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Objectvies This study is aimed at establishing reference intervals (RIs) of 40 chemistry and immunochemistry analytes for Ghanaian adults based on internationally harmonized protocol by IFCC Committee on Reference Intervals and Decision Limits (C-RIDL). Methods A total of 501 healthy volunteers aged ≥18 years were recruited from the northern and southern regions of Ghana. Blood samples were analyzed with Beckman-Coulter AU480 and Centaur-XP/Siemen auto-analyzers. Sources of variations of reference values (RVs) were evaluated by multiple regression analysis (MRA). The need for partitioning RVs by sex and age was guided by the SD ratio (SDR). The RI for each analyte was derived using parametric method with application of the latent abnormal values exclusion (LAVE) method. Results Using SDR≥0.4 as threshold, RVs were partitioned by sex for most enzymes, creatinine, uric acid (UA), bilirubin, immunoglobulin-M. MRA revealed age and body mass index (BMI) as major source of variations of many analytes. LAVE lowered the upper limits of RIs for alanine/aspartate aminotransferase, γ-glutamyl transaminase and lipids. Exclusion of individuals with BMI≥30 further lowered the RIs for lipids and CRP. After standardization based on value-assigned serum panel provided by C-RIDL, Ghanaian RIs were found higher for creatine kinase, amylase, and lower for albumin and urea compared to other collaborating countries. Conclusions The LAVE effect on many clinical chemistry RIs supports the need for the secondary exclusion for reliable derivation of RIs. The differences in Ghanaian RIs compared to other countries underscore the importance of country specific-RIs for improved clinical decision making.

Introduction: COVID-19 vaccines have been the most effective means in curbing the infection, however, vaccine hesitancy has been seen as a threat to global health. Objective: the study aimed to assess the prevalence and predictors of COVID-19 vaccine hesitancy among healthcare workers in infectious disease centers in Ghana. Method: A cross-sectional study and proportionate stratified sampling method was used to recruit participants from various infectious disease centers. Result: data from 170 participants were analyzed, revealing a low prevalence of COVID-19 vaccine hesitancy (11.2%) among healthcare workers. However, only 31.1% of the fully vaccinated participants had taken the booster dose. Factors such as concerns about vaccine safety and side effects from previous doses, indecisiveness, a lack of time to receive the vaccine and lack of access to accurate information, prefered natural immunity were the significant predictors of vaccine hesitancy among healthcare workers. Participants with good perception of the risk posed by COVID-19 was positively correlated with COVID-19 vaccine acceptance. Conclusion: the study suggests that policies should be enacted to ensure health workers are vaccinated against highly contagious infectious diseases to prevent their spread among the general population. Training and health promotion campaigns should also be organized to encourage healthcare workers to accept and patronize the vaccines.

This study assessed the impact of Ghana's Environmental Protection Agency (EPA) Akoben programme, a rating and disclosure tool which seeks to promote better environmental performance in the mining and manufacturing industries in Ghana. Using a case study approach, the Akoben audit report card for a mining company was analyzed over a three-year period (2009–2011) based on 7-criteria – legal requirements, hazardous on-site waste management, toxic emissions management, environmental monitoring and reporting, best practice environmental management, complaint management, and corporate social responsibility. Key stakeholders' perceptions of the programme's suitability were solicited from the Ghana Chamber of Mines, EPA, and the mining company. Findings revealed that overall environmental performance over the three-year period under review was poor (2009 – 56.6%; 2010 – 65.6%; 2011 – 59.1%) with none of the years meeting the expected minimum limit, with the exception of legal requirements and corporate social responsibilities; the company failed in all other criteria. Specifically, both toxic and non-toxic waste emission discharges were major concerns as toxic parameters, such as for Arsenic, pH and Cyanide, were exceeded. Environmental monitoring and reporting was also a problem for the company. Stakeholders identified inadequate publicity, an absence of legal backing, and a lack of incentives for outstanding performances as the main weaknesses of the programme. Despite this, the stakeholders acknowledge the fact that the Akoben programme has improved the environmental performance of the mining companies because it puts their operations in check, although more can yet be achieved with regards environmental sustainability with this programme, if adequate measures including legal backing are put in place to ensure its continuity. Keywords: Akoben, Environmental, Ghana, Mining, Performance, Rating