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Abstract Background Vaccination has contributed to the reduction in vaccine preventable diseases. Despite, improved global coverage, vaccination among nomadic populations is still low especially in Africa. This study explored factors influencing vaccination uptake among pastoralist nomads in Ghana. Methods We conducted key informant interviews (KII) in 11 districts across four regions of Ghana, using grounded theory qualitative research approach. One hundred and eighty-two KII were conducted among pastoralist nomads, community opinion leaders, community health volunteers, security services personnel, local government personnel and health workers. Guided by the WHO health systems building blocks, data was coded using Nvivo 12 and analysed thematically. Results were presented as narratives with excerpts to support the findings. Results Community leaders support vaccination among pastoralist nomads as part of their leadership and governance responsibilities. Language barrier between health workers and pastoralist nomads affects service delivery. Also, healthcare providers fear being attacked by pastoralist nomads hence are hesitant to visit their settlements for vaccination. With regards to health workforce, healthcare providers’ perceived use of derogatory words and discrimination against pastoralist nomads influence their vaccination uptake. On medical product, the lack of knowledge about diseases, severity and perceived negative effects about vaccines influence vaccination uptake. Inadequate funds and logistics at the district health directorates affects outreach to nomads during vaccinations. Leveraging existing partnership between the health services and community leaders, information centers, volunteers and butchers to send health information to pastoralist nomads influence vaccination uptake. Conclusion Community leaders support vaccination among pastoralist nomads. Nomadic pastoralist miss vaccination dues to language barrier, feel discriminated against, and lack information about diseases and vaccinations. Strengthening Ghana Health Service collaboration with leaders of pastoralist nomads could build trust, create awareness and overcome language barrier between healthcare providers and pastoralist nomads.

Abstract Background There is a close link between the lack of electricity access and poverty indicators such as illiteracy, high infant mortality, lack of access to health care and malnutrition among others. Most rural farming communities in Ghana lack access to electricity due to the high cost of extending the grid to these communities. This lack of access tends to worsen the gap between urban and rural inhabitants regarding access to education, healthcare and development. Methods This study assessed the technical and theoretical potential of agricultural residues in providing electricity to off-grid communities. The study used crop production figures of maize, cassava, millet and groundnut in the Soma and Goyiri farming communities in the Sawla-Tuna-Kalba District to conduct an assessment of the theoretical and technical potential of residues from the crops. The production figures of these crops were obtained from the District Office of the Ministry of Food and Agriculture. Expected electricity demand of households, schools and health centers in the study communities were collected and employed for the projected load demand estimates. Results The study found that 312.23 MWh/day of electricity could be generated from the combined residues of maize, cassava, millet and groundnut from the two communities. This amount of electricity is capable of providing ~ 202 to 263 times the peak electricity demand of the studied communities. Out of the total electricity demand of the two communities, only about 91 kWh/day is needed for use in a school and Community Health Promotion and Services (CHPS) compound, implying that the electricity from crop residues can also help to improve education and health provision in the rural communities. Conclusion It is concluded that the potential of crop residues in meeting the electricity demand of off-grid communities is enormous. Hence, it must be considered in Ghana’s energy development plans to achieve universal electricity access.

This research assessed patients’ perspective of factors associated with patient-centred care in selected health facilities in the Volta Region of southern Ghana. A descriptive hospital-based cross-sectional survey design was used where a structured questionnaire was administered to 403 patient participants. Regression analysis was conducted and the results reported in proportions, frequencies and odds ratios. The level of patient-centred care practice among patients in the selected health facilities was 56.8%. Patient-centred care was influenced by age (aOR=1.13; CI:1.02-1.25), educational status (aOR=0.02; CI:0.001-0.63), road network (aOR=0.09; CI:0.02-0.63) and cultural barriers (aOR=15.22; CI:1.65-139.99). Individual patient and community system factors including cultural beliefs have the potential of influencing patient-centred care satisfaction with the quality of care delivery in health facilities. Thus, there is a need for the government to address the problem of deplorable road networks in the communities.

Objectives: Complications following breast cancer treatment result in chronic upper limb disabilities. To plan an informed and effective rehabilitation for timely intervention to prevent, mitigate, or manage the functional impairments for breast cancer survivors, especially in settings with limited resources, the burden of upper limb disabilities needs to be ascertained. This study examined upper limb disabilities and associated factors among breast cancer survivors. Methods: This cross-sectional quantitative study recruited 60 breast cancer survivors using purposive sampling method. Text messages and face-to-face interactions were used to inform participants about the study. Disability of the Arm, Shoulder and Hand questionnaire was used to ascertain the upper limb disabilities. To determine lymphedema, tape measurements of upper limb circumference were translated into a limb volume with the geometric formula for a truncated cone. Visual analogue scale, hand dynamometer, and goniometer were used to measure pain, grip strength, and shoulder range of movement, respectively. Descriptive statistics were used to summarize data. Linear regression was used to determine the correlation between upper limb disabilities and selected variable. Alpha level was set at p

The failure of the South African economy to achieve the desired economic expansion raised a serious concern to investigate the potency of trade liberalization policy adopted in the country. This is evidence in macroeconomic indices such as high level of unemployment, poverty and most importantly sluggish economic growth. It is against this back drop that this study was spurred to conduct an analysis of the impact of trade liberalization on economic growth in South Africa covering the period of 1986-2022. The mixed order of integration revealed by the unit root test informed the decision to adopt the ARDL method of estimation. The main findings of interest in this study is the existence of a strong positive relationship between trade liberalization and economic growth in South Africa. Thus, the study concludes that economic integration is healthy for the national economy and hence more liberalization policies should be strategically embrace. The study recommends that the African governments especially South Africa should further open it economic border to allow for free trade with other economies of the world.

Abstract Background Uropathogens are microorganisms that cause urinary tract infections (UTIs). Owing to higher blood glucose levels and compromised immune functions, treatment of uropathogens in diabetic patients is a challenge. Aim This study aims to assess the prevalence of uropathogens and their antibiotic susceptibility among diabetic patients at St. John of God Hospital at Duayaw Nkwanta (SJGHDN) in the Ahafo region of Ghana. Methods The cross‐sectional study recruited 175 diabetic patients at SJGHDN between August and September 2023. Questionnaires were used to collect patients’ background information. Fasting Blood Sugar (FBS) was assessed by using a glucometer. Urine samples were examined for the presence of uropathogens. A sterile inoculating loop with a calibrated volume of 2 µl was used for plating. Each colony equals 500 CFU/mL. Significant uropathogen was determined by multiplying the counted colonies by 500 to obtain CFU/mL. Positive uropathogen was defined as CFU ≥ 105/mL. Significant uropathogen was defined as ≥200 colonies per sample. The disc diffusion method was used to determine antibiotic susceptibility. Results Out of the 175 patients, 19.4% expressed various uropathogens with Escherichia coli being the predominant. Suboptimal glucose level was the most significant risk factor (p = 0.038). Glucosuria (p = 0.036), hazy urine (p = 0.028), positive leukocyte esterase (p = 0.001), and pus cells in urine sediment (p = 0.020) were significant indicators of uropathogen occurrence. Klebsiella pneumonia and Proteus mirabilis were resistant to ≥4 antibiotics. Amikacin, nitrofurantoin, levofloxacin, ciprofloxacin, and ceftriaxone demonstrated efficacy against the isolates. Conclusion This study underscores the notable prevalence of uropathogens in diabetic patients and the alarming levels of antibiotic resistance observed. The results highlight the critical need for vigilant monitoring and customized treatment approaches, particularly for diabetic patients exhibiting risk factors such as elevated urine glucose levels, cloudy urine, and presence of leukocyte esterase and pus cells in urine sediment. The significant resistance to frequently used antibiotics like co‐trimoxazole and tetracycline points to the necessity of routine susceptibility testing and the use of alternative antibiotics for effective treatment. These findings can assist healthcare providers in more effectively managing and preventing UTIs in diabetic populations.

This paper investigates the relative importance of public and private sector capital formation on economic growth in Malawi. Employing both the Two-Stage Least Squares and dynamic Generalised Method of Moments techniques on quarterly data from 1970Q1 to 2019Q4, the study finds that private sector capital formation makes a significant contribution to economic growth. The relationship between public sector capital formation and economic growth, however, is insignificant. The study finds no evidence of complementarity between public and private sector capital formation in Malawi. The study observes that private sector capital formation affects public sector capital formation, and not vice versa. Consistent with orthodox classical political economics, we recommend a small government for Malawi with a lean budget, especially since there are no observed benefits from large government spending in spurring economic growth. The only public sector investments that may be undertaken are public goods in areas associated with market failure.

This study explores the dynamic relationship between crude oil price volatility and revenue generation in Nigeria over a 41-year period from 1981 to 2021. It encompasses an analysis of key variables, including total revenue (REV), oil price (OPV), oil revenue (ORV), non-oil revenue (NRV), and exchange rate (EXCHR). The study employs the Auto Regressive Distributed Lags (ARDL) model to examine the long-term and short-term impacts of oil price volatility on revenue generation. This study reveals that crude oil price volatility (OPV) failed to exert strong impact on total revenue (REV) in Nigeria in the distance period. Oil revenue (ORV) exhibits a strong and positive influence on total revenue, highlighting its pivotal role in revenue generation. Non-oil revenue (NRV) also significantly contributes to total revenue, emphasizing the importance of diversifying revenue sources. Exchange rate (EXCHR) fluctuations do not significantly predict changes in total revenue. Based on the findings, policy recommendations include diversifying revenue sources, enhancing non-oil revenue collection, effective oil revenue management, promoting economic diversification, strengthening tax infrastructure, and adopting prudent budgeting practices.

This study seeks to examine the effect of capital structure on financial performance of the listed information and communications technology firms in Nigeria. This study adopted correlation and ex-post facto research design. The population of this study consists of all listed information and communications technology firms in Nigeria. Census sampling technique was employed. Multiple regression model based on pooled ordinary lease square, robust test was adopted in analyzing the panel data obtained from audited financial statement of the listed sampled information and communications technology firms for the periods of 10 years between (2013- 2022). The study reveals that both long term debt financing ratio short term debt financing, and debt to equity financing ratio have positive and significant influence on return on assets of the listed information and communications technology firms in Nigeria. On the other hand, equity financing ratio has a positive but insignificant effect on performance of listed information and communications technology companies in Nigeria. Therefore, it is recommended that the management of the listed information and communications technology firms in Nigeria should initiate coherent and integrated financial policies towards encouraging long-and short-term debt financing and debt to equity financing to ultimately improve the financial performance of the list information and communications technology firms in Nigeria.

The double burden of tuberculosis (TB) and diabetes mellitus (DM) represents a major public health challenge that demands urgent and integrated approaches. The interplay between these two chronic conditions presents unique clinical and public health management challenges, as well as social and economic implications. We explored the bidirectional relationship between TB and DM, emphasizing how DM increases susceptibility to TB and complicates its management, while TB may exacerbate glycemic control in diabetic patients. This review underscores the challenges associated with the management of both diseases, obstacles in screening TB patients for DM and TB preventive therapy for DM since inadequate glycemic control can impact treatment outcomes. Several studies have investigated the disease interplay; however, the results have been equivocal, and this may be exerting negative impacts on the disease prevention and treatment. TB-diabetes comorbidity has been linked to poor treatment outcomes whereas TB prevention in people with DM at present is a dilemma. In addition to highlighting how urgent it is to address this comorbidity, this review offers a road map for better prevention, treatment, and control of several factors underlying the TB-diabetes syndemic interaction.

Patient Satisfaction with Service Quality of a Private Health Facility in Accra, Ghana

Sustainability assessment of dairy systems is necessary to understand bottlenecks and to identify measures to enhance sustainability of the systems. The Dairy Sustainability Assessment Tool (DSAT) was developed with a focus on the facilitation of discussion on sustainability among dairy sector actors in East Africa. DSAT has been applied in several case studies, but the tool has not been systematically evaluated. The objectives of this study were to evaluate the strengths and weaknesses of DSAT and to compare its main features with similar dairy assessment tools for Africa. This evaluation consisted of a literature search to identify relevant assessment tools and an online survey about the tool among its users. DSAT was different from other tools compared with as it does not require input data from farm surveys as the assessments rely on expert opinion, and it can conduct assessments at farm, regional and national scales. Results also showed that DSAT was appropriate for holistic assessments of the sustainability of dairy systems in Africa by providing a good overview of threats to sustainability. Weaknesses were mainly the scoring of indicators, which tends to be subjective and the absence of numerical reference values for indicators. Therefore, improving DSAT requires addressing the identified weaknesses.

Objective: This study aimed to investigate the impact of diabetes mellitus (DM) on tuberculosis (TB) treatment response using bacterial clearance as a surrogate marker. Method: We compared smear microscopy, culture, and tuberculosis molecular bacterial load assay (TB-MBLA) for treatment monitoring. Following that, bacterial clearance was longitudinally monitored among TB-only (TB without DM) and TB-diabetes (TBDM) patients using TB-MBLA. Results: Ninety-three participants, including 59 TB-only and 34 TBDM patients, were enrolled. TB-only patients exhibited higher upper zone infiltrations (32/35 vs 16/22, p = 0.059) suggesting a trend towards significance, and significantly more cavitation in the same zone (16/18 vs 7/13, p = 0.028). There was a high proportion of Mycobacterium africanum (Maf) among the TBDM cohort (p = 0.0044).At baseline, TB-only patients exhibited a higher average bacterial burden (4.49 logeCFU/mL) compared to the TBDM group (3.91 logeCFU/mL) (p = 0.042). The bacterial load in the TB-only group decreased significantly during treatment but the TBDM group experienced delayed clearance throughout the intensive phase of anti-TB treatment even at day 56 (p = 0.028). The TB-only group demonstrated a shorter median time to TB-MBLA conversion to negative (57 days) compared to the TBDM group (62 days) (p = 0.022). Conclusion: These findings underscore the urgent call for understanding the interplay between diabetes and TB, emphasizing the need for tailored interventions in optimizing TB care for individuals comorbid with diabetes.

BackgroundVaccines serve as a crucial public health tool, although vaccine hesitancy continues to pose a significant threat to full vaccine uptake and, consequently, community health. Understanding and tracking vaccine hesitancy is essential for effective public health interventions; however, traditional survey methods present various limitations. ObjectiveThis study aimed to create a real-time, natural language processing (NLP)–based tool to assess vaccine sentiment and hesitancy across 3 prominent social media platforms. MethodsWe mined and curated discussions in English from Twitter (subsequently rebranded as X), Reddit, and YouTube social media platforms posted between January 1, 2011, and October 31, 2021, concerning human papillomavirus; measles, mumps, and rubella; and unspecified vaccines. We tested multiple NLP algorithms to classify vaccine sentiment into positive, neutral, or negative and to classify vaccine hesitancy using the World Health Organization’s (WHO) 3Cs (confidence, complacency, and convenience) hesitancy model, conceptualizing an online dashboard to illustrate and contextualize trends. ResultsWe compiled over 86 million discussions. Our top-performing NLP models displayed accuracies ranging from 0.51 to 0.78 for sentiment classification and from 0.69 to 0.91 for hesitancy classification. Explorative analysis on our platform highlighted variations in online activity about vaccine sentiment and hesitancy, suggesting unique patterns for different vaccines. ConclusionsOur innovative system performs real-time analysis of sentiment and hesitancy on 3 vaccine topics across major social networks, providing crucial trend insights to assist campaigns aimed at enhancing vaccine uptake and public health.

Bioinformatics, the interdisciplinary field that combines biology, computer science, and data analysis, plays a pivotal role in advancing our understanding of life sciences. In the African context, where the diversity of biological resources and healthcare challenges is substantial, fostering bioinformatics literacy and proficiency among students is important. This perspective provides an overview of the state of bioinformatics literacy among African students, highlighting the significance, challenges, and potential solutions in addressing this critical educational gap. It proposes various strategies to enhance bioinformatics literacy among African students. These include expanding educational resources, fostering collaboration between institutions, and engaging students in research projects. By addressing the current challenges and implementing comprehensive strategies, African students can harness the power of bioinformatics to contribute to innovative solutions in healthcare, agriculture, and biodiversity conservation, ultimately advancing the continent’s scientific capabilities and improving the quality of life for her people. In conclusion, promoting bioinformatics literacy among African students is imperative for the continent’s scientific development and advancing frontiers of biological research.

Drilling water-sensitive shale formations often leads to wellbore instability, resulting in drilling problems because of the clay's high-water affinity. To solve this problem, different nanoparticles (NPs), such as nanosilica, have been used to formulate water-based muds with potassium chloride (KCl-WBM). Nevertheless, the unmatched pore size of shale pores when using nanosilica fails to completely prevent shale swelling and dispersion. This study discusses the effects of KCl-WBM with sodium dodecyl sulphate-treated nanohydroxyapatite (nHAp/SDS) on shale swelling inhibition through various laboratory techniques. These techniques encompass the linear swell meter (LSM), the dynamic linear swell meter (DLSM), hot-rolling dispersion, suspension stability, and pore structure characterization of shale. The rheological and filtration characteristics of nHAp/SDS and compatibility tests were also studied, and the results were compared with those of nanosilica and KCl-WBM. At all concentrations, the performance of the nHAp/SDS test fluids surpassed that of nanosilica. When compared with KCl-WBM system at 10 cP and 25 °C, the nHAp/SDS and nanosilica concentrations increased the plastic viscosity by 20–90 % and 10–70 %, respectively. The inhibitory effect of nHAp/SDS surpasses that of conventional KCl-WBM and inorganic nanosilica. By adding 2.0 wt% nHAp/SDS to KCl-WBM, the shale swelling decreased from 10.1 to 4.7 % (a 53.4 % reduction). Nanosilica also reduced the swelling to 6.1 % (a 39.6 % reduction) during the LSM test at 25 °C. Under the DLSM test conditions, the shale swelling increased due to the activation of the clay platelet site at an increased temperature of 80 °C. For instance, between 25 and 80 °C, the DLSM test revealed that the shale plug height expanded from 6.1 to 9.8 % for 2.0 wt% nanosilica, 4.7–7.6 % for 2.0 wt% nHAp/SDS, and 10.1–18.8 % for KCl-WBM. Furthermore, the recovery rate of hot-rolled shale plugs with KCl-WBM increased from 89.8 to 96.2 % for nHAp/SDS and 76.6 to 88.8 % for nanosilica from the initial rates of 52.1–63.3 % between 65 and 120 °C. The contact angle results showed that nHAp/SDS is hydrophobic, reducing shale-water attraction. Moreover, the 12 nm nanosilica matches nanopore sizes to partially block shale pores. This research found that nHAp/SDS has the potential to improve wellbore stability.

Abstract Background The Directly Observed Therapy Short Course (DOTS) strategy recommended by World Health Organization for tuberculosis control requires multiple clinic visits which may place economic burden on treatment supporters especially those with low socio-economic status. The End tuberculosis goal targeted eliminating all tuberculosis associated costs. However, the economic burden and coping mechanisms by treatment supporters is unknown in Ghana. Objectives The study determined the economic burden and coping mechanism by treatment supporters in Bono Region of Ghana. Methods Cross-sectional study using mixed method approach for data collection. For the quantitative data, a validated questionnaire was administered to 385 treatment supporters. Sixty in-depth interviews with treatment supporters to elicit information about their coping mechanisms using a semi-structured interview guide for the qualitative data. Descriptive statistics, costs estimation, thematic analysis and bivariate techniques were used for the data analysis. Results Averagely, each treatment supporter spent GHS 112.4 (US$21.1) on treatment support activities per month which is about 19% of their monthly income. Borrowing of money, sale of assets, used up saving were the major coping mechanisms used by treatment supporters. Highest level of education, household size, marital status and income level significantly influence both the direct and indirect costs associated with tuberculosis treatment support. The significant levels were set at 95% confidence interval and p

Self-incompatibility (SI) is a complex mechanism that prevents plants from self-fertilizing to preserve and promote genetic variability. The angiosperm species have developed two different SI systems, the sporophytic (SSI) and the gametophytic (GSI) systems. SI is a significant impediment to steady fruit production in fruit tree species of the Rosaceae. In Rosaceae, GSI is genetically regulated via a single locus, named the ‘S-locus’, which includes a minimum of two polymorphic and relatively intercorrelated S genes: a pistil-expressed S-RNase gene and several pollen-expressed SFBB (S-locus F-Box Brothers) or SFB (S haplotype-specific F-box protein). This necessitates the interaction of S-RNases with the male determinants. Although genetic and molecular analyses of S genes have shown that mutations in both pistils and pollen-specific components induce self-compatibility in many species and cultivars, other genes or molecules outside the S-locus can co-participate in the male gamete rejection in GSI. However, we highlight and synthesize the most recent knowledge on different mechanisms of GSI in Rosaceae in this current review.

IntroductionGhana established Community-based Health Planning and Services (CHPS) as the primary point of contact for primary healthcare in 1999. CHPS has since emerged as the country’s primary strategy for providing close-to-client healthcare delivery, with numerous positive health outcomes recorded as a result of its implementation. There is, however currently a paucity of systematic reviews of the literature on CHPS. The purpose of this study was not only to investigate dominant trends and research themes in Community-based Health Planning and Services, but also to track the evolution of the CHPS intervention from its inception to the present.MethodWe adopted a systematic review approach for selected articles that were searched on Google Scholar, PubMed, and Scopus databases. The study was conducted and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We then applied a reflexive thematic analysis approach in synthesizing the results.ResultsThe search resulted in 127 articles of which 59 were included in the final review. Twenty (20) papers targeted the national level, eighteen (18) for the regional level, sixteen (16) for the district level, two (2) for the sub-district level, and three (3) papers targeted the community. The years 2017 and 2019 were recorded to be the years with the highest number of publications on CHPS in Ghana.ConclusionCommunity-based Health Planning and Services (CHPS) is an effective tool in addressing barriers and challenges to accessing quality and affordable health care causing significant effects on health. It provides close-to-client healthcare delivery in the community.

Abstract Background Ensuring access to the continuum of care for maternal, neonatal, and child health is an effective strategy for reducing maternal and child mortality. We investigated the extent of dropout, wealth-related inequalities, and drivers of inequality in the continuum of care for maternal health services in sub-Saharan Africa. Methods We analysed Demographic and Health Surveys (DHS) conducted between 2013 and 2019 across 25 sub-Saharan African countries. We defined the continuum of care for maternal health services as women who had received at least four ANC contacts (ANC 4 + contacts), skilled care at birth, and immediate postnatal care (PNC). We used concentration index to estimate wealth-related inequalities across the continuum of care. Multilevel logistic regression models were used to identify predictors of inequality in completing the continuum of care. Results We included data on 196,717 women with the most recent live birth. About 87% of women reported having at least one ANC contact, but only 30% of women received the recommended care package that includes ANC 4 + contacts, skilled care at birth, and PNC. The proportion of women who had completed the continuum of care ranged from 6.5% in Chad to 69.5% in Sierra Leone. Nearly 9% of women reported not having contact with the health system during pregnancy or childbirth; this ranged from 0.1% in Burundi to 34% in Chad. Disadvantaged women were more likely to have no contact with health systems and less likely to have the recommended care package than women from wealthier households. Women with higher education levels, higher exposure to mass media (radio and TV), and higher household wealth status had higher odds of completing the continuum of care. Conclusions Persistent and increasing inequalities were observed along the continuum of care from pregnancy to the postnatal period, with socioeconomically disadvantaged women more likely to drop out of care. Improving access to and integration of services is required to improve maternal health. Initiatives and efforts to improve maternal health should prioritise and address the needs of communities and groups with low coverage of maternal health services.

Abstract Due to the rampant rise in obesity and diabetes, consumers are desperately seeking for ways to reduce their sugar intake, but to date there are no options that are both accessible and without sacrifice of palatability. One of the most promising new ingredients in the food system as a non-nutritive sugar substitute with near perfect palatability is D-psicose. D-psicose is currently produced using an in vitro enzymatic isomerization of D-fructose, resulting in low yield and purity, and therefore requiring substantial downstream processing to obtain a high purity product. This has made adoption of D-psicose into products limited and results in significantly higher per unit costs, reducing accessibility to those most in need. Here, we found that Escherichia coli natively possesses a thermodynamically favorable pathway to produce D-psicose from D-glucose through a series of phosphorylation-epimerization-dephosphorylation steps. To increase carbon flux towards D-psicose production, we introduced a series of genetic modifications to pathway enzymes, central carbon metabolism, and competing metabolic pathways. In an attempt to maximize both cellular viability and D-psicose production, we implemented methods for the dynamic regulation of key genes including clustered regularly interspaced short palindromic repeats inhibition (CRISPRi) and stationary-phase promoters. The engineered strains achieved complete consumption of D-glucose and production of D-psicose, at a titer of 15.3 g L-1, productivity of 2 g L-1 h-1, and yield of 62% under test tube conditions. These results demonstrate the viability of whole-cell catalysis as a sustainable alternative to in vitro enzymatic synthesis for the accessible production of D-psicose.

Abstract Background Indonesia implemented one of the world’s largest single-payer national health insurance schemes (the Jaminan Kesehatan Nasional or JKN) in 2014. This study aims to assess the incidence of catastrophic health spending (CHS) and its determinants and trends between 2018 and 2019 by which time JKN enrolment coverage exceeded 80%. Methods This study analysed data collected from a two-round cross-sectional household survey conducted in ten provinces of Indonesia in February–April 2018 and August–October 2019. The incidence of CHS was defined as the proportion of households with out-of-pocket (OOP) health spending exceeding 10% of household consumption expenditure. Chi-squared tests were used to compare the incidences of CHS across subgroups for each household characteristic. Logistic regression models were used to investigate factors associated with incurring CHS and the trend over time. Sensitivity analyses assessing the incidence of CHS based on a higher threshold of 25% of total household expenditure were conducted. Results The overall incidence of CHS at the 10% threshold fell from 7.9% to 2018 to 4.4% in 2019. The logistic regression models showed that households with JKN membership experienced significantly lower incidence of CHS compared to households without insurance coverage in both years. The poorest households were more likely to incur CHS compared to households in other wealth quintiles. Other predictors of incurring CHS included living in rural areas and visiting private health facilities. Conclusions This study demonstrated that the overall incidence of CHS decreased in Indonesia between 2018 and 2019. OOP payments for health care and the risk of CHS still loom high among JKN members and among the lowest income households. More needs to be done to further contain OOP payments and further research is needed to investigate whether CHS pushes households below the poverty line.

With the rapid emergence and distribution of red crown rot (RCR) across countries, durable sources of resistance against Calonectria ilicicola in soybean [Glycine max (L.) Merrill] is required to control the disease. We employed two RIL populations for the experiment. We identified 15 and 14 QTLs associated with RCR resistance in ZM6 and MN populations, respectively, totaling 29 QTLs. Six and eight QTLs had phenotypic variation above 10% in ZM6 and MN populations, respectively. We identified six (6) “QTL hotspots” for resistance to RCR from the ZM6 and MN RIL populations on chromosomes 1, 7, 10, 11, 13, and 18. Gene annotations, gene ontology enhancement, and RNA sequencing assessment detected 23 genes located within six “QTL Hotspots” as potential candidate genes that could govern RCR resistance in soybeans. Our data will generally assist breeders in rapidly and effectively incorporating RCR resistance into high-yielding accession through marker-assisted selection.

The per capita municipal solid waste (MSW) generation per day in Ghana is estimated to be 0.47 kg/person/day, which translates to over 14,000 tonnes of solid waste generation daily. The disposal and management of this amount of solid waste has been challenging worldwide, and in Ghana, this is evident with the creation of unsanitary dumping sites scattered across most communities in the country, especially urban communities. The indiscriminate disposal of solid waste in Ghana is known to cause flooding, the pollution of water bodies, and the spread of diseases. The purpose of this review is to highlight the prospects of waste incineration with energy recovery as a waste-to-energy (WtE) technology which has contributed immensely to the disposal and management of MSW in nations worldwide (especially developed ones). The review indicates that waste incineration with energy recovery is a matured waste-to-energy technology in developed nations, and there are currently about 492 waste incineration plants in operation in the EU, over 77 in operation in about 25 states in the USA, and about 1900 in operation in Japan. Waste incineration with energy recovery is also gradually gaining prominence in developing nations like China, Brazil, Bangladesh, Nigeria, Indonesia, and Pakistan. The adoption of waste incineration with energy technology can reduce Ghana’s overdependence on fossil fuels as primary sources of energy. It is, however, recommended that a techno-economic assessment of proposed waste incineration facilities is performed considering the MSW generated in Ghana. Additionally, it is also recommended that the possibility of incorporating the use of artificial intelligence technology into the management of MSW in Ghana be investigated.

Abstract Background Exploration of biomarkers for debilitating diseases such as cervical spondylosis is important to revolutionize clinical diagnosis and management of such conditions. The study aimed to determine the correlation between neck pain and disability and serum levels of interleukin-6 (IL-6), osteoprotegerin (OPG), estradiol (E2), testosterone (TES), calcium (Ca), and magnesium (Mg) among individuals with symptomatic cervical spondylosis. Methods This study was a cohort design. The participants were new referrals to two Nigerian physical therapy clinics. Participants’ neck pain intensity (PI), neck disability index (NDI), IL-6, OPG, E2, TES, Ca, and Mg were measured at baseline and after 13 weeks of follow-up. Data were analyzed using descriptive statistics, independent samples t test, Pearson’s correlation, and multiple linear regression. Results Forty individuals aged 52.40 ± 8.60 years participated in the study. Women had significantly higher levels of IL-6 (t = − 2.392, p = 0.026), OPG (t = − 3.235, p = 0.005), E2 (t = − 6.841, p = 0.001), but lower TES (t = 17.776, p = 0.001). There were no significant sex differences in PI and NDI. There were significant correlations between PI and OPG (r = 0.385, p

Seepage or loss of the mix-water from the drilling muds into the porous and permeable formations is a common problem during drilling operation. The drilling mud design requires a good knowledge of sealing integrity and all the factors influencing the mud to bridge through fractures or pore throat of exposed rocks. Loss circulation materials (LCMs) are commonly introduced into the drilling mud to prevent or minimize filtrate loss. This study investigates silica nanoparticle (SNP) derived from rice husk (RH) termed RH-SNP using the wet-milling method as an LCM in water-based mud (WBM). The impact of the RH-SNP in the enhancement of rheology and filtrate loss control properties of WBM was studied. Subsequently, the sealing integrity of the RH-SNP in a 1 mm and 2 mm simulated fracture for 7 min was determined using a stainless-steel slotted filter disk. The performance of the developed RH-SNP was compared with the widely applied nutshell. The synthesized RH-SNP at amount of 2.0 wt% significantly enhanced the yield point and plastic viscosity of the WBM by 75% and 386%, respectively, and minimized the fluid loss of the WBM by 47% at 80 °F. The enhancement is due to the particles ability to spread and interact efficiently with the WBM. With the use of 1 mm and 2 mm simulated fracture for 7 min, the mud loss volume of the base mud reduced by 50%, 66.7%, 86%, and 90% (for 1 mm) and 40%, 65.7%, 77.1%, and 80% (for 2 mm) with the inclusion of 0.5 wt%, 1.0 wt%, 1.5 wt%, and 2.0 wt% of RH-SNP, respectively. Overall, the results showed that RH-SNP enhanced the seal integrity of the drilling mud and was more resistant to deformation compared to the nutshell. The findings of this study can help for better understanding of the application of RH-SNP as a loss circulation agent owing to its superior ability to seal fractured formation compared with the often used nutshell.

Abstract Background Key populations (KPs) such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID), and their partners contribute more than a quarter (27.5%) of new HIV infection in Ghana. Oral pre-exposure prophylaxis (PrEP) can substantially reduce HIV acquisition among this group. While the available research indicates KPs willingness to take PrEP in Ghana, little is known about the position of policymakers and healthcare providers on the introduction of PrEP for KPs. Methods Qualitative data were collected from September to October 2017 in the Greater Accra (GA) and Brong-Ahafo (BA) regions of Ghana. Key informant interviews were conducted with 20 regional and national policymakers and supplemented with In-depth Interviews with 23 healthcare providers to explore their level of support for PrEP and their perspectives on challenges and issues to consider for oral PrEP implementation in Ghana. Thematic content analysis was used to unearth the issues emerging from the interviews. Results Policymakers and healthcare providers in both regions expressed strong support for introducing PrEP for KPs. Key concerns regarding oral PrEP introduction included potential for behavioral disinhibition, non-adherence and side effects of medication, cost and long-term financial implications, and stigma related to HIV and key populations. Participants stressed the need to integrate PrEP into existing services and the provision of PrEP should start with high risk groups like sero-discordant couples, FSWs and MSM. Conclusions Policymakers and providers recognize the value of PrEP in cubing new HIV infections but have concerns about disinhibition, non-adherence, and cost. Therefore, the Ghana health service should roll-out a range of strategies to address their concerns including: sensitization with providers to mitigate underlying stigma towards KPs, particularly MSM, integration of PrEP into existing services, and innovative strategies to improve continued use of PrEP.

BackgroundThe HIV epidemic in Ghana is characterized as a mix of a low-level generalized epidemic with significant contributions from transmission among female sex workers (FSW) and their clients. This study seeks to identify and describe key characteristics and sexual behaviors of FSW and estimate the prevalence of HIV, syphilis, gonorrhea, chlamydia, and hepatitis B virus (HBV) among FSW in Ghana.MethodA total of 7,000 FSW were recruited for the study using Time Location Sampling (TLS) approach with 5,990 (85.6%) participants completing both biological and the behavioral aspects of the study. A structured questionnaire was administered to respondents to assess several factors, such as background characteristics, sexual risk behaviors, condom usage, HIV/AIDS knowledge, opinions, and attitudes. Trained staff conducted face-to-face interviews using mobile data collection software (REDCap) after provision of specimens for HIV and STI testing. Descriptive statistics such as medians, ranges, charts, and percentages are performed and presented. Also included, are bivariate analyses to establish relationships between FSW type and other relevant characteristics of the study.ResultsAmong the 7,000 (100%) FSW sampled from all regions, 6,773 took part in the behavioral and 6,217 the biological. There were 783 (11.2%) respondents who took part only in the behavioral and 227 (3.2%) only in the biological. Most were young, with a median age of 26 years, majority had never been married or were widowed/divorced and a quarter had no education or had only primary education. Majority (74.8%) of FSW first sold sex at age 25 years or less with a median age of 20 years. Most (84.8%) of the FSW indicated that they entered sex work for money, either for self or family and had an average of eleven (11) sexual partners per week. More than half (55.2%) of the FSW were new entrants who had been in sex work for less than 5 years before the study. Consistent condom use with paying clients was generally unsatisfactory (71%), and was however, very low (24%) with their intimate partners or boyfriends. Only about half (54.6%) of FSW have been exposed to HIV prevention services in the last three months preceding the survey, and this varies across regions. Overall, comprehensive knowledge about HIV and AIDS was low. Only 35% of FSW had comprehensive knowledge. HIV prevalence was 4.6% and was higher among seaters (brothel-based) and older FSW who had been sex work for a longer period. The HIV prevalence from the previous bio-behavioral survey (BBS) in 2015 and 2011 were estimated to be 6.9 and 11.1%, respectively.ConclusionCompared to the results from the previous studies, the findings give an indication that Ghana is making significant progress in reducing the burden of HIV among FSW in the country. However, risky behaviors such as low consistent condom use, low coverage of HIV services across the regions, and low comprehensive knowledge could reverse the gains made so far. Immediate actions should be taken to expand coverage of HIV services to all locations. Efforts must be made to reach out to the new entrants while also addressing strongly held myths and misconceptions about HIV.

Agriculture in China is undergoing a swift transformation to modify labour relocation. This change is spearheaded by commercial farms and other Chinese government interventions thereby promoting agricultural production and rural growth. The input-dependent industrial model of agriculture is also considered in conflict with attaining a safe and healthy environment for its inhabitants. The current approaches initiated in the tea sector have witnessed several enriched sustainable agricultural technologies (SATs). The SATs seek to increase yield while ensuring agricultural sustainability via ecological strategies. However, reports have shown farmers have low desire resulting in a lower acceptance rate of SATs among Chinese farmers. We provide a systematic review with a focus on the key determinants of SATs adoption rate in tea production in China from 2000 to 2022. The results revealed the significance and suitability of different approaches in establishing farmers’ adoption behaviour. The specificity of farmers’ SAT adoption behaviour is essentially not compromised by any codified variables but the interrelationship among the determinants, including socio-demographic, agroecological and environmental, technological, institutional, and social networks, and informational, and farmer behavioural factors. We recommend that the government increase awareness of SATs to promote public demand for agricultural sustainability, particularly in developing countries.

On glass substrates in a basic medium, Zn(1-x)SCux nanostructures were produced using a chemical bath approach for an adjusted dopant concentration (DC) (0.01–0.05 M) at 80 °C, and annealed at 300 °C for 2.5 h. The X-ray diffraction pattern revealed a α-ZnS phase in the produced films with a stronger diffraction peak at 31.775°. The creation of a high crystalline structure in the α-ZnS phase is confirmed by Raman spectral analysis. SEM images revealed a uniform and dense surface morphology with modest grain size sharing and no fractures. The existence of anticipated Zn, S, and Cu was detected by energy-dispersive X-ray spectroscopy. Spectrophotometry in the UV–visible range showed a redshift. Additionally, as DC is increased, the optical band gaps (3.82–3.99 eV) and transmittance were observed to increased. The projected crystallite sizes (3.58–2.45 nm) based on energy band gaps shrank as DC increased. Infrared spectroscopy using the Fourier transform did not reveal any contaminant signals. The electrical conductivity was p-type, according to the Hall Effect investigation.

Abstract Background Many cardiovascular (CV) medicines are required for long term. However, with their limited resources, low- and middle-income countries (LMICs) may have challenges with access to cardiovascular medicines. The aim of this review was to provide a summary of available evidence on access to cardiovascular medicines in LMICs. Methods We searched PubMed and Google scholar for English language articles on access to cardiovascular medicines for the period 2010–2022. We also searched for articles reporting measures for challenges in access to CV medicines from 2007 to 2022. Studies conducted in LMICs, and reporting availability and affordability were included for review. We also reviewed studies reporting affordability or availability using the World Health Organisation/Health Action International (WHO/HAI) method. Levels of affordability and availability were compared. Results Eleven articles met the inclusion criteria for review on availability and affordability. Although availability appears to have improved, many countries did not meet the availability target of 80%. Between economies and within countries, there are equity gaps in access to CV medicines. Availability is lower in public health facilities than private facilities. Seven out of 11 studies reported availability less than 80%. Eight studies which investigated availability in the public sector reported less than 80% availability. Overall, CV medicines, especially combined treatments are not affordable in the majority of countries. Simultaneous achievement of availability and affordability target is low. In the studies reviewed, less than 1–53.5 days wages were required to purchase one month supply of CV medicines. Failure to meet affordability was 9–75%. Five studies showed that, on average 1.6 days’ wages of the Lowest-Paid Government Worker (LPGW) was required to purchase generic CV medicines in the public sector. Efficient forecasting and procurement, increased public financing and policies to improve generic use, among others are measures for improving availability and affordability. Conclusions Significant gaps exist in access to cardiovascular medicines in LMICs, and in many low—and lower middle—income countries access to cardiovascular medicines is low. To improve access and achieve the Global Action Plan on non-communicable diseases in these countries, policy interventions must be urgently instituted.

Abstract Background COVID-19 has created unprecedented challenges for health systems worldwide. Since the confirmation of the first COVID-19 case in Ghana in March 2020 Ghanian health workers have reported fear, stress, and low perceived preparedness to respond to COVID-19, with those who had not received adequate training at highest risk. Accordingly, the Paediatric Nursing Education Partnership COVID-19 Response project designed, implemented, and evaluated four open-access continuing professional development courses related to the pandemic, delivered through a two-pronged approach: e-learning and in-person. Methods This manuscript presents an evaluation of the project's implementation and outcomes using data for a subset of Ghanaian health workers (n = 9966) who have taken the courses. Two questions were answered: first, the extent to which the design and implementation of this two-pronged strategy was successful and, second, outcomes associated with strengthening the capacity of health workers to respond to COVID-19. The methodology involved quantitative and qualitative survey data analysis and ongoing stakeholder consultation to interpret the results. Results Judged against the success criteria (reach, relevance, and efficiency) the implementation of the strategy was successful. The e-learning component reached 9250 health workers in 6 months. The in-person component took considerably more resources than e-learning but provided hands-on learning to 716 health workers who were more likely to experience barriers to accessing e-learning due to challenges around internet connectivity, or institutional capacity to offer training. After taking the courses, health workers' capacities (addressing misinformation, supporting individuals experiencing effects of the virus, recommending the vaccine, course-specific knowledge, and comfort with e-learning) improved. The effect size, however, varied depending on the course and the variable measured. Overall, participants were satisfied with the courses and found them relevant to their well-being and profession. An area for improvement was refining the content-to-delivery time ratio of the in-person course. Unstable internet connectivity and the high upfront cost of data to access and complete the course online were identified as barriers to e-learning. Conclusions A two-pronged delivery approach leveraged distinct strengths of respective e-learning and in-person strategies to contribute to a successful continuing professional development initiative in the context of COVID-19.

This paper examines the interaction between health expenditure and health outcomes with due consideration for government effectiveness across developing African economies. The rich data for this study draw from forty-five Sub-Saharan African (SSA) countries covering the period 1960 to 2022. The analysis follows a country-specific comparative manner using the Autoregressive Distributed Lag (ARDL) model as the major estimation technique. The results indicate that poor health outcomes are not due to inadequate budgetary allocations alone. Specifically, this study found a cointegrating relationship and strong adjustment of health outcomes deriving from the shocks and dynamics of not just health expenditures, but also government effectiveness. It is therefore recommended that strong institutions and safety nets be created to guard against corruption and leakages that derail the beneficial impact of public health spending. Also, government expenditures should be focused more on cottage and primary health dimensions to better mitigate adverse health conditions in SSA countries.

Red crown rot (RCR) disease caused by Calonectria ilicicola negatively impacts soybean yield and quality. Unfortunately, the knowledge of the genetic architecture of RCR resistance in soybeans is limited. In this study, 299 diverse soybean accessions were used to explore their genetic diversity and resistance to RCR, and to mine for candidate genes via emergence rate (ER), survival rate (SR), and disease severity (DS) by a multi-locus random-SNP-effect mixed linear model of GWAS. All accessions had brown necrotic lesions on the primary root, with five genotypes identified as resistant. Nine single-nucleotide polymorphism (SNP) markers were detected to underlie RCR response (ER, SR, and DS). Two SNPs colocalized with at least two traits to form a haplotype block which possessed nine genes. Based on their annotation and the qRT-PCR, three genes, namely Glyma.08G074600, Glyma.08G074700, and Glyma.12G043600, are suggested to modulate soybean resistance to RCR. The findings from this study could serve as the foundation for breeding RCR-tolerant soybean varieties, and the candidate genes could be validated to deepen our understanding of soybean response to RCR.

Oxidative stress plays a crucial role in the development of type 2 diabetes and the associated microvascular and cardiovascular complications. In the study, we have investigated the effects of Heinsia crinita (H. crinita) extracts on lipid peroxidation and oxidative stress responses using diabetic rats. Type 2 diabetes was induced with 10 % fructose/40 mg/kg body weight streptozotocin (STZ). H. crinita extract was administered at 200 and 400 mg/kg body weight twice daily for 21 days, in addition to metformin (MET: 500 mg/kg body weight) control. Molecular docking analysis was performed to determine the binding affinity of H. crinita extracts to the DNA binding domains of peroxisome proliferator-activated receptor (Ppar) and retinoid x receptor (Rxr) protein crystal structures, showing different binding affinities for putative active compounds from the plant. Fasting blood glucose (FBG), body and organ weight changes were determined showing that H. crinita extract induced an anti-hyperglycemic effect in the treated animals, with changes (either decrease or increase) in liver and kidney weights. A decrease in mRNA expression of peroxisome proliferator-activated receptors (ppar), sterol regulatory element-binding protein 1 (srebp-1c), liver x-receptor (lxr), retinoid x receptors (rxr), cytochrome p45041 (cyp4a1) and acyl-CoA oxidase (acox1) in diabetic animals were observed, compared to the control. A dose-specific decrease or increase in antioxidant enzymes (superoxide dismutase: SOD, catalase: CAT, reduced glutathione: GSH, glutathione peroxidase: GPx) transcripts and activity levels were also observed. We also observed exposure-specific decrease or increase of malondialdehyde (MDA) levels. Our data suggested that H. crinita extract possesses protective effects against diabetes-induced oxidative stress. These effects might be attributed to their binding and activation of nuclear receptors, indicating their cellular mode of action that is comparable to MET.

The present study offers a flexible method for the ecologically friendly synthesis of palladium nanoparticles and their assessment as a catalyst and antibacterial agent. Using an aqueous leaf extract of Carica papaya as a capping and reducing agent with Total Organic Carbon (TOC) measured at 959 mg/L, palladium nanoparticles (PdNPs) were biochemically created. This is undoubtedly a modest green synthesis method, and the structural characteristics of the nanoparticles were investigated utilizing the techniques of UV, FTIR, powder XRD, SEM, and HR-TEM. According to FTIR studies, the polyphenols in Carica papaya leaf extract may be what causes Pd2+ to be converted into PdNPs. The face-centered cubic geometry of the PdNPs was extremely crystalline, as shown by the X-ray diffraction., and SEM images confirmed their spherical shape. The particle size of the synthesized PdNPs was found to be 20 nm as determined by HR-TEM. In the reduction of anionic Congo red (CR) and cationic Methylene blue (MB) dyes, green-produced PdNPs showed substantial catalytic activity. The PdNPs may have a catalytic impact as seen by the decrease in absorption band intensity with passing time, which results in 92 % degradation of Congo red, an anionic dye, and 95 % degradation of Methylene Blue, a cationic dye. Significant antibacterial action was also shown by the synthetic green PdNPs against bacterial and fungi strains.

Introduction According to the World Health Organization, Stroke is the 2nd leading cause of death, responsible for approximately 11% of total deaths worldwide (1). In Nigeria, stroke accounts for 4% ‐ 17% of medical deaths (2).Effective stroke management is essential to reduce morbidity and mortality. Few trained neurologists in Nigeria who are mostly concentrated in the cities, making non‐specialists the backbone of initial acute stroke assessment and management in Nigeria. Physician‐related factors have been identified as one of the factors leading to suboptimal stroke care. There is limited literature analysing the proficiency of non‐specialists in the optimal management of stroke in Nigeria. This study was vital for the evaluation of the knowledge of acute stroke care among medical doctors and the factors responsible for the disparity in their skills. Methods A descriptive cross‐sectional survey was conducted among 404 medical doctors across all six geopolitical zones in Nigeria using the Acute Stroke Management Questionnaire (ASMaQ). Data were analysed using descriptive statistics and simple logistic regression to predict the relationship between independent variables and the outcome variable (good knowledge vs poor knowledge). Results 39.1 % of respondents encounter stroke patients a few times a month, 52% work without a neurologist ,and 88.4% work in hospitals without stroke units. 67% (95% CI =63% – 72%) of respondents had good overall knowledge of stroke management. General Stroke Knowledge (GSK) domain had the largest percentage of good knowledge (88.6%, 95% CI= 85‐92%), followed by Hyperacute Stroke Management (HSM), (52.5%, 95% CI=47.3% – 57.7%) and Advanced Stroke Management (ASM), (49.5%, 95%CI= 49.5% –54.4%).Most participants (>85%) demonstrated good knowledge of stroke signs and symptoms. Only 21.8% and 4.2% of respondents work in facilities equipped with intravenous thrombolysis and mechanical thrombectomy respectively. 92% erroneously believe that a full neurological examination is essential in acute stroke while 33.4% demonstrated poor knowledge of blood pressure control in patients with acute stroke .Working in Primary Healthcare Centre (PHCs) and Government Hospital was a significant predictor of overall poor knowledge of stroke. Compared to Private Hospitals, working in Government Hospitals had 1.98 times the odds of poor knowledge (P = 0.011) and medical doctors in Primary Healthcare Practice had 2.29 times the odds of poor knowledge than those in Tertiary Hospitals (P = 0.045). Conclusion Despite the fact that the majority demonstrated good knowledge of stroke management, there is a significant knowledge deficit in the ASM domain. This study highlights the need for regular retraining and professional development of medical doctors in acute stroke management in Nigeria. There is an urgent need to address the critical shortage of neurologists in the country and improve access to thrombolysis care in order to reduce the burden of stroke related‐morbidity and mortality.

Objective: There is as yet a paucity of data on intramedullary spinal cord tumours (IMSCTs) in sub-Saharan Africa. This study aims to define the clinical profile and outcome of management of IMSCTs in a Nigerian tertiary hospital. Methods: This is a retrospective study of all the patients who had surgery for IMSCTs in our hospital over a 14 year period. Results: There were 20 patients, 9 males, 11 females, in this study. The median age was 33 years (range = 7–78 years). The median duration of symptoms was 12 months (range = 1–120 months). Motor deficit was present in all but one (95%) of our patients. Only 25% of the patients presented in good functional status (McCormick grades I and II). The tumours were confined to the thoracic region in 10 patients (50%), while tumours in the thoracic region extending to the adjoining cervical and lumbar regions were seen in 6 patients (30%). Gross total tumour resection was achieved in 60% of the patients and subtotal resection in the remaining 40%. Astrocytoma and ependymoma were the most common tumours, each occurring in 35% of the cases. Six patients (30.0%) improved, 12 patients (60.0%) remained neurologically the same, while 2 patients (10.0%) deteriorated at the time of last follow up. The mortality rate was 15%. The preoperative functional status was a significant predictor of postoperative outcome (p = 0.03). Conclusion: Astrocytoma and ependymoma were the most common histological tumour types among our patients. Late presentation and poor pre-operative functional status were prominent features of our patients’ cohort.

Background: The Ghana Health Service has been implementing the Directly Observed Therapy Short Course (DOTS) strategy for decades now, to cure and reduce the transmission of tuberculosis. DOTS strategy requires TB patients and their treatment supporters to make multiple clinic visits in the course of treatment, and this may place financial burden on treatment supporters with low socio-economic status. However, the determinants of tuberculosis treatment support costs to treatment supporters are unknown in Ghana. Objectives: This study determined the costs associated with treatment support to the treatment supporters in Bono Region, Ghana. Methods: In a cross-sectional study using cost-of-illness approach, 385 treatment supporters were selected and interviewed. A validated questionnaire for the direct and indirect costs incurred was used. Descriptive statistics and bivariate techniques were used for data analysis. Results: Averagely, each treatment supporter spent GHS 122.4 (US$ 21.1) on treatment support activities per month, which is about 19% of their monthly income. The findings also revealed that highest level of education, household size, monthly income and district of residence were significant predictors of the direct costs. On the other hand, gender of the respondents, highest level of education, ethnicity, household size, income level and relationship with patient were some of the factors that significantly influenced the indirect costs. The significance levels were set at a 95% confidence interval and p < 0.05. Conclusion: The study concludes that the estimated cost associated with assisting tuberculosis patients with treatment is significant to treatment supporters. If these costs are not mitigated, they have the tendency of affecting the socio-economic status and welfare of individuals assisting tuberculosis patients with treatment.

Data on geographically restricted SARS-CoV-2 variants is lacking in some regions. In this nationwide effort including 18 public health labs, the authors used genomic epidemiology and travel data to understand the origin and spread of 2 variants of interest that predominated during the second wave of the pandemic in Nigeria.

The increase in human activities in urban areas resulting from the urbanisation process continues to put immense pressure on urban ecological resources including water bodies. This study seeks to assess the relationship between the various categories of human activities within the 100 m buffer of the major water bodies in the Kumasi Metropolis and the chemical and biological composition of the pollutants that are emitted into the water bodies. The findings of this study showed that the Kumasi Metropolis is confronted with weak enforcement of regulations that protect water bodies. For example, along the Subin River, human activities such as commercial activities and the development of squatter settlements did not conform to the standard setback average distance of 100 feet in the Zoning Regulation and Planning Standards. There is a need for city authorities to strategically respond to the various human activities that threaten the sustainability of water resources in cities.

Abstract Spices are prolific sources of phytochemicals of pharmaceutical and nutritional importance. They have been employed for centuries in the treatment of various maladies, in cuisines, and as inhibitors of oxidative degradation in foods. On this premise, a comparative assessment of the quantitative mineral composition, phytochemical and proximate constituents of Xylopia aethiopica (fruits), Piper guineense (seeds), and Rhaphiostylis beninensis (roots) was done using standard protocols. Subsequently, methanol extracts of the spices were subjected to Gas Chromatography–Mass Spectrometry (GC–MS) analysis. Mineral analysis of the culinary spices revealed significant differences (p

Abstract Background Many countries implementing pro-poor reforms to expand subsidized health care, especially for the poor, recognize that high-quality healthcare, and not just access alone, is necessary to meet the Sustainable Development Goals. As the poor are more likely to use low quality health services, measures to improve access to health care need to emphasise quality as the cornerstone to achieving equity goals. Current methods to evaluate health systems financing equity fail to take into account measures of quality. This paper aims to provide a worked example of how to adapt a popular quantitative approach, Benefit Incidence Analysis (BIA), to incorporate a quality weighting into the computation of public subsidies for health care. Methods We used a dataset consisting of a sample of households surveyed in 10 provinces of Indonesia in early-2018. In parallel, a survey of public health facilities was conducted in the same geographical areas, and information about health facility infrastructure and basic equipment was collected. In each facility, an index of service readiness was computed as a measure of quality. Individuals who reported visiting a primary health care facility in the month before the interview were matched to their chosen facility. Standard BIA and an extended BIA that adjusts for service quality were conducted. Results Quality scores were relatively high across all facilities, with an average of 82%. Scores for basic equipment were highest, with an average score of 99% compared to essential medicines with an average score of 60%. Our findings from the quality-weighted BIA show that the distribution of subsidies for public primary health care facilities became less ‘pro-poor’ while private clinics became more ‘pro-rich’ after accounting for quality of care. Overall the distribution of subsidies became significantly pro-rich (CI = 0.037). Conclusions Routine collection of quality indicators that can be linked to individuals is needed to enable a comprehensive understanding of individuals’ pathways of care. From a policy perspective, accounting for quality of care in health financing assessment is crucial in a context where quality of care is a nationwide issue. In such a context, any health financing performance assessment is likely to be biased if quality is not accounted for.

Mesoporous silica nanoparticles (MSNP) were used to trap reservoir fines and adsorption capacity of MSNP was optimized. Box-Behnken design was used to model effect of concentration, time, salinity and pH on adsorption capacity of reservoir fines. Multiple response surface method was applied to optimize any combination of variables at which the maximum adsorption of the reservoir fines occurred. Microstructural analysis shows a mesoporous structure ranging from 2.88 to 44.8 nm with high specific surface area of 332 m2/g and purity of 94%. Pseudo-second order with regression coefficient (R2) of 0.99 shows that the model best defines reservoir fines adsorption. Langmuir isotherm model with R2 of 0.985 best fitted the equilibrium adsorption of kaolinite whereas high R2 of 0.98 and lower sum of squared errors of illite for Freundlich model indicates it is better than Langmuir model. Heterogeneity factor value of 1/n

Carboxymethyl cellulose (CMC) has emerged in oil and gas industries as a superior substitution to the conventional HPAM and xanthan gum (XG) for high viscosity polymer flooding application. In this study, the combined effect of conventional surfactant, sodium dodecylbenzenesulfonate (SDBS) and CMC for potential surfactant-polymer (SP) flooding in enhanced oil recovery (EOR) has been investigated. Thereafter, SDBS – CMC interaction and the functional groups present in CMC were appropriately identified. The presence of various C–O bonds signifies the existence of carboxymethyl group which greatly influence the rheological properties of CMC solution. The behaviour of SDBS–CMC was characterized by their viscosity, shear rate, solubilization, wettability, and surface tension. Tertiary flooding utilizing SDBS-CMC was performed and compared to commercial SDBS-XG SP flooding. The results indicate several SDBS-CMC combinations are favourable for EOR application. Solution viscosity shows direct relationship with CMC concentrations. Consequently, at any given SDBS concentrations, significant increment was observed at 0.3 wt% and above. However, the trend displayed inconclusive relation to SDBS fractions. Majority of the SDBS-CMC combinations generate Winsor III emulsions particularly at CMC of 0.2 and 0.3 wt%, while Type II were observed in few combinations. Increasing CMC concentrations increased the contact angle, while gradual reductions were observed with SDBS concentrations. The gradual reduction in surface tension was highly influenced by the addition of CMC rather than SDBS. A novel combination of 0.3 wt% SDBS and 0.4 wt% CMC possessed an encouraging criterion in term of viscosity, solubilization, and surface tension reduction for EOR application. Flooding experiment from several SDBS-CMC combinations proved to recover additional oil ranging 16.4–20.2% of oil initially in place (OIIP). The trend in incremental oil recovery is similar to that of when utilising SDBS-XG.

Surfactant flooding is an enhanced oil recovery (EOR) method for recovering residual oil in the reservoir through mechanism of interfacial tension (IFT) reduction and wettability alteration. Due to toxicity and high cost associated with conventional surfactants, recent research has focussed on developing low-cost and environmentally benign surfactants. Herein, a low-cost green surfactant is extracted from Vernonia Amygdalina (VA) and appraised for EOR applications. The extracted surfactant was characterized using Fourier Transform Infrared (FTIR) and High-Pressure Liquid Chromatography (HPLC). The IFT of the synthesized surfactant at the oil-water interface was determined using Kruss tensiometer. Additionally, the foam stability of the synthesized surfactant was examined. Moreover, the wettability of the saponin based natural surfactant (SBNS) at the rock-fluid interface was analysed using Dataphysics drop shape analyser. Experimental result revealed that SBNS (1 wt% concentration) stabilized foam for longer periods with half-life of 1100 min. Furthermore, the synthesized surfactant was effective in lowering the IFT of oil-water interface from 18 mN/m to 0.97 mN/m. Finally, SBNS altered the wettability of sandstone cores to water-wetting condition by reducing the contact angle from 118.5 ° to 45.7 °. Overall, SBNS exhibit excellent properties desirable for EOR and thereby recommended as supplementary alternative to conventional surfactants.

The advent of Corona virus Disease 2019 (COVID-19) distorted health systems of many countries. Efforts have been made to either develop new treatment solutions such as vaccines or repurpose previously adopted drugs. Challenges in accessing available treatment, inadequate, non-existent, or overstretched healthcare facilities, long COVID disease, cultural practices and beliefs about vaccination, vaccine hesitancy, availability, accessibility and perceived safety of herbal supplements seem to be major factors propelling individuals to use herbal supplements. Published reports advocating for clinical development of herbal supplements for COVID-19 and other emerging and re-emerging viral diseases are sparse. This paper aims to review the pathogenesis of COVID-19, use of herbal products during the pandemic and make case for clinical development of herbal supplements through the adoption of modern and acceptable technologies and research processes.This was a scoping review. Database searches of Google Scholar, PubMed and ResearchGate among others were performed using related keywords to identify relevant journals and lists of primary articles. Clinical trial databases:-Clinicaltrial.gov, Pan African Clinical Trial Registry (PACTR) and WHO international clinical trial registry (ICTRP) were reviewed to extract data.The use of herbal supplements during COVID-19 was not only peculiar to individuals living in Sub-Saharan Africa, but a global practice. Herbal supplements recommended to manage COVID-19 have not been validated using clinical trials. Available data showed that the number of herbal supplements undergoing clinical trial for COVID-19 indication in Africa was low.The availability of medicinal plants in Sub-Saharan Africa if well explored has great potentials to address various emerging and re-emerging viral diseases confronting the region. The economic potential of clinically validated herbal supplements are huge, and tapping into this opportunity created by preference of population to herbal supplement could increase export of herbal supplement and gross domestic product (GDP) of respective countries in Africa.

Globally, family planning services were disrupted during the height of the COVID-19 pandemic. Access to these services was a challenge for sexually active urban youth, and this warrants investigation. Using in-depth interview data, we qualitatively explored the effect of the lockdown on the relationship quality and contraception behaviour of emerging adults (19–24 year olds) who were in relationships during a specified lockdown period. Participants were purposively selected from a densely populated urban area in Accra and two public universities in that vicinity. In-depth interviews were also conducted with two family planning providers. Transcripts generated from the interviews were analysed thematically.Twelve of the 23 emerging adults were sexually active during the lockdown and varied in their reports on the stability of their relationships. The sexually inactive had disruptions in their relationships, mainly due to partner absence and a lack of sexual activity. Modern contraceptives, especially male condoms, were used but were obtained prior to the lockdown as confirmed by family planning providers. Traditional and folkloric methods were used by four participants. Participants reported no unintended pregnancies but rare cases of sexually transmitted infections.During the height of the COVID-19 pandemic, sexually active urban youth in Accra navigated the restrictions of lockdown imposition with diverse experiences. Therefore, understanding young adults’ unique contraceptive behaviours and practices is essential to providing relevant sexual and reproductive health services to meet their needs. Discussions on the impacts of COVID-19 should be extended to sexual and reproductive health concerns such as access to contraceptives.

The exceptional and appealing qualities of the polysaccharide biopolymer chitosan, such as biodegradability, biocompatibility and nontoxicity have been successfully utilized in the creation of specialized polysaccharide-based composite material. The bio-nano composites in the current work were prepared by combining curcumin nanoparticles of two distinct sizes that were produced using a green method with carboxymethyl chitosan (CMC). Additional testing methods used for the composite include XRD, TEM, UV-Vis, and FTIR. XRD and TEM provided data on things like grain size, crystalline nature, shape and size respectively. Curcumin interacts with the NH2 group of Carboxymethyl Chitosan (CMC) which is confirmed through FTIR spectra. UV-Vis spectra indicate a blue shift when the particle size decreases. The conductivity of the CMC with curcumin is high than the pristine. The CMC with curcumin enhances the conductivity. The CMC with curcumin nanoparticle S1 has higher conductivity than the curcumin nanoparticle S2 has the lower conductivity. The conductivity for the curcumin with smaller size (9 nm) has higher conductivity(12.35 mS) when compare with larger size (18 nm) of curcumin has the lower conductivity (11.38 mS). The composite with higher conductivity has good antimicrobial activities against C. glabrata and A.niger .The detailed results are presented and discussed.

Background: Sexually transmitted infections (STIs) are responsible for a high burden of morbidity and mortality in many developing countries especially among adolescents. Adolescents are predisposed to STIs because they are more likely to engage in unhealthy lifestyles. However, these adolescents have limited knowledge of the use and barriers to sexual and reproductive health information and care services. This study explored the knowledge of STIs among Senior High School Adolescents in the Wa Municipality of Ghana. Method: The study designed as a descriptive cross-sectional research. A multistage sampling technique was used to recruit these adolescents for the study. Totally 355 adolescents were selected from senior high schools in the Wa Municipality. Descriptive statistics and Chi-square test were used to analyze the data, at a significance level of P < 0.05. Results: The majority of respondents had good knowledge of STIs, with the most common examples of STIs identified as HIV/AIDS (80.8%, 287/355) and gonorrhea (73.8%, 262/355). The main known signs and symptoms identified were discharges from the penis/vagina (72.4%, 257/355), painful urination (71.5%, 254/355), and itching, and sores around the genital area (72.7%, 258/355). The main sources of information/education of STIs for these adolescents were the school, hospital, internet and mother. Whom respondent lived with was found to be significantly associated with knowledge of STI (P < 0.001). Conclusion: Many of the respondents had good knowledge of STI, and the school was the most common source of information on STI. It is, therefore, important for the Ghana Education Service and the Ghana Health Service to strengthen the School Health Education Programme in second cycle institutions in the Wa Municipality. Parents, especially mothers, should be actively involved in the sexual health education of adolescents.