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Abstract Background The RTS,S malaria vaccine has been prequalified for use in endemic settings prioritizing areas with moderate to high disease transmission. The impact of a vaccine at the population level may differ from observations during clinical trial due to programmatic, and individual-related factors, among others. The objective of this study was to assess the impact of the RTS,S malaria vaccine on uncomplicated malaria among children aged 12–59 months in the Phase IV study districts, Upper East Region, Ghana. Methods A retrospective study was conducted using routine malaria surveillance data for the period 2020–2022. The burden of uncomplicated malaria was compared between the implementing (Kasena Nankana East and West districts) and comparator areas (Builsa North and South districts). The impact of RTS,S malaria vaccine was assessed by estimating the percentage reduction in uncomplicated malaria and incidence averted in the implementing area, accounting for the effect of confounders. Results Over 50,000 episodes of uncomplicated malaria among children aged 12–59 months were included in the study. Uncomplicated malaria was reduced by 33% (95%CI 29–36) over the entire study period, but the malaria incidence averted declined from 324/1,000 (95% CI 298–339; p

Abstract Background Preeclampsia and eclampsia (PE/E) are hypertensive disorders of pregnancy with significant morbidity and mortality for both mothers and fetuses. This study aimed to investigate the prevalence of PE/E, associated complications, and mortality rates in pregnant women in Nigeria using a systematic review and meta-analysis approach. Methods A search strategy was employed to identify relevant studies published in English from electronic databases like PubMed, Google Scholar, Science Direct, AJOL, DOAJ and Cochrane Library. Studies investigating the prevalence of PE/E, associated complications, and mortality rates in pregnant women in Nigeria were included. Data extraction and quality assessment were conducted using standardized tools. Pooled prevalence estimates were calculated using random-effects models. Statistical heterogeneity was assessed using the I 2 statistic. Publication bias was evaluated using the Egger test. Results The analysis revealed a pooled prevalence of 4.51% (95% CI 3.82–5.29) for preeclampsia and 1.39% (95% CI 1.02–1.84) for eclampsia in Nigerian pregnant women. Significant heterogeneity was observed for both PE (I 2 = 99.20%, P

This case report discusses the clinical presentation, imaging findings, and successful management of a rare case of intussusception in a 6-month-old female infant referred to a regional hospital in Ghana. The patient presented with vomiting, lethargy, fever, and currant jelly stool. Differential diagnoses considered included Merkel diverticulum, volvulus, lymphadenopathy, and hypertrophic pyloric stenosis. Ultrasound imaging revealed a concentric lesion with characteristic signs of intussusception. Ileo-caeco coli intussusception was confirmed as the diagnosis. Surgical management was used for this patient. The postsurgery phase was without any complications. The patient recovered well and was discharged with a switch to oral medications. Infant intussusception is still a disease with a low morbidity rate.

Abstract This study highlights the importance of managing fishpond effluent to minimize its impact on aquatic environments. Fish effluents are a major concern worldwide in aquatic environments. It also provides information on the impacts of effluents on the water quality index of streams when released into aquatic environments. Streams and fishponds were sampled bimonthly for two annual cycles, covering different sampling stations both upstream and downstream of the fishpond effluents at 50-m intervals. Water quality parameters associated with in situ conditions were determined in the field. In the laboratory, other physicochemical parameters were determined via proper standard protocols. The results of the study revealed that water quality parameters such as turbidity, total suspended solids, total solids, conductivity, total dissolved solids, dissolved oxygen, biological oxygen demand and organic matter recorded in water samples collected from 50 m upstream at the point of effluent discharge were significantly (p

Abstract Climate change is the greatest challenge to developing countries, especially where rain-fed agriculture is the main source of livelihood and revenue. Agroforestry provides an opportunity for farmers to adapt and reduce the carbon footprint. We conducted an exploratory review on the role of cocoa agroforestry for climate change mitigation and adaptation of smallholders by applying combinations of keywords that include climate change, agroforestry, stakeholders, Paris agreement, INDCs/NDCs, mitigation and adaptation. The paper combined data sources covering reports on past and on-going cocoa sustainability projects and policy interventions in Ghana as well as the output of exploratory review that utilized relevant key words to identify appropriate literature for investigation and analysis. We established that, there is low adoption of pro-environmental interventions introduced by both Government and NGOs in the cocoa sector. In addition, there is a shift in cocoa farming from expansion into forest areas to adoption of intensive cocoa monoculture. Despite the importance of shaded trees in cocoa production such as the benefits gained from agroforestry system, cocoa farmers have low appreciation of their environmental, soil, nutrients and other ecological benefits. We recommend that cocoa farmers should be involved in the formulation and implementation of pro-environmental interventions that affect their cocoa production practices. This will make farmers take ownership of the innovation instead of it being introduced to them. In addition, since our review of the literature established that the surge in yield is the impetus for cocoa monoculture adoption, there is the need to introduce cocoa varieties with higher yields under agroforestry system. Finally, there should be monetary valuation of shade trees used in cocoa agroforestry systems for payment to farmers to help improve agroforestry adoption. We argue that cocoa agroforestry though considered an old practice, remains one of the most appropriate land-use systems that is climate-smart with great potential to contribute to sustainable cocoa production.

Abstract Current treatment strategy for managing Weber B ankle fractures is mainly governed by mortise congruency, malleolar alignment, deltoid ligament competence and fracture stability. While nonoperative treatment has yielded good functional outcomes in satisfactorily aligned stable injuries, a biomechanical rationale is not firmly established. Furthermore, current radiographic analysis is obscured by observer inaccuracy and beam rotation. This study aimed to utilize weightbearing CT and computational biomechanics to analyse 3D mortise displacement and contact mechanics in Weber-B ankle fractures and compare them with the uninjured contralateral side. 32 patients were included who sustained a Weber-B ankle fracture and underwent bilateral weightbearing CT imaging at injury. Segmentation into 3D models of bone was performed semi-automatically, and individualized cartilage layers were modeled based on a previously validated methodology. The 3D mortise congruency was evaluated by use of following parameters: alpha angle, fibular length, talocrural angle, medial gutter- and tibiofibular clear space- distance mapping. Contact mechanics were evaluated by the mean and maximum contact stress of the tibiotalar articulation. Statistical analysis revealed that there were no significant differences for all anatomical parameters. There was also no significant difference between the mean contact stress of the injured (2.10 ± 0.42 MPa) and uninjured side (2.10 ± 0.41 MPa), nor the maximum contact stress of the injured (7.67 ± 1.55 MPa) and uninjured (7.47 ± 1.67), respectively. Contact mechanics were unaffected in congruent Weber-B fractures. These findings support consideration of nonoperative management in such cases, given their presumably low risk for posttraumatic arthritic development in the long term. Level of Evidence: Level III; retrospective case-control study.

Background Benign prostatic hyperplasia (BPH) is one of the causes of lower urinary tract symptoms (LUTS) in men above 50 years of age. It is known that the severity of LUTS (degree of bladder outlet obstruction) does not correlate with the size of the prostate gland in BPH. Severity of LUTS due to BPH can be assessed using the internationally validated international prostate symptom score (IPSS). There are some concerns that the IPSS is subjective and may pose some challenges to the poorly educated patients in our environment during administration. Intravesical prostatic protrusion may be an objective index of degree of bladder outlet obstruction in men with BPH measured using abdominopelvic ultrasound. So the objective of this study is to evaluate for any correlation between IPP and IPSS in men with symptomatic BPH. Objective The objective of the study is to assess the correlation between IPP and IPSS. Patients and Methods A hospital based cross-sectional study of new patients with symptomatic LUTS of BPH, who presented to the Urology clinics of University of Nigeria Teaching Hospital Ituku-Ozalla Enugu. Ethical approval was obtained from the ethical committee of the hospital and informed consent from patients. After evaluation (including IPSS, PSA, and FBC, S/E/Ur/Cr, Urinalysis and M/C/S), participants had abdominopelvic ultrasonography measurement of IPP and midline sagittal image of the prostate (at bladder Volume of > 100mls) using Prosound model SSD 3500 with an abdominal probe frequency of 3.5MHz (Versana Essentials) IPP was divided into three grades (Grade I: 0-4.9mm; Grade II: 5.0-9.9mm; Grade III: 10.0mm and above). Data was analyzed using SPSS Version 20 (IBM, SPSS, Chicago, IL, USA). The Pearson correlation was used to assess correlation where necessary. P- value

Abstract Background Cervical cancer is the fourth most frequent cancer in women worldwide. Even though cervical cancer deaths have decreased significantly in Western countries, low and middle-income countries account for nearly 90% of cervical cancer deaths. While Western countries are leveraging the powers of artificial intelligence (AI) in the health sector, most countries in sub-Saharan Africa are still lagging. In Uganda, cytologists manually analyze Pap smear images for the detection of cervical cancer, a process that is highly subjective, slow, and tedious. Machine learning (ML) algorithms have been used in the automated classification of cervical cancer. However, most of the MLs have overfitting limitations which limits their deployment, especially in the health sector where accurate predictions are needed. Methods In this study, we propose two kernel-based algorithms for automated detection of cervical cancer. These algorithms are (1) an optimized support vector machine (SVM), and (2) a deep Gaussian Process (DGP) model. The SVM model proposed uses an optimized radial basis kernel while the DGP model uses a hybrid kernel of periodic and local periodic kernel. Results Experimental results revealed accuracy of 100% and 99.48% for an optimized SVM model and DGP model respectively. Results on precision, recall, and F1 score were also reported. Conclusions The proposed models performed well on cervical cancer detection and classification, and therefore suitable for deployment. We plan to deploy our proposed models in a mobile application-based tool. The limitation of the study was the lack of access to high-performance computational resources.

Abstract Background In adults aged 50 + years, vaccine-preventable diseases (VPDs) pose a significant health burden and can lead to additional ‘downstream effects’ of infection beyond the acute phase e.g., increasing the risk for non-communicable disease and exacerbating chronic conditions. The aim was to understand and quantify the burden of VPD downstream effects in hospitalised adults in the United States. Methods This retrospective observational study analysed hospitalisation claims data (2016–2019) with 1-year follow-up, in adults with a VPD diagnosis versus matched controls (using Optum’s de-identified Clinformatics Data Mart Database). Outcomes included mortality; increase in Charlson Comorbidity Index (CCI) score; new diagnosis of comorbidities; and loss of independence (defined by need for home health/home care and/or move to long-term facility). Results Mortality was significantly increased in VPD cases versus controls at 30-day (risk ratio [RR] of 4.08 [95% CI 3.98–4.18]) and 1-year follow-up (RR 2.76 [2.73–2.80]). Over a 1-year follow-up period, morbidity increased following VPD hospitalisation: 65–86% of VPD cases had new comorbidities diagnosed (versus 13–41% of controls); with a significantly higher mean increase in CCI score versus baseline (3.23 in VPD cases versus 0.89 in controls, p

Abstract Background Malaria in pregnancy (MiP) is a public health concern especially for pregnant women living in slums. The World Health Organization recommends at least three doses of Sulfadoxine-Pyrimethamine (SP) to prevent MiP. In Ghana, it is recommended that pregnant women receive a minimum of five doses of the medication. This study sought to determine the level of adherence to IPT5 policy and factors associated with adherence among pregnant women in a slum community in Ghana. Methods This was a cross-sectional study involving 232 nursing mothers and four healthcare workers at the St. Martin’s Memorial Hospital, Sukura, Ghana. Sociodemographic characteristics of nursing mothers were obtained using an interview-administered questionnaire. Data on the number of SP doses and other obstetrics characteristics were collected by reviewing the antenatal record books. To obtain information about healthcare and health system factors associated with adherence to the five-dose policy, four healthcare providers were interviewed. A data extraction form was used to obtain information about the availability of SP at the facility. Results The level of adherence to IPT5 was 8.6% (20/232) (95% CI 5.0–12.3) among the participants. Only 8.4% of the participants received their first dose at 16 weeks. Respondents who began ANC in the second trimester were 81% less likely to adhere to IPT5 than those who began in the first trimester (aOR = 0.19, 95% CI 90.01–0.65, p

Abstract Introduction In Ghana, access to health care is impeded mostly by financial capital. The National Health Insurance (NHIS) rolled out in 2003 was an attempt to remove cost as a barrier and help bridge this gap in health access. Despite the benefits, enrolment and use have been low. Hence a need to assess the knowledge, access and satisfaction of pregnant women on the use of NHIS to access healthcare. Materials and methods The study employed a facility-based descriptive cross-sectional study. A structured questionnaire was used to collect data from a total of 387 pregnant women using a simple random sampling technique. Data was collected to gain an insight into the knowledge, accessibility and satisfaction level of pregnant women on the usage of NHIS. Data was analyzed using Stata version 17.0 and results were presented in frequency tables. Results Overall, most of the pregnant women had a good knowledge of 228 (67.5%) and a high accessibility of 279 (82.5%) to using NHIS use it in accessing healthcare. Whilst for satisfaction, 311 (92.01%) said they were satisfied with the services and would prefer the use of NHIS to out-of-pocket payment. Conclusion In the current study the level of knowledge, accessibility, and satisfaction of NHIS is high. However, to sustain this gain, a multidimensional approach to community education should be intensified.

Abstract We investigate the emergence, mutation profile, and dissemination of SARS-CoV-2 lineage B.1.214.2, first identified in Belgium in January 2021. This variant, featuring a 3-amino acid insertion in the spike protein similar to the Omicron variant, was speculated to enhance transmissibility or immune evasion. Initially detected in international travelers, it substantially transmitted in Central Africa, Belgium, Switzerland, and France, peaking in April 2021. Our travel-aware phylogeographic analysis, incorporating travel history, estimated the origin to the Republic of the Congo, with primary European entry through France and Belgium, and multiple smaller introductions during the epidemic. We correlate its spread with human travel patterns and air passenger data. Further, upon reviewing national reports of SARS-CoV-2 outbreaks in Belgian nursing homes, we found this strain caused moderately severe outcomes (8.7% case fatality ratio). A distinct nasopharyngeal immune response was observed in elderly patients, characterized by 80% unique signatures, higher B- and T-cell activation, increased type I IFN signaling, and reduced NK, Th17, and complement system activation, compared to similar outbreaks. This unique immune response may explain the variant's epidemiological behavior and underscores the need for nasal vaccine strategies against emerging variants.

Abstract This study investigated the effects of corn cob biochar (CCB) and rice husk biochar (RHB) additions (at 0%, 5%, and 10% w/w) on nitrogen and carbon dynamics during co-composting with poultry litter, rice straw, and domestic bio-waste. The study further assessed the temperature, moisture, pH, and nutrient contents of the mature biochar co-composts, and their potential phytotoxicity effects on amaranth, cucumber, cowpea, and tomato. Biochar additions decreased NH4 +-N and NO3- contents, but bacteria and fungi populations increased during the composting process. The mature biochar co-composts showed higher pH (9.0–9.7), and increased total carbon (24.7–37.6%), nitrogen (1.8–2.4%), phosphorus (6.5–8.1 g kg−1), potassium (26.8–42.5 g kg−1), calcium (25.1–49.5 g kg−1), and magnesium (4.8–7.2 g kg−1) contents compared to the compost without biochar. Germination indices (GI) recorded in all the plants tested with the different composts were greater than 60%. Regardless of the biochar additions, all composts treatments showed no or very minimal phytotoxic effects on cucumber, amaranth and cowpea seeds. We conclude that rice husk and corn cob biochar co-composts are nutrient-rich and safe soil amendment for crop production.

Abstract Improvement of particle swarm optimization (PSO) is relevant to solving the inherent local optima and premature convergence problem of the PSO. In this paper, a novel improvement of the particle swarm optimization is provided to curb the problem of the classical PSO. The proposed improvement modifies the updating velocity function of the PSO, and it uses a local best murmuration particle which is found using the k-means clustering technique. In this contribution, each particle moves towards the global best position by not only using the personal best and global best, but particles are modelled to move in murmuration towards the global best using the personal best, global best and a local best particle known as the local best murmuration particle. The improved model was tested against the traditional PSO and two other variants of the PSO and genetic algorithm (GA) using 18 benchmark test functions. The proposed improvement demonstrated superior exploration abilities by achieving the best optimum values in 15 out of 18 functions, particularly in the multimodal functions, where it achieved the best optimum value in all 6 cases. It also achieved the best worst-case values in 12 out of 18 functions, especially in the variable-dimension functions, where other algorithms showed significant escalation, indicating the proposed improvement’s reliability and robustness. In terms of convergence, the proposed improvement exhibited the best convergence rate in all 18 functions. These findings highlight the impressive ability of the proposed improvement to converge swiftly without compromising accuracy.

Abstract The Brazilian Amazon is a vast area with limited health care resources. To assess the epidemiology of critically ill acute kidney injury (AKI) patients in this area, a prospective cohort study of 1029 adult patients of the three intensive care units (ICUs) of Rio Branco city, the capital of Acre state, were evaluated from February 2014 to February 2016. The incidence of AKI was 53.3%. Risk factors for AKI included higher age, nonsurgical patients, admission to the ICU from the ward, higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores at ICU admission, and positive fluid balance > 1500 ml/24 hours in the days before AKI development in the ICU, with aOR of 1.3 (95% CI 1.03–1.23), 1.47 (95% CI 1.07–2.03), 1.96 (95% CI 1.40–2.74), 1.05 (95% CI 1.03–1.08) for each unit increase, and 1.62 (95% CI 1.16–2.26), respectively. AKI was associated with higher ICU mortality (aOR 2.03, 95% CI 1.29–3.18). AKI mortality was independently associated with higher age, nonsurgical patients, sepsis at ICU admission, presence of shock or use of vasoactive drugs, mechanical ventilation and mean positive fluid balance in the ICU > 1500 ml/24 hours, both during ICU follow-up, with aOR 1.27 (95% CI 1.14–1.43) for each 10-year increase, 1.64 (95% CI 1.07–2.52), 2.35 (95% CI 1.14–4.83), 1.88 (95% CI 1.03–3.44), 6.73 (95% CI 4.08–11.09), 2.31 (95% CI 1.52–3.53), respectively. Adjusted hazard ratios for AKI mortality 30 and 31–180 days after ICU discharge were 3.13 (95% CI 1.84–5.31) and 1.69 (95% CI 0.99–2.90), respectively. AKI incidence was strikingly high among critically ill patients in the Brazilian Amazon. The AKI etiology, risk factors and outcomes were similar to those described in high-income countries, but mortality rates were higher.

The contribution of agriculture in the socio-economic development is undeniable and is truly an important part of the Philippine economy. It is also a major source of livelihood and employment of most Filipinos especially in the rural areas. The general intent of this study is to evaluate the impact of the government agricultural intervention on selected upland communities in Goa, Camarines Sur especially on the far-flung barangays of the municipality using Regression Discontinuity Design. This study assessed the socio-economic and poverty status of the local farmers through the agricultural interventions received. The results showed that the distribution of seeds, fertilizers and cash assistance to the upland farmers could improve the overall outputs of the farmers, which can help alleviate their lives. Similarly, the agricultural interventions of the government have great and positive impact to alleviate poverty and improve the quality of life of the local farmers. However, irrigation and farm-to-market roads need to be prioritized to ensure that agricultural production output increase.

Abstract Schistosomiasis, an endemic neglected tropical disease in areas with poor sanitation, causes physical and mental defects in both children and adults. Various strategies, especially drug administration for morbidity control, have been implemented to combat the disease in Ghana and globally. Despite these efforts, schistosomiasis remains prevalent in Ghana, negatively impacting children's academic performance, growth, and overall quality of life. This study aimed to determine the prevalence of schistosomiasis in school children at Esuekyir, a peri-urban community in Ghana. A cross-sectional study using simple random sampling technique to select participants and collect stool and urine samples from 246 school children in Esuekyir was adopted. Microscopy of urine and stool samples was performed involving urine sedimentation and stool formol-ether sedimentation techniques to analyse for parasite eggs. Questionnaires were developed to help detect risk factors that expose these children to the disease. The prevalence of urogenital schistosomiasis in children at Esuekyir was 15.45% while that of intestinal schistosomiasis was 6.957.0%. There was one case of co-infection of urogenital and intestinal schistosomiasis from a 13 year old primary student. Children in primary school had higher risks of infection due to their activities around the water body. There was a significant association between class groups and urogenital schistosomiasis (p-value = 0.042). The presence of schistosomiasis in school children highlights the importance of targeted interventions and public health initiatives in addressing this specific disease condition especially in primary school children. Findings from the research revealed a higher prevalence of urogenital schistosomiasis in the study population as compared to intestinal schistosomiasis.

Abstract In this paper, we have provided more insights on the relationship between under five morbidity in Nigeria and some background characteristics using a Poisson regression model and the most recent 2018 NDHS data on Acute Respiratory Infection (ARI), diarrhoea and fever. Some of our results are that children 36–47 months old have the highest risk of ARI [OR = 1.45; CI (1.31,1.60)] while children less than 6 months old have the lowest risk of ARI [OR = 0.14; CI (0.11,0.17)]. The prevalence of diarrhoea is generally high among children under 48-59 months old but highest among children 6–11 months old [OR = 4.34; CI (3.69,5.09)]. Compared to children 48–59 months old, children in all other age categories except 24–34 months old have a high risk of fever [OR = 0.95; CI (0.73,1.24)]. ARI is more prevalent among female children [OR = 8.88; CI (8.02,9.82)] while diarrhoea [OR = 21.75; (19.10,24.76)] and fever [OR = 4.78; CI (4.31,5.32)] are more prevalent among male children. Children in urban areas are more likely to suffer ARI [OR = 9.49; CI (8.31,10.85)] while children in rural areas are more likely to suffer both diarrhoea [OR = 21.75; CI (19.10,24.76)] and fever [OR = 4.90; CI (4.26,5.63)]. Children in the South-South have the highest risk of ARI [OR = 4.03; CI (3.65,4.454)] while children in the North Central have the lowest risk of ARI [OR = 1.55; CI (1.38,1.74)] and highest risk of diarrhoea [OR = 3.34; CI (2.30,5.11)]. Children in the Northeast have the highest risk of fever [OR = 1.30; CI (1.14,1.48)]. In the Northcentral region, Kogi state has the highest prevalence of fever [OR = 2.27; CI (1.62,3.17)], while Benue state has the lowest [OR = 0.35; CI (0.20,0.60)]. Children in Abuja state face similar risks of fever and diarrhoea [OR = 0.84; CI (0.55,1.27)], with the risk of diarrhoea in Abuja being comparable to that in Plateau state [OR = 1.57; CI (0.92,2.70)]. Nasarawa state records the highest incidence of diarrhoea in the Northcentral [OR = 5.12; CI (3.03,8.65)], whereas Kogi state reports the lowest [OR = 0.29; CI (0.16,0.53)]. In the Northeast, Borno state has the highest rate of fever [OR = 3.28; CI (2.80,3.84)], and Bauchi state the lowest [OR = 0.38; CI (0.29,0.50)]. In Adamawa state, the risks of fever and diarrhoea are nearly equivalent [OR = 1.17; CI (0.97,1.41)], and the risk of fever there is similar to that in Taraba state [OR = 0.92; CI (0.75,1.12)]. Diarrhoea is most prevalent in Yobe state [OR = 3.17; CI (2.37,4.23)] and least prevalent in Borno state [OR = 0.26; CI (0.20,0.33)]. In the Northwest, the risk of fever is similarly high in Zamfara and Kebbi states [OR = 1.04; CI (0.93,1.17)], with Kastina state showing the lowest risk [OR = 0.39; CI (0.34,0.46)]. Children in Zamfara state experience notably different risks of fever and diarrhoea [OR = 0.07; CI (0.05,0.10)]. Kaduna state reports the highest incidence of diarrhoea [OR = 21.88; CI (15.54,30.82)], while Kano state has the lowest [OR = 2.50; CI (1.73,3.63)]. In the Southeast, Imo state leads in fever incidence [OR = 8.20; CI (5.61,11.98)], while Anambra state has the lowest [OR = 0.40; CI (0.21,0.78)]. In Abia state, the risk of fever is comparable to that in Enugu state [OR = 1.03; CI (0.63,1.71)], but the risks of fever and diarrhoea in Abia differ significantly [OR = 2.67; CI (1.75,4.06)]. Abia state also has the highest diarrhoea rate in the Southeast [OR = 2.67; CI (1.75,4.06)], with Ebonyi state having the lowest [OR = 0.05; CI (0.03,0.09)]. In the South-South region, Bayelsa and Edo states have similar risks of fever [OR = 1.28; CI (0.84,1.95)], with Akwa Ibom state reporting the highest fever rate [OR = 4.62; CI (3.27,6.52)] and Delta state the lowest [OR = 0.08; CI (0.02,0.25)]. Children in Bayelsa state face distinctly different risks of fever and diarrhoea [OR = 0.56; CI (0.34,0.95)]. Rivers state shows the highest incidence of diarrhoea in the South-South [OR = 10.50; CI (4.78,23.06)], while Akwa Ibom state has the lowest [OR = 0.30; CI (0.15,0.57)]. In the Southwest, Lagos and Osun states have similar risks of fever [OR = 1.00; CI (0.59,1.69)], with Ogun state experiencing the highest incidence [OR = 3.47; CI (2.28,5.28)] and Oyo state the lowest [OR = 0.18; CI (0.07,0.46)]. In Lagos state, the risks of fever and diarrhoea are comparable [OR = 0.96; CI (0.57,1.64)], and the risk of diarrhoea is similar to those in Ekiti, Ogun, and Ondo states. Oyo state has the highest diarrhoea rate in the Southwest [OR = 10.99; CI (3.81,31.67)], with Ogun state reporting the lowest [OR = 0.77; CI (0.42,1.42)]. Children of mothers with more than secondary education are significantly less likely to suffer ARI [OR = 0.35; CI (0.29,0.42)], whereas children of mothers without any education run a higher risk of diarrhoea [OR = 2.12; CI (1.89,2.38)] and fever [OR = 2.61; CI (2.34,2.91)]. Our analysis also indicated that household wealth quintile is a significant determinant of morbidity. The results in this paper could help the government and non-governmental agencies to focus and target intervention programs for ARI, diarrhoea and fever on the most vulnerable and risky under five groups and populations in Nigeria.

Abstract Background Male infertility is a global problem, and varicoceles are a common and treatable cause of male infertility. This study prospectively evaluated the effects of varicoceles on the fertility status and potential among Nigerian men. The consequences of the presence, location, and grades of varicoceles on the fertility status of infertile men with varicoceles were determined using a Doppler scrotal ultrasound scan and their seminal fluid parameters. Methods One hundred infertile males with clinical varicoceles (study group) and 100 infertile males without varicocele (control group) were recruited. Varicoceles were confirmed/excluded and graded with an ultrasound scan in each subject. They also all had a seminal fluid analysis to measure their fertility potential. The findings were compared and correlated in the two groups. Results Most subjects in the study group (67%) had bilateral varicoceles, 31% had isolated left varicoceles, and only 2% had isolated right varicoceles. The majority of the participants (61%) in the study group had secondary infertility, while the majority (63%) in the control group had primary infertility (p = 0.001). There were significant increases in the prevalence of azoospermia (p = 0.008) and oligospermia (p = 0.030) with the higher grades of left varicoceles. Conclusion Bilateral varicoceles were significantly present in males with infertility in the study group. Varicoceles were more common in males with secondary infertility, and higher grades of varicoceles were significantly more associated with azoospermia and severe oligospermia. We recommend the routine use of ultrasound scans to diagnose varicoceles for the optimal management of infertile male patients.

Objective The main objective of this study was to analyze the efficacy and feasibility of surgical management for patients with thoracic spinal tuberculous spondylitis (STB) by using posterior-only transforaminal debridement and interbody fusion (PTDIF) with preservation of posterior ligamentous complex (PLC) and noninferior of PTDIF compared with conventional posterior-only debridement and interbody fusion (CPDIF). Methods From January 2019 to January 2022, a prospective, randomized, controlled trial was conducted in which patients with thoracic STB were enrolled and assigned to undergo either the PTDIF group (group A) or CPDIF group (group B) in a 1:1 ratio. The clinical efficacy was evaluated on average operation time, blood loss, hospitalization durations, visual analogue scale, Oswestry Disability Index scores, erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), and neurological function recovery using the American Spinal Injury Association’s impairment scale and operative complications. Radiological measurements included kyphosis correction, loss of correction. The outcomes were compared between the groups at preoperation, postoperaion, and final follow-up. Results All 65 patients were completely cured during the follow-up. The intraoperative blood loss and operation time in group B were more than that in group A. All patients were pain-free at the final follow-up visit. ESR, CRP returned to normal limits in all patients 3 months after surgery. All patients had improved neurological signs. No significant difference was found in kyphosis angle correction, loss of correction between the 2 groups. Conclusion PTDIF, with preservation of PLC, achieved debridement, decompression, and reconstruction of the spine’s stability, similar to CPDIF in the surgical treatment of thoracic STB. PTDIF has less surgical trauma with less intraoperative blood loss and operation time.

Abstract Prostate cancer (PCa) metastasis significantly influences treatment decisions and prognosis. This study evaluated the individual and combined diagnostic ability of apparent diffusion coefficient (ADC), Gleason score and prostate‐specific antigen (PSA) in detecting metastasis. The study included data from 120 biopsy‐confirmed PCa patients treated from 2019 to 2023. Whole‐body MRI images, incorporating high‐resolution T2 and axial DWI sequences, were evaluated by experienced radiologists. Receiver operating characteristic (ROC) curves and logistic regression models were used to assess the diagnostic performance of ADC, Gleason score, and PSA in detecting metastasis. The prevalence of PCa metastasis was 25.0%, with pelvic lymph node metastasis (16.7%) and bony metastasis (12.5%) being most prevalent. Patients with PCa metastasis had significantly lower ADC values, higher Gleason scores, and higher PSA levels compared to those without metastasis. Individually, an ADC cut‐off of ≤549.00 mm2/s was the best marker for detecting metastasis. The combined bioscore model including PSA, ADC values and Gleason score was the best independent predictor, correlating with a 159‐fold increased likelihood of detecting PCa metastasis. This study demonstrated the prognostic ability of PCa markers in detecting metastasis. ADC was an independent, sensitive, specific, and accurate diagnostic marker. The combined bioscore model of ADC, PSA and Gleason score significantly enhanced the identification of patients with PCa metastasis.

The recent increase in starch utilization for food and other applications demands research into other potential sources of starch. Hence, starch isolated from cocoyam corm, was succinylated and the functional and pasting properties were determined, to provide an insight into its potential applications. The succinylation was done by blending the cocoyam starch (CS) with succinic anhydride (SA), using the central composite rotatable design of the Design Expert software. The succinylated and native cocoyam starches were evaluated for their functional and pasting properties using standard methods. The 39.64 g CS: 7.50 M SA succinylated starch differed significantly from the native cocoyam starch in all the functional properties except swelling power. However, a succinylated starch of comparable functional and pasting properties to that of the native cocoyam starch was produced from the blends of 100.00 g CS and 3.00 M SA. Additionally, succinylation had a significant effect on all the pasting properties of the starch samples. The pasting properties of 50.00 g CS: 3.00 M SA (except breakdown viscosity), 39.64 g CS: 7.50 M SA (except pasting temperature), 110.36 g CS: 7.50 M SA (except peak viscosity), and 50.00 g CS: 12.00 M SA (except peak viscosity) succinylated starches were significantly different from the native cocoyam starch. Therefore, the succinylated cocoyam starch could find applications as a binder, thickener, stabilizer, and emulsifier in the food industries, depending on the level of succinylation.

Contract farming (CF) is a sort of vertical integration in agricultural commodity chains that provides a business with strong control over several operational processes, including the production process, the features of the items, quantity, quality, and timeliness of project execution. Birds were first domesticated by humans as farm animals, and as a result, many years ago, the contemporary practice of raising birds began with the harvesting of their eggs and young from their natural habitat. The Nigerian poultry industry falls into three main categories: small-, medium-, and large-scale, which are also referred to as backyard, semi-commercial, and commercial respectively. Contract farming emerged as an alternative to traditional or spot marketbased agricultural production and was introduced into Nigeria under a variety of business names, including CHI, AMO, ANIMAL CARE, and ZARTECH, among others. Nigeria consumes 192.69 MT of poultry meat and egg products annually, resulting in enormous environmental impacts that have not been adequately addressed because of the growing use of contract farming. Contract farming has always received a lot of attention from academics and policymakers. Even though contract farming acknowledges the transfer of technology, prospects for increased revenue, and improved access to inputs, a great deal of research has focused on the risks that smallholder farmers face. In recent years, debate has erupted regarding the benefits and dangers of factory poultry production considering rising awareness of the challenges it poses to public health and the environment. This review reveals that backyard flocks of chickens can thrive independently of large-scale poultry operations. Survival traits including tiny size, hardiness, sluggish growth, low mature body weight, tolerance, or resistance to common local disease organisms and parasites define local chickens.

Abstract Background Apoptosis, a form of programmed cell death, is critical for the development and homeostasis of the immune system. Chimeric antigen receptor T (CAR-T) cell therapy, approved for hematologic cancers, retains several limitations and challenges associated with ex vivo manipulation, including CAR T-cell susceptibility to apoptosis. Therefore, strategies to improve T-cell survival and persistence are required. Mesenchymal stem/stromal cells (MSCs) exhibit immunoregulatory and tissue-restoring potential. We have previously shown that the transfer of umbilical cord MSC (UC-MSC)-derived mitochondrial (MitoT) prompts the genetic reprogramming of CD3+ T cells towards a Treg cell lineage. The potency of T cells plays an important role in effective immunotherapy, underscoring the need for improving their metabolic fitness. In the present work, we evaluate the effect of MitoT on apoptotis of native T lymphocytes and engineered CAR-T cells. Methods We used a cell-free approach using artificial MitoT (Mitoception) of UC-MSC derived MT to peripheral blood mononuclear cells (PBMCs) followed by RNA-seq analysis of CD3+ MitoTpos and MitoTneg sorted cells. Target cell apoptosis was induced with Staurosporine (STS), and cell viability was evaluated with Annexin V/7AAD and TUNEL assays. Changes in apoptotic regulators were assessed by flow cytometry, western blot, and qRT-PCR. The effect of MitoT on 19BBz CAR T-cell apoptosis in response to electroporation with a non-viral transposon-based vector was assessed with Annexin V/7AAD. Results Gene expression related to apoptosis, cell death and/or responses to different stimuli was modified in CD3+ T cells after Mitoception. CD3+MitoTpos cells were resistant to STS-induced apoptosis compared to MitoTneg cells, showing a decreased percentage in apoptotic T cells as well as in TUNEL+ cells. Additionally, MitoT prevented the STS-induced collapse of the mitochondrial membrane potential (MMP) levels, decreased caspase-3 cleavage, increased BCL2 transcript levels and BCL-2-related BARD1 expression in FACS-sorted CD3+ T cells. Furthermore, UC-MSC-derived MitoT reduced both early and late apoptosis in CAR-T cells following electroporation, and exhibited an increasing trend in cytotoxic activity levels. Conclusions Artificial MitoT prevents STS-induced apoptosis of human CD3+ T cells by interfering with the caspase pathway. Furthermore, we observed that MitoT confers protection to apoptosis induced by electroporation in MitoTpos CAR T-engineered cells, potentially improving their metabolic fitness and resistance to environmental stress. These results widen the physiological perspective of organelle-based therapies in immune conditions while offering potential avenues to enhance CAR-T treatment outcomes where their viability is compromised.

Abstract Background Over the past two decades, antenatal care (ANC) coverage has increased in most settings across low- and middle-income countries, including Ghana. However, evidence shows that there is a need to focus on both access and quality to improve maternal and newborn health outcomes. We investigated ANC quality among public healthcare facilities in the northern region of Ghana. Methods We conducted a facility-based study involving 420 postpartum women, selected randomly from five public health facilities. We collected information on a set of prenatal services that respondents self-reported to have received during their most recent pregnancy. Women who received all the interventions assessed were considered to have received quality ANC. Using multilevel (mixed-effects) regression analysis, we identified the independent factors associated with ANC quality, with healthcare facility as the cluster variable. Results Of the 420 women, 31.2% (95% CI: 26.9, 35.8) received ANC services of high quality. ANC quality differed significantly by women’s background characteristics and ANC use. However, gestational age at first ANC and the number of follow-up visits before delivery were significantly associated with ANC quality: booking the first visit in the second or third trimester reduced the odds of receiving high-quality ANC compared to booking in the first trimester (aOR = 0.15, 95% CI: 0.07, 0.31, and aOR = 0.09, 95% CI: 0.01, 0.83, respectively). In contrast, achieving a minimum of eight ANC follow-ups before delivery increased the odds of receiving high-quality ANC compared to attaining fewer than eight visits (aOR = 4.82, 95% CI: 2.33, 9.99). Conclusions A significant proportion of pregnant women in the study setting received suboptimal quality ANC during their most recent pregnancy. ANC quality was primarily associated with the timing of the first visit and the number of follow-up visits before delivery. Timely initiation of ANC and frequent follow-up visits will be crucial in the study’s setting for pregnant women to benefit from comprehensive ANC services.

Abstract Background The incidence of chronic diseases, which are significant contributors to maternal deaths and adverse new-born outcomes, is increasing among women of reproductive age in northern Ghana. This emerging health issue raises serious concerns about the potential exacerbation of adverse birth outcomes in this setting, given that it is one of the regions in the country with a high incidence of such outcomes. We investigated the risks of preterm birth (PTB), low birth weight (LBW), and concurrent PTB and LBW among women with preexisting chronic conditions prior to conception in the Tamale Metropolis of northern Ghana. Methods A facility-based cross-sectional study was conducted among 420 postpartum women randomly selected from five public health facilities. Information was collected electronically on participants’ self-reported experience of chronic conditions, namely, hypertension, diabetes, asthma, heart disease, and sickle cell disease, prior to their most recent pregnancy. Information on gestational age at delivery and birth weight was also collected. Regression modeling was used to quantify the risk of adverse newborn outcomes among women who reported preexisting chronic conditions prior to pregnancy. Results Chronic diseases affected 31.2% of our sample. Of these, 28.6% had a single chronic condition, while 2.6% had comorbid chronic conditions. The prevalence of PTB was 24.0% (95% CI: 20.2, 28.4), 27.6% (95% CI: 23.5, 32.1) of the newborns were born LBW, and 17.4% (95% CI: 14.0, 21.3) of the pregnancies resulted in both PTB and LBW. Compared with those without chronic conditions, women with chronic conditions prior to conception had a greater risk of PTB (aOR = 6.78, 95% CI: 3.36, 13.68), LBW (aOR = 5.75, 95% CI: 2.96, 11.18), and the co-occurrence of PTB and LBW (aOR = 7.55, 95% CI: 3.32, 17.18). Conclusions We observed significant rates of PTB, LBW, and the co-occurrence of PTB and LBW among women who were already aware that they had preexisting chronic conditions prior to conception. Our findings highlight a potential gap in the quality of prenatal care provided to these women before delivery. Preconception care may offer an opportunity to address preexisting chronic conditions in women before pregnancy and potentially improve maternal and newborn health outcomes.

Abstract The use of herbal products for the treatment of malaria, has increased globally. However, inadequate scientific studies about the safety and effectiveness of such herbal products have been raised. Also, the reduced sensitivity of the malaria parasites to artemisinin-based combination therapies is of concern. There is therefore the need for new antimalarial medications including those from alternative sources such as herbal medicinal products. In this study, a prospective, comparative parallel group randomized, clinical study was done to assess the safety and effectiveness of Mist Amen Fevermix and Mist Edhec Malacure with Artemether/Lumefantrine as control at the Tafo Government Hospital, Kumasi between July and November 2019, after Committee on Human Research, Publication and Ethics approval (CHRPE/AP/424/19). The study was conducted in accordance with Good Clinical and Laboratory Practice (GCLP) and registered with the Pan African Clinical Trials Registry with trial number PACTR202109664146698. Participant completed an informed consent form. Randomization was based on a single sequence to allocate participants to a group. SPSS version 19. One-way ANOVA test and exploratory statistics was used for data analysis. Total sample size was 150 participants with 50 on each arm of the group. Male and female patients aged 15–45 years and meet inclusion criteria with clinically established malaria were treated with Mist Amen Fevermix and Mist Edhec Malacure, at the specified doses of 45 mls (0.1063 g) and 30 mls (0.0521 g) three times daily after meals for three days. Artemether/Lumefantrine was administered at a dose of 80/480 mg/kg twice daily after meals for three days. Baseline data was taken on day 0. Patients were then followed up on Day 3, 7 and 28 to establish treatment outcomes and any side effect using a checklist for signs and symptoms and Karnofsky’s scale to assess the quality of life. Mist Amen Fevermix was effective with a cure rate of 95.89%. Mist Edhec Malacure was also effective with a cure rate of 91.87%. The cure rate of Artemether/Lumefantrine was 97.25%. Kidney and liver panels were within normal reference range at the end of the 28-day study. This study supports the use of Mist Amen Fevermix and Mist Edhec Malacure, two multi-component products as safe and effective for the treatment of uncomplicated malaria. Both products achieved a comparable clinical treatment outcome with Artemether/Lumefantrine.

A 40-year-old female arrived with persistent posterior right knee pain, swelling in the popliteal, infrapatellar, anterior calf areas and difficulty walking due to joint stiffness. Multiple hypoechoic collections with internal echoes and debris were discovered in the anterior calf region using ultrasound imaging, which extended from a thick-walled infrapatellar hypoechoic collection with peripheral vascularity. A significant popliteal fossa cyst of comparable appearance was also observed. The results were consistent with a ruptured infrapatellar bursa sac and a popliteal fossa (Baker's cyst). The patient received conservative treatment with anti-inflammatory drugs, leading to the resolution of symptoms after a period of 6 weeks. For patients with more complex cysts, procedures like aspiration and corticosteroid injections under ultrasound guidance may be necessary. Recognizing the condition and using ultrasound for diagnosis and management can lead to successful outcomes.

Abstract Background Little is known about the nexus between online gambling and psychological distress among youth, especially in Ghana. This study aimed to investigate the effects of online sports betting on psychological distress, focusing on depression, anxiety, and stress among young individuals in the Volta region of Ghana. Methods A cross-sectional study was carried out at various betting centers in the Volta region of Ghana. Four hundred and three (403) participants were selected using a multi-stage sampling method. The study used a standardized questionnaire to assess psychological distress with the Depression, Anxiety, and Stress Scale (DASS 21) and problematic gambling with the Problem Gambling Severity Index (PGSI). The analysis included both descriptive and inferential methods. These include the implementation of the bootstrap technique within multiple regression models using the current versions of Jeffreys’s Amazing Statistics Program (JASP) [0.18.2], Statistical Package for the Social Sciences (SPSS) [29.0.2], and Microsoft Excel (2019). Results The study found a prevalence of 40% for problematic gambling and 44% for moderate gambling problems among participants, resulting in an overall gambling prevalence of 84%. Regarding psychological distress, the estimated prevalence of depression among participants was 43.6%, with stress reported at 31.1% and anxiety at 68.8%. The overall prevalence of psychological distress was 48%. When analyzing the link between gambling and psychological distress, the study noted that males were more prone to gambling-related psychological distress than females (β = 2.036, p = 0.025). Furthermore, individuals with problem gambling showed the highest probability of experiencing more significant psychological distress compared to other groups (β = 9.228, p = 0.002), followed by those with moderate gambling levels (β = 3.283, p = 0.002). Conclusion We recommend that the mental health unit of the Ghana Health Service, in collaboration with the Gaming Commission of Ghana, should develop youth-friendly interventions to address the prevalence and onset of problematic gambling among the youth, especially males. This could, in turn, reduce the prevalence of psychological distress among youth engaged in online gambling in Ghana.

Background: Researchers have consistently found higher rates of mental illnesses, especially depression, in prison populations compared to the general population. Even though specific coping strategies have been implicated as a factor influencing the mental well-being of inmates, little is known about this interplay in resource-poor settings. This study aimed to investigate the relationship between coping strategies and depression among inmates of a prison in Nigeria. Subjects and Methods: This was a two-stage cross-sectional study involving 269 inmates of Calabar Prison, Nigeria. Participants were administered a sociodemographic questionnaire, the Coping Strategies Inventory-Short Form, and the General Health Questionnaire-12 (GHQ-12). Respondents who scored ≥3 on the GHQ-12 together with 10% of low scorers proceeded to the second stage for an interview using the Mini-International Neuropsychiatric Interview. Results: The prevalence of depression among study participants was 30.5%. Emotion-focused disengagement coping strategies (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.05–1.20) and a history of mental illness before imprisonment (OR: 3.4, 95% CI: 1.34–8.57) significantly predicted depression, whereas problem-focused engagement was protective (OR: 1.92, 95% CI: 0.86–0.98). Conclusion: Compared to the general population, depression is more common among prison inmates and is associated with using specific coping strategies. Coping strategies deserve increasing consideration when planning mental health intervention programs for this population.

Abstract The East African Community (EAC) grapples with many challenges in tackling infectious disease threats and antimicrobial resistance (AMR), underscoring the importance of regional and robust pathogen genomics capacities. However, a significant disparity exists among EAC Partner States in harnessing bacterial pathogen sequencing and data analysis capabilities for effective AMR surveillance and outbreak response. This study assesses the current landscape and challenges associated with pathogen next-generation sequencing (NGS) within EAC, explicitly focusing on World Health Organization (WHO) AMR-priority pathogens. The assessment adopts a comprehensive approach, integrating a questionnaire-based survey amongst National Public Health Laboratories (NPHLs) with an analysis of publicly available metadata on bacterial pathogens isolated in the EAC countries. In addition to the heavy reliance on third-party organizations for bacterial NGS, the findings reveal a significant disparity among EAC member States in leveraging bacterial pathogen sequencing and data analysis. Approximately 97% (n = 4,462) of publicly available high-quality bacterial genome assemblies of samples collected in the EAC were processed and analyzed by external organizations, mainly in Europe and North America. Tanzania led in-country sequencing efforts, followed by Kenya and Uganda. The other EAC countries had no publicly available samples or had all their samples sequenced and analyzed outside the region. Insufficient local NGS sequencing facilities, limited bioinformatics expertise, lack of adequate computing resources, and inadequate data-sharing mechanisms are among the most pressing challenges that hinder the EAC’s NPHLs from effectively leveraging pathogen genomics data. These insights emphasized the need to strengthen microbial pathogen sequencing and data analysis capabilities within the EAC to empower these laboratories to conduct pathogen sequencing and data analysis independently. Substantial investments in equipment, technology, and capacity-building initiatives are crucial for supporting regional preparedness against infectious disease outbreaks and mitigating the impact of AMR burden. In addition, collaborative efforts should be developed to narrow the gap, remedy regional imbalances, and harmonize NGS data standards. Supporting regional collaboration, strengthening in-country genomics capabilities, and investing in long-term training programs will ultimately improve pathogen data generation and foster a robust NGS-driven AMR surveillance and outbreak response in the EAC, thereby supporting global health initiatives.

Goal: To accurately detect infections in Diabetic Foot Ulcers (DFUs) using photographs taken at the Point of Care (POC). Achieving high performance is critical for preventing complications and amputations, as well as minimizing unnecessary emergency department visits and referrals. Methods: This paper proposes the Guided Conditional Diffusion Classifier (ConDiff). This novel deep-learning framework combines guided image synthesis with a denoising diffusion model and distance-based classification. The process involves (1) generating guided conditional synthetic images by injecting Gaussian noise to a guide (input) image, followed by denoising the noise-perturbed image through a reverse diffusion process, conditioned on infection status and (2) classifying infections based on the minimum Euclidean distance between synthesized images and the original guide image in embedding space. Results: ConDiff demonstrated superior performance with an average accuracy of 81% that outperformed state-of-the-art (SOTA) models by at least 3%. It also achieved the highest sensitivity of 85.4%, which is crucial in clinical domains while significantly improving specificity to 74.4%, surpassing the best SOTA model. Conclusions: ConDiff not only improves the diagnosis of DFU infections but also pioneers the use of generative discriminative models for detailed medical image analysis, offering a promising approach for improving patient outcomes.

Anti-CD19 CAR-T cell therapy represents a breakthrough in the treatment of B-cell malignancies, and it is expected that this therapy modality will soon cover a range of solid tumors as well. Therefore, a universal cheap and sensitive method to detect CAR expression is of foremost importance. One possibility is the use of epitope tags such as c-Myc, HA or FLAG tags attached to the CAR extracellular domain, however, it is important to determine whether these tags can influence binding of the CAR with its target molecule. Here, we conducted in-silico structural modelling of an FMC63-based anti-CD19 single-chain variable fragment (scFv) with and without a c-Myc peptide tag added to the N-terminus portion and performed molecular dynamics simulation of the scFv with the CD19 target. We show that the c-Myc tag presence in the N-terminus portion does not affect the scFv’s structural equilibrium and grants more stability to the scFv. However, intermolecular interaction potential (IIP) analysis reveals that the tag can approximate the complementarity-determining regions (CDRs) present in the scFv and cause steric impediment, potentially disturbing interaction with the CD19 protein. We then tested this possibility with CAR-T cells generated from human donors in a Nalm-6 leukemia model, showing that CAR-T cells with the c-Myc tag have overall worse antitumor activity, which was also observed when the tag was added to the C-terminus position. Ultimately, our results suggest that tag addition is an important aspect of CAR design and can influence CAR-T cell function, therefore its use should be carefully considered.

Abstract Background Plasmodium falciparum erythrocyte membrane protein‐1 (PfEMP‐1) is important in malaria pathogenicity as it mediates Pf‐infected erythrocytes cytoadherence to host endothelial microvasculature receptors. Naturally acquired antibodies against specific PfEMP‐1 antigens may be beneficial in clinical malaria protection. This study determined antibodies to DBLα2, CIDRα1, DBLβ12, and DBLγ6 domains of PfEMP‐1 in children with P. falciparum malaria in Tamale, Ghana. Methods Sixty P. falciparum‐infected children, and 30 controls, aged 1–12 years were recruited for this case‐control study from April to July 2023 in Northern Ghana. Participants with uncomplicated malaria had asexual P. falciparum in peripheral blood and Hb ≥ 5.0 g/dL, and severe malaria was diagnosed when participants had Hb

IntroductionYam is an important crop for food security in East and West Africa due to its high market value and customer demand. High tuber quality with yield and disease resistance are the main traits for acceptability of yam cultivars across the tropical zone. There has been limited progress in enhancing the production and quality traits of yams, despite the significant socio-economic significance of this crop.MethodTo expedite the development of high-quality yam cultivars in Uganda, traits association study was conducted to identify genomic regions associated with key traits such as disease resistance, high yields, and dry matter content. The association mapping was conducted with multi-random mixed linear model (mrMLM) to compute the associations using five genetic models.ResultsA total of 16 significant single nucleotide polymorphisms (SNPs) markers were identified to be associated with the traits studied. Gene identification analysis revealed the presence of key putative genes such as Vicilin-like seed storage protein At2g28490 (ARATH)and Growth-regulating factor 1 involved in a variety of functions ranging from storage and gene regulation for disease resistance.DiscussionThe results obtained from this work have significant implications for the in-depth analysis of the genetic structure underlying key traits in yam. Additionally, this study emphasizes the identification of SNP variants and genes that may be utilized for genomic-informed selection in order to enhance yield and disease resistance in yams.

Studies have established that giving incentives for votes is extremely widespread in many democracies; however, only little is known about the new dimension of vote-buying in Nigeria's 2023 elections. The study utilized qualitative tools to select four states, 32 interviewees, and 12 discussants. The study revealed that vote-buying increased the voters' turnout and became institutionalized and rampant with ruling parties and general elections rather than off-cycle elections. Voters were enticed with branded materials, financial incentives in kangaroo inducement activities (funeral/birthday/idol ceremonies, cooperative/artisan societies), and temporary social incentives (camouflage community, aged/less privileged assistance, age-grade social competitions). Other dimensions were the payment of salaries to parties' executives and fake committees, the use of community leaders in pretentious social care, and the welfare of their subjects mainly for the exchange of their votes. There is a need for electoral acts to capture these new dimensions and improve the activities of law enforcement agents.

Abstract Background Insects act as disease vectors, spreading disease-causing organisms between plants and animals. There have been studies devoted to determining ways to control these pests. One of the most effective ways to accomplish this is to reduce their vector competency. This review article explains how these factors can reduce vector competency. Main body The major ways by which vector competence can be reduced were reviewed. Entomopathogens are organisms that cause disease in arthropods like insects, mites, and ticks. Wolbachia is a genus of intracellular bacteria that mostly infects arthropods, including a significant number of insects. It is one of the most frequent insect reproductive parasites that kill or severely disables insects. Entomopathogenic nematodes are a type of worm that attacks insects and kills them. Insect-specific viruses are a relatively new class of viruses with a variety of intriguing traits that could be used to better understand and possibly inhibit arbovirus transmission. Entomopathogenic fungi are a type of fungus that kills insects by attacking and infecting their insect hosts. Disrupting the environment and nutrition of insects could also help to reduce their ability to spread diseases to humans, animals, and plants. Conclusions Chemical control has been one of the most widely used methods for controlling disease vectors, but there have been reports of insect resistance, environmental degradation, and a variety of other side effects. Instead of chemical control, there are a variety of techniques that can be used, including targeting insects' endosymbionts (bacteria, viruses, fungi, nematodes, and protozoa), changing insects' nutrition, manipulating their environment, and many others. This paper discussed the alternative ways to reduce vectors’ competence without the use of synthetic chemical.

Abstract Background Staphylococcus aureus (S. aureus) often colonizes the human skin, upper respiratory and genital tracts. In the female genital tract, it can be passed on to the newborn during vaginal delivery leading to either ordinary colonization, or neonatal infections notably umbilical stump sepsis, scalded skin syndrome, arthritis, or bacteraemia/sepsis. These infections are mediated by staphylococcal virulence factors such as (i) Staphylococcal Enterotoxins A, B, C, D, and E encoded by the sea, seb, sec, sed, see genes, (ii) Exfoliative Toxins A and B encoded by the eta and etb genes, (iii) Toxic Shock Syndrome Toxin 1 (TSST-1) encoded by the tst gene, (iv) Panton-Valentine Leukocidin (PVL) encoded by the pvl gene, and (v) Hemolysins alpha and delta encoded by the hla and hld genes, respectively. We determined the prevalence of S. aureus possessing one or more virulence factor genes and of methicillin resistant Staphylococcus aureus (MRSA) in this population. Methods This was a cross-sectional study, which used 85 S. aureus isolates from the Chlorohexidine (CHX) clinical trial study in Uganda. The isolates had been obtained by culturing vaginal swabs (VS) from 1472 women in labour, frozen at minus 80oC, then thawed, sub-cultured, and tested for the selected virulence genes sea, seb, sec, sed, see eta, etb, tst, pvl, hla and hld, and for the methicillin resistance determining gene (mecA). Data were analyzed using SPSS version 20. Results Of the 85 S. aureus isolates 13 (15.3%) were positive for one or more virulence factor genes, as follows: pvl 9/85 (10.6%), hld 5/85 (5.9%), sea 1/85 (1.2%) and seb genes 1/85 (1.2%). The other virulence genes (sec, sed, see, eta, etb, hla and tst) were not detected in any of the isolates. MRSA was detected in 55.3% (47/85) of the isolates, but only two of these carried the pvl virulence gene. Conclusion This study demonstrated that 15% of the S. aureus colonizing the female lower genital tract of mothers in labour in central Uganda carried one or more virulence genes, mostly pvl, indicating potential for newborn infection with S. aureus acquired in the maternal birth canal. More than half of the isolates were MRSA.

Abstract Objective As there are no substantial selection criteria for determining the lowest instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) Lenke 5C/6C, thus, many surgeons base their selection on experience. The study aims to compare the selection of the lowest instrumented vertebrae (LIV) lumbar vertebra three (L3) with the use of direct vertebrae rotation (DVR) to the lowest instrumented vertebrae (LIV) lumbar vertebra four (L4) with the use of non-DVR for the correction of adolescent idiopathic scoliosis (AIS) Lenke 5C/6C when the lower end vertebrae (LEV) is at lumbar vertebrae four (L4). Methods This prospective study involved 101 patients who were divided into two groups based on different techniques. The patients were prospectively followed up for at least four years. All patients included in the study had a lower end vertebra (LEV) at L4, while patients older than 18 years and patients with prior surgical procedures were excluded. The DVR group consisted of 49 patients, and the non-DVR group included 51 patients. Results The preoperative mean LIV disc angle was 3.1 ± 3 and 3.1 ± 1, P = 0.097, which corrected to 1.2 ± 0 and 1.1 ± 0 in both groups at 4-year follow-up without statistical significance. The LIVDA and LIVT were statistically insignificant at the preoperative, and there were no significant differences at the follow-up visitation. The DVR group achieved a satisfactory coronal and Cobb’s angle correction compared to the NDVR group; however, there were no statistical differences at the follow-up visitations. Both groups achieve a satisfactory correction rate without substantial significance in clinical and radiological outcomes. Furthermore, no post-surgical complications were recorded in either group. Conclusions DVR is suitable for selecting L3 as the LIV in AIS Lenke 5C/6C compared to L4 in non-DVR. DVR preserved more segments without substantial complications during the follow-up visitations. Nevertheless, both groups will continue to be followed up to prevent adding-on post-surgical complications.

Abstract Background Hypertension is a common heart condition in the United States (US) and severely impacts racial and ethnic minority populations. While the understanding of hypertension has grown considerably, there remain gaps in US healthcare research. Specifically, there is a lack of focus on undiagnosed and uncontrolled hypertension in primary care settings. Aim The present study investigates factors associated with undiagnosed and uncontrolled hypertension in primary care patients with hypertension. The study also examines whether Black/African Americans are at higher odds of undiagnosed and uncontrolled hypertension compared to White patients. Methods A cross-sectional study was conducted using electronic health records (EHR) data from the University of Utah primary care health system. The study included for analysis 24,915 patients with hypertension who had a primary care visit from January 2020 to December 2020. Multivariate logistic regression assessed the odds of undiagnosed and uncontrolled hypertension. Results Among 24,915 patients with hypertension, 28.6% (n = 7,124) were undiagnosed and 37.4% (n = 9,319) were uncontrolled. Factors associated with higher odds of undiagnosed hypertension included age 18–44 (2.05 [1.90–2.21]), Hispanic/Latino ethnicity (1.13 [1.03–1.23]), Medicaid (1.43 [1.29-1.58]) or self-pay (1.32 [1.13-1.53]) insurance, CCI 1-2 (1.79 [1.67-1.92]), and LDL-c ≥ 190 mg/dl (3.05 [1.41–6.59]). For uncontrolled hypertension, risk factors included age 65+ (1.11 [1.08–1.34]), male (1.24 [1.17–1.31]), Native-Hawaiian/Pacific Islander (1.32 [1.05-1.62]) or Black/African American race (1.24 [1.11-1.57]) , and self-pay insurance (1.11 [1.03-1.22]). Conclusion The results of this study suggest that undiagnosed and uncontrolled hypertension is prevalent in primary care. Critical risk factors for undiagnosed hypertension include younger age, Hispanic/Latino ethnicity, very high LDL-c, low comorbidity scores, and self-pay or medicaid insurance. For uncontrolled hypertension, geriatric populations, males, Native Hawaiian/Pacific Islanders, and Black/African Americans, continue to experience greater burdens than their counterparts. Substantial efforts are needed to strengthen hypertension diagnosis and to develop tailored hypertension management programs in primary care, focusing on these populations.

Abstract Background Spatial repellents (SRs) have been widely used for the prevention of mosquito bites, and preliminary findings suggest efficacy against both malaria (1) and Aedes-borne viruses (2) but their effectiveness in reducing mosquito-borne diseases under operational use has never been evaluated. SRs have the potential of being critical tools in the prevention of mosquito-borne diseases in contexts where typical vector control strategies, such as insecticide-treated nets (ITNs) and indoor residual spraying, are inaccessible or underutilized such as among displaced persons or in emergency relief settings. Methods Children will be enrolled in 3 separate cohorts to establish the effectiveness of SRs in reducing malaria infection in different distribution channels. One cohort will estimate the direct effect of the SR distributed through a reference channel (study personnel distribution). The two remaining cohorts will estimate the protection of the SR distributed through a voucher channel and the Village Health Team channel. Cohorts will be followed twice a month (approximately every 15 days): during the first scheduled household visit in the month, a blood sample will be taken for malaria rapid diagnostic test (Monthly Visit #1); and, during the second scheduled household visit, a blood sample will only be taken if the participant has a recent history of fever (Monthly Visit #2). The incidence of malaria in each cohort will be estimated and compared to the reference cohort to determine the benefit of using a SR in an area with high, year-round transmission of malaria. Discussion This study will address the knowledge gap of whether or not SRs are effective in reducing human malaria disease in humanitarian assistance and emergency response settings in sub-Saharan Africa where underlying transmission rates are historically high and ITNs may or may not be widely deployed. This research will inform policy makers on whether to recommend SRs as a means to further reduce malaria transmission for such operational programs. Trial registration ClinicalTrials.gov NCT06122142. Registered on November 8, 2023.

Abstract This work aims to produce dextrin from sweet potato (Ipomoea batatas) starch by pyroconversion. The effect of dextrinization process (roasting time, temperature, and hydrochloric acid concentration) on properties (structural and functional) of starch have been studied using central composite design of experiment. Reaction conditions included: roasting time (55 and 94 min), temperature (127 and 152 °C), and hydrochloric acid concentration (0.17 and 0.43 M). The temperature (quadratic effect X2 2) is highly significant on the three measured responses (p

Globally, effective and efficient healthcare is critical to the wellbeing and standard of living of any society. Unfortunately, several distant communities far from the national grid do not have access to reliable power supply, owing to economic, environmental, and technical challenges. Furthermore, unreliable, unavailable, and uneconomical power supply to these communities contributes significantly to the delivery of substandard or absence of qualitative healthcare services, resulting in higher mortality rates and associated difficulty in attracting qualified healthcare workers to the affected communities. Given these circumstances, this paper aims to conduct a comprehensive review of the status of renewable energy available to rural healthcare clinics around the globe, emphasizing its potential, analysis, procedures, modeling techniques, and case studies. In this light, several renewable energy modeling techniques were reviewed to examine the optimum power supply to the referenced healthcare centers in remote communities. To this end, analytical techniques and standard indices for reliable power supply to the isolated healthcare centers are suggested. Specifically, different battery storage systems that are suitable for rural healthcare systems are examined, and the most economical and realistic procedure for the maintenance of microgrid power systems for sustainable healthcare delivery is defined. Finally, this paper will serve as a valuable resource for policymakers, researchers, and experts in rural power supply to remote healthcare centers globally.

Objective: To assess the effect of leaf extract of Persicaria lanigera on cotton pellet-induced granuloma tissue formation and acetic acid-induced ulcerative colitis. Methods: Rats were randomly divided into six groups: normal control, negative control, positive control (dexamethasone or sulfasalazine) as well as Persicaria lanigera (100-600 mg/kg)-treated groups. The effects of the extracts on body weight, antioxidant, and hematological parameters, as well as mast cell proliferation, were assessed. In addition, a histological evaluation was conducted. Results: Persicaria lanigera extract significantly decreased the mean exudate amount and suppressed granuloma tissue formation in a concentration-dependent manner in rats (P

Abstract Background The two major causes of cancer-related deaths among women in Ghana are breast cancer (BC) and cervical cancer (CC). These types of cancers typically do not show any symptoms until they have progressed. Therefore, it is important to screen for early detection. This research aimed to investigate the rate of breast cancer and cervical cancer screening, as well as the factors associated with it, among women of reproductive age in Ghana. Methods This study analysed data from the 2022 Ghana Demographic and Health Survey. A total of 15,014 women aged 15 to 49 years were included in the analysis. Descriptive statistics and binary logistic regression were employed to analyse the data with the aid of STATA/SE, version 17. Results It was found that 18.4% and 5.0% of the women had screened for BC and CC, respectively. Women aged 45–49 years were about three times more likely (aOR = 2.83, 95% CI: 1.88–4.24) to screen for BC compared to those aged 15–19 years. Women who had tested for HIV had increased odds (aOR = 1.88, 95% CI: 1.56–2.25) of screening for BC compared to their counterparts. Women within the richest wealth index (aOR = 1.95, 95% CI: 1.40–2.72) had increased odds of screening for BC compared to those in the poorest wealth index. Regarding CC screening, women with higher education (aOR = 2.56, 95% CI: 1.53–4.29) were two times more likely to screen for CC compared to those with no formal education. Women who did not use tobacco (aOR = 0.45, 95% CI: 0.21–0.96) had decreased odds of CC screening compared to their counterparts. Conclusions This study showed that the uptake of BC and CC screening services among women in Ghana was very low. The drivers of BC and CC screening included enabling, predisposing, and need factors. Stakeholders can leverage the mass media to raise awareness and educate women in reproductive age about the importance of BC and CC screening. This study provides relevant information that can inform BC and CC policies and programmes in Ghana.

Objectives: This narrative review aimed to explore the impact of checklists and error reporting systems on hospital patient safety and medical errors. Methods: A systematic search of academic databases from 2013 to 2023 was conducted, and peer-reviewed studies meeting inclusion criteria were assessed for methodological rigor. The review highlights evidence supporting the efficacy of checklists in reducing medication errors, surgical complications, and other adverse events. Error reporting systems foster transparency, encouraging professionals to report incidents and identify systemic vulnerabilities. Results: Checklists and error reporting systems are interconnected. Interprofessional collaboration is emphasized in checklist implementation. In this review, limitations arise due to the different methodologies used in the articles and potential publication bias. In addition, language restrictions may exclude valuable non-English research. While positive impacts are evident, success depends on organizational culture and resources. Conclusions: This review contributes to patient safety knowledge by examining the relevant literature, emphasizing the importance of interventions, and calling for further research into their effectiveness across diverse healthcare and cultural settings. Understanding these dynamics is crucial for healthcare providers to optimize patient safety outcomes.

Abstract Aim This study aimed to differentiate moderate to high myopic astigmatism from forme fruste keratoconus using Pentacam parameters and develop a predictive model for early keratoconus detection. Methods We retrospectively analysed 196 eyes from 105 patients and compared Pentacam variables between myopic astigmatism (156 eyes) and forme fruste keratoconus (40 eyes) groups. Receiver operating characteristic curve analysis was used to determine the optimal cut-off values, and a logistic regression model was used to refine the diagnostic accuracy. Results Statistically significant differences were observed in most Pentacam variables between the groups (p

Abstract Purpose The aim of the current study was to molecularly determine Bcl-2 and BAX gene mutations in HPV-associated squamous cell carcinoma of the cervix. Methods Formalin-fixed, paraffin-embedded tissue blocks, all consisting of squamous cell carcinoma of the cervix, were used for this study. The nucleic acid amplification technique and various steps for DNA sequencing, including DNA extraction and polymerase chain reaction, were used. Results Mutations were detected in the Bcl-2 gene of patients with squamous cell carcinoma of the cervix in the 10–860 bp region, while BAX gene mutations were detected in the 10–320 bp region. The nucleotide mutations in the Bcl-2 gene were A > G (50%), C > T (33.33%), and G > A > T (16.67%), while the BAX gene mutations were A > (16.67%), T > (16.67%), G > (16.67%), A > C (16.67%), T > G (16.67%), and T > C (16.67%). The mutations in the BAX gene were Indel (50%), Transversion (33.4%), and Transition (16.6%), while only the Transition mutation (100%) was detected in the Bcl-2 gene. The functional mutations in the BAX gene were only missense mutations (100%), but in the Bcl-2 gene, the functional mutations were missense (50%) and silent (50%) mutations. Conclusion Our findings revealed genomic mutations of different types and frequencies in the BAX and Bcl-2 genes in squamous cell carcinoma of the cervix, which should encourage further research to better understand these mutations and exploit them for clinical use.

Abstract Introduction Terminal illness is an irreversible illness that, without life-sustaining procedures, usually results in death or permanent disability from which recovery is unlikely. When involved, family caregivers are believed to improve health outcomes, such as reduced hospitalization, and establishing a patient’s initial access to professional treatment services. However, caring for a patient with a terminal illness is viewed as one of the most difficult aspects of providing care. This study aimed to identify the challenges, and coping strategies developed by family caregivers to cope with the care of the terminally ill person. Methods An exploratory descriptive qualitative approach was used. Twenty (20) family caregivers voluntarily participated in the study from the Korle-Bu Teaching Hospital. Semi-structured interviews were conducted with the participants. The transcribed interviews were then analysed using thematic analysis. Results From the analysis, three main themes emerged: challenges, coping strategies, and social support. These themes encompassed sixteen subthemes including financial burden, bad health conditions, faith and prayer, and support from health professionals. From the study, both male and female family caregivers narrated that providing care for sick relatives undergoing terminal disease is characterized as a daily duty demanding one’s time and fraught with emotional strain. In addition, even though it was a difficult job, family members who provided care for ailing relatives never gave up, citing responsibility, the importance of family, and religious beliefs as the primary motivations for doing so. Conclusion The difficulties and demands of family caregiving roles for terminally ill relatives are complex and multifactorial. The findings call for multidisciplinary professional attention for family caregivers and policies that will support their lives holistically.