Pathogen diversity and host resistance in dieback disease of cocoa caused by Fusarium decemcellulare and Lasiodiplodia theobromae

Dieback disease caused by Fusarium and Lasiodiplodia species is a major threat to cocoa production in Ghana and elsewhere in West Africa. Current recommendations involve insecticide application to control mirid bugs whose feeding punctures provide entry points for these fungi. Little is known about the true identity of the causal pathogens of this disease. Earlier work implicated F. decemcellulare as the causal agent and more rarely L. theobromae (Cotterell, 1927; Crowdy, 1947). A total of 117 single spore fungal cultures was established from diseased cocoa stems imported from Ghana. On morphological grounds cultures could be designated as either Fusarium or Lasiodiplodia spp. The Fusarium cultures exhibited inter-isolate variability with respect to macroscopic appearance and macro-conidium morphology, suggesting the presence of more than a single species. The isolates were further characterised by PCR amplification and sequencing of the ITS region of rDNA and comparison with authentic reference cultures. Thirty-seven Fusarium isolates were identified to twenty F. chlamydosporum, nine F. solani and four isolates each of F. oxysporum and F. proliferatum. The thirty-six Lasiodiplodia isolates were identified to two species, twenty-seven L. pseudotheobromae and nine L. theobromae. In pathogenicity tests, F. chlamydosporum, F. oxysporum, F. proliferatum, F. solani and L. pseudotheobromae, previously unknown as pathogens of either cocoa or any member of the Malvaceae, caused significant wilting and dieback in Amelonado seedlings similar to that observed in the field. All isolates exhibited optimal growth at 30 ºC on PDA. Disease incidence in 29 and 15 cocoa germplasm lines in the laboratory and greenhouse, respectively, showed reproducible differences in their reaction to necrotic lesion and dieback infection. LCTEEN 37/F was one of the most susceptible genotypes. CATIE 1000, T85/799 and MXC 67 were the most tolerant and could be used in cocoa breeding programmes for resistance to dieback

Women and Medicine: A Historical and Contemporary Study on Ghana

Women have always been central concerning the provision of healthcare. The transitions into the modern world have been very slow for women because of how societies classify women. Starting from lay care, women provided healthcare for their family and sometimes to the members of the community in which they lived. With no formal education, women served as midwives and served in other specialised fields in medicine. They usually treated their fellow women because they saw ‘women’s medicine’ as women’s business. They were discriminated against by the opposite sex and by the church, which regarded it as a taboo to allow women to practice medicine. This study points to a Ghanaian context on how the charismas of women have made them excel in their efforts to provide healthcare for their people. The study also focused on the role of indigenous practitioners who are mostly found in the rural areas and modern practitioners who are mostly found in the peri-urban, urban areas and larger cities in Ghana

Preparing for future outbreaks in Ghana:An overview of current COVID-19, monkeypox, and Marburg disease outbreaks

Amidst the ongoing COVID-19 pandemic, Ghana is currently grappling with simultaneous outbreaks of Marburg virus disease and human monkeypox virus. The coexistence of these outbreaks emphasizes the imperative for a collaborative and global approach to enhance surveillance and expedite case detection. While Ghana has made efforts to respond to these outbreaks, this paper outlines the lessons learned and proposes recommendations in this regard. It is crucial to intensify response efforts at the local, regional, and national levels to effectively contain the spread of these infectious diseases. Therefore, this paper suggests prioritizing the following recommendations as crucial for assisting Ghana in adequately preparing for future outbreaks and safeguarding global public health: strengthening surveillance system through digitization, rapid and effective response; risk communication and community engagement; healthcare system readiness; and research and collaboration. Also, prioritizing building healthy public policies and developing personal skills of health personnel across the country is key for future outbreak response.</p

Vitamin B-12 deficiency in type 2 diabetic patients on metformin: a cross-sectional study from South-Western part of Ghana

Introduction: Metformin is the most widely administered anti-diabetic medication among type 2 diabetes mellitus (T2DM) patients. However, metformin induces vitamin B12 malabsorption which may increase the risk of vitamin B12 deficiency among T2DM patients. We determined the prevalence of vitamin B12 deficiency and related risk factors among Ghanaian T2DM patients on metformin therapy. Methods: This cross-sectional study recruited 196 T2DM patients attending the outpatient diabetic clinic at the Effia Nkwanta Regional Hospital, Ghana. Fasting venous blood was collected for biochemical analysis. Vitamin B12 deficiency was defined as serum B12 \u3c 100 pg/ml and methylmalonic acid (MMA) ≥ 0.4µmol/L. Results: The prevalence of vitamin B12 deficiency based on serum vitamin B12, MMA, and the combination of both methods were 32.1%, 14.8%, and 14.3%, respectively. Longer duration of metformin use [5-9 years, aOR= 2.83, 95% CI (1.03-7.81), p=0.045 and ≥ 10 years, aOR= 4.17, 95% CI (1.41-12.33), p=0.010], higher daily dose of metformin [1000-2000 mg/day, aOR= 1.34, 95% CI (0.25-2.74), p=0.038 and \u3e 2000 mg/day, aOR= 1.13, 95% CI (0.39-2.97), p=0.047], and very high body fat [aOR= 2.98, 95% CI (1.47-6.05), p=0.020] were significantly associated with increased odds of vitamin B12 deficiency. For daily dose of metformin, a cutoff value of 1500 mg/day presented with a sensitivity, specificity, and AUC of 71.4%, 40.1%, and 0.54 (95% CI, 0.53-0.54), respectively, in predicting vitamin B12 deficiency. A ≥ six (6) years duration of metformin therapy presented with a sensitivity, specificity, and AUC of 70.4%, 62.9%, and 0.66 (95% CI, 0.57-0.75), respectively, in predicting vitamin B12 deficiency. Conclusion: Vitamin B12 deficiency is high among T2DM patients on metformin therapy in Ghana. There is the need for regular monitoring of vitamin B12 levels especially in T2DM patients on metformin daily dose of ≥ 1500 mg for duration of therapy ≥ 6 years

The role of digital surveillance during outbreaks:the Ghana experience from COVID‑19 response

Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and information dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana duringthe COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digitalsurveillance tools to combat the pandemic. These included the ‘Surveillance Outbreak Response Management and Analysis System (SORMAS)’, the digitalized health declaration form, ArcGIS Survey123, Talkwalker, ‘Lightwave Health information Management System’ (LHIMS), and the ‘District Health Information Management System (DHIMS)’. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely production of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions.This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths andchallenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation.<br/

Preparing for future outbreaks in Ghana: An overview of current COVID-19, monkeypox, and Marburg disease outbreaks

Amidst the ongoing COVID-19 pandemic, Ghana is currently grappling with simultaneous outbreaks of Marburg virus disease and human monkeypox virus. The coexistence of these outbreaks emphasizes the imperative for a collaborative and global approach to enhance surveillance and expedite case detection. While Ghana has made efforts to respond to these outbreaks, this paper outlines the lessons learned and proposes recommendations in this regard. It is crucial to intensify response efforts at the local, regional, and national levels to effectively contain the spread of these infectious diseases. Therefore, this paper suggests prioritizing the following recommendations as crucial for assisting Ghana in adequately preparing for future outbreaks and safeguarding global public health: strengthening surveillance system through digitization, rapid and effective response; risk communication and community engagement; healthcare system readiness; and research and collaboration. Also, prioritizing building healthy public policies and developing personal skills of health personnel across the country is key for future outbreak response

Developing a modified low-density lipoprotein (M-LDL-C) Friedewald’s equation as a substitute for direct LDL-C measure in a Ghanaian population: a comparative study

Despite the availability of several homogenous LDL-C assays, calculated Friedewald\u27s LDL-C equation remains the widely used formula in clinical practice. Several novel formulas developed in different populations have been reported to outperform the Friedewald formula. This study validated the existing LDL-C formulas and derived a modified LDL-C formula specific to a Ghanaian population. In this comparative study, we recruited 1518 participants, derived a new modified Friedewald\u27s LDL-C (M-LDL-C) equation, evaluated LDL-C by Friedewald\u27s formula (F-LDL-C), Martin\u27s formula (N-LDL-C), Anandaraja\u27s formula (A-LDL-C), and compared them to direct measurement of LDL-C (D-LDL-C). The mean D-LDL-C (2.47±0.71 mmol/L) was significantly lower compared to F-LDL-C (2.76±1.05 mmol/L), N-LDL-C (2.74±1.04 mmol/L), A-LDL-C (2.99±1.02 mmol/L), and M-LDL-C (2.97±1.08 mmol/L) p \u3c 0.001. There was a significantly positive correlation between D-LDL-C and A-LDL-C (r=0.658, p\u3c0.0001), N-LDL-C (r=0.693, p\u3c0.0001), and M-LDL-C (r=0.693, p\u3c0.0001). M-LDL-c yielded a better diagnostic performance [(area under the curve (AUC)=0.81; sensitivity (SE) (60%) and specificity (SP) (88%)] followed by N-LDL-C [(AUC=0.81; SE (63%) and SP (85%)], F-LDL-C [(AUC=0.80; SE (63%) and SP (84%)], and A-LDL-C (AUC=0.77; SE (68%) and SP (78%)] using D-LDL-C as gold standard. Bland-Altman plots showed a definite agreement between means and differences of D-LDL-C and the calculated formulas with 95% of values lying within ±0.50 SD limits. The modified LDL-C (M-LDL-C) formula derived by this study yielded a better diagnostic accuracy compared to A-LDL-C and F-LDL-C equations and thus could serve as a substitute for D-LDL-C and F-LDL-C equations in the Ghanaian population

The role of digital surveillance during outbreaks: the Ghana experience from COVID‑19 response

Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and information dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana during the COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digital surveillance tools to combat the pandemic. These included the “Surveillance Outbreak Response Management and Analysis System (SORMAS)”, the digitalized health declaration form, ArcGIS Survey123, Talkwalker, “Lightwave Health information Management System” (LHIMS), and the “District Health Information Management System (DHIMS)”. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely production of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions. This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths and challenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation

Contact toxicity and proximate effect of fipronil on insect pest and predatory ant community structure in cocoa agro-ecosystem

Although usage persists in some countries, fipronil is banned or restricted in many others. Prior to its ban on cocoa in Ghana, concerns about its effect on non-target insects and secondary outbreak of Anomis leona were conflicting. This study, which predates the ban, assessed the toxicity and the short-term effect of fipronil on specific insect community structure in the cocoa agro-ecosystem alongside bifenthrin and a non-insecticide control. Although the insecticides induced a high mortality (90-100%) on the target (mirid: Sahlbergella singularis, stink bug: Bathycoelia thalassina and coreid bug: Pseudotheraptus devastans) and non-target (ants: Oecophylla longinoda, Crematogaster africana, Pheidole megacephala and Camponotus consobrinus) insects, the knockdown to fipronil was very low compared to bifenthrin. On the field, fipronil was more detrimental to the ants. Insecticide-treated plots recorded relatively lower post-treatment pest diversity compared to the control, except the last sampling month while ant abundance, richness and diversity were lowest on the fipronil-treated plots at the end of the study period. This study demonstrates that although fipronil was effective against pests and did not result in acute secondary pest outbreak, it was harmful to the ants. This effect could potentially be replicated on these ant species in other cropping systems where the insecticide is used, adversely affecting ecosystem service delivery. Hence, research on its impact on non-target organisms in other cropping systems is needed to regulate and monitor its use

Pathogen diversity and host resistance in dieback disease of cocoa caused by Fusarium decemcellulare and Lasiodiplodia theobromae

Dieback disease caused by Fusarium and Lasiodiplodia species is a major threat to cocoa production in Ghana and elsewhere in West Africa. Current recommendations involve insecticide application to control mirid bugs whose feeding punctures provide entry points for these fungi. Little is known about the true identity of the causal pathogens of this disease. Earlier work implicated F. decemcellulare as the causal agent and more rarely L. theobromae (Cotterell, 1927; Crowdy, 1947). A total of 117 single spore fungal cultures was established from diseased cocoa stems imported from Ghana. On morphological grounds cultures could be designated as either Fusarium or Lasiodiplodia spp. The Fusarium cultures exhibited inter-isolate variability with respect to macroscopic appearance and macro-conidium morphology, suggesting the presence of more than a single species. The isolates were further characterised by PCR amplification and sequencing of the ITS region of rDNA and comparison with authentic reference cultures. Thirty-seven Fusarium isolates were identified to twenty F. chlamydosporum, nine F. solani and four isolates each of F. oxysporum and F. proliferatum. The thirty-six Lasiodiplodia isolates were identified to two species, twenty-seven L. pseudotheobromae and nine L. theobromae. In pathogenicity tests, F.chlamydosporum, F. oxysporum, F. proliferatum, F. solani and L. pseudotheobromae, previously unknown as pathogens of either cocoa or any member of the Malvaceae, caused significant wilting and dieback in Amelonado seedlings similar to that observed in the field. All isolates exhibited optimal growth at 30 °C on PDA. Disease incidence in 29 and 15 cocoa germplasm lines in the laboratory and greenhouse, respectively, showed reproducible differences in their reaction to necrotic lesion and dieback infection. LCTEEN 37/F was one of the most susceptible genotypes. CATIE1000, T85/799 and MXC 67 were the most tolerant and could be used in cocoa breeding programmes for resistance to dieback.EThOS - Electronic Theses Online ServiceCommonwealth Scholarships Commission, U.K.GBUnited Kingdo