. High intensity of resistance to 5 × and 10 × the discriminating concentration (DC) of pyrethroids was observed in both species inducing a considerable loss of efficacy of long-lasting insecticidal nets (LLINs). Temporal expression analysis revealed a massive 12-fold increase in expression of the CYP6P4a cytochrome P450 gene in An. funestus s.s., initially from a fold change of 41 (2014) to 500 (2021). For both species, the expression of candidate genes did not vary according to discriminating doses. An. gambiae s.l. exhibited high frequencies of target-site resistance including Vgsc-1014F (90%) and Ace-1 (50%) while these mutations were absent in An. funestus s.s. Conclusions: The multiple and high intensity of resistance observed in both malaria vectors highlights the need to implement resistance management strategies and the introduction of new insecticide chemistries

Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana

The clinical outcome of falciparum malaria in endemic areas is influenced by erythrocyte polymorphisms including the ABO blood groups. Studies have reported association of ABO blood group to resistance, susceptibility, and severity of P. falciparum malaria infection. Individuals with blood group “A” have been found to be highly susceptible to falciparum malaria whereas blood group “O” is said to confer protection against complicated cases. We analyzed samples from 293 young children less than six years old with malaria in the Korle-Bu Teaching Hospital in Accra, Ghana. It was observed that group O was present in about 16.1% of complicated cases weighed against 40.9% of uncomplicated controls. Individuals with complicated malaria were about twice likely to be of blood groups A and B compared to group O (A versus O, OR = 1.90, 95% CI = 1.59–2.26, P<0.0001; B versus O, OR = 1.82. 95% CI = 1.57–2.23, P<0.0001). Blood group O participants with complicated diseases had low parasitaemia compared to the other blood groups (P<0.0001). This may give blood group O individuals a survival advantage over the other groups in complicated malaria as suggested. Participants with complicated falciparum malaria were generally anaemic and younger than those with uncomplicated disease

Diversity of dung beetle-associated yeasts from pristine environments of Botswana

Yeast-insect interactions are increasingly becoming an attractive source of discovery for previously unknown, unique, diverse, and industrially relevant yeast species. Despite a wealth of studies that have recently focused on yeasts in symbiotic association with Hymenopteran insects, yeasts associated with Coleopteran insects, such as lignocellulosic-rich dung-dependent beetles, remain poorly studied. Trends in yeast discovery suggest that species richness and diversity can be attributed to the ecological niche of the insect. Here, we considered the potential of dung beetles inhabiting the extreme environments of Botswana, characterized by desert-like conditions (semi-arid to arid and hot) as well as protected pristine environments, as possible attribute niches that can shape the extremophilic and diverse life history strategies of yeasts. We obtained a total of 97 phylogenetically diverse yeast isolates from six species of dung beetles from Botswana's unexplored environments, representing 19 species belonging to 11 genera. The findings suggest that the guts of dung beetles are a rich niche for non-Saccharomyces yeast species. Meyerozyma and Pichia were the most dominant genera associated with dung beetles, representing 55% (53 out of 97) of the yeast isolates in our study. Trichosporon and Cutaneotrichosporon genera represented 32% (31 out of 97) of the isolates. The remaining isolates belonged to Apiotrichum, Candida, Diutina, Naganishia, Rhodotorula, and Wickerhamiella genera (12 out of 97). We found out that about 62% (60 out of 97) of the isolates were potentially new species because of their low internal transcribed spacer (ITS) sequence similarity when compared to the most recent optimal species delineation threshold. A single isolate was unidentifiable using the ITS sequences. Using an in silico polymerase chain reaction-restriction fragment length polymorphism approach, we revealed that there was genetic diversity within isolates of the same species. Our results contribute to the knowledge and understanding of the diversity of dung beetle-associated yeasts

Quality of Sulfadoxine-Pyrimethamine Given as Antimalarial Prophylaxis in Pregnant Women in Selected Health Facilities in Central Region of Ghana

The use of sulfadoxine-pyrimethamine (SP) as an intermittent preventive treatment (IPT) against malaria during pregnancy has become a policy in most sub-Sahara African countries and crucially depends on the efficacy of SP. This study sets out to evaluate the effectiveness of the SP given to the pregnant women in some selected health facilities in the Central Region of Ghana to prevent maternal malaria in pregnant women. A total of 543 pregnant women recruited from 7 selected health centres in Central Region of Ghana participated in the study. Parasite density of Plasmodium falciparum was determined from peripheral blood of the pregnant women using microscopy. High performance liquid chromatography (HPLC) and dissolution tester were used to determine the quality of the SP. Malaria infection was recorded in 11.2% of pregnant women who had a history of SP consumption. SP failed the dissolution test. Pregnant women who did not receive IPT-SP were 44%. Low haemoglobin level was recorded in 73.5% of the pregnant women. The results indicated that SP was substandard. IPT-SP is ineffective in preventing malaria infection

Effectiveness of Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine against Submicroscopic falciparum

Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR) (submicroscopic malaria) are common in endemic areas like Ghana. Submicroscopic malaria has been linked with severe pregnancy outcomes as well as contributing to malaria transmission. In this cross-sectional study 872 consenting pregnant women (gestation ≥ 20 weeks) were recruited from 8 hospitals in Central Region, Ghana, between July and December 2009. Malaria infection was detected by microscopy and PCR. Haemoglobin was measured and anaemia was defined as haemoglobin lower than 11 g/dL. Majority of the women, 555 (63.6%), were Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) users while 234 (36.4%) were nonusers. The prevalence of malaria by microscopy was 20.9% (182/872) and 9.7% (67/688) of microscopy negative women had submicroscopic malaria. IPTp-SP usage significantly (odds ratio = 0.13, 95% confidence interval = 0.07–0.23, p=0.005) reduced the prevalence of submicroscopic malaria as more nonusers (51/234) than users (16/454) were PCR positive. After controlling for other variables the effect of IPTp-SP remained statistically significant (odds ratio = 0.11, 95% confidence interval = 0.02–0.22, p=0.006). These results suggest that Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine is useful in the reduction of submicroscopic malaria in pregnancy