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This study sequenced 1077 SARS-CoV-2 genomes from patient isolates (106 from arriving travellers and 971 from communities) to track the molecular evolution and spatio-temporal dynamics of the SARS-CoV-2 variants in Ghana. The data show that initial local transmission was dominated by B.1.1 lineages, but the second wave in Ghana was overwhelmingly driven by the Alpha variant, which was detected in community cases from January 2021, with Eta also contributing to reported cases. Subsequently, an unheralded variant under monitoring, B.1.1.318, dominated transmission from April to June 2021 before being displaced by Delta (B.1.1.617) and Delta Plus (AY.*) variants, which were introduced into community transmission in May 2021 and have remained dominant to date. Mutational analysis indicated that variants that took hold in Ghana harboured transmission enhancing and immune escape spike substitutions. The apparent rapid viral evolution observed demonstrate the potential for emergence of novel variants with greater mutational fitness.

This book provides an overview on the major neglected tropical diseases (NTDs) occurring in Sub-Saharan Africa, such as Leishmaniasis, Buruli Ulcer and Schistosomiasis. In well-structured chapters epidemiology and biology of these parasitic diseases will be discussed in detail. Further, diagnostics and therapeutic approaches as well as prevention strategies will be reviewed. The book will be of interest to basic researchers and clinicians engaged in infectious disease, tropical medicine, and parasitology, and a must-have for scientists specialized in the characteristics of the Sub-Saharan region

OBJECTIVE: To examine the extent to which district health teams could reduce the burden of malaria, a continuing major cause of mortality and morbidity, in a situation where severe resource constraints existed and integrated care was provided. METHODS: Antimalarial drugs were prepackaged into unit doses in an attempt to improve compliance with full courses of chemotherapy. FINDINGS: Compliance improved by approximately 20% in both adults and children. There were 50% reductions in cost to patients, waiting time at dispensaries and drug wastage at facilities. The intervention, which tended to improve both case and drug management at facilities, was well accepted by health staff and did not involve them in additional working time. CONCLUSION: The prepackaging of antimalarials at the district level offers the prospect of improved compliance and a reduction in the spread of resistance.