The changing epidemiology of esophageal cancer in sub-Saharan Africa – the case of Ghana

Introduction: Esophageal cancer portends a grim prognosis. Most patients present with incurable disease. Scanty epidemiologic data on the disease has contributed to its low priority on the national. We sought to evaluate the current national trend in the presentation and outcome of esophageal cancer using our institutional experience from 1992 – 2010. Methods: This is a retrospective study based on 152 patients who were seen in our institution during the study period. The perioperative data of these patients were retrieved and the relevant details recorded. Histopathological reports were available for 75 patients managed over the period. The study setting was The National Cardiothoracic Centre, which serves as the only tertiary referral centre in the country for cardiothoracic problems. Results: There were 122 males and 30 females with a mean age of 57.8±11.7 years. The yearly trend from 1992 to 2010 showed a steady increase in the incidence of esophageal cancer. High alcohol consumption and smoking dominated the history of 82.2% of the patients. Squamous cell carcinoma accounted for 78.7% and adenocarcinoma 21.3%. Distribution of esophageal carcinoma by anatomical location was 84.9% for distal third, 11.8% for middle third and 3.3% for upper third. All patients presented with incurable disease. Conclusion: The study shows an increasing incidence of esophageal carcinoma in this country. Alcohol abuse and smoking are major risk factors; squamous cell carcinoma is the dominant histological type in this study.Pan African Medical Journal 2012; 13:

Evaluation of Key Antimicrobial Properties of Moringa oleifera in Relation to Its Use as a Hand-Washing Product

Moringa oleifera (M. oleifera) is a fast-growing, drought-resistant plant found throughout tropical and subtropical regions. A previous study found dry M. oleifera leaf powder to be similarly efficacious to non-medicated soap when used as a hand-wash, even without the use of water. These characteristics suggest that M. oleifera could serve as a potential hand-washing product in water and resource-limited contexts, such as humanitarian and emergency settings. The purpose of this study was to assess the efficacy of minimally processed M. oleifera sourced locally in Ghana as a hand-washing and antimicrobial product by assessing whether: (1) different preparations of M. oleifera have antibacterial properties against potential diarrheal pathogens through set-up of die-off studies; (2) M. oleifera is an effective hand-washing product by conducting an in-vivo trial with healthy volunteers; and (3) M. oleifera has antimicrobial properties in potentially reusable aqueous solutions, such as rinse water used for hand-washing. M. oleifera was found to be significantly less effective than non-medicated soap when tested as a hand-washing product and promoted the growth of bacteria in aqueous solution. Moreover, the Moringa used in the study was found to be host to pathogenic bacteria, reinforcing the idea that it is unsuitable to use as a hand-washing product. Accordingly, in its minimally processed form, M. oleifera appears to be an ineffective antimicrobial agent and its use as a hand-washing product in water-scarce and resource-limited settings is not recommended

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

Laboratory capacity assessments in 25 African countries at high risk of yellow fever, August-December 2018.

INTRODUCTION: accurate and timely laboratory diagnosis of yellow fever (YF) is critical to the Eliminate Yellow Fever Epidemics (EYE) strategy. Gavi, the Vaccine Alliance recognized the need to support and build capacity in the national and regional laboratories in the Global YF Laboratory Network (GYFLN) as part of this strategy. METHODS: to better understand current capacity, gaps and needs of the GYFLN laboratories in Africa, assessments were carried out in national and regional reference laboratories in the 25 African countries at high risk for YF outbreaks that were eligible for new financial support from Gavi. RESULTS: the assessments found that the GYFLN in Africa has high capacity but 21% of specimens were not tested due to lack of testing kits or reagents and approximately 50% of presumptive YF cases were not confirmed at the regional reference laboratory due to problems with shipping. CONCLUSION: the laboratory assessments helped to document the baseline capacities of these laboratories prior to Gavi funding to support strengthening YF laboratories