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Abstract ATAD2 (ATPase Family AAA Domain-Containing 2) is highly expressed across varies tumor types, yet its common roles in tumor progression and immune interaction remain unclear. We analyzed the expression and alteration profiles of ATAD2, along with its diagnostic and prognostic role in pan-cancer, utilizing TCGA, GTEx, CPTAC, HPA, and cBioPortal databases. Furthermore, we examined the relationship between ATAD2 and immune infiltration utilizing single-cell sequencing data and TCGA database. Additionally, the expression and oncogenic functions of ATAD2 were verified in papillary thyroid carcinoma (PTC) through MTT, wound-healing, transwell, and flow cytometry assays. Our results revealed significant overexpression of ATAD2 in most cancers, strongly associated with poor prognosis. Amplification was the most frequent alteration type of ATAD2, with its mutation correlating with improved overall survival. ATAD2 was positively correlated with multiple inhibitory immune checkpoints and closely associated with the immunosuppressive microenvironment, particularly in PTC. In vitro experiments demonstrated that ATAD2 promoted the proliferation, migration, and invasion of PTC cells by activating the PI3K-AKT pathway and modulating the G1/S cell cycle checkpoint. Collectively, ATAD2 holds promise as a biomarker for pan-cancer diagnosis and prognosis, as well as a predictor of immunotherapeutic responsiveness and a therapeutic target to enhance the efficacy of existing anti-tumor immune therapies.

Background: Cannabis is the most commonly used federally illicit substance during pregnancy. Yet, little is known about women’s lived experiences of being screened for cannabis use during pregnancy. Objective: To explore perceptions of cannabis use during pregnancy and childbirth, including experiences of being screened for cannabis use during the intrapartum period. Methods: We conducted a phenomenological qualitative study using semi-structured, online interviews with 16 English-speaking women who gave birth at a U.S. hospital within the past three months. After transcription of interview recordings, two coders analyzed data using inductive thematic analysis. We also generated descriptive statistics for sociodemographic characteristics and cannabis use behaviors. Findings: Most participants were 25–34 years of age (75 %, n=12), Black (75.00 %. n=12), and had less than a bachelor’s degree (68.75 %, n=14). Participants reported low-risk perceptions of cannabis use during pregnancy and often used cannabis to alleviate mental health conditions and pain during pregnancy and childbirth. Women reported mixed perceptions of harm, using cannabis as a medicine and because they were addicted, being fearful of disclosing cannabis use due to potential involvement of child welfare and protective services, and perceiving negative provider communication a barrier to disclosing cannabis use. Conclusions: Findings underscore the importance of patient education about adverse maternal and neonatal health outcomes of prenatal cannabis use, regardless of whether disclosure occurs. To facilitate disclosure of use, close attention should be paid to verbal and non-verbal communication when screening and counseling women during pregnancy and childbirth. Additional studies are needed to further examine patient-provider cannabis-related communication, with a focus on identifying discriminatory behaviors and practices resulting in health inequities.

While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term sleep trajectories in a cohort of Black individuals and White individuals predominantly from low-income communities. We used data from the Southern Community Cohort Study (N = 28,759 Black individuals and 16,276 White individuals). Sleep duration was self-reported at baseline and after an average of five years of follow-up, based on which we constructed nine sleep trajectories: normal–normal (optimal, reference), short–short, long–long, short–long, long–short, normal–short, normal–long, short–normal, and long–normal. LAN and nighttime noise were derived from satellite imagery and model-based estimates, respectively. Multinomial logistic regression was used to determine the relationship between LAN and noise exposures and sleep trajectories. Higher exposures to LAN and nighttime noise were associated with multiple suboptimal long-term sleep trajectories. In the total sample, higher LAN was associated with higher odds of long–long (OR Q5 vs. Q1 = 1.23 (CI = 1.02, 1.48)) and long–short (OR = 1.35 (CI = 1.06, 1.72)) trajectories, while higher nighttime noise was associated with short–short (1.19 (1.07, 1.31)), long–short (1.31 (1.05, 1.64)), and normal–song (1.16 (1.01, 1.34)) trajectories. Black and White individual-specific results showed qualitatively similar patterns between Black individuals and White individuals, although we also observed suggestive evidence for Black–White individual differences. In conclusion, elevated LAN and nighttime noise levels were associated with various suboptimal long-term sleep trajectories. However, it is noteworthy that the light and noise measures in our study may not accurately reflect individual-level exposures, and residual confounding from other factors is a concern. Future studies should use more accurate exposure measurements, collect information on and control for a wider range of factors, and examine whether reductions in neighborhood light and noise levels may contribute to improved long-term sleep health.

Abstract The absence of biodegradability exhibited by plastics is a matter of significant concern among environmentalists and scientists on a global scale. Therefore, it is essential to figure out potential pathways for the use of recycled plastics. The prospective applications of its utilisation in concrete are noteworthy. The use of recycled plastic into concrete, either as a partial or complete substitution for natural aggregates, addresses the issue of its proper disposal besides contributing to the preservation of natural aggregate resources. Furthermore, the use of agricultural wastes has been regarded as a very promising waste-based substance in the industry of concrete manufacturing, with the aim of fostering the creation of an environmentally sustainable construction material. This paper illustrates the impact of nano sunflower ash (NSFA) and nano walnut shells ash (NWSA) on durability (compressive strength and density after exposure to 800 °C and sulphate attack), mechanical properties (flexural, splitting tensile and compressive strength) and fresh characteristics (slump flow diameter, T50, V-funnel flow time, L-box height ratio, segregation resistance and density) of lightweight self-compacting concrete (LWSCC). The waste walnut shells and local Iraqi sunflower were calcinated at 700 ± 50 °C for 2 h and milled for 3 h using ball milling for producing NSFA and NWSA. The ball milling succeeded in reducing the particle size lower than 75 nm for NSFA and NWSA. The preparation of seven LWSCC concrete mixes was carried out to obtain a control mix, three mixtures were created using 10%, 20% and 30% NWSA, and the other three mixtures included 10%, 20% and 30% NSFA. The normal weight coarse aggregates were substituted by the plastic waste lightweight coarse aggregate with a ratio of 75%. The fresh LWSCC passing capacity, segregation resistance, and filling capability were evaluated. The hardened characteristics of LWSCC were evaluated by determining the flexural and splitting tensile strength at 7, 14 and 28 days and the compressive strength was measured at 7, 14, 28 and 60 days. Dry density and compressive strength were measured after exposing mixes to a temperature of 800 °C for 3 h and immersed in 10% magnesium sulphate attack. The results demonstrated that the LWSCC mechanical characteristics were reduced when the percentages of NWSA and NSFA increased, except for 10% NWSA substitution ratio which had an increase in splitting tensile strength test and similar flexural strength test to the control mixture. A minor change in mechanical characteristics was observed within the results of LWSCC dry density and compressive strength incorporating various NSFA and NWSA` contents after exposing to temperature 800 °C and immersed in 10% magnesium sulphate attack. Furthermore, according to the findings, it is possible to use a combination of materials consisting of 10–20% NSFA and 10–20% NWSA to produce LWSCC.

While often undetected and untreated, persistent seasonal asymptomatic malaria infections remain a global public health problem. Despite the presence of parasites in the peripheral blood, no symptoms develop. Disease severity is correlated with the levels of infected red blood cells (iRBCs) adhering within blood vessels. Changes in iRBC adhesion capacity have been linked to seasonal asymptomatic malaria infections, however how this is occurring is still unknown. Here, we present evidence that RNA polymerase III (RNA Pol III) transcription in Plasmodium falciparum is downregulated in field isolates obtained from asymptomatic individuals during the dry season. Through experiments with in vitro cultured parasites, we have uncovered an RNA Pol III-dependent mechanism that controls pathogen proliferation and expression of a major virulence factor in response to external stimuli. Our findings establish a connection between P. falciparum cytoadhesion and a non-coding RNA family transcribed by Pol III. Additionally, we have identified P. falciparum Maf1 as a pivotal regulator of Pol III transcription, both for maintaining cellular homeostasis and for responding adaptively to external signals. These results introduce a novel perspective that contributes to our understanding of P. falciparum virulence. Furthermore, they establish a connection between this regulatory process and the occurrence of seasonal asymptomatic malaria infections.

Abstract This study conducts an extensive comparative analysis of computational intelligence approaches aimed at predicting the compressive strength (CS) of concrete, utilizing two non-destructive testing (NDT) methods: the rebound hammer (RH) and the ultrasonic pulse velocity (UPV) test. In the ensemble learning approach, the six most popular algorithms (Adaboost, CatBoost, gradient boosting tree (GBT), random forest (RF), stacking, and extreme gradient boosting (XGB)) have been used to develop the prediction models of CS of concrete based on NDT. The ML models have been developed using a total of 721 samples, of which 111 were cast in the laboratory, 134 were obtained from in-situ testing, and the other samples were gathered from the literature. Among the three categories of analytical models—RH models, UPV models, and combined RH and UPV models; seven, ten, and thirteen models have been used respectively. AdaBoost, CatBoost, GBT, RF, Stacking, and XGB models have been used to improve the accuracy and dependability of the analytical models. The RH-M5, UPV-M6, and C-M6 (combined UPV and RH model) models were found with highest performance level amongst all the analytical models. The MAPE value of XGB was observed to be 84.37%, 83.24%, 77.33%, 59.46%, and 81.08% lower than AdaBoost, CatBoost, GBT, RF, and stacking, respectively. The performance of XGB model has been found best than other soft computing techniques and existing traditional predictive models.

Abstract Vector-borne diseases emergence, particularly malaria, present a significant public health challenge worldwide. Anophelines are predominant malaria vectors, with varied distribution, and influenced by environment and climate. This study, in Ghana, modelled environmental suitability for Anopheles stephensi, a potential vector that may threaten advances in malaria and vector control. Understanding this vector’s distribution and dynamics ensures effective malaria and vector control programmes implementation. We explored the MaxEnt ecological modelling method to forecast An. stephensi’s potential hotspots and niches. We analysed environmental and climatic variables to predict spatial distribution and ecological niches of An. stephensi with a spatial resolution of approximately 5 km2. Analysing geospatial and species occurrence data, we identified optimal environmental conditions and important factors for its presence. The model’s most important variables guided hotspot prediction across several ecological zones aside from urban and peri-urban regions. Considering the vector’s complex bionomics, these areas provide varying and adaptable conditions for the vector to colonise and establish. This is shown by the AUC = 0.943 prediction accuracy of the model, which is considered excellent. Based on our predictions, this vector species would thrive in the Greater Accra, Ashanti Central, Upper East, Northern, and North East regions. Forecasting its environmental suitability by ecological niche modelling supports proactive surveillance and focused malaria management strategies. Public health officials can act to reduce the risk of malaria transmission by identifying areas where mosquitoes may breed, which will ultimately improve health outcomes and disease control.

Abstract The escalating threat of natural disasters to public safety worldwide underlines the crucial role of effective environmental risk management tools, such as insurance. This is particularly evident in the case of earthquakes that occurred in Oklahoma between 2011 and 2020, which were linked to wastewater injection, underscoring the need for earthquake insurance. In this regard, from a survey of 812 respondents in Oklahoma, USA, we used supervised machine learning techniques (i.e., logit, ridge, least absolute shrinkage and selection operator (LASSO), decision tree, and random forest classifiers) to identify the factors that influence earthquake insurance uptake and to predict individuals who would acquire earthquake insurance. Our findings reveal that influential factors that affect earthquake insurance uptake include demographic factors such as older age, male gender, race, and ethnicity. These were found to significantly influence the decision to purchase earthquake insurance. Additionally, individuals residing in rental properties were less likely to purchase earthquake insurance, while longer residency in Oklahoma had a positive influence. Past experience of earthquakes was also found to positively influence the decision to purchase earthquake insurance. Both decision trees and random forests demonstrated good predictive capabilities for identifying earthquake insurance uptake. Notably, random forests exhibited higher precision and robustness, emerging as an encouraging choice for earthquake insurance modeling and other classification problems. Empirically, we highlight the importance of insurance as an environmental risk management tool and emphasize the need for awareness and education on earthquake insurance as well as the use of supervised machine learning algorithms for classification problems.

Introduction Leveraging data science could significantly advance the understanding of the health impacts of climate change and air pollution to meet health systems’ needs and improve public health in Africa. This scoping review will aim to identify and synthesise evidence on the use of data science as an intervention to address climate change and air pollution-related health challenges in Africa.Methods and analysis The search strategy will be developed, and the search will be conducted in the Web of Science, Scopus, CAB Abstracts, MEDLINE and EMBASE electronic databases. We will also search the reference lists of eligible articles for additional records. We will screen titles, technical reports, abstracts and full texts and select studies reporting the use of data science in relation to the health effects and interventions associated with climate change and air pollution in Africa.Ethics and dissemination There are no formal ethics requirements as we are not collecting primary data. Results, once published, will be disseminated via conferences and shared with policy-makers and public health, air pollution and climate change key stakeholders in Africa.

Abstract Objective Haematological and liver fibrotic markers could be appreciably utilized for effective monitoring of Chronic Hepatitis B viral (HBV) infection, thereby increasing patient’s treatment outcome. The objective of this study was to assess the applicability of complete blood count (CBC) and non-invasive liver-fibrotic indices as markers of prognostic outcome and monitoring in HBV infections. Results Significant differences in levels of white cell and differentials counts, red blood cell count, hemoglobin indices, and platelet indices were observed between HBV-infected patients (cases) and uninfected persons (controls). Levels of haemoglobin (Hb), total white blood cells (tWBC), neutrophils, monocytes, platelets, and Platelet Distribution width (PDW) were significantly lower (p

Viral encephalitis is a rare, yet severe neurological disorder. It poses a significant public health threat due to its high morbidity and mortality. Despite the disproportionate burden of the disease in impoverished African countries, the true extent of the problem remains elusive due to the scarcity of accurate diagnostic methods. The absence of timely and effective diagnostic tools, particularly Real-time Polymerase Chain Reaction, has led to misguided treatment, and an underestimation of the disease burden in Ghana. We conducted a prospective cross-sectional study to determine the viral aetiologies of encephalitis among patients presenting to a major referral hospital in Ghana from May 2019 and August 2022. The study aimed at providing a comprehensive information on the clinical epidemiology, and outcomes of viral encephalitis in Ghana. Clinical samples were collected from patients presenting with signs and symptoms of encephalitis and tested for viral agents using real-time polymerase chain reaction. We assessed the clinical epidemiology, risk factors and outcome of individuals using descriptive and logistic regression analysis. Seventy-seven (77) patients were enrolled unto the study. The participants frequently presented with fever (85.7%), seizures (80.5%), lethargy (64.9%) and headache (50.6%). Viruses were detected in 40.3% of the study participants in either cerebrospinal fluid, rectal or oral swab samples. The most frequently detected viruses were cytomegalovirus (48.4%), enteroviruses (38.7%) and HSV (29.0%). Twenty-one (27.3%) of the patients died while on hospital admission. Gender (OR = 5.70 (1.536-1.172), p = 0.01), and negative polymerase chain reaction test results were identified as significant factors associated with death. Antiviral treatment increased the chance of survival of viral encephalitis patients by 21.8%. Our results validate the crucial role of molecular tools as essential for the rapid diagnosis of viral encephalitis, enabling effective treatment and improved patient outcomes. This study contributes valuable epidemiological and clinical insight into viral encephalitis in Ghana.

This paper explores Itinerant Medicine Sellers’ (IMSs) operations at loading bays within bus terminals in the Kumasi metropolis. The paper examines how the sellers negotiated access into the loading bays, how they marketed their medicines, where they sourced their medicines from, and the challenges they faced. An exploratory qualitative survey design was adopted for the study. Through convenience sampling, 18 IMSs operating within the bus terminals in the Kumasi metropolis participated in this study. In-depth interviews were conducted, audio-recorded and transcribed. The transcripts were thematically analysed. The study found that these hawkers negotiated access to the loading bays through multiple informal gatekeepers and employed direct customer engagement in marketing their medicines. It was further revealed that the IMSs sourced their medicines from both formal and informal sources for different reasons, such as affordability and informality of medicines acquisition. The participants operated outside government-prescribed regulations and faced challenges of low capital and sales revenue, poor reception by prospective clients, and government clampdown. The study concludes that medicine hawking is an illegal livelihood strategy and a public health concern. As a phenomenon outside government’s policy guidelines, it is recommended that government intensifies its clampdown activities on these hawkers and engage in public health education on the negative implications of accessing medicines from these IMSs.

ABSTRACTBackground: Hand hygiene practise is an effective school-based measure for infectious disease prevention, especially in developing countries. School children model their behaviour through the observation of significant others, including teachers. However, little is known about the handwashing behaviour and factors influencing the handwashing practises of teachers at the primary school level in Ghana.Methods: A quantitative cross-sectional study was conducted among 214 primary school teachers, recruited by convenience sampling. Data were collected using a structured questionnaire which were designed based on selected constructs in the Theory of Planned Behaviour and the Health Belief Model. Data analyses was done with the aid of STATA software, version 14.0. To identify determinants of hand washing with soap (HWWS) among participants, correlation and multiple linear regression analysis were used.Results: The participants’ mean SD age was 34.7 7.6 years, ranging from 20 to 51 years. The majority were males (87.9%). The majority (84.0% and 86.0%) of the teachers, respectively, reported HWWS practises after using the toilet and before eating with bare hands. A correlation was found between reported HWWS practise and toilet use (r = 0.64; p = 0.001) and eating with bare hands (r = 0.84; p = 0.001). A multiple linear regression analysis found that knowledge (p = 0.001), attitude toward HWWS (p = 0.002), and teachers’ perception of the severity of diarrhoea (p = 0.009) were determinants of teachers’ reported HWWS behaviours.Conclusion: Teachers’ perceptions of their susceptibility to and severity of diarrhoea, and their knowledge and attitude towards HWWS at critical times should be focus areas for handwashing programmes to achieve the desired outcomes.

Abstract Background Emerging data suggests the neuroprotective and anti-neuroinflammatory effects of glucosamine. We aimed to examine the association between regular glucosamine use and risk of incident dementia, including dementia subtypes. Methods We conducted large-scale observational and two-sample Mendelian randomization (MR) analyses. Participants in UK Biobank having accessible data for dementia incidence and who did not have dementia at baseline were included in the prospective cohort. Through the Cox proportional hazard model, we examined the risks of incident all-cause dementia, Alzheimer’s disease (AD), and vascular dementia among glucosamine users and non-users. To further test the causal association between glucosamine use and dementia, we conducted a 2-sample MR utilizing summary statistics from genome-wide association studies (GWAS). The GWAS data were obtained from observational cohort participants of mostly European ancestry. Results During a median follow-up of 8.9 years, there were 2458 cases of all-cause dementia, 924 cases of AD, and 491 cases of vascular dementia. In multivariable analysis, the hazard ratios (HR) of glucosamine users for all-cause dementia, AD, and vascular dementia were 0.84 (95% CI 0.75–0.93), 0.83 (95% CI 0.71–0.98), and 0.74 (95% CI 0.58–0.95), respectively. The inverse associations between glucosamine use and AD appeared to be stronger among participants aged below 60 years than those aged above 60 years (p = 0.04 for interaction). The APOE genotype did not modify this association (p > 0.05 for interaction). Single-variable MR suggested a causal relationship between glucosamine use and lower dementia risk. Multivariable MR showed that taking glucosamine continued to protect against dementia after controlling for vitamin, chondroitin supplement use and osteoarthritis (all-cause dementia HR 0.88, 95% CI 0.81–0.95; AD HR 0.78, 95% CI 0.72–0.85; vascular dementia HR 0.73, 95% CI 0.57–0.94). Single and multivariable inverse variance weighted (MV-IVW) and MR-Egger sensitivity analyses produced similar results for these estimations. Conclusions The findings of this large-scale cohort and MR analysis provide evidence for potential causal associations between the glucosamine use and lower risk for dementia. These findings require further validation through randomized controlled trials.

Abstract The ability of machine learning (ML) techniques to forecast the shear strength of corroded reinforced concrete beams (CRCBs) is examined in the present study. These ML techniques include artificial neural networks (ANN), adaptive-neuro fuzzy inference systems (ANFIS), decision tree (DT) and extreme gradient boosting (XGBoost). A thorough databank with 140 data points about the shear capacity of CRCBs with various degrees of corrosion was compiled after a review of the literature. The inputs parameters of the implemented models are the width of the beam, the effective depth of the beam, concrete compressive strength (CS), yield strength of reinforcement, percentage of longitudinal reinforcement, percentage of transversal reinforcement (stirrups), yield strength of stirrups, stirrups spacing, shear span-to-depth ratio (a/d), corrosion degree of main reinforcement, and corrosion degree of stirrups. The coefficient of determination of the ANN, ANFIS, DT, and XGBoost models are 0.9811, 0.9866, 0.9799, and 0.9998, respectively. The MAPE of the XGBoost model is 99.39%, 99.16%, and 99.28% lower than ANN, ANFIS, and DT models. According to the results of the sensitivity examination, the shear strength of the CRCBs is most affected by the depth of the beam, stirrups spacing, and the a/d. The graphical displays of the Taylor graph, violin plot, and multi-histogram plot additionally support the XGBoost model's dependability and precision. In addition, this model demonstrated good experimental data fit when compared to other analytical and ML models. Accurate prediction of shear strength using the XGBoost approach confirmed that this approach is capable of handling a wide range of data and can be used as a model to predict shear strength with higher accuracy. The effectiveness of the developed XGBoost model is higher than the existing models in terms of precision, economic considerations, and safety, as indicated by the comparative study.

Abstract Background Diabetes Mellitus (DM) is a major health problem, with a global prevalence of 9.3%, 4.7% in Africa, and 2.5% in Ghana. Despite the availability of the classic anti-diabetic medications, many patients have not benefited from them due to their poor glycemic controls, high costs, inability to halt disease progression, and untoward side effects. Some patients thus resort to plant-based medicines such as those obtained from L. taraxacifolia etc., which have little empirical evidence of efficacy. Therefore, this study investigated the possible antidiabetic effects of the leaf extracts of L. taraxacifolia and some potential mechanistic targets involved. Methodology Ethanolic extract of L. taraxacifolia leaves (LTE) was screened for phytoconstituents and tested for blood glucose-lowering properties in both non-diabetic and streptozotocin-nicotinamide-induced (STZ-NAD) type-2 model diabetic rats for 4 weeks at doses of 500 mg/kg, 750 mg/kg, and 1000 mg/kg. Metformin (200 mg/kg) and glibenclamide (5 mg/kg) were used as positive controls. Effects of LTE on blood glucose, serum lipids, hepatic gluconeogenesis, intestinal glucose absorption, liver enzymes, oral glucose tolerance, and rat organ weights were all studied. Pancreatic Islet histology was also conducted. Results The ethanolic extract of L. taraxacifolia leaves reduced fasting blood glucose levels and suppressed hyperglycemia during the oral glucose tolerance test. In addition, hepatic gluconeogenesis and intestinal glucose absorption were inhibited. The extract lowered levels of liver enzymes, total cholesterol, and LDL cholesterol while increasing HDL cholesterol levels. Again, it reversed STZ-induced weight changes to the liver, kidneys, and pancreas as well as restored the morphology of the pancreatic Islet of Langerhans. Conclusion Launaea taraxacifolia leaves extract (LTE) possesses anti-diabetic constituents and has the potential to repair diabetes-induced damages to the liver, kidney, and pancreatic Islets in SD rats.

Abstract In this study, a machine learning model for the precise manufacturing of green cementitious composites modified with granite powder sourced from quarry waste was designed. For this purpose, decision tree, random forest and AdaBoost ensemble models were used and compared. A database was created containing 216 sets of data based on an experimental study. The database consists of parameters such as the percentage of cement substituted with granite powder, time of testing and curing conditions. It was shown that this method for designing green cementitious composite mixes, in terms of predicting compressive strength using ensemble models and only three input parameters, can be more accurate and much more precise than the conventional approach. Moreover, to the best of the authors' knowledge, artificial intelligence has been one of the most effective and precise methods used in the design and manufacturing industry in recent decades. The simplicity of this method makes it more suitable for construction practice due to the ease of evaluating the input variables. As the push towards decreasing carbon emissions increases, a method for designing green cementitious composites without producing waste that is more precise than traditional tests performed in a laboratory is essential.

IntroductionDetermining the high-risk human papillomavirus (HR-HPV) genotypes burden in women with and without cervical cancer afford a direct comparison of their relative distributions. This quest is fundamental to implementing a future population-based cervical cancer prevention strategy in Ghana. We estimated the cervical cancer risk by HPV genotypes, and the HPV vaccine-preventable proportion of cervical cancer diagnosed in Ghana.Materials and methodsAn unmatched case-control study was conducted at the two largest cervical cancer treatment centres in Ghana from 1st October 2014 to 31st May 2015. Cases were women diagnosed with cervical cancer and controls were women without cervical cancer who were seeking care at the two hospitals. Nested multiplex polymerase chain reaction (NM-PCR) was used to detect HPV infection in cervical samples. Logistic regression was used to determine the association between the risk of cervical cancer and identified HPV infection. P ≤0.05 was considered statistically significant.ResultsHPV deoxyribonucleic acid (DNA) data were analysed for 177 women with cervical cancer (cases) and 201 without cancer (controls). Cervical cancer was diagnosed at older ages compared to the age at which controls were recruited (median ages, 57 years vs 34 years; p < 0.001). Most women with cervical cancer were more likely to be single with no formal education, unemployed and less likely to live in metropolitan areas compared to women without cervical cancer (all p-value ConclusionWomen with cervical cancer in Ghana have HPV infection with multiple genotypes, including some non-vaccine genotypes, with an estimated cervical cancer risk of about six- to ten-fold in the presence of a positive HPV test. HPV DNA tests and multivalent vaccine targeted at HPV 16, 18, 45 and 35 genotypes will be essential in Ghana's cervical cancer control programme. Large population-based studies are required in countries where cervical cancer is most prevalent to determine non-vaccine HPV genotypes which should be considered for the next-generation HPV vaccines.

Dengue, Zika and chikungunya are Aedes-borne viral diseases that have become great global health concerns in the past years. Several countries in Africa have reported outbreaks of these diseases and despite Ghana sharing borders with some of these countries, such outbreaks are yet to be detected. Viral RNA and antibodies against dengue serotype-2 have recently been reported among individuals in some localities in the regional capital of Ghana. This is an indication of a possible silent transmission ongoing in the population. This study, therefore, investigated the entomological transmission risk of dengue, Zika and chikungunya viruses in a forest and domestic population in the Greater Accra Region, Ghana. All stages of the Aedes mosquito (egg, larvae, pupae and adults) were collected around homes and in the forest area for estimation of risk indices. All eggs were hatched and reared to larvae or adults for morphological identification together with larvae and adults collected from the field. The forest population had higher species richness with 7 Aedes species. The predominant species of Aedes mosquitoes identified from both sites was Aedes aegypti (98%). Aedes albopictus, an important arbovirus vector, was identified only in the peri-domestic population at a prevalence of 1.5%, significantly higher than previously reported. All risk indices were above the WHO threshold except the House Index for the domestic site which was moderate (19.8). The forest population recorded higher Positive Ovitrap (34.2% vs 26.6%) and Container (67.9% vs 36.8%) Indices than the peri-domestic population. Although none of the mosquito pools showed the presence of dengue, chikungunya or Zika viruses, all entomological risk indicators showed that both sites had a high potential arboviral disease transmission risk should any of these viruses be introduced. Continuous surveillance is recommended in these and other sites in the Metropolis to properly map transmission risk areas to inform outbreak preparedness strategies.

BackgroundApolipoprotein E is involved in lipid transport and clearance of lipoprotein through low-density lipoprotein receptors (LDLR). ApoE variation has been linked to cardiovascular disease (CVD) risk. There are 3 isoforms of ApoE which originate from two non-synonymous single nucleotide polymorphisms denoted as ε2, ε3 and ε4. The ε2 isoform is implicated in higher levels of atherogenic lipoprotein with the ε4 isoform causing LDLR downregulation. This leads to variable effects and differential CVD risk. Malaria and HIV are life-threatening diseases affecting several countries globally especially in sub-Saharan Africa. Parasite and viral activities have been implicated in lipid dysregulation leading to dyslipidaemia. This study examined ApoE variation and CVD risk assessment in malaria and HIV patients.MethodsWe compared 76 malaria-only, 33 malaria-HIV coinfected, 21-HIV-only and 31 controls from a tertiary health facility in Ghana. Fasting venous blood samples were taken for ApoE genotyping and lipid measurements. Clinical and laboratory data were collected with ApoE genotyping performed using Iplex Gold microarray and PCR-RFLP. Cardiovascular disease risk was calculated using the Framingham BMI and cholesterol risk and Qrisk3 tools.ResultsThe frequency of C/C genotype for rs429358 was 9.32%, whiles T/T genotype for rs7412 was found in 2.48% of all participants. ε3/ε3 was the most distributed ApoE genotype accounting for 51.55% of the total participants whiles ε2/ε2 was found in 2.48% of participants, with 1 in malaria-only and 3 in HIV-only patients. There was a significant association between ε4+ and high TG (OR = 0.20, CI; 0.05-0.73; p = 0.015), whiles ε2+ was significantly associated with higher BMI (OR; 0.24, CI; 0.06-0.87; p = 0.030) and higher Castelli Risk Index II in females (OR = 11.26, CI; 1.37-92.30; p = 0.024). A higher proportion of malaria-only participants had a moderate to high 10-year CVD risk.ConclusionOverall malaria patients seem to have a higher CVD risk though the means through which this occurs may be poorly understood. ε2/ε2 genotypes was observed in our population at a lower frequency. Further studies are vital to determine CVD risk in malaria and how this occurs.

Abstract Background and Aim Adipocytes secrete a peptide hormone called leptin, which plays a crucial role in controlling appetite and energy expenditure. Alterations in leptin concentrations are associated with CKD‐related cardiovascular problems such as hypertensive heart disease (HHD). Despite the link, data on the precise function of leptin in people with CKD and HHD is scant. Methods An observational cross‐sectional study involving a total of 108 participants (72 CKD patients with HHD and 36 healthy controls). Their demographic and anthropometric information was collected using a standardized questionnaire. Certain clinical measures such as blood pressure and body mass index (BMI) were assessed. Fasting blood samples were analyzed for levels of plasma glucose (FPG), lipids, creatinine, and leptin. Data were analyzed with SPSS v23. Results Leptin, FPG, creatinine and triglyceride levels were all significantly higher in CKD patients with HHD compared to controls (p

Abstract Background Rabies, caused by a lyssavirus, is a viral zoonosis that affects people in many parts of the world, especially those in low income countries. Contact with domestic animals, especially dogs, is the main source of human infections. Humans may present with the disease only after a long period of exposure. Nearly half of rabies cases occur in children

Abstract Dicers and dicer-like enzymes play an essential role in small RNA processing in eukaryotes. Nematodes are thought to encode one dicer, DCR-1; only that for Caenorhabditis spp. is well-characterised. Using genomic sequences of eight root-knot nematodes (Meloidogyne spp.), we identified putative coding sequences typical of eukaryotic DICERS. We noted that the primary and secondary structures of DICERS they encode were different for different Meloidogyne species and even for isolates of the same species, suggesting paralogy for the gene. One of the genes for M. incognita (Midcr-1.1) expressed in eggs, juvenile stage 2 and adults, with the highest expression in the adult females. All the Meloidogyne DICERS had seven major domains typical of those for Caenorhabditis spp. and humans with very similar protein folding. RNAi of Midcr-1.1 in J2s using seven dsRNAs, each based on sequences encoding the domains, induced mild paralysis but measurable knockdown was detected in J2s treated with five of the dsRNAs. For four of the dsRNAs, the RNAi effect lasted and reduced the nematode’s infectivity. Also, host plant delivery of dsRNAs complementary to coding sequences of the Dicer Dimerisation domain impaired development, reducing nematode infection by 71%. These results confirm the importance of the gene to nematode health.

Abstract Human erythrocytes are indispensable for Plasmodium falciparum development. Unlike other eukaryotic cells, there is no existing erythroid cell line capable of supporting long-term P. falciparum in vitro experiments. Consequently, invasion phenotyping experiments rely on erythrocytes of different individuals. However, the contribution of the erythrocytes variation in influencing invasion rates remains unknown, which represents a challenge for conducting large-scale comparative studies. Here, we used erythrocytes of different blood groups harboring different hemoglobin genotypes to assess the relative contribution of blood donor variability in P. falciparum invasion phenotyping assays. For each donor, we investigated the relationship between parasite invasion phenotypes and erythrocyte phenotypic characteristics, including the expression levels of surface receptors (e.g. the human glycophorins A and C, the complement receptor 1 and decay accelerating factor), blood groups (e.g. ABO/Rh system), and hemoglobin genotypes (e.g. AA, AS and AC). Across all donors, there were significant differences in invasion efficiency following treatment with either neuraminidase, trypsin or chymotrypsin relative to the control erythrocytes. Primarily, we showed that the levels of key erythrocyte surface receptors and their sensitivity to enzyme treatment significantly differed across donors. However, invasion efficiency did not correlate with susceptibility to enzyme treatment or with the levels of the selected erythrocyte surface receptors. Furthermore, we found no relationship between P. falciparum invasion phenotype and blood group or hemoglobin genotype. Altogether, our findings demonstrate the need to consider erythrocyte donor uniformity and anticipate challenges associated with blood donor variability in early stages of large-scale study design.

Abstract The pool of β-Amyloid (Aβ) length variants detected in preclinical and clinical Alzheimer disease (AD) samples suggests a diversity of roles for Aβ peptides. We examined how a naturally occurring variant, e.g. Aβ(1–38), interacts with the AD-related variant, Aβ(1–42), and the predominant physiological variant, Aβ(1–40). Atomic force microscopy, Thioflavin T fluorescence, circular dichroism, dynamic light scattering, and surface plasmon resonance reveal that Aβ(1–38) interacts differently with Aβ(1–40) and Aβ(1–42) and, in general, Aβ(1–38) interferes with the conversion of Aβ(1–42) to a β-sheet-rich aggregate. Functionally, Aβ(1–38) reverses the negative impact of Aβ(1–42) on long-term potentiation in acute hippocampal slices and on membrane conductance in primary neurons, and mitigates an Aβ(1–42) phenotype in Caenorhabditis elegans. Aβ(1–38) also reverses any loss of MTT conversion induced by Aβ(1–40) and Aβ(1–42) in HT-22 hippocampal neurons and APOE ε4-positive human fibroblasts, although the combination of Aβ(1–38) and Aβ(1–42) inhibits MTT conversion in APOE ε4-negative fibroblasts. A greater ratio of soluble Aβ(1–42)/Aβ(1–38) [and Aβ(1–42)/Aβ(1–40)] in autopsied brain extracts correlates with an earlier age-at-death in males (but not females) with a diagnosis of AD. These results suggest that Aβ(1–38) is capable of physically counteracting, potentially in a sex-dependent manner, the neuropathological effects of the AD-relevant Aβ(1–42).

The genus Escherichia has been extensively studied and it is known to encompass a range of commensal and pathogenic bacteria that primarily inhabit the gastrointestinal tracts of warm-blooded vertebrates. However, the presence of E. coli as a model organism and potential pathogen has diverted attention away from commensal strains and other species in the genus. To investigate the diversity of Escherichia in healthy chickens, we collected fecal samples from antibiotic-free Lohmann Brown layer hens and determined the genome sequences of 100 isolates, 81 of which were indistinguishable at the HC0 level of the Hierarchical Clustering of Core Genome Multi-Locus Sequence Typing scheme. Despite initial selection on CHROMagar Orientation medium, which is considered selective for E. coli, in silico phylotyping and core genome single nucleotide polymorphism analysis revealed the presence of at least one representative of all major clades of Escherichia, except for E. albertii, Shigella, and E. coli phylogroup B2 and cryptic clade I. The most frequent phylogenomic groups were E. coli phylogroups A and B1 and E. ruysiae (clades III and IV). We compiled a collection of reference strains isolated from avian sources (predominantly chicken), representing every Escherichia phylogroup and species, and used it to confirm the phylogeny and diversity of our isolates. Overall, the isolates carried low numbers of the virulence and antibiotic resistance genes typically seen in avian pathogenic E. coli. Notably, the clades not recovered are ones that have been most strongly associated with virulence by other studies.

BackgroundThe declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana.MethodsSwab samples collected from suspected COVID-19 patients were transported to the Zipline office by health workers. Information on the samples were sent to laboratory personnel located at KCCR through a WhatsApp platform to get them ready to receive the suspected COVID-19 samples while Zipline repackaged samples and transported them via drone. Time of take-off was reported as well as time of drop-off.ResultsA total of 2537 COVID-19 suspected samples were received via drone transport from 10 districts between April 2020 to June 2021 in 440 deliveries. Ejura-Sekyedumase District Health Directorate delivered the highest number of samples (765; 30%). The farthest district to use the drone was Pru East, located 270 km away from KCCR in Kumasi and 173 km to the Zipline office in Mampong. Here, significantly, it took on the average 39 minutes for drones to deliver samples compared to 117 minutes spent in transporting samples by road (pConclusionThe use of drones for sample transport during the COVID-19 pandemic significantly reduced the travel time taken for samples to be transported by road to the testing site. This has enhanced innovative measures to fight the pandemic using technology.

BackgroundInfluenza co-infection with bacteria is a leading cause of influenza-related deaths and severe respiratory infections, especially among high-risk groups like cancer patients undergoing treatment. However, acute respiratory infection (ARI)-like symptoms developed by upper-torso cancer (UTC) patients receiving radiotherapy are considered as side-effects of the radiation. Hence influenza and bacterial pathogens implicated in ARI are not investigated.MethodsThis prospective cohort study examined 85 in-patients with upper-torso cancers undergoing radiotherapy at the National Radiotherapy, Oncology and Nuclear Medicine Centre (NRONMC) of Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Eligible patients who consented were recruited into the study from September 2018 to April 2019. Influenza viruses A and B in addition to the following bacteria species Streptococcus pneumonia, Haemophilus influenzae, Neisseria meningitidis and Staphylococcus aureus were detected from oropharyngeal and nasopharyngeal swab specimens collected at three different time points. Presence of respiratory pathogens were investigated by influenza virus isolation in cell culture, bacterial culture, polymerase chain reaction (PCR) and next generation sequencing (NGS) assays.ResultsOf the 85 eligible participants enrolled into the study, 87% were females. Participants were 17 to 77 years old, with a median age of 49 years. Most of the participants (88%) enrolled had at least one pathogen present. The most prevalent pathogen was N. meningitidis (63.4%), followed by H. influenzae (48.8%), Influenza viruses A and B (32.9%), S. pneumoniae (32.9%) and S. aureus (12.2%). Approximately, 65% of these participants developed ARI-like symptoms. Participants with previous episodes of ARI, did not live alone, HNC and total radiation less than 50 Gy were significantly associated with ARI. All treatment forms were also significantly associated with ARI.ConclusionData generated from the study suggests that ARI-like symptoms observed among UTC patients receiving radiotherapy in Ghana, could be due to influenza and bacterial single and co-infections in addition to risk factors and not solely the side-effects of radiation as perceived. These findings will be prime importance for diagnosis, prevention, treatment and control for cancer patients who present with such episodes during treatment.

Recent reports of haemagglutinin antigen (HA) mismatch between vaccine composition strains and circulating strains, have led to renewed interest in influenza B viruses. Additionally, there are concerns about resistance to neuraminidase inhibitors in new influenza B isolates. To assess the potential impact in Ghana, we characterized the lineages of influenza B viruses that circulated in Ghana between 2016 and 2017 from different regions of the country: Southern, Northern and Central Ghana. Eight representative specimens from the three regions that were positive for influenza B virus by real-time RT-PCR were sequenced and compared to reference genomes from each lineage. A total of eleven amino acids substitutions were detected in the B/Victoria lineage and six in the B/Yamagata lineage. The strains of influenza B viruses were closely related to influenza B/Brisbane/60/2008 and influenza B/Phuket/3073/2013 for the Victoria and Yamagata lineages, respectively. Three main amino acid substitutions (P31S, I117V and R151K) were found in B/Victoria lineages circulating between 2016 and 2017, while one strain of B/Victoria possessed a unique glycosylation site at amino acid position 51 in the HA2 subunit. Two main substitutions (L172Q and M251V) were detected in the HA gene of the B/Yamagata lineage. The U.S. CDC recently reported a deletion sub-group in influenza B virus, but this was not identified among the Ghanaian specimens. Close monitoring of the patterns of influenza B evolution is necessary for the efficient selection of representative viruses for the design and formulation of effective influenza vaccines.

Objectives Define the services available for the care of breast cancer at hospitals in the Eastern Region of Ghana, identify areas of the region with limited access to care through geospatial mapping, and test a novel survey instrument in anticipation of a nationwide scale up of the study.Design A cross-sectional, facility-based survey study.Setting This study was conducted at 33 of the 34 hospitals in the Eastern Region of Ghana from March 2020 to May 2020.Participants The 33 hospitals surveyed represented 97% of all hospitals in the region. This included private, government, quasi-government and faith-based organisation owned hospitals.Results Sixteen hospitals (82%) surveyed provided basic screening services, 11 (33%) provided pathological diagnosis and 3 (9%) provided those services in addition to basic surgical care.53%, 64% and 78% of the population lived within 10 km, 25 km and 45 km of screening, diagnostic and treatment services respectively. Limited chemotherapy was available at two hospitals (6%), endocrine therapy at one hospital (3%) and radiotherapy was not available. Twenty-nine hospitals (88%) employed a general practitioner and 13 (39%) employed a surgeon. Oncology specialists, pathology personnel and a plastic surgeon were only available in one hospital (3%) in the Eastern Region.Conclusions Although 16 hospitals (82%) provided screening, only half the population lived within reasonable distance of these services. Few hospitals offered diagnosis and surgical services, but 64% and 78% of the population lived within a reasonable distance of these hospitals. Geospatial analysis suggested two priorities to cost-effectively expand breast cancer services: (1) increase the number of health facilities providing screening services and (2) centralise basic imaging, pathological and surgical services at targeted hospitals.

In late September 2017, Bwabwata National Park in Namibia experienced a sudden die-off of hippopotamuses and Cape buffalo. A multiorganizational response was initiated, involving several ministries within Namibia and the US Centers for Disease Control and Prevention. Rapid interventions resulted in zero human or livestock cases associated with this epizootic.

Individuals with heart failure (HF) frequently present with comorbidities, including obesity, insulin resistance, hypertension, and dyslipidemia. Many patients with HF experience cardiogenic dementia, yet the pathophysiology of this disease remains poorly understood. Using a swine model of cardiometabolic HF (Western diet+aortic banding; WD-AB), we tested the hypothesis that WD-AB would promote a multidementia phenotype involving cerebrovascular dysfunction alongside evidence of Alzheimer’s disease (AD) pathology. The results provide evidence of cerebrovascular insufficiency coupled with neuroinflammation and amyloidosis in swine with experimental cardiometabolic HF. Although cardiac ejection fraction was normal, indices of arterial compliance and cerebral blood flow were reduced, and cerebrovascular regulation was impaired in the WD-AB group. Cerebrovascular dysfunction occurred concomitantly with increased MAPK signaling and amyloidogenic processing (i.e., increased APP, BACE1, CTF, and Aβ40 in the prefrontal cortex and hippocampus) in the WD-AB group. Transcriptomic profiles of the stellate ganglia revealed the WD-AB group displayed an enrichment of gene networks associated with MAPK/ERK signaling, AD, frontotemporal dementia, and a number of behavioral phenotypes implicated in cognitive impairment. These provide potentially novel evidence from a swine model that cerebrovascular and neuronal pathologies likely both contribute to the dementia profile in a setting of cardiometabolic HF.

Background The chicken is the most abundant food animal in the world. However, despite its importance, the chicken gut microbiome remains largely undefined. Here, we exploit culture-independent and culture-dependent approaches to reveal extensive taxonomic diversity within this complex microbial community. Results We performed metagenomic sequencing of fifty chicken faecal samples from two breeds and analysed these, alongside all (n = 582) relevant publicly available chicken metagenomes, to cluster over 20 million non-redundant genes and to construct over 5,500 metagenome-assembled bacterial genomes. In addition, we recovered nearly 600 bacteriophage genomes. This represents the most comprehensive view of taxonomic diversity within the chicken gut microbiome to date, encompassing hundreds of novel candidate bacterial genera and species. To provide a stable, clear and memorable nomenclature for novel species, we devised a scalable combinatorial system for the creation of hundreds of well-formed Latin binomials. We cultured and genome-sequenced bacterial isolates from chicken faeces, documenting over forty novel species, together with three species from the genus Escherichia, including the newly named species Escherichia whittamii. Conclusions Our metagenomic and culture-based analyses provide new insights into the bacterial, archaeal and bacteriophage components of the chicken gut microbiome. The resulting datasets expand the known diversity of the chicken gut microbiome and provide a key resource for future high-resolution taxonomic and functional studies on the chicken gut microbiome.

Childbirth outside marriage has several negative implications for the well-being of children, women, and families globally. In sub-Saharan Africa, however, the phenomenon appears to be under-studied. In this study, we examine the levels and socioeconomic correlates of nonmarital fertility in Ghana. Using pooled data from the 2003, 2008, and the 2014 Ghana Demographic and Health Surveys, logistic regression models were used in determining significantly predictive factors of nonmarital fertility. The results show that nonmarital fertility levels have been on the rise over time without any sign of reduction (24.0%, 33.0%, and 40.0% for 2003, 2008, and 2014, respectively). Some socioeconomic characteristics are linked to nonmarital fertility levels with women without formal education, women from poor households, and self-employed women having significantly higher nonmarital fertility risks. Also, older unmarried women, women who have an early sexual debut, cohabiters, women with unmet need for family planning are all associated with considerably higher risks of nonmarital childbearing. A few significant regional disparities also exist, with the Central Region having higher whereas the Upper West Region has lower risks of nonmarital fertility compared to the Greater Accra Region. Childbirth outside marriage is a social concern among women in Ghana. The findings have possible implications for bridging socioeconomic disparities among unmarried women.

In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p =

The pace of decline in fertility rates in sub-Saharan Africa appears to have slowed or stalled in the last few decades. This study examines the socioeconomic associated with cumulative fertility in Ghana. Negative binomial regression models were used to estimate determinants of cumulative fertility using data from the Ghana Demographic and Health Surveys of 2003, 2008, and 2014. The composition of children ever born by women did not change considerably over the study periods. Socioeconomic disparities in educational attainment, household wealth, employment, and employer status are significantly associated with cumulative fertility risks in Ghana. The current age of women, age at sexual debut, and marital status, among others, are also linked to cumulative fertility levels. Place and region of residence are also linked to fertility in Ghana. Cumulative fertility levels in Ghana are underscored by considerable socioeconomic disparities among women of reproductive age. Fertility regulation policies should hinge on improving the socio-economic wellbeing of women in Ghana.

Aedes-borne viral diseases mainly Yellow Fever (YF), Dengue (DEN), Zika (ZIK) and Chikungunya (CHK) have contributed to many deaths' in the world especially in Africa. There have been major outbreaks of these diseases in West Africa. Although, YF outbreaks have occurred in Ghana over the years, no outbreak of DEN, ZIK and CHK has been recorded. However, the risk of outbreak is high due to its proximity to West African countries where outbreaks have been recently been recorded. This study surveyed the mosquito fauna to assess the risk of transmission of Yellow fever (YFV), Dengue (DENV), Chikungunya (CHKV) and Zika (ZIKV) viruses in Larabanga and Mole Game Reserve areas in Northern Ghana. The immature and adult stages of Aedes mosquitoes were collected from Larabanga and Mole Game Reserve area. There was a significant (P>0.001) number of mosquitoes collected during the rainy season than the dry season. A total of 1,930 Aedes mosquitoes were collected during the rainy season and morphologically identified. Of these, 1,915 (99.22%) were Aedes aegypti and 15 (0.22%) were Aedes vittatus. During the dry season, 27 Ae. aegypti mosquitoes were collected. A total of 415 Ae. aegypti mosquitoes were molecularly identified to subspecies level of which Ae. (Ae) aegypti aegypti was the predominant subspecies. Both Ae. aegypti aegypti and Ae aegypti formosus exist in sympatry in the area. All Aedes pools (75) were negative for DENV, ZIKV and CHKV when examined by RT- PCR. Three Larval indices namely House Index, HI (percentage of houses positive for Aedes larvae or pupae), Container Index, CI (the percentage of containers positive for Aedes larvae or pupae) and Breteau Index, BI (number of positive containers per 100 houses inspected) were assessed as a measure for risk of transmission in the study area. The HI, CI and BI for both sites were as follows; Mole Game Reserve (HI, 42.1%, CI, 23.5% and BI, 100 for rainy season and 0 for all indices for dry season) and Larabanga (39%, 15.5% and 61 for rainy season and 2.3%, 1.3% and 2.3 for dry season). The spatial distribution of Aedes breeding sites in both areas indicated that Aedes larvae were breeding in areas with close proximity to humans. Lorry tires were the main source of Aedes larvae in all the study areas. Information about the species composition and the potential role of Aedes mosquitoes in future outbreaks of the diseases that they transmit is needed to design efficient surveillance and vector control tools.

In this study, different versions of feedforward neural network (FFNN), Gaussian process regression (GPR), and decision tree (DT) models were developed to estimate daily river water temperature using air temperature (Ta), flow discharge (Q), and the day of year (DOY) as predictors. The proposed models were assessed using observed data from eight river stations, and modelling results were compared with the air2stream model. Model performances were evaluated using four indicators in this study: the coefficient of correlation (R), the Willmott index of agreement (d), the root mean squared error (RMSE), and the mean absolute error (MAE). Results indicated that the three machine learning models had similar performance when only Ta was used as the predictor. When the day of year was included as model input, the performances of the three machine learning models dramatically improved. Including flow discharge instead of day of year, as an additional predictor, provided a lower gain in model accuracy, thereby showing the relatively minor role of flow discharge in river water temperature prediction. However, an increase in the relative importance of flow discharge was noticed for stations with high altitude catchments (Rhône, Dischmabach and Cedar) which are influenced by cold water releases from hydropower or snow melting, suggesting the dependence of the role of flow discharge on the hydrological characteristics of such rivers. The air2stream model outperformed the three machine learning models for most of the studied rivers except for the cases where including flow discharge as a predictor provided the highest benefits. The DT model outperformed the FFNN and GPR models in the calibration phase, however in the validation phase, its performance slightly decreased. In general, the FFNN model performed slightly better than GPR model. In summary, the overall modelling results showed that the three machine learning models performed well for river water temperature modelling.

Chlamydia and gonorrhea are common sexually transmitted infections (STIs) that can cause multiple problems, and can be easily treated, but frequently present without symptoms. Because of this, commonly used syndromic diagnosis misses a majority of infected persons. Previously, diagnostic tests were expensive and invasive, but newer nucleic-acid amplification tests (NAATs) are available that use urine to non-invasively test for these infections. These analyses used data from seroprevalence studies conducted in five militaries. Data included self-reported current symptoms of STIs as well as chlamydia and gonorrhea NAAT results. A total of 4923 men were screened for chlamydia and gonorrhea from these 5 militaries during April 2016 to October 2017. The combined prevalence of chlamydia and gonorrhea in these five militaries ranged from 2.3% in Burundi to 11.9% in Belize. These infections were not successfully identified by symptomology; for example, only 2% of cases in Belize reported symptoms. In three of the five countries there was no statistical association between symptoms and positive NAAT results. The majority of individuals with these infections (81% to 98%) would be undiagnosed and untreated using only symptomology. Therefore, using symptoms alone to diagnose cases of chlamydia and gonorrhea is not an effective way to control these infections. We propose that automated, cartridge-based NAATs, be considered for routine use in diagnosing those at risk for STIs.

INTRODUCTION: Neonatal Sepsis (NNS) is a public health problem which causes death or disability unless appropriate antibiotic treatment is given promptly. Globally, sepsis is an important cause of morbidity and mortality in neonates despite recent progress in health care delivery. We assessed the factors associated with culture proven sepsis among neonates in the Ho Municipality, Ghana. METHODS: a cross-sectional study was conducted in two public hospitals in the Ho Municipality between January and May, 2016. All neonates who were clinically suspected with sepsis in the Neonatal Intensive Care Unit (NICU) and their mothers were recruited. A 2ml blood sample was taken aseptically and dispensed into a mixture of thioglycollate and tryptone soy broth in a 1:10 dilution and microbiological procedures performed. Case notes of both neonates and their mothers were reviewed and interviews conducted to collect both clinical and socio-demographic data. We determined the factors associated with culture proven neonatal sepsis using logistic regression model and statistical significance was determined at 95% confidence intervals. RESULTS: out of 150 neonates, 26 (17%) had laboratory confirmed sepsis. The most common pathogen isolated was Staphylococcus epidermidis 14, (54%). Neonates whose mothers were primigravida (OR=2.74; 95% CI:1.12-6.68), and those who attended antenatal clinics (ANC) fewer than three schedules (OR=2.90; 95% CI:1.06-7.96) had higher odds of developing culture proven sepsis. CONCLUSION: neonates who were the first babies of their mothers were more likely to develop laboratory confirmed sepsis. Also, neonates of mothers who attended ANC less than 3 times were more likely to develop laboratory confirmed sepsis. High index of suspicion is required to diagnose neonatal sepsis among neonates of primigravida mothers and mothers who attend fewer than three ANC schedules.

Apicomplexan parasites have challenged researchers for nearly a century. A major challenge to developing efficient treatments and vaccines is the parasite’s ability to change its cellular and molecular makeup to develop intracellular and extracellular niches in its hosts. Ca 2+ signaling is an important messenger for the egress of the malaria parasite from the infected erythrocyte, gametogenesis, ookinete motility in the mosquito, and sporozoite invasion of mammalian hepatocytes. Calcium-dependent protein kinases (CDPKs) have crucial functions in calcium signaling at various stages of the parasite’s life cycle; this therefore makes them attractive drug targets against malaria. Here, we summarize the functions of the various CDPK isoforms in relation to the malaria life cycle by emphasizing the molecular mechanism of developmental progression within host tissues. We also discuss the current development of anti-malarial drugs, such as how specific bumped kinase inhibitors (BKIs) for parasite CDPKs have been shown to reduce infection in Toxoplasma gondii , Cryptosporidium parvum , and Plasmodium falciparum . Our suggested combinations of BKIs, artemisinin derivatives with peroxide bridge, and inhibitors on the Ca(2+)-ATPase PfATP6 as a potential target should be inspected further as a treatment against malaria.

The literature on spatial patterns and contextual factors affecting modern contraceptive use is not well-documented in Ghana. This study describes the spatial variations and estimates the socioeconomic determinants of modern contraception among women in reproductive age in Ghana. Using data from the 2014 Ghana Demographic and Health Survey, both global and local Moran's I test were performed to show spatial autocorrelation and Bayesian multilevel models estimated to determine socioeconomic factors affecting modern contraceptive use. The results show evidence of low prevalence and spatial clustering of modern contraception use across the country. There were also notable regional disparities in contraceptive use that favour mostly the southern regions. Modern contraceptive use is significantly associated with socioeconomic factors such as educational attainment, work status, and marital status, as well as age, religious affiliation, and parity. Contextual factors such as the convenient location of health facility and family planning messages exposure also have a considerable positive effect on modern contraceptive use. Uneducated, unemployed and never-married women are considerably disadvantaged in the utilisation of modern contraception in Ghana. Socioeconomic and contextual factors play a key role in modern contraceptive use in Ghana.

Cassava is the 6th most important source of dietary energy in the world but its root system architecture (RSA) had seldom been quantified. Ability to select superior genotypes at juvenile stages can significantly reduce the cost and time for breeding to bridge the large yield gap. This study adopted a simple approach to phenotyping RSA traits of juvenile and mature cassava plants to identify genotypic differences and the relationships between juvenile traits and harvest index of mature plants. Root classes were categorised and root and shoot traits of eight (8) juvenile pot-grown cassava genotypes, were measured at 30 and 45 days after planting (DAP). The same or related traits were measured at 7 months after planting of the same genotypes grown in the field while yield and yield components were measured in 12-months old field-grown plants. The field experiment was done in 2017 and repeated in 2018. Differences between genotypes for the measured traits were explored using analysis of variance (ANOVA) while traits in juvenile plants were correlated or regressed onto traits measured in 7- and 12-months old plants. The results show significant genotypic variations for most of the traits measured in both juvenile and 7-months old plants. In the 12-months old plants, differences between genotypes were consistent for both 2017 and 2018. Broad-sense heritability was highest for the number of commercial roots (0.87) and shoot fresh weight (0.78) and intermediate for the total number of roots (0.60), harvest index (0.58), fresh weight of roots (0.45). For all the sampling time points or growth stages, there were greater correlations between traits measured at a particular growth stage than between the same traits at different growth stages. However, some juvenile-mature plant trait relationships were significant, positive and consistent for both 2017 and 2018. For example, total root length and the total number of roots in 30 DAP, and branching density of upper nodal roots in 45 DAP, positively correlated with harvest index of 12-months old plants in both 2017 and 2018. Similarly, the diameter of nodal roots, for example, had a negative, significant correlation with fresh shoot biomass of mature plants in both 2017 and 2018. Regression of traits measured in 30 DAP explained up to 22% and 36% of the variation in HI of mature plants in 2017 and 2018, respectively. It is concluded that the simple, rapid, inexpensive phenotyping approach adopted in this study is robust for identifying genotypic variations in juvenile cassava using root system traits. Also, the results provide seminal evidence for the existence of useful relationships between traits of juvenile and mature cassava plants that can be explored to predict yield and yield components.

There is a dearth of information on induced abortion in Ghana, possibly owing to the sensitive nature of the subject. In this study, we examine the effect of socioeconomic and contextual factors on induced abortion in Ghana. This study draws on data from the 2017 Ghana Maternal Health Survey. The study used a Bayesian multilevel logistic regression analysis to estimate both individual- and contextual-level factors affecting induced abortion levels in Ghana. The results show a total induced abortion prevalence of 19.6% coupled with considerable district-level disparities. Induced abortion is significantly associated with socioeconomic factors such as educational attainment, wealth status, and marital status at the individual-level. The risk of induced abortion is considerably higher among the educated, wealthy, and cohabiting women. The current age of women, age at first sex, religious affiliation, parity, and type of residence are the demographic factors having an association with induced abortion levels. At the contextual-level, district health insurance coverage and poverty rate have a significant association with induced abortion. Induced abortion appears to be prevalent in Ghana and is underpinned by both individual-level socioeconomic and aggregate-level factors. Addressing induced abortion levels in Ghana may require policies that take a multilevel approach by focusing on the socioeconomic status of women and district-level contextual factors.

Abstract After the successful roll out of MenAfriVac, Nigeria has experienced sequential meningitis outbreaks attributed to meningococcus serogroup C (NmC). Zamfara State in North-western Nigeria recently was at the epicentre of the largest NmC outbreak in the 21st Century with 7,140 suspected meningitis cases and 553 deaths reported between December 2016 and May 2017. The overall attack rate was 155 per 100,000 population and children 5–14 years accounted for 47% (3,369/7,140) of suspected cases. The case fatality rate (CFR) among children 5–9 years was 10%, double that reported among adults ≥ 30 years (5%). NmC and pneumococcus accounted for 94% (172/184) and 5% (9/184) of the laboratory-confirmed cases, respectively. The sequenced NmC belonged to the ST-10217 clonal complex (CC). All serotyped pneumococci were PCV10 serotypes. The emergence of NmC ST-10217 CC outbreaks threatens the public health gains made by MenAfriVac, which calls for an urgent strategic action against meningitis outbreaks.

Introduction: the impact of HIV/AIDS on women and children has called for a higher increase in global commitment and response to the prevention of mother-to-child transmission (PMTCT). The study investigated the knowledge, attitudes and practices of pregnant women regarding PMTCT of HIV in Bosome Freho District in the Ashanti region of Ghana. Methods: a facility-based cross-sectional study was conducted in August of 2017, involving 339 pregnant women, selected through a multistage sampling technique. Data were collected through a structured pre-tested and validated questionnaire and analysed by using Stata SE version 12.0. Logistic regression analyses were used to test associations between background factors and the knowledge, attitudes and practices at 0.05 level of significance. Results: the level of knowledge was high (77.0%), attitudes were good (71.1%), and the practice of PMTCT was high (95.9%). However, the knowledge of participants on the importance of exclusive breastfeeding, the moments when HIV transmission occurs, and the merits of elective caesarean sections as an HIV preventive method were grossly insufficient. Knowledge was influenced by the level of education (AOR=19 (95% CI: 1.08-333.82); p=0.04); attitudes were influenced by the level of knowledge regarding PMTCT (AOR=5.3 (95% CI: 2.76-10.35); p less than0.001). Conclusion: interventions to improve the knowledge, attitudes and practices regarding PMTCT should focus more on women with less than Senior High School (SHS) level of education. Exclusive breastfeeding and elective caesarean sections, though effective in reducing transmission of HIV from the mother to the child, could be missed opportunities in reducing the burden of HIV in this community

Abstract Background Globally, 4 million neonates die annually, with one-third of such deaths occurring as a result of infections. In 2011, there were 7.2million deaths in children below 5 years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multidrug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health. The change in these organisms has been reported to vary across regions, between health facilities and even within the same facility. Continuous surveillance is required to inform antibiotic choice for neonatal sepsis management. We identified the common causative organisms of neonatal sepsis and their antibiotic susceptibility pattern in the Ho municipality. Method A cross sectional study was conducted in the Ho municipality from January to May, 2016. A semi-structured questionnaire was used to collect socio-demographic data from mothers of neonates with clinically suspected of sepsis. Clinical data of both mothers and neonates were extracted from case notes. A 2 ml volume of blood was also taken from neonates and dispensed into a 20 ml mixture of thioglycollate fluid broth and tryptone soy broth for culture and antibiotic susceptibility pattern determined. Results Out of the 150 clinically suspected neonatal sepsis cases, 91 (60.7%) were males. The Median gestational week was 38 (IQR: 36–39) and Median birthweight was 3.0 kg (IQR 2.5–3.4). The prevalence of culture positive sepsis was 17.3% of the 150 suspected cases. A total of 26 different pathogens were isolated, of which gram positive organisms had a preponderance of 18 (69%) over gram negative organisms 8 (31%). Staphylococcus epidermidis was the most common 14 (53.8%) isolate identified. There was a single isolate (4%) each of Proteus mirabilis and Escherichia coli identified. All the isolates identified showed 100% resistance to ampicillin. Conclusion The prevalence of culture proven sepsis was 17.3% and Staphylococcus epidermidis was the most common isolate identified. Pathogens isolated were resistant to the first line drugs for management of neonatal sepsis. Hence, the need for a review of first line drug for empirical treatment in neonatal sepsis.

The bio-chemical and physical characteristics of a river are directly affected by water temperature, which thereby affects the overall health of aquatic ecosystems. It is a complex problem to accurately estimate water temperature. Modelling of river water temperature is usually based on a suitable mathematical model and field measurements of various atmospheric factors. In this article, the air–water temperature relationship of the Missouri River is investigated by developing three different machine learning models (Artificial Neural Network (ANN), Gaussian Process Regression (GPR), and Bootstrap Aggregated Decision Trees (BA-DT)). Standard models (linear regression, non-linear regression, and stochastic models) are also developed and compared to machine learning models. Analyzing the three standard models, the stochastic model clearly outperforms the standard linear model and nonlinear model. All the three machine learning models have comparable results and outperform the stochastic model, with GPR having slightly better results for stations No. 2 and 3, while BA-DT has slightly better results for station No. 1. The machine learning models are very effective tools which can be used for the prediction of daily river temperature.

Abstract There is growing concern that interventions that alter microbial ecology can adversely affect health. We characterised the impact of the seven-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal carriage and the bacterial component of the nasopharyngeal microbiome during infancy. Newborns were recruited into three groups as follows: Group1 (n = 33) was the control group and comprised infants who received PCV7 after 6 months and came from unvaccinated communities. Group 2 (n = 30) came from unvaccinated communities and Group 3 (n = 39) came from vaccinated communities. Both group 2 and 3 received PCV7 at 2, 3 and 4 months. Culture and 16 S rRNA gene sequencing were performed on nasopharyngeal specimens collected at regular intervals from infants. Nasopharyngeal carriage of PCV7 serotypes in Group 1 was significantly higher than in Group 2 and 3 (p