Ghana’s HIV epidemic and PEPFAR’s contribution towards epidemic control

Background: The aim of this review was to summarize the data on HIV/AIDS epidemiology and affected populations in Ghana and to describe the United States President’s Emergency Plan for Emergency Relief’s (PEPFAR) response to the epidemic. Design: We conducted a literature review focusing on PEPFAR’s contribution to the HIV response in Ghana. Additionally, we summarized the epidemiology of HIV. We searched both peer-reviewed and grey literature. Setting: Ghana Results: Overall, HIV prevalence in Ghana is 1.6% with regional variation. Key populations (KPs) are disproportionately affected by HIV in the country. FSW and their clients, and MSM, account for 28% of all new infections. PEPFAR provides technical assistance (TA) to Ghana to maximize the quality, coverage and impact of the national HIV/AIDS response. To ensure adequate supply of antiretrovirals (ARVs), in 2016-2017, PEPFAR invested $23.7 million as a onetime supplemental funding to support Ghana’s ARV treatment program. In addition, the National AIDS Control Programme in collaboration with PEPFAR is implementing a scale up of viral load testing. PEPFAR is also implementing a comprehensive package of prevention services in five regions to help reach MSM and FSW and to expand HIV testing services for KPs. Conclusions: Ghana is making changes at both policy and program level in the fight against HIV/AIDS and is working towards achieving the UNAIDS’ 90-90-90 targets. PEPFAR is providing TA to ensure these goals can be achieved. Funding: This manuscript has been supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC). Keywords: HIV, epidemic, Ghana, PEPFA

Fungal Endophthalmitis Associated with Compounded Products

Fungal endophthalmitis is a rare but serious infection. In March 2012, several cases of probable and laboratory-confirmed fungal endophthalmitis occurring after invasive ocular procedures were reported nationwide. We identified 47 cases in 9 states: 21 patients had been exposed to the intraocular dye Brilliant Blue G (BBG) during retinal surgery, and the other 26 had received an intravitreal injection containing triamcinolone acetonide. Both drugs were produced by Franck’s Compounding Lab (Ocala, FL, USA). Fusarium incarnatum-equiseti species complex mold was identified in specimens from BBG-exposed case-patients and an unopened BBG vial. Bipolaris hawaiiensis mold was identified in specimens from triamcinolone-exposed case-patients. Exposure to either product was the only factor associated with case status. Of 40 case-patients for whom data were available, 39 (98%) lost vision. These concurrent outbreaks, associated with 1 compounding pharmacy, resulted in a product recall. Ensuring safety and integrity of compounded medications is critical for preventing further outbreaks associated with compounded products. Download MP3  Length: 1:4

Characteristics of symptomatic COVID-19 cases by disease severity.

Characteristics of symptomatic COVID-19 cases by disease severity.</p

SARS-CoV-2 outbreak by week of onset–Haiti: Number of suspected and confirmed outpatient SARS-CoV-2 cases and percent positivity of tests by epidemiological week from March 18 to August 4, 2020.

SARS-CoV-2 outbreak by week of onset–Haiti: Number of suspected and confirmed outpatient SARS-CoV-2 cases and percent positivity of tests by epidemiological week from March 18 to August 4, 2020.</p

Surveillance flow chart for reporting outpatient SARS-CoV-2 cases—Haiti: Data streams for the detection, investigation, and testing of persons suspected of having SARS-CoV-2 infection from March 18 to August 4, 2020.

NP: Nasopharyngeal; LNSP: National Public Health Laboratory (Laboratorie nationale de santé publique; NAAT: Nucleic acid amplification testing; DELR: Directorate of Epidemiology, Laboratories and Research (Direction d’epidemiologie, de laboratoire et de recherches).</p

Characteristics of all COVID-19 cases, by symptom status, Haiti, March to August 2020.

Characteristics of all COVID-19 cases, by symptom status, Haiti, March to August 2020.</p

Logistic regression modelling evaluating risk factors related to the severity of clinical manifestations of COVID-19 outpatients, i.e. comparing moderate-to-severe and mild case as the outcome.

Logistic regression modelling evaluating risk factors related to the severity of clinical manifestations of COVID-19 outpatients, i.e. comparing moderate-to-severe and mild case as the outcome.</p