Epidemiological Survey of Soil-Transmitted Helminths in Occupational Risk Groups and Non School Going Children in the Kintampo North District of Ghana

Soil-transmitted helminths (STHs) remain a major health threat to humans especially children throughout the world, mostly in developing nations including Ghana. The present de-worming programme by the Ministry of Health is only for children of school-going age; hence occupa-tional risk groups and non-school going children may remain as sources of infection throughout the year. The aim of this study was to conduct a survey on STHs in occupational risk groups and non-school going children in the Kintampo North District of the Brong Ahafo Region of Ghana. Seven hundred and eleven (711) individuals made up of occupational risk groups and non-school going children, between the ages of 1-90 years, were recruited in a cross sectional survey in six (6) rural communities in the Kintampo North District for various STHs. All faecal samples collected were analyzed using the Kato-Katz method which is recognized as the gold standard for the diagnosis of intestinal helminths. A total of 443 (62.3%) individuals were infected with at least one intestinal parasite. Parasites isolated included hookworm, 376/711 (52.9%); Ascaris lumbricoides, 15 (2.1%); Trichuris trichiura, 6 (0.8%); Hymenolepis nana, 38 (5.3%) and Tae-nia spp., 8 (1.1%). Hookworm prevalence was higher in all the six communities (p0.05). Hookworm intensities observed included 362/376 (96.3%) light infections, 10 (2.7%) moderate infections and 4 (1.1%) heavy infections. All the observed cases of Ascaris lumbricoides and Trichuris trichiura were of light intensities. The incidence rate of STH infection declined with age with the highest of 151/225 observed in the 1-10 age group. The highest prevalence of 81.1% (99/122) was however recorded among the 11-20 age group. Overall prevalence of intestinal parasite infection was found to be 62.3%. Hookworm is the predominant STH found among the general populace. The most affected risk groups are the non-school going children. General knowledge on STHs among the community members is low, with poor attitudes and practices towards STH prevention, control and treat-ment. It is recommended that future MoH de-worming programmes should include non-school going children and occupational risk groups

Resistance-Mediating Polymorphisms of Plasmodium Falciparum Among Isolates From Children With Severe Malaria in Kumasi, Ghana

Background: Antimalarial drug resistance has been a major contributor to the failure of the battle against malaria in many developing countries. The P. falciparum genes, pfcrt and pfmdr-1, have been implicated in chloroquine resistance. The objective of this study was to determine the presence of mutant alleles of these chloroquine resistance genes amongisolates of P. falciparum from children presenting with severe malaria in Ghana.Methods: Venous blood samples were taken from patients, and plasma chloroquine levels measured. P. falciparum chromosomal DNA was isolated from the blood samples, and subjected to PCR, restriction digestion and sequencing. Resulting data were analysed using the STATA statistical software.Results: Of 140 children recruited into the study, 109 (77.9%) had detectable pre-treatment chloroquine levels. PCR and restriction digestion analysis of the pfcrt gene indicated that 124 (88.6%) had the mutantT76 gene, and that this correlated with higher chloroquine levels. Sequence analysis of these showed consistent genetic sequences for chloroquine resistant and sensitive parasites with respect to Pfcrt codons 72through 76.The Pfcrt T76 mutation was found in 88.4% of isolates having the Pfmdr-1Y86 mutation. The Pfmdr-1 Y86 mutation was found in 67.6% of isolates having the Pfcrt T76 mutation.Conclusion: The study affirms Pfcrt as a better chloroquine resistance marker. Both mutations are independently selected by chloroquine levels and that one mutation (Y86) might modify/increase the effect ofthe other (T76). This study also depicts the muchoverlooked antimalarial drug resistance situation in the area and emphasizes the need for a proper treatment strategy