Healthcare waste characteristics and management in Kumasi, Ghana

The healthcare waste management in developing countries has shortfalls compared with international best practices. The main purpose of this study was to assess the generation rate, composition and practices of healthcare waste management (HWM) in Kumasi, Ghana. Healthcare waste samples were collected from four hospitals and three healthcare centres for waste generation, composition and bulk density analyses. The average waste generation rates of the hospitals ranged from 0.76 to 2.92 kg/bed-day and that of the community health centres ranged from 0.012 to 0.08 kg/patient-day. The compositions of the general and hazardous healthcare wastes were 50.35% and 49.65% respectively. The hazardous healthcare waste far exceeded the World Health Organization threshold of within 10 – 25% as a result of inadequate segregation. The facilities had no specific HWM framework and did not comply with best practices. The lack of National regulatory framework for HWM may compromise the prevention of disease transmission

Comediation of Erythrocyte Haemolysis by Erythrocyte-Derived Microparticles and Complement during Malaria Infection

Background. Due to the sustained morbidity and mortality that malaria-associated anaemia imposes on patients, malaria is still a global threat, most especially, to residents in sub-Saharan Africa. Merozoite invasion and destruction of erythrocytes, a target for this study, have been necessary due to its unique nature and also since the erythrocytes suffer the most brunt of malarial infection leading to anaemia. The issue of malaria anaemia has to do with why uninfected RBCs get destroyed and even more so than infected ones. Studies have proposed that cytophilic anti-RSP2 (ring surface protein 2—merozoite rhoptry protein 2) antibodies present in sera enhance phagocytosis of RSP2-tagged RBCs by macrophages either directly or via complement, while others have proposed transfer of RSP2 to both infected and uninfected RBCs which may render them susceptible to phagocytosis. What is missing is the agent involved in the transfer of these parasite-induced surface proteins onto the uninfected RBCs, i.e., the mediator molecules. Considering the intracellular location of the parasite in the parasitophorous vacuolar membrane and the absence of a transport mechanism such as the Golgi apparatus within the mature RBC, since the latter has no nucleus, we propose that erythrocyte-derived microparticles (EMPs) may be the possible mediators. Aim. This study aimed at examining the immunological interactions between EMPs released during malarial infections and host erythrocytes that may lead to their lysis possibly through complement mediation. Methods. This was an experimental study during which malarial EMPs were isolated by differential centrifugation of malaria-positive plasma. This was followed by cell-based in vitro assays where malaria-positive EMPs were added to uninfected blood group “O” negative erythrocytes in the presence of complement and haemolysis checked for. Results and Conclusion. At a fixed volume of 50 μL complement, there were statistically significant (p<0.01) increases in mean percentage haemolysis as the volume of EMPs increased. Similarly, at a fixed volume of 50 μL EMPs, there were statistically significant (p<0.01) increases in mean percentage haemolysis with increasing volumes of complement. This was an indication that both complement and EMPs contribute significantly to uninfected erythrocyte haemolysis during malaria infection