Challenges in public procurement in Kwahu West Municipal Assembly, Ghana

Public procurement is a legal means by which goods, works and services are acquired by public entities including District Assemblies to promote development. Although the procurement process is to enhance judicious government spending, it has been seen as bureaucratic and cumbersome. This study set out to examine challenges that characterise public procurement process in Kwahu West Municipal Assembly within the legal framework in Ghana. Qualitative approach was employed in the study. Purposive and snowballing sampling techniques were used to draw participants for the study while interview guides and focus group discussion guides were used in data collection. The study found that low level of professionalism on the part of suppliers and contractors, bureaucracy, corruption and political interference characterised the procurement process and recommended that citizens should be concerned about how their monies are being spent by monitoring the procurement process in order to achieve value for money.Keywords: Bureaucracy, Corruption, Development, Government, Procuremen

A systematic review and meta-analysis of the prevalence of hepatitis B virus infection among pregnant women in Nigeria

Background: Nigeria has a high burden of hepatitis B virus (HBV) infection, commonly acquired through vertical transmission. However, there is a lack of an efficient surveillance system for monitoring and understanding the epidemiology of HBV among pregnant women. Building on a previous review on the prevalence of HBV in Nigeria (2000–2013), we conducted a systematic review and meta-analysis of HBV prevalence among pregnant women in Nigeria. Methods: Four electronic databases PubMed, Embase, Global Health, and Scopus were systematically searched from January 2014 to February 2021. We also searched the African Journal Online and manually scanned the reference lists of the identified studies for potentially eligible articles. Observational studies that reported the prevalence of HBsAg and/or HBeAg among pregnant women in peer-reviewed journals were included in the study. We performed a meta-analysis using a random-effects model. We defined HBV infection as a positive test to HBsAg. Results: From the 158 studies identified, 20 studies with a total sample size of 26, 548 were included in the meta-analysis. The pooled prevalence of HBV infection among pregnant women across the studies was 6.49% (95% confidence interval [CI] = 4.75–8.46%; I2 = 96.7%, p = 0.001; n = 20). The prevalence of HBV was significantly lower among pregnant women with at least secondary education compared with those with no education or primary education (prevalence ratio = 0.7, 95% CI = 0.58–0.87; n = 10). However, the prevalence of HBV was not significantly different by age, religion, marital status, or tribe. The prevalence of HBV was not significantly different among pregnant women with previous surgery, blood transfusion, multiple lifetime sex partners, tribal marks, tattoos, scarification, or sexually transmitted infections, compared with those without these risk factors. From a total sample size of 128 (n = 7), the pooled prevalence of HBeAg among HBV-infected pregnant women was 14.59% (95% CI = 4.58–27.99%; I2 = 65.5%, p = 0.01). Subgroup analyses of HBV infection by study region and screening method, and meta-regression analysis of the study year, sample size, and quality rating were not statistically significant. Conclusions: There is an intermediate endemicity of HBV infection among pregnant women in Nigeria. Interventions, such as routine antenatal HBV screening, antiviral prophylaxis for eligible pregnant women, and infant HBV vaccination should be scaled up for the prevention of perinatal transmission of HBV infection in Nigeria

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Evaluation of Consumer Purchasing Behaviour, Perceptions and Requirements of Aquaculture Products to Improve Growth of Sharptooth Catfish Small Businesses in Phetwane and Kaapmuiden Villages, South Africa

Aquaculture is becoming increasingly responsible for supplying fish for human consumption and has rapidly turned into one of the significant food production sectors globally. The aim of this study was to evaluate consumer perceptions of aquaculture products in order to improve growth of small businesses in Phetwane and Kaapmuiden communities, South Africa. Primary data were collected through face to face interviews using a semi-structured questionnaire. Descriptive statistics and Binary Logistic Regression (BLR) model on the Statistical Package for the Social Sciences (SPSS) version 25 was used to test significance of purchasing behaviour. The results showed that education level positively and significantly influenced the respondent’s decision to buy catfish. Quality, red meat, poultry and fish negatively and significantly influenced the respondents’ decision to purchase catfish. The Hosmer and Lemeshow test had a p-value less than 0.004, and it was statistically significant. This means that the model was appropriate from data, and goodness of fit measures may produce the same results constantly. Information gathered from this study was useful for guiding policy makers, economists and retailers to enhance aquaculture and develop sustainable small businesses

Spatial prediction and mapping of water quality of Owabi reservoir from satellite imageries and machine learning models

Estimation and mapping of surface water quality are vital for the planning and sustainable management of inland reservoirs. The study aimed at retrieving and mapping water quality parameters (WQPs) of Owabi Dam reservoir from Sentinel-2 (S2) and Landsat 8 (L8) satellite data, using random forests (RF), support vector machines (SVM) and multiple linear regression (MLR) models. Water samples from 45 systematic plots were analysed for pH, turbidity, alkalinity, total dissolved solids and dissolved oxygen. The performances of all three models were compared in terms of adjusted coefficient of determination (R2.adj), and the root mean square error (RMSE) using repeated k-fold cross-validation procedure. To determine the status of water quality, pixel-level predictions were used to compute model-assisted estimates of WQPs and compared with reference values from the World Health Organization. Generally, all three models produced more accurate results for S2 compared to L8. On average, the inter-sensor relative efficiency showed that S2 outperformed L8 by 67% in retrieving WQPs of the Owabi Dam reservoir. S2 gave the highest accuracy for RF (R2.adj = 95–99%, RMSE = 0.02–3.03) and least for MLR (R2.adj = 55–91%, RMSE = 0.03–3.14). Compared to RF, SVM showed similar results for S2 but with slightly higher RMSEs (0.03–3.99). The estimated pH (7.06), total dissolved solids (39.19 mg/L) and alkalinity (179.60 mg/L) were within acceptable limits, except for turbidity (33.49 mg/L) which exceeded the reference thresholds. The S2 and RF models are recommended for the monitoring of surface water quality of the Owabi Dam reservoir

Application of an Index-Based Approach in Geospatial Techniques for the Mapping of Flood Hazard Areas: A Case of Cape Coast Metropolis in Ghana

Floods remain one of the disasters that destroy properties, livelihoods, and in extreme situations, take lives. As a way of prevention, geospatial applications have been employed in many cities to map flood zones and predict floods. For a country such as Ghana, floods have been ranked as the second fatal disaster after epidemics leading to several kinds of research to resolve them. To date, the Cape Coast Metropolis (CCM) has received little attention in terms of research, though flood cases in the area continue to escalate. This study, therefore, examines the use of geospatial techniques as tools in addressing flood problems in the CCM of Ghana. From a Digital Elevation Model, hydrologic variables were generated using the ArcGIS software (Esri, Redlands, CA, USA). The soil drainage classification for the study was generated from a downloaded African Soil Grid Drainage map, while other important factors that influenced flooding in the CCM were obtained from Landsat 8 imagery. Over 21% of the CCM was classified as high flood hazard zones with areas around the river Kakum estuary being flood hotspots. It is, therefore, recommended that the CCM Assembly fund dredging of streams/rivers and promote afforestation along river banks to reduce the risk of flooding within the metropolis

Endogenous Sphingolipid Signaling Pathway Implicated in the Action of Croton membranaceus on the Prostate Gland in BPH Patients

Background: Croton membranaceus extract has apoptotic effects on BPH-1 cells. This study determined if the apoptotic effects were created through the ceramide pathway. Methods: The study was a follow-up to a previous observational study of 30 histologically confirmed patients with benign prostatic hyperplasia (BPH) who were on C. membranaceus ethanolic extract at 20 mg t.i.d orally for 3 mo. Thereafter, total and free prostate-specific antigen (PSA), lipid profile plus Apo lipoprotein A and B, ceramide/Sphingophospho-kinase 1 (SphK1) and 2 (SphK2), sphingosine lyase (SPL), the cytotoxic adducts of oxidative stress 4-hydroxy-2-nonenal (4HNE) and malondialdehyde (MDA), were determined. Results: Total and free PSA were significantly (p < 0.05) different after treatment. Apo lipoprotein A was significantly different (p = 0.024). The SphK1/SphK2 ratio reduced significantly (p = 0.049). Furthermore, SPL, ceramide, and MDA increased significantly after treatment (p = 0.05, p = 0.004, and p = 0.007, respectively). A weak positive correlation was found between high-density lipoprotein (HDL) cholesterol and SphK1, and HDL and ceramide before treatment (p = 0.036, r = 0.3826; p = 0.018, r = 0.4286, respectively. Conclusions: C. membranaceus uses the ceramide pathway by modulating the SphK1/SphK2 ratio and increasing SPL to generate oxidative stress and consequently apoptosis

Identification of Plasmodium falciparum circumsporozoite protein-specific CD8+ T cell epitopes in a malaria exposed population.

BACKGROUND:Sterile protection against malaria, most likely mediated by parasite-specific CD8+ T cells, has been achieved by attenuated sporozoite vaccination of animals as well as malaria-naïve and malaria-exposed subjects. The circumsporozoite protein (CSP)-based vaccine, RTS,S, shows low efficacy partly due to limited CD8+ T cell induction, and inclusion of such epitopes could improve RTS,S. This study assessed 8-10mer CSP peptide epitopes, present in predicted or previously positive P. falciparum 3D7 CSP 15mer overlapping peptide pools, for their ability to induce CD8+ T cell IFN-γ responses in natural malaria-exposed subjects. METHODS:Cryopreserved PBMCs from nine HLA-typed subjects were stimulated with 23 8-10mer CSP peptides from the 3D7 parasite in IFN-ɣ ELISpot assays. The CD8+ T cell specificity of IFN-γ responses was confirmed in ELISpot assays using CD8+ T cell-enriched PBMC fractions after CD4+ cell depletion. RESULTS:Ten of 23 peptide epitopes elicited responses in whole PBMCs from five of the nine subjects. Four peptides tested positive in CD8+ T cell-enriched PBMCs from two previously positive responders and one new subject. All four immunodominant peptides are restricted by globally common HLA supertypes (A02, A03, B07) and mapped to regions of the CSP antigen with limited or no reported polymorphism. Association of these peptide-specific responses with anti-malarial protection remains to be confirmed. CONCLUSIONS:The relatively conserved nature of the four identified epitopes and their binding to globally common HLA supertypes makes them good candidates for inclusion in potential multi-epitope malaria vaccines