Cage fish farming in the Volta lake and the lower Volta : Practices and potential impacts on water quality

Concerns have been raised about the proliferation of cage fish farming in the Volta lake and the potential water quality impacts. The study was undertaken to determine current cage fish farming practices on the lake, and to assess their impacts on water quality of the lake. Forty cage fish farm operators were interviewed for information on farming practices using structured questionnaires. Water qualities of sites on the lake with, and without cage fish farms were also determined. Results from the survey showed that Oreochomis niloticus, an indigenous species from the Volta lake, was the main species being cultured. Two main feed types were employed by the farmers; 60 per cent being extruded pelletised floating feeds and 40 per cent being non-extruded pelletised feeds. Stocking densities were varied, ranging from less than 50 to over 300 fingerlings m-3. The water quality results from the study were compared with data collected a decade to three decades ago on the lake to assess changes in water quality. The results did not show marked changes to the water quality of the lake. The study, however, recommends the need for continuous monitoring, and the institution of management strategies for the sector to forestall future eventualities

MRI to determine the chronological age of Ghanaian footballers

Background. The chronological age of the ordinary Ghanaian has often been difficult to verify as registration at birth is not compulsory. Consequently, an accurate method of age determination is needed in competitive age-restricted sports.Objective. To evaluate the age of Ghanaian soccer players who are aspiring to play for the national under-17 (U17) team, using the degree of fusion of the distal radius on magentic resonance imaging (MRI) and comparing it with the Fédération Internationale de Football Association (FIFA) MRI grading.Methods. MRI scans of the left wrists of 86 players aspiring to play for the national U17 football team were recruited for the study during a ‘justify your inclusion tournament’ organised by the Ghana Football Association between June and August 2012. The study was conducted in a diagnostic centre in Accra using a 0.35T MRI scanner. The images were analysed using the previously published FIFA grading system.Results. The mean chronological age of the players was 15.4 years (standard deviation ±0.7; range 12 - 17). The study showed that 43.0% of the MRI images were grade 6 (≥17 years) in relation to the degree of fusion of the distal radius, and 93.0% of the grade 6 players were aged 15 - 16 years chronologically. There was no significant correlation between the chronological age and the degree of fusion (r=0.075; p=0.493).Conclusion. Ghanaian U17 soccer players seem to be more biologically mature than a normative population of the same age category. The lack of correlation between age category and degree of fusion supports the suspicion that most Ghanaian players may not know their true age

Compression force variability in mammography in Ghana – a baseline study

Introduction: Breast compression during mammographic examinations improves image quality and patient management. Several studies have been conducted to assess compression force variability among practitioners in order to establish compression guidelines. However, no such study has been conducted in Ghana. This study aims to investigate the compression force variability in mammography in Ghana. Methods: This retrospective study used data gathered from 1071 screening and diagnostic mammography patients from January, 2018–December, 2019. Data were gathered by seven radiographers at three centers. Compression force, breast thickness and practitioners' years of work experience were recorded. Compression force variability among practitioners and the correlation between compression force and breast thickness were investigated. Results: Mean compression force values recorded for craniocaudal (CC) (17.2 daN) and mediolateral oblique (MLO) (18.2 daN), were within the recommended values used by western countries. Most of the mammograms performed – 80% – were within the National Health Service Breast Screening Programme (NHSBSP) range. However, 65% were above the Norwegian Breast Cancer Screening Programme (NBCSP) range. Compression forces varied significantly (p = 0.0001) among practitioners. Compression forces increased significantly (p = 0.0001) with the years of work experience. A weak negative correlation (r = −0.144) and a weak positive correlation (r = 0.142) were established between compression force and breast thickness for CC and MLO projections respectively. Conclusion: This initial study confirmed that although wide variations in compression force exist among practitioners in Ghana, most practitioners used compression forces broadly within the range set by the NHSBSP. As no national guidelines for compression force currently exist in Ghana, provision of these may help to reduce the range of variations recorded. Implications for practice: Confirmation of variations in compression will guide future practice to minimize image quality disparities and improve quality of care

An experimental intervention study assessing the impact of a thin silicone gel surface overlay on interface pressure

Introduction. The incidence of pressure ulcers (PUs) presents a substantial threat to patients, especially geriatric patients, those with restricted mobility, and patients suffering from chronic diseases such as cancer. PUs creates a huge financial burden on healthcare authorities and patients, costing billions to treat and manage. Radiography and radiotherapy patients may experience medical device related (MDR) PUs and studies have shown that high interface pressure (IP) values exist for the head when placed on an X-ray table without a mattress. These high IP values pose a PU risk to patients, especially those accessing prolonged radiography/radiology and radiotherapy procedures. The current study assessed the impact on IP values for the head from using a thin silicone gel surface overlay during radiographic procedures and identified whether this reduced the risk of PUs. Materials and Methods. A calibrated XSENSOR pressure mat was used to measure IP for the head on an X-ray table with and without a thin silicone gel surface overlay. Prior to pressure mapping, the silicone gel surface overlay was assessed for its impact on radiation attenuation and image quality. Results. Study participants were 14 males (70%) and six females (30%), with an age range of 25–53 years (mean = 34.4 ± 7.0). Paired-samples t-test results indicated that there was a statistically significant decrease in the mean IP for the head on the X-ray table without the silicone gel surface overlay (mean = 83.9 ± 8.2 in mmHg) and the X-ray table with the gel surface overlay (mean = 62.4 ± 6.1 in mmHg), p ≤ 0.001 . Paired-samples t-test results indicated that there was a statistically significant decrease in the mean peak pressure index (PPI) for the head on the X-ray table without the silicone gel surface overlay (mean = 205.1 ± 28.2 in mmHg) and the X-ray table with the gel surface overlay (mean = 159.8 ± 26.8 in mmHg), p ≤ 0.001 . Conclusions. The use of a thin silicone gel surface overlay could reduce IP risk for the head by approximately 25%. The reduction in IP risk could have a significant impact in reducing the risk of developing a PU. To ensure maximum benefit, the silicone gel surface overlay should be evaluated to address the specific needs within radiography and radiotherapy planning and treatment settings

Scale-up of Malaria Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy: Challenges and Perspectives in Sub-Saharan Africa.

Guido Bastiaens and colleagues describe barriers to achieving scale-up and appropriate use of rapid diagnostic tests and artemisinin-based combination therapy for malaria in sub-Saharan Africa. Please see later in the article for the Editors' Summary

Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact

Maternal and Fetal Prognosis in Abruptio Placentae at Korle-Bu Teaching Hospital, Ghana

The study provided baseline data of abruptio placentae in Korle-Bu Teaching Hospital (KBTH), Ghana, and gave recommendations to minimize poor outcomes. A prospective cross sectional study was conducted at the Maternity Department of the KBTH between February 2008 and January 2010. Two hundred women with diagnosis of placental abruption were studied using a pretested standardized structured questionnaire. Statistical Package for Social Sciences (SPSS) version 17 was used to analyse the data. Fifteen thousand five hundred and ten (15,510) deliveries were recorded during the study period out of which 1.4% abruptio placentae cases were confirmed. The perinatal and maternal mortality rates were 65% and 2% respectively. The key risk factors identified were low socio-economic status, grandmultiparity and hypertensive disorders in pregnancy. Intrauterine foetal death, (IUFD) and maternal shock were significantly associated with coagulopathy (p= 0.001 and 0.004 respectively). Early diagnoses of placental abruption will significantly improve foetal and maternal survival.Keywords: abruptio placentae, foetal, maternal, mortalityL'étude a fourni des données de base de décollement prématuré du placenta au Centre Hospitalier Universitaire de Korle-Bu (CHUK) au Ghana, et a donné des recommandations pour minimiser les mauvais résultats. Une étude transversale prospective a été menée au Département de la maternité de CHUK entre le mois du février 2008 et janvier 2010. Deux cents femmes avec le diagnostic de décollement placentaire ont été étudiées en utilisant un questionnaire structuré pré-testé et normalisé. Le Paquet Statistique pour les sciences économiques (PSPSE) la version 17 a été utilisé pour analyser les données. Quinze mille cinq cent dix (15510) accouchements ont été enregistrés pendant la période d'étude dont 1,4% des cas de décollement placentaire ont été confirmés. Les taux de mortalité périnatale et maternelle étaient de 65% et 2% respectivement. Les principaux facteurs de risque identifiés sont le faible situation socio-économique, une grande multiparité et de l'hypertension pendant la grossesse. La mort intra-utérine du foetus, (MIUF) et le choc maternel étaient significativement associés à la coagulopathie (p = 0,001 et 0,004 respectivement). Les premiers diagnostics de décollement placentaire s’amélioreront de façon significative la survie foetale et maternelle. Mots clés: décollement prématuré du placenta, foetus, maternelle, mortalit

Pen Culture of the Black-Chinned Tilapia, Sarotherodon Melanotheron in the Aglor Lagoon in Ghana

Pen-fish-culture as a culture-based fisheries approach was investigated in the Aglor Lagoon from December 2003 to June, 2004. The fish used in the study was the Black-chinned tilapia Sarotherodon melanotheron. The growth performance of S. melanotheron cultured for six months in the Aglor Lagoon under three different treatments were monitored. In the first treatment, the cultured fish was fed with a feed of 29.80 % protein at 3 % body weight once a day. In the second treatment, bamboo was stacked at a density of 6 per metre square in pens to serve as substrate for periphyton growth and development. In the third treatment, there was no feeding (control). There was significant difference in growth between the fed and the unfed S. melanotheron in the pens, with no significant difference in growth between the fish that subsisted on periphyton de-veloped on bamboo and the other treatments. S. melanotheron cultured in the bamboo equipped pens had the best condition factor of 3.57 ± 0.23. The experimental values of b obtained from the length-weight relationship (W = aLb) for the three treatments were 2.07, 2.13 and 2.80 for feeding, unfed and bamboo respectively. From the results, the least yield was obtained from the unfed control pen (0.045 kg/m2), whilst the highest was from the bamboo equipped pens (0.183 kg/m2)