Detection of Parasite-Specific DNA in Urine Sediment Obtained by Filtration Differentiates between Single and Mixed Infections of \u3cem\u3eSchistosoma mansoni\u3c/em\u3e and \u3cem\u3eS. haematobium\u3c/em\u3e from Endemic Areas in Ghana

Differential diagnosis of Schistosoma mansoni and S. haematobium, which often occur sympatrically in Africa, requires both urine and stool and the procedures are low in sensitivity. The standard diagnostic tests, such as Kato-Katz (KK) for S. mansoni eggs and presence of haematuria for S. haematobium both lack sensitivity, produce false-negative results and show reduced accuracy with decreasing intensity of infection. The need for a single diagnostic test with high sensitivity and specificity for both parasites is important as many African countries are implementing Mass Drug Administration (MDA) following recommendations of the World Health Organization (WHO). Eighty-six samples of urine sediment obtained by filtration were collected from a group of 5–23 years old people from an endemic area of southern Ghana. DNA was extracted from the urine sediment on filter paper from which a species-specific repeat fragment was amplified by polymerase chain reaction (PCR) with specific primers for S. mansoni and for S. haematobium. Additionally, all participants were tested by KK (stool) and dipstick for haematuria. Diagnostic parameters for all three tests were analyzed statistically. Amplification of species-specific DNA by PCR showed much higher sensitivity (99%–100%) and specificity (100%) compared to KK and haematuria (sensitivity: 76% and 30% respectively) for both schistosome species. The same pattern was observed when the data were stratified for age group and sex specific analysis. In addition PCR amplification detected DNA from 11 individuals infected with both parasites who were negative by KK and haematuria. This approach of detecting parasite specific DNA from either or both species in a single urine specimen is a practical advantage that avoids the need for two specimens and is more effective than standard tests including those based on serology. This promises to improve the effectiveness of surveillance of MDA control programs of schistosomiasis

Learning style preferences among clinical year physiotherapy students in Ghana

Background. Learning style is the manner by which one learns. Every student has a different and unique learning style. However, the educational implication of learning style preferences has been a source of controversy among researchers and educators. Objectives. To determine the learning style preferences of clinical year physiotherapy students. Methods. This cross-sectional study was conducted in 82 undergraduate physiotherapy students from two universities in Ghana. A data-capturing form was used to obtain participants’ sociodemographic information, while the Kolb learning style questionnaire was used to determine the learning style preferences of the students. The χ2 statistic was used to determine the association between gender and learning style preferences, as well as between level of study and learning style preferences. Results. The participants comprised 43 (52.4%) male students and 39 (47.6%) female students. Eight (9.8%) students preferred the accommodating learning style, 46 (56.0%) preferred the diverging learning style, 15 (18.3%) preferred the assimilating learning style and 13 (15.9%) preferred the converging learning style. There was a significant association between gender and preferred learning style (p=0.027), but no significant association between level of study and preferred learning style (p=0.179). Conclusion. This study revealed that the diverging learning style was the most preferred style, followed by the assimilating learning style. However, there was no association between gender and learning style preferences, as well as level of study and learning style preferences. Further research should be conducted to find the association between the learning environments and the learning style preferences

Point of Care Diagnosis of Multiple Schistosome Parasites: Species-specific DNA Detection in Urine by Loop-mediated Isothermal Amplification (LAMP)

Schistosomes are easily transmitted and high chance of repeat infection, so if control strategies based on targeted mass drug administration (MDA) are to succeed it is essential to have a test that is sensitive, accurate and simple to use. It is known and regularly demonstrated that praziquantel does not always eliminate an infection so in spite of the successes of control programs a residual of the reservoir survives to re-infect snails. The issue of diagnostic sensitivity becomes more critical in the assessment of program effectiveness. While serology, such as antigen capture tests might improve sensitivity, it has been shown that the presence of species-specific DNA fragments will indicate, most effectively, the presence of active parasites. Polymerase chain reaction (PCR) can amplify and detect DNA from urine residue captured on Whatman No. 3 filter paper that is dried after filtration. Previously we have detected S. mansoni and S. haematobium parasite-specific small repeat DNA fragment from filtered urine on filter paper by PCR. In the current study, we assessed the efficacy of detection of 86 urine samples for either or both schistosome parasites by PCR and loop-mediated isothermal amplification (LAMP) that were collected from a low to moderate transmission area in Ghana. Two different DNA extraction methods, standard extraction kit and field usable LAMP-PURE kit were also evaluated by PCR and LAMP amplification. With S. haematobium LAMP amplification for both extractions showed similar sensitivity and specificity when compared with PCR amplification (100%) verified by gel electrophoresis. For S. mansoni sensitivity was highest for LAMP amplification (100%) for standard extraction than PCR and LAMP with LAMP-PURE (99% and 94%). The LAMP-PURE extraction produced false negatives, which require further investigation for this field usable extraction kit. Overall high positive and negative predictive values (90% − 100%) for both species demonstrated a highly robust approach. The LAMP approach is close to point of care use and equally sensitive and specific to detection of species-specific DNA by PCR. LAMP can be an effective means to detect low intensity infection due to its simplicity and minimal DNA extraction requirement. This will enhance the effectiveness of surveillance and MDA control programs of schistosomiasis

Perceptions of undergraduate allied health students of the clinical learning environment and clinical educators’ attributes at the University of Ghana

Background. Clinical education is a vital aspect of the education of health sciences students and consists of two components, i.e. the clinical learning environment and supervision. Objectives. To determine the undergraduate allied health sciences students’ perceptions regarding clinical educators’ attributes and the clinical learning environment. Methods. This cross-sectional study included 169 undergraduate students, randomly recruited from various allied health professions programmes of the University of Ghana. The McGill clinical teacher evaluation tool and the clinical learning environment inventory were used to determine students’ perceptions of clinical educators’ attributes and the clinical learning environment, respectively. The Kruskal-Wallis test and independent t-tests were used to test for relationships between students’ level and programme of study and their perceptions. The level of significance was set at 95%. Results. Of the 169 participants, there were 99 (58.6%) male students, 79 (46.7%) third-year students and 82 (48.5%) medical laboratory science students. Only 16 (9.5%) participants indicated visits by lecturers during clinical rotations. The third-year students had a statistically significant perception of their clinical learning environment (p=0.000), while the differences between perceptions of clinical learning environment among the various programmes were also statistically significant (p=0.028), but not for clinical educators’ attributes (p=0.261). Conclusion. Allied health sciences students have positive perceptions of their clinical learning environment and clinical educators’ attributes. More frequent visits by lecturers to students during clinical rotations may ensure that student innovation is achieved in accordance with their classroom tuition

Detection of TYLCV in Ten Genotypes of Tomato (Solanum spp L.) using Serological and Molecular Techniques in a Coastal Savanna Zone of Ghana

Use of resistant varieties is a proven way of controlling the tomato yellow leaf curl virus (TYLCV), which causes a devastating disease of tomato in tropical and warm temperate regions, resulting in significant yield losses. However, breeding for resistant varieties is slow due to lack of effective methods of virus detection that will lead to efficient selection of desired varieties. A study was conducted to evaluate the susceptibility or otherwise of ten tomato genotypes to TYLCV under field conditions. The ten (10) tomato genotypes were planted in the field and left to natural infection by whitefly vectors. Leaf samples were collected from symptomatic as well as asymptomatic plants at five weeks after transplanting (5WAT) for analysis by serological and nucleic acid-based techniques. Triple antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) detected TYLCV in five out of ten genotypes while polymerase chain reaction using six primers (virus-specific and degenerate) detected the virus in eight out of ten genotypes. The polymerase chain reaction (PCR) technique detected the virus in three samples that tested negative to TAS-ELISA, implying its enhanced sensitivity. A correlation of symptom expression in the field to the presence of TYLCV in test samples led to an effective and unbiased selection of tolerant/resistant genotypes which can be used in further breeding programmes. The study highlights the need for a combination of two or more detection techniques in breeding to enhance the efficiency of selection of TYLC-resistant lines. Keywords: Tomato yellow leaf curl virus, enzyme-linked immunosorbent assay, polymerase chain reaction, genotypes, resistant varieties, Solanum lycopersicon

The anxious wait: assessing the impact of patient accessible EHRs for breast cancer patients

<p>Abstract</p> <p>Background</p> <p>Personal health records (PHRs) provide patients with access to personal health information (PHI) and targeted education. The use of PHRs has the potential to improve a wide range of outcomes, including empowering patients to be more active participants in their care. There are a number of widespread barriers to adoption, including privacy and security considerations. In addition, there are clinical concerns that patients could become anxious or distressed when accessing complex medical information. This study assesses the implementation of a PHR, and its impact on anxiety levels and perceptions of self-efficacy in a sample of breast cancer patients.</p> <p>Methods</p> <p>A quasi-experimental pre-test/post-test design was used to collect data from participants to evaluate the use of the PHR. Study participants completed background and pre-assessment questionnaires and were then registered into the portal. By entering an activation key, participants were then able to review their lab results and diagnostic imaging reports. After six weeks, participants completed post-assessment questionnaires and usability heuristics. All data were collected using an online survey tool. Data were cleaned and analyzed using SAS v9.1.</p> <p>Results</p> <p>A total of 311 breast cancer patients completed demographic and pre-assessment questionnaires, 250 registered to use the online intervention, and 125 participants completed all required study elements. Matching the pre- and post-anxiety scores demonstrated a decrease in mean anxiety scores (-2.2, p = 0.03); the chemotherapy sub-group had a statistically insignificant mean increase (1.8, p = .14). There was no mean change in self-efficacy scores.</p> <p>Conclusions</p> <p>Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use of this PHR may be of benefit for informing patients, further research is required to investigate the impact on the patients experiences, their participation in their care, their relationships with the health care team, and their health outcomes.</p

Rapid testing for malaria in settings where microscopy is available and peripheral clinics where only presumptive treatment is available: a randomised controlled trial in Ghana

Objective To test in West Africa the impact of rapid diagnostic tests on the prescription of antimalarials and antibiotics both where microscopy is used for the diagnosis of malaria and in clinical (peripheral) settings that rely on clinical diagnosis

South-South Irregular Migration: The Impacts of China’s Informal Gold Rush in Ghana

This article examines irregular South‐South migration from China to Ghana, and the role it played in transforming livelihoods and broader developmental landscapes. It looks at the entry of approximately 50,000 Chinese migrants into the informal small‐scale gold mining sector from 2008‐2013. These migrants mainly hailed from Shanglin County in Guangxi Province. In Ghana, they formed mutually beneficial relationships with local miners, both legal and illegal, introducing machinery that substantially increased gold production. However, the legal status of Chinese miners was particularly problematic as, by law, small‐scale mining is restricted to Ghanaian citizens. In mid‐2013, President Mahama established a military task force against illegal mining, resulting in the deportation of many Chinese miners. The article examines the experiences of both Chinese migrants and Ghanaian miners. Findings are that irregular migration into an informal sector had long‐lasting impacts and played a significant role in the transformation of economic, political, and physical landscapes in Ghana

Complement-Mediated Virus Infectivity Neutralisation by HLA Antibodies Is Associated with Sterilising Immunity to SIV Challenge in the Macaque Model for HIV/AIDS.

Sterilising immunity is a desired outcome for vaccination against human immunodeficiency virus (HIV) and has been observed in the macaque model using inactivated simian immunodeficiency virus (SIV). This protection was attributed to antibodies specific for cell proteins including human leucocyte antigens (HLA) class I and II incorporated into virions during vaccine and challenge virus preparation. We show here, using HLA bead arrays, that vaccinated macaques protected from virus challenge had higher serum antibody reactivity compared with non-protected animals. Moreover, reactivity was shown to be directed against HLA framework determinants. Previous studies failed to correlate serum antibody mediated virus neutralisation with protection and were confounded by cytotoxic effects. Using a virus entry assay based on TZM-bl cells we now report that, in the presence of complement, serum antibody titres that neutralise virus infectivity were higher in protected animals. We propose that complement-augmented virus neutralisation is a key factor in inducing sterilising immunity and may be difficult to achieve with HIV/SIV Env-based vaccines. Understanding how to overcome the apparent block of inactivated SIV vaccines to elicit anti-envelope protein antibodies that effectively engage the complement system could enable novel anti-HIV antibody vaccines that induce potent, virolytic serological response to be developed