Lack of Evidence from Studies of Soluble Protein Fragments that Knops Blood Group Polymorphisms in Complement Receptor-Type 1 Are Driven by Malaria

Complement receptor-type 1 (CR1, CD35) is the immune-adherence receptor, a complement regulator, and an erythroid receptor for Plasmodium falciparum during merozoite invasion and subsequent rosette formation involving parasitized and non-infected erythrocytes. The non-uniform geographical distribution of Knops blood group CR1 alleles Sl1/2 and McCa/b may result from selective pressures exerted by differential exposure to infectious hazards. Here, four variant short recombinant versions of CR1 were produced and analyzed, focusing on complement control protein modules (CCPs) 15–25 of its ectodomain. These eleven modules encompass a region (CCPs 15–17) key to rosetting, opsonin recognition and complement regulation, as well as the Knops blood group polymorphisms in CCPs 24–25. All four CR1 15–25 variants were monomeric and had similar axial ratios. Modules 21 and 22, despite their double-length inter-modular linker, did not lie side-by-side so as to stabilize a bent-back architecture that would facilitate cooperation between key functional modules and Knops blood group antigens. Indeed, the four CR1 15–25 variants had virtually indistinguishable affinities for immobilized complement fragments C3b (KD = 0.8–1.1 µM) and C4b (KD = 5.0–5.3 µM). They were all equally good co-factors for factor I-catalysed cleavage of C3b and C4b, and they bound equally within a narrow affinity range, to immobilized C1q. No differences between the variants were observed in assays for inhibition of erythrocyte invasion by P. falciparum or for rosette disruption. Neither differences in complement-regulatory functionality, nor interactions with P. falciparum proteins tested here, appear to have driven the non-uniform geographic distribution of these alleles

Dynamics in Morbidity Markers and Cytological Observations Made in Urine of Schistosoma haematobium-Infected Children: Pre- and Post-Praziquantel Treatment in an Endemic Setting

Background: Schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. Morbidity markers and cytological observations such as squamous metaplastic cells, inflammatory cells, and hyperkeratotic cells in the urine of S. haematobium-infected children may suggest disease severity. They may also help predict severe forms of clinical presentation, such as bladder cancer in later years, among infected ones who miss out on early detection and treatment. Insights into possible changes in the morbidity markers and cytological observations in the urine of these S. haematobium-infected children before and after treatment would be of high clinical importance. Aim: The aim of this study was to identify changes/dynamics in morbidity markers and cytological abnormalities in the urine deposits of S. haematobium-infected children, pre- and post-praziquantel treatment. Methodology: This was a longitudinal study involving baseline and follow-up sampling among basic school children living in schistosomiasis-endemic communities. Urine samples were collected from 520 children at baseline and examined for S. haematobium ova by microscopy, while urine chemistry analyses were used for the examination of morbidity markers. The cytological analyses involved cytopathological examination of the urine deposits. Children whose urine showed positivity for S. haematobium eggs were treated with a single oral dose of praziquantel (40 mg/kg), after which urine chemistry and cytological analyses were repeated weekly for comparison with baseline, until the eighth week. Results: Morbidity markers such as hematuria, proteinuria, and leukocyturia were detected both at baseline and post-treatment among the infected children (30/520). Hematuria was the predominant parameter (90%, 27/30) detected at baseline, followed by proteinuria (53.3%, 16/30). Leukocyturia was the rarest parameter detected at baseline (13.3%, 4/30). However, almost all these parameters declined gradually post-treatment. Regarding cytological analyses, inflammatory cells were observed most (70.0%, 21/30) at baseline. For hyperkeratotic cells and squamous metaplastic cells, 46.7% and 26.7% were respectively observed at baseline, all of which gradually declined during the weekly follow-ups. Notably, squamous metaplastic cells persisted in all the participants from Week 1 through Week 3 post-treatment, but declined gradually thereafter. Conclusions: Morbidity markers and cytological observations in the children gradually decreased after treatment. Therefore, we continue to recommend routine cytological screening for urogenital schistosomiasis patients at hospitals in S. haematobium-endemic locations using both baseline and follow-up samples to detect these abnormalities early and monitor changes that may be occurring after treatment. Such changes may be useful in assessing treatment progress in infected persons

Self-Medication Practices with Antibiotics among Tertiary Level Students in Accra, Ghana: A Cross-Sectional Study

The study was carried out to estimate the prevalence of self-medication with antibiotics among tertiary level students in Accra (Ghana) and evaluate factors associated with the practice. This was a descriptive cross-sectional study and involved face-to-face interviews of 600 respondents selected by convenient sampling. Prevalence of self medication was 70% (95% CI: 66.3–73.7), and the practice was significantly lower among medically inclined students (OR: 0.2, 95% CI: 0.1–0.4, p < 0.001). Among the respondents who practiced self medication, the most common frequency of antibiotic usage was at intervals of one month (30%, 95% CI: 25.6–34.4%), and the most common antibiotic used was amoxacillin (23.9%, 95% CI: 21.0–26.8%). Treatment failure were reported by 35% (95% CI: 30.5–39.6%) of the respondents, and the main reasons cited for self medication were that, it was less expensive compared to medical care in the hospital and  secondly, medical care in hospitals were associated with long delays. Forty nine percent (95% CI: 44.2–53.8%) of the respondents had poor knowledge about the health implications of irrational use of antibiotics, and 46% (95% CI: 41.2–50.8%) did not comply with the completion of the full course of antibiotics. Self medication among tertiary students in Accra is an important public health problem and this may reflect the situation among tertiary students in the whole of Ghana

Foodborne Microbiological Hazards in Ghana: A Scoping Review

Background: Foodborne diseases pose a significant public health threat, particularly in regions with poor sanitation and food handling practices. These diseases, mainly caused by microbiological hazards like bacteria, fungi, and parasites, affect millions globally. Despite the global burden, the true extent of these hazards remains underestimated, especially in low- and middle-income countries like Ghana. This study aimed to map the available literature on foodborne microbiological hazards in Ghana, providing an overview of the evidence and identifying areas where further research is needed. Method: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. A detailed search was done in PubMed, Scopus, Web of Science, and Google Scholar, and articles were exported to Rayyan for screening. A three-phase screening process was used to identify relevant articles. Data from the included articles were extracted and analysed, with specific information related to food type, specific hazards, sample population, and hazard groups summarised using proportions and tables. Results: This review included 72 studies which were published between 2001 and 2023. Eighty-five percent of these studies (85%) reported on bacterial hazards, while 19%, 11%, and 6% reported on fungi, parasites, and mycotoxins, respectively. The most reported bacterial, fungal, and parasitic hazards were Escherichia coli , Aspergillus spp. and Trichuris trichiura , respectively. Aflatoxins were reported in maize, groundnut, and spices, with prevalence ranging from 61% to 100% and at levels exceeding standards set by Ghana Standards Authority and European Food Safety Authority. Conclusion: This review highlighted the spectrum of microbiological hazards in foods in Ghana. The hazards identified pose significant public health risks, particularly among vulnerable populations. It is crucial that stricter enforcement of food safety laws and improved food handling practices are implemented in the country, particularly in the informal food sector, to protect consumers

Multidrug-Resistant Gram-Negative Bacteria Contaminating Raw Meat Sold in Accra, Ghana

Background: Efforts to combat antimicrobial resistance (AMR) should be based on the One Health approach, involving human health, animal health, and the environment. In Ghana, previous studies on AMR have given little attention to animal source food, a major route of transmission of antibiotic-resistant zoonotic pathogens. The aim of this study was to investigate the occurrence of multidrug-resistant (MDR) bacteria in meat sold in Accra. Methods: This was a cross-sectional study in which 270 meat samples (90 each of beef, goat meat, and chicken) were collected, and investigated for contamination with multidrug-resistant bacteria. The bacteria were subjected to susceptibility testing against amikacin (30 µg), ampicillin (10 µg), amoxicillin-clavulanate (20/10 µg), cefuroxime (30 µg), ceftriaxone (30 µg), ceftazidime (30 µg), cefepime (30 µg), ciprofloxacin (5 µg), trimethoprim-sulfamethoxazole (1.25/23.75 µg), ertapenem (10 µg), meropenem (10 µg), imipenem (10 µg), tigecycline (15 µg), and gentamicin (10 µg). Results: Thirty-two different types of bacteria, totalling 558, were isolated, the predominant being Escherichia coli (44.6%), Aeromonas hydrophila (19.9%), Vibrio cholerae (3.4%), Aeromonas veronii (3.2%), and Klebsiella pneumoniae (3.1%). The prevalence of MDR among the contaminating bacteria was 14.9%. The MDR distribution among the predominant bacteria was Escherichia coli (18.7%), Aeromonas hydrophila (11.1%), Vibrio cholerae and Aeromonas veronii (0.0% each), and K. pneumoniae (5.6%). Moreover, 2.0% of the contaminating bacteria were extended-spectrum beta-lactamase (ESBL) producers, all of which occurred in the chicken samples, and their distribution was: Escherichia coli (1.3%), Klebsiella pneumoniae, Pantoea spp., Enterobacter cloacae, and Serratia plymuthica (0.2% each). Conclusions: The meat samples were heavily contaminated with Escherichia coli and Aeromonas hydrophila, and less frequently, with Vibrio cholerae, Klebsiella pneumoniae, and other organisms. The prevalence of multidrug-resistant bacteria was moderate (14.9%), while that of ESBL producers was low (2%)

Colonization of HIV-Infected Children with Methicillin-Resistant Staphylococcus aureus

Background: Methicillin-resistant Staphylococcus aureus (MRSA) poses a public health threat owing to its extensive resistance to antibiotics, association with persistent outbreaks, and markedly increased healthcare costs. Moreover, HIV-infected individuals are at a greater risk for colonization with MRSA, and may act as reservoirs for subsequent transmission to other individuals. In Ghana, little is known about MRSA in relation to at-risk populations, such as HIV-infected children. The aim of this study was to investigate nasal carriage of S. aureus and MRSA among HIV-infected children in Accra, including the prevalence, risk factors and antibiotic resistance. Methodology: The study was cross-sectional, and involved 107 children with HIV infection and an equal number of sex- and age group- matched apparently healthy controls recruited from the Princess Marie Louis Children’s Hospital in Accra. Nasal swab specimens were collected from the study participants and cultured for bacteria. S. aureus isolates were confirmed by the coagulase test while MRSA was confirmed by PCR of the mecA gene. Antimicrobial susceptibility testing of S. aureus isolates was done by the Kirby Bauer method. A structured questionnaire was used to collect data on demographic, household and clinical features of the study participants. A logistic regression analysis was performed to identify determinants of S. aureus and MRSA carriage among participants of both study groups. Results: The carriage prevalence of S. aureus and MRSA were 44.9% (48) and 5.6% (6), respectively, among the HIV-infected individuals, and the corresponding values within the control group were 23.4% (25) and 0.9% (1). There was a significant association between HIV infection and S. aureus colonization (p < 0.001), but not MRSA colonization (p = 0.055). The main predictor of S. aureus colonization in both study groups was absence of colonization with coagulase negative staphylococcus (p < 0.001). Furthermore, the main predictor of MRSA colonization was regular hand washing with soap (p = 0.043); this was observed among HIV-infected individuals but not the control group. The proportion of S. aureus isolates that were multidrug resistant was 62.3% (33/53) in the HIV-infected group and 80% (20/25) in the control group (p = 0.192). Conclusions: HIV infection is a risk factor for nasal colonization of S. aureus among children in Accra but may not be for MRSA. Both the HIV-infected and uninfected children are reservoirs of multidrug resistant S. aureus. Demographic, household and clinical features appear to have little or no relationship with S. aureus and MRSA colonization in the study children

The Impact of Plasmodium Infection on Placental Histomorphology: A Stereological Preliminary Study

Background. Malaria during pregnancy may threaten the mother’s health and cause serious structural damage to the internal architecture of the placenta, which subsequently affects the pregnancy outcome. A better understanding of the impact of malaria parasites on the placenta morphology is crucial for better management of pregnant women and their babies. Aim. To assess by stereology the histomorphology of selected placental structures in placenta malaria compared with normal placentae at term. Method. A total of 10 placentae comprising 5 controls and 5 cases were selected from 50 placentae that were collected at term (38 weeks ± 2 weeks) from the maternal delivery suit of Korle-Bu Teaching Hospital in Accra, Ghana. Blood from the placentae was collected for both rapid diagnostic test and microscopic examinations. Samples collected were examined for Plasmodium parasites, after which they were classified as study group (Plasmodium positive) or control (Plasmodium negative). Stereological quantification using systematic uniform random sampling technique with test point and intersection counting of photomicrographs were employed to estimate the mean volume densities of syncytial knots, syncytial necrosis, foetal capillaries, and intervillous spaces of the placentae on a total of 1,600 photomicrographs. Results. Out of the fifty placental samples from the maternal side tested for Plasmodium, six representing 12% were found to be infected with the parasite by both rapid diagnostic test and microscopy. On stereological assessment, the mean volume density of syncytial knots was significantly higher in the placental malaria group compared with the control placentae at term (P = 0.0080), but foetal capillaries (P = 0.7813), intervillous spaces (P = 0.8078), and syncytial necrosis (P = 0.8249) were not significantly different. Conclusion. This preliminary result indicates that placental malaria may cause significant increase in the syncytial knots but not foetal capillaries, intervillous spaces, or syncytial necrosis. This finding signifies early maturation of the placenta and may be crucial in understanding perinatal outcomes

Microbial Carriage of Cockroaches at a Tertiary Care Hospital in Ghana

Cockroaches are common in the environment of many hospitals in Ghana; however, little is known about their public health risks. To evaluate potential risks, we investigated the external and internal microbial flora of 61 cockroaches from a tertiary hospital in Ghana and evaluated the antibiotic resistance profiles of the common bacterial species. Standard methods were used in all the microbiological investigations and antibiotic susceptibility testing. A rotavirus carriage rate of 19.7% was observed among the cockroaches. Four types of intestinal parasites were carried externally by the cockroaches, and the most prevalent was Hookworm (4.9%). Eight nosocomial bacteria were isolated from the cockroaches, and the most prevalent was Klebsiella pneumoniae , which occurred internally in 29.5% of the cockroaches and 26.2% externally. Multiple drug resistance among common bacteria isolated from the cockroaches ranged from 13.8% ( Escherichia coli ) to 41.1% ( Klebsiella pneumoniae ). Cockroaches constitute an important reservoir for pathogenic microorganisms, and may be important vectors of multiple resistant nosocomial pathogens in the studied hospital