Appropriateness of Antibiotic Prescribing for Acute Conjunctivitis: A Cross-Sectional Study at a Specialist Eye Hospital in Ghana, 2021

Most presentations of conjunctivitis are acute. Studies show that uncomplicated cases resolve within 14 days without medication. However, antibiotic prescription remains standard practice. With antimicrobial resistance becoming a public health concern, we undertook this study to assess antibiotic prescription patterns in managing acute conjunctivitis in an eye hospital in Ghana. We recorded 3708 conjunctivitis cases; 201 were entered as acute conjunctivitis in the electronic medical records (January to December 2021). Of these, 44% were males, 56% were females, 39% were under 5 years, 21% were children and adolescents (5–17 years) and 40% were adults (≥18 years). A total of 111 (55.2%) patients received antibiotics, of which 71.2% were appropriately prescribed. The use of antibiotics was more frequent in children under 17 years compared to adults (p < 0.0001). Of the prescribed antibiotics, 44% belonged to the AWaRe “Access” category (Gentamycin, Tetracycline ointment), while 56% received antibiotics in the “Watch” category (Ciprofloxacin, Tobramycin). Although most of the antibiotic prescribing were appropriate, the preponderance of use of the Watch category warrants stewardship to encompass topical antibiotics. The rational use of topical antibiotics in managing acute conjunctivitis will help prevent antimicrobial resistance, ensure effective health care delivery, and contain costs for patients and the health system

Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi).

BACKGROUND: Intermittent preventive antimalarial treatment in infants (IPTi) is currently evaluated as a malaria control strategy. Among the factors influencing the extent of protection that is provided by IPTi are the transmission intensity, seasonality, drug resistance patterns, and the schedule of IPTi administrations. The aim of this study was to determine how far the protective efficacy of IPTi depends on spatio-temporal variations of the prevailing incidence of malaria. METHODS: One thousand seventy infants were enrolled in a registered controlled trial on the efficacy of IPTi with sulphadoxine-pyrimethamine (SP) in the Ashanti Region, Ghana, West Africa (ClinicalTrial.gov: NCT00206739). Stratification for the village of residence and the month of birth of study participants demonstrated that the malaria incidence was dependent on spatial (range of incidence rates in different villages 0.6-2.0 episodes/year) and temporal (range of incidence rates in children of different birth months 0.8-1.2 episodes/year) factors. The range of spatio-temporal variation allowed ecological analyses of the correlation between malaria incidence rates, anti-Plasmodium falciparum lysate IgG antibody levels and protective efficacies provided by IPTi. RESULTS: Protective efficacy of the first SP administration was positively correlated with malaria incidences in children living in a distinct village or born in a distinct month (R2 0.48, p < 0.04 and R2 0.63, p < 0.003, respectively). Corresponding trends were seen after the second and third study drug administration. Accordingly, IgG levels against parasite lysate increased with malaria incidence. This correlation was stronger in children who received IPTi, indicating an effect modification of the intervention. CONCLUSION: The spatial and temporal variations of malaria incidences in a geographically and meteorologically homogeneous study area exemplify the need for close monitoring of local incidence rates in all types of intervention studies. The increase of the protective efficacy of IPTi with malaria incidences may be relevant for IPTi implementation strategies and, possibly, for other malaria control measures

Micro-Computed Tomography Beamline of the Australian Synchrotron: Micron-Size Spatial Resolution X-ray Imaging

The first new beamline of the BRIGHT project&mdash;involving the construction of eight new beamlines at the Australian Synchrotron&mdash;is the Micro-Computed Tomography (MCT) beamline. MCT will extend the facility&rsquo;s capability for higher spatial resolution X-ray-computed tomographic imaging allowing for commensurately smaller samples in comparison with the existing Imaging and Medical Beamline (IMBL). The source is a bending-magnet and it is operating in the X-ray energy range from 8 to 40 keV. The beamline provides important new capability for a range of biological and material-science applications. Several imaging modes will be offered such as various X-ray phase-contrast modalities (propagation-based, grating-based, and speckle-based), in addition to conventional absorption contrast. The unique properties of synchrotron radiation sources (high coherence, energy tunability, and high brightness) are predominantly well-suited for producing phase contrast data. An update on the progress of the MCT project in delivering high-spatial-resolution imaging (in the order of micron size) of mm-scale objects will be presented in detail with some imaging results from the hot-commissioning stage

Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)-3

<p><b>Copyright information:</b></p><p>Taken from "Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)"</p><p>http://www.malariajournal.com/content/6/1/163</p><p>Malaria Journal 2007;6():163-163.</p><p>Published online 9 Dec 2007</p><p>PMCID:PMC2234423.</p><p></p>the respective study arm in each village. A, stratified by month of birth (Wald test, p = 0.118). B, stratified by village of residence (Wald test, p < 0.001). Blue circles and lines (linear regression), children from placebo arm; red diamonds and lines (linear regression), children from SP arm. PYAR, person year at risk

Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)-0

<p><b>Copyright information:</b></p><p>Taken from "Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)"</p><p>http://www.malariajournal.com/content/6/1/163</p><p>Malaria Journal 2007;6():163-163.</p><p>Published online 9 Dec 2007</p><p>PMCID:PMC2234423.</p><p></p>year, beginning at the time of recruitment. A, PYAR stratified for the month of birth of the children; B, PYAR stratified for the village of residence of the children. PYAR, person year at risk

X-ray phase-contrast computed tomography for full-breast mastectomy imaging at the Australian Synchrotron

One of the imaging modalities offered by the Imaging and Medical Beamline (IMBL) at the Australian Synchrotron is Xray phase-contrast propagation-based computed tomography (PB-CT). The unique combination of high coherence and high brightness of radiation produced by synchrotron X-ray sources enables phase contrast imaging with excellent sensitivity to small density differences in soft tissues and tumors. The PB-CT images using spatially coherent radiation show high signal-to-noise ratio (SNR) without reducing the spatial resolution. This is due to the combined effect of forward free-space propagation and the advanced step of phase retrieval in the reconstruction processes that allows to accommodate noisier recorded images. This gives an advantage of potentially reducing the radiation dose delivered to the sample whilst preserving the reconstructed image quality. It is expected that the PB-CT technique will be well suited for diagnostic breast imaging in the near future with the advantage that it could provide better tumor detection and characterization/grading than mammography and other breast imaging modalities/techniques in general. The PB-CT technique is expected to reduce false negative and false positive cancer diagnoses that result from overlapping regions of tissue in 2D mammography and avoid patient pain and discomfort that results from breast compression. The present paper demonstrates that PB-CT produces superior results for imaging low-density materials such as breast mastectomy samples, when compared to the conventional absorption-based CT collected at the same radiation dose. The performance was quantified in terms of both the measured objective image characteristics and the subjective scores from radiological assessments. This work is part of the ongoing research project aimed at the introduction of 3D X-ray medical imaging at the IMBL as innovative tomographic methods to improve the detection and diagnosis of breast cancer. Major progress of this project includes the characterization of a large number of mastectomy samples, both normal and cancerous

Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)-2

<p><b>Copyright information:</b></p><p>Taken from "Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)"</p><p>http://www.malariajournal.com/content/6/1/163</p><p>Malaria Journal 2007;6():163-163.</p><p>Published online 9 Dec 2007</p><p>PMCID:PMC2234423.</p><p></p>dence rates in the placebo arm. A, stratified by month of birth (red diamonds and lines [linear regression, R0.54, p < 0.006], children from the SP arm; blue circles and lines [linear regression R0.05, p = 0.475], children from the placebo arm. B, stratified by village of residence (red diamonds and lines [linear regression, R0.90, p < 0.001], children from the SP arm; blue circles and lines [linear regression, R0.89, p < 0.001], children from the placebo arm). Panel C and D, correlation between malaria incidence rates and incidence rates in the placebo arm. C, stratified by month of birth (red diamonds and lines [slope 0.07, p < 0.80], children from the SP arm; blue circles and lines, children from the placebo arm as comparison [slope 1]). D, stratified by village of residence (red diamonds and lines [slope 0.67, p < 0.007], children from the SP arm; blue circles and lines, children from the placebo arm as comparison [slope 1]). PYAR, person year at risk

Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)-1

<p><b>Copyright information:</b></p><p>Taken from "Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)"</p><p>http://www.malariajournal.com/content/6/1/163</p><p>Malaria Journal 2007;6():163-163.</p><p>Published online 9 Dec 2007</p><p>PMCID:PMC2234423.</p><p></p> after the drug administration (blue circles and line, after IPTi-1; red diamonds and line, after IPTi-2; green triangles and line, after IPTi-3) and malaria incidence rates per PYAR for the same time periods in the placebo arm. A, stratified by month of birth (IPTi-1, R0.63, p < 0.003; IPTi-2, R0.29, p = 0.07; IPTi-3, R0.37, p < 0.04); B, stratified by village of residence (IPTi-1, R0.48, p < 0.04; IPTi-2, R0.33, p = 0.11; IPTi-3, R0.04, p = 0.60). PYAR, person year at risk

A Cross-Sectional Study of Ocular Changes in Children and Adolescents with Diabetes Mellitus in Selected Health Facilities in Ghana

Background: The main objective of the study was to determine the prevalence of diabetic retinopathy (DR), other diabetes-related ocular changes (e.g., cataracts, corneal ulceration), and non-diabetic ocular disease in Ghanaian children and adolescents. The second objective was to evaluate the relationship between these conditions and age at diagnosis, current age, diabetes mellitus (DM) duration, and participant’s sex. Methods: A cross-sectional study, undertaken by a multidisciplinary team, included a cohort of children and adolescents (4–19 years) with DM recruited from selected health facilities in Ghana, from March 2016 to September 2019, after written informed consent or assent. The cohort will be followed up for 3 years to determine the natural course of the ocular changes, reported later. Participants were examined for all microvascular and macrovascular complications, non-diabetic ocular disease, anthropometric measurements, laboratory characteristics and quality of life issues. Full ocular examination was also undertaken. Statistical Package for Social Sciences (SPSS Version 25.0) was used for the data analysis. Continuous and categorical variables were presented as mean and standard deviation (SD), median (interquartile range) and as percentages (%), respectively. T-test and Mann–Whitney U test were used in establishing associations. Results: A total of 58 participants were recruited. DR was detected in only 1 out of 58 (1.7%) participants at baseline. Cataracts were the most common ocular finding, detected in 42 (72%) at baseline. Other anterior segment changes observed included blepharitis 46 (79.3%) and tear film instability 38 (65.5%). There was a significant positive association between duration of the DM and the risk of cataract (p = 0.027). Participants’ age at diagnosis was significantly associated with the presence of prominent corneal nerves (p = 0.004). Conclusions: DR was uncommon in this cohort of young persons with DM in Ghana. Cataracts, blepharitis and refractive errors were ocular changes commonly observed. All young persons with diabetes should undergo regular eye examination in all clinics where follow-up care is provided