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Rapid urbanization and uncontrolled industrial activities in developing countries have raised concerns about potentially toxic metal contamination of the environment. This study assessed the levels of potentially toxic elements in soil and airborne particulate matter in the Suame and Asafo areas in the Kumasi metropolis, characterized by a high concentration of auto mechanic workshops and residential settlements. X-ray fluorescence analysis and inductively coupled plasma-mass spectrometry were used to determine the metal concentrations in the samples. The results showed high concentrations of potentially toxic elements in the soil and air samples, indicating contamination from automotive activities. Metals such as Co, Ni, Pb, and Zn were found to be present at concentrations (13.42–6101.58 mg/kg and 14.15–11.74 mg/kg for Suame and Asafo respectively) that pose potential health risks to exposed populations. Mathematical models such as pollution indices were used to assess the extent of contamination and determine the potential sources of the metals - the automotive repairs. The findings highlight the urgent need for environmental management and remediation strategies to mitigate the health risks of exposure to potentially toxic elements in the Kumasi metropolis automotive hub.

Introduction: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. Objectives: This scoping review aims to identify, document and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: The scoping review was planned and executed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity and family history, personal health conditions, and academic and socioeconomic issues. Image: Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Objective In developing countries, malnutrition is a noteworthy concern related to the well-being of people, and this study aimed to determine the factors that affect malnutrition among children below 5 years in Ghana.Design The study used a secondary data source, specifically the Ghanaian Multiple Indicator Cluster Survey Six (MICS 6), which was conducted by the Ghana Statistical Service in 2017–2018. The MICS data are hierarchical, as children are categorised within households, and households are further grouped within a higher cluster, violating the independence assumption that must be addressed in the analyses. This study used a Bayesian multilevel ordinal logistic regression to model, identify and analyse the factors linked to child malnutrition in Ghana.Setting The setting of the study was the household level across the previous 10 administrative regions in Ghana.Participants Data for 8875 children under 5 years were used for the study. The data were gathered from households in all 10 administrative regions of Ghana using a sampling procedure consisting of stratification and random selection to ensure national representation.Results The results showed that the Northern Region of Ghana had the highest occurrence rate of severe and moderate malnutrition, and factors such as the count of children’s books or picture books, whether the child experienced fever in the last 2 weeks, age and sex of the child, and the child’s household wealth index quintile were strongly linked to malnutrition among Ghanaian children.Conclusion These findings underscore the intricate interplay of factors contributing to child nutrition in Ghana and suggest that addressing malnutrition necessitates a comprehensive approach that considers factors such as access to healthcare and reading materials, household wealth, and other social and environmental factors.

Abstract: This study aimed to determine the levels of heavy metal(loid)s in local and imported cosmetics purchased from the Kejetia market and to conduct their health risk assessment. Seven (7) metal(loid)s (Pb, Cd, As, Fe, Ni, Cr, and Hg) were analyzed in twenty-one (21) cosmetic samples. Atomic absorption spectroscopy (AAS) was used in this study. Some of the metal(loid)s in imported cosmetic samples were higher than those found in local cosmetic samples. However, there was no significant difference between the concentrations of the metal(loid)s in both local and imported cosmetic samples. The margin of safety (MoS) values for all the metal(loid)s in the cosmetics sample were below the WHO standard of 100. The HQ and HI values for almost all the metal(loid)s in the cosmetic samples were greater than their permissible limit of 1, suggesting that there may be health risks associated with using cosmetic samples for the sensitive sub-population. On the other hand, carcinogenic risk (CR) for Cr and As in local and imported cream and lotion were all higher than the tolerance levels. Moreover, from the results, the Pb, Cd, and Hg concentrations were higher than the acceptable permissible limits set by the various regulatory bodies. Cosmetic manufacturing industries are encouraged to adhere to the permissible limits set by regulators. We admonish the regulatory agencies to unforce regulations on permissible limits of heavy metals in cosmetics

Lead, cadmium, arsenic, and copper are potentially toxic elements that are of concern to man because of their negative effects on human health. The Atomic Absorption Spectrometer was used to evaluate the quantities of these heavy metals, and a value of heavy metal consumption in human meals was derived to determine the danger to human health. The mean cadmium content in the three vegetables from the four market sites varied from 0.60 mg/kg to 1.33 mg/kg, above the Food and Agricultural Organization/World Health Organization permissible limit. Lead, arsenic, and copper had mean values ranging from 0.064 mg/kg to 0.106 mg/kg, 0.003 mg/kg to 0.004 mg/kg, and 12.35 mg/kg to 21.54 mg/kg, respectively, all of which were below the World Health Organization’s maximum limit for each heavy metal. The Target Hazard Quotient (THQ) was used to determine the health risk that these heavy metals posed to vegetable eaters. Cadmium and copper THQ levels were greater than the acceptable limit of 1 in both adults and children, whereas lead THQ values were higher in just children, indicating a considerable health risk to the population. Arsenic THQ levels in both populations and lead THQ values in the adult population were both below the acceptable limit of 1, indicating that there was no major health risk to the population.

The River Subin, which serves as a source of direct drinking water downstream, flows through the Metropolis of Kumasi in Ghana, making it vulnerable to pollution due to human activities. In this study, we assessed the heavy metals content in the sediment of the Subin River as well as the physicochemical properties and microbial load in the river. Water and sediments were sampled from Race course upstream and downstream, Asafo, and Abinkyi upstream and downstream, Kaase, Asokwa and Wood village with a sampling distance of 100 m. Index of Geoaccumulation (Igeo), contamination factor (CF), contamination degree (CD) and pollution load index (PLI) were used to assess the level of heavy metal enrichment and contamination in the sediments of River Subin. Analysis showed that temperature of the river ranged between 31.23 to 31.40 °C, pH ranged between 6.62 and 7.52, conductivity ranged between 1.16 and 4.67 µS/cm, total hardness ranged from 0.65 to 3.82 mg/L, Ca ranged from 0.26 to 1.22 mg/L, alkalinity ranged from 324 to 711 mg/L, Mg from 0.24 to 3.35 mg/L and Cl ranged from 56.76 to 99. 30 mg/L. The microbial load assessment indicated that the River Subin is highly polluted by E. coli, Faecal Enterococci, Total coliform and faecal coliform, which generally increased as the river flows downstream since more solid waste from domestic and industrial effluents enter the river. Igeo data suggested that the river was highly contaminated by Ag and Cd and moderately polluted by Pb and Co. The CF, CD and PLI, results showed high levels of Ag, Cd, Cr, Cu, Fe, Hg, Co, and Zn, indicating a progressive deterioration of water quality at the various sites. Our results suggest that the River Subin is highly polluted and thus, urgent management strategies are needed to mitigate further deterioration of the river.

Background. Anthropogenic activities such as artisanal mining pose a major environmental health concern due to the potential for discharge of toxic metals into the environment. Objectives. To determine the distribution and pollution patterns of arsenic (As), iron (Fe), nickel (Ni), cobalt (Co), chromium (Cr), manganese (Mn), copper (Cu) and zinc (Zn) in the topsoil of a mining community in Ghana, along with potential human health risks and in vitro bioaccessibility. Methods. Concentrations of metals were determined using X-ray fluorescence techniques and validated using inductively coupled plasma-mass spectrometry. Results. Concentrations of the metals in topsoil were in the order of magnitude of Cu (31.38 mg/kg) < Ni (45.39 mg/kg) < As (59.66 mg/kg) < Cr (92.87 mg/kg) < Zn (106.98 mg/kg) < Mn (1195.49 mg/kg) < Fe (30061.02 mg/kg). Geo-statistical and multivariate analyses based on hazard indices including contamination, ecological risks, geo-accumulation, and pollution load suggest that the topsoils are contaminated in the study area. The potential ecological risk index (PERI) showed high ecological risk effects (PERI=269.09), whereas the hazard index (1×10−7) and carcinogenic risk index (1×10−5) indicated low human health risks. Elevated levels of As, Cr, Ni, and Zn were found to emanate from anthropogenic origins, whereas Fe, Mn, and Cu levels were attributed mainly to geological and atmospheric depositions. Physicochemical parameters (pH, electrical conductivity and total organic carbon) showed weak positive correlations to the metal concentrations. Elemental bioaccessibility was variable, decreasing in the order of Mn (35± 2.9%) > Cu (29± 2.6%) > Ni (22± 1.3%) > As (9± 0.5%) > Cr (4± 0.6%) > Fe (2± 0.4%). Conclusions. Incorporation of in-vitro bioaccessibility into the risk characterization models resulted in a hazard index of less than 1, implying low human health risks. However, due to accumulation effects of the metals, regular monitoring is required. Competing Interests. The authors declare no competing financial interests.

Osteoarthritis (OA) is a chronic disease affecting over 500 million people worldwide. As the population ages and obesity rates rise, the societal burden of OA is increasing. Pro-inflammatory cytokines, particularly interleukin-1β, are implicated in the pathogenesis of OA. Recent studies suggest that crosstalk between cartilage and synovium contributes to OA development, but the mechanisms remain unclear. Extracellular vesicles (EVs) were purified from cell culture-conditioned medium via ultracentrifugation and confirmed using transmission electron microscopy, nanoparticle tracking analysis, and western blotting. We demonstrated that EVs were taken up by human synoviocytes and chondrocytes in vitro, while in vivo experiments revealed that fluorescent-labelled EVs injected into mouse joints were incorporated into chondrocytes and synoviocytes. EV uptake was significantly inhibited by dynamin-mediated endocytosis inhibitors, indicating that endocytosis plays a major role in this process. Additionally, co-culture experiments with HEK-293 cells expressing red fluorescent protein (RFP)-tagged CD9 and the chondrocytic cell line OUMS-27 confirmed the transfer of RFP-positive EVs across a 600-nm but not a 30-nm filter. These findings suggest that EVs from chondrocytes are released into joint fluid and taken up by cells within the cartilage, potentially facilitating communication between cartilage and synovium. The results underscore the importance of EVs in OA pathophysiology., Competing Interests: The authors declare no conflict of interest.

Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

Amyloid-β (Aβ) deposition in the brain parenchyma is one of the pathological hallmarks of Alzheimer disease (AD). We have previously identified amyloid precursor protein (APP)669-711 (a.k.a. Aβ(-3)-40) in human plasma using immunoprecipitation combined with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (IP-MALDI-MS). Furthermore, we found that the level of a composite biomarker, i.e., a combination of APP669-711/Aβ1-42 ratio and Aβ1-40/Aβ1-42 ratio in human plasma, correlates with the amyloid PET status of AD patients. However, the production mechanism of APP669-711 has remained unclear. Using in vitro and in vivo assays, we identified A Disintegrin and Metalloproteinase with a Thrombospondin type 1 motif, type 4 (ADAMTS4) as a responsible enzyme for APP669-711 production. ADAMTS4 cleaves APP directly to generate the C-terminal stub c102, which is subsequently proteolyzed by γ-secretase to release APP669-711. Genetic knockout of ADAMTS4 reduced the production of endogenous APP669-711 by 30% to 40% in cultured cells as well as mouse plasma, irrespectively of Aβ levels. Finally, we found that the endogenous murine APP669-711/Aβ1-42 ratio was increased in aged AD model mice, which shows Aβ deposition as observed in human patients. These data suggest that ADAMTS4 is involved in the production of APP669-711, and a plasma biomarker determined by IP-MALDI-MS can be used to estimate the level of Aβ deposition in the brain of mouse models., (© 2023. The Author(s).)

Introduction: Hypertension is an important public health menace globally and in sub-Saharan Africa. The prevalence of hypertension is on the rise in low- and lower-middle-income countries (LMIC) such as Ghana. This rise led to the adoption of the May Measurement Month (MMM) initiative, a global blood pressure screening campaign. We aimed to create awareness and present the findings of the 2019 MMM screening campaign in the Ashanti region of Ghana., Methods: Ghana was 1 of 92 countries that participated in this global community-based cross-sectional study in May 2019. Participants (⩾18 years) were recruited by opportunistic sampling. The blood pressures of participants were measured 3 times and the mean of the last 2 was used for the analysis. Summary statistics were used to describe the data. Simple and multiple logistic regression models were used to determine the predictors of hypertension., Results: We screened 3080 participants with a mean age of 39.8 ± 16.8 years. The prevalence of hypertension was 27.3% among participants. Two-thirds of the hypertensives were unaware of their condition and only 49.5% of participants with a history of hypertension on medication were controlled. Predictors of hypertension in a multiple logistic regression were increasing age (OR = 1.05 (CI 1.04-1.06), P  < .001) and high body mass index (OR = 1.06 (1.02-1.10), P  = .005)., Conclusion: The MMM initiative is highly commendable and of huge public health importance in LMICs like Ghana. Population-based health programs such as the MMM initiative is encouraged to shape appropriate public health policies to reduce the prevalence of hypertension., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Osteoarthritis is a progressive disease characterized by cartilage destruction in the joints. Matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTSs) play key roles in osteoarthritis progression. In this study, we screened a chemical compound library to identify new drug candidates that target MMP and ADAMTS using a cytokine-stimulated OUMS-27 chondrosarcoma cells. By screening PCR-based mRNA expression, we selected 2-(8-methoxy-2-methyl-4-oxoquinolin-1(4H)-yl)-N-(3-methoxyphenyl) acetamide as a potential candidate. We found that 2-(8-methoxy-2-methyl-4-oxoquinolin-1(4H)-yl)-N-(3-methoxyphenyl) acetamide attenuated IL-1β-induced MMP13 mRNA expression in a dose-dependent manner, without causing serious cytotoxicity. Signaling pathway analysis revealed that 2-(8-methoxy-2-methyl-4-oxoquinolin-1(4H)-yl)-N-(3-methoxyphenyl) acetamide attenuated ERK- and p-38-phosphorylation as well as JNK phosphorylation. We then examined the additive effect of 2-(8-methoxy-2-methyl-4-oxoquinolin-1(4H)-yl)-N-(3-methoxyphenyl) acetamide in combination with low-dose betamethasone on IL-1β-stimulated cells. Combined treatment with 2-(8-methoxy-2-methyl-4-oxoquinolin-1(4H)-yl)-N-(3-methoxyphenyl) acetamide and betamethasone significantly attenuated MMP13 and ADAMTS9 mRNA expression. In conclusion, we identified a potential compound of interest that may help attenuate matrix-degrading enzymes in the early osteoarthritis-affected joints.

Objectives: Hypertension is a major risk factor for cardiovascular mortality globally and in Ghana. May Measurement Month (MMM) is a global awareness and screening campaign initiated by the International Society of Hypertension., Methods: Participants were recruited by opportunist sampling in the Ashanti region of Ghana. The blood pressures of participants were measured three times and the mean of the last two readings was used for the analysis. Simple and multiple logistic regression was used to determine the predictors of hypertension., Results: The MMM 2018 awareness and screening campaign enrolled 5054 participants with a mean age of 39.4 ± 14.7 years. There were 2553 (50.6%) males, 987 (20.1%) of respondents had never checked their blood pressure and 676 (13.9%) had a prior history of hypertension. The prevalence of hypertension was 37.4%. We found that 589(66.8%) of 822 respondents with high blood pressure did not have a history of hypertension. Respondents with a known history of hypertension on medication were 442 (65.9%) and 219(68.0%) of 322 respondents on medication had uncontrolled hypertension. The predictors of high blood pressure in a multiple logistic regression were increasing age (OR = 1.05 CI 1.05-1.06, p < 0.001), history of alcohol intake (OR = 1.33 CI 1.04 -1.70, p = 0.02), overweight (OR = 1.4 CI 1.14-1.76, p = 0.001) and obesity (OR = 1.32, CI 1.01-1.74, p = 0.047)., Conclusion: There is a high prevalence of hypertension in the Ashanti region in Ghana. Most participants with hypertension were not aware and the majority of those with hypertension on medications were uncontrolled. This calls for more education and screening of hypertension to decrease cardiovascular mortality., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Idiopathic pulmonary fibrosis (IPF) is the most common and most deadly form of interstitial lung disease. Osteopontin (OPN), a matricellular protein with proinflammatory and profibrotic properties, plays a major role in several fibrotic diseases, including IPF; OPN is highly upregulated in patients' lung samples. In this study, we knocked down OPN in a bleomycin (BLM)-induced pulmonary fibrosis (PF) mouse model using small interfering RNA (siRNA) to determine whether the use of OPN siRNA is an effective therapeutic strategy for IPF. We found that fibrosing areas were significantly smaller in specimens from OPN siRNA-treated mice. The number of alveolar macrophages, neutrophils, and lymphocytes in bronchoalveolar lavage fluid was also reduced in OPN siRNA-treated mice. Regarding the expression of epithelial-mesenchymal transition (EMT)-related proteins, the administration of OPN-siRNA to BLM-treated mice upregulated E-cadherin expression and downregulated vimentin expression. Moreover, in vitro, we incubated the human alveolar adenocarcinoma cell line A549 with transforming growth factor (TGF)-β1 and subsequently transfected the cells with OPN siRNA. We found a significant upregulation of Col1A1, fibronectin, and vimentin after TGF-β1 stimulation in A549 cells. In contrast, a downregulation of Col1A1, fibronectin, and vimentin mRNA levels was observed in TGF-β1-stimulated OPN knockdown A549 cells. Therefore, the downregulation of OPN effectively reduced pulmonary fibrotic and EMT changes both in vitro and in vivo. Altogether, our results indicate that OPN siRNA exerts a protective effect on BLM-induced PF in mice. Our results provide a basis for the development of novel targeted therapeutic strategies for IPF., (Copyright © 2021 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Raised blood pressure (BP) remains the biggest single risk factor contributing to the global burden of disease and to global mortality. Although a substantial number of people who have hypertension are either oblivious of it, not treated, or being managed but remain uncontrolled. May Measurement Month (MMM) is a global initiative led by the International Society of Hypertension (ISH) with the goal of increasing awareness of high BP and serving as a spur to establish screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. Measurement of BP and collection of relevant health information were performed according to a standardized protocol for MMM. Screening sites were set up in churches, mosques, health facilities, pharmacies, recreational parks, sports facilities, shopping centres, marketplaces, universities, workplaces, and community centres across four regions of Ghana. A total of 7102 participants gave their consent and were screened during MMM 2019. After multiple imputation, of all 7102 participants 1836 (25.9%) had hypertension. Of all 1836 participants with hypertension, 36.5% were aware of their status and 30.0% were on anti-hypertensive medication. Of 550 participants on antihypertensive medications, 46.1% had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). Also, of all 1836 participants with hypertension, 13.8% had their BP controlled. Again, the proportion of participants with hypertension of those not receiving anti-hypertensive treatment was 1286 (19.6%). Data obtained from this project demonstrates that there is still a significant number of people with hypertension who are unaware of having it, are untreated, or are on treatment but remain uncontrolled. It also highlights the significance of BP screening campaigns as a tool to identify persons with elevated BP., (Published on behalf of the European Society of Cardiology. © The Author(s) 2021.)

Impact Statement: Plasmodium falciparum malaria is a global health problem. Erythrocyte invasion by P. falciparum merozoites appears to be a promising target to curb malaria. We have identified and characterized a novel protein that is involved in erythrocyte invasion. Our data on protein subcellular localization, stage-specific protein expression pattern, and merozoite invasion inhibition by α-peptide antibodies suggest a role for PF3D7&#95;1459400 protein during P. falciparum erythrocyte invasion. Even more, the human immunoepidemiology data present PF3D7&#95;1459400 protein as an immunogenic antigen which could be further exploited for the development of new anti-infective therapy against malaria.

Objective: The authors assess the impact of Ghanaian diaspora-based psychiatrists' participation in clinical teaching in Ghana on the attitudes of medical students toward careers in psychiatry., Methods: This quantitative cross-sectional study involved fifth- and sixth-year medical students of the four public medical schools in Ghana. Data were analyzed with descriptive and inferential statistics., Results: About half (49.7%) of clinical year medical students in Ghana reported that diaspora-based Ghanaian psychiatrists participated in their teaching during their clinical psychiatry rotation. A significantly higher proportion of medical students who had diaspora-based psychiatrists participate in their clinical training expressed that the depth of clinical teaching (54.4% vs. 45.6%, p = 0.003) and the extent of experience gained during their psychiatric rotations (54.7% vs. 45.3%, p = 0.001) were adequate or somewhat adequate when compared with medical students who did not have diaspora psychiatrists participate in their clinical training. Medical students who had diaspora-based Ghanaian psychiatrists participate in their teaching were significantly more likely to consider careers in psychiatry after their clinical rotation (42.2% versus 25.6%, χ 2  = 16.2, p = 0.00)., Conclusions: In a low-resource country with few psychiatrists, the involvement of diaspora-based psychiatrists in the teaching of clinical year medical students has the potential to improve the global experience and attitude of the medical students toward psychiatry.

Background: Currently, Ghana has 14 actively practicing psychiatrists and about 26 psychiatric residents for a population of over 28 million people. Previous research suggests a lack of interest by Ghanaian medical students and medical graduates in considering psychiatry as a career option., Objectives: To examine the perception of medical students and psychiatry residents in Ghana about the barriers which hinder Ghanaian medical graduates from choosing careers in psychiatry and how these barriers could be overcome., Methods: This was a cross-sectional qualitative study with data gathered using focus group discussion. Twenty clinical year medical students were selected through block randomization from the four public medical schools in Ghana and invited to participate in one of two focus group discussions. Also, four psychiatric residents were invited to participate in the focus group discussions., Results: The main barriers identified by participants could be grouped under four main themes, namely: (a) myths and stigma surrounding mental health and patients, (b) negative perceptions of psychiatrists, (c) infrastructure and funding issues, (d) lack of exposure and education. To address the barriers presented, participants discussed potential solutions that could be categorized into five main themes, namely: (a) stigma reduction, (b) educating professionals, (c) addressing deficient infrastructure, (d) risk management, and (e) incentivizing the pursuit of psychiatry among students., Conclusion: Health policy planners and medical training institutions could consider implementing proposed solutions to identify barriers as part of efforts to improve the psychiatrist to patient ratio in Ghana., Competing Interests: All authors declare that there are no competing interests., (© The Author(s) 2020.)

Nearly half of the genes in the Plasmodium falciparum genome have not yet been functionally investigated. We used homology-based structural modeling to identify multiple copies of Armadillo repeats within one uncharacterized gene expressed during the intraerythrocytic stages, PF3D7&#95;0410600, subsequently referred to as P. falciparum Armadillo-Type Repeat Protein (PfATRP). Soluble recombinant PfATRP was expressed in a bacterial expression system, purified to apparent homogeneity and the identity of the recombinant PfATRP was confirmed by mass spectrometry. Affinity-purified α-PfATRP rabbit antibodies specifically recognized the recombinant protein. Immunofluorescence assays revealed that α-PfATRP rabbit antibodies reacted with P. falciparum schizonts. Anti-PfATRP antibody exhibited peripheral staining patterns around the merozoites. Given the localization of PfATRP in merozoites, we tested for an egress phenotype during schizont arrest assays and demonstrated that native PfATRP is inaccessible on the surface of merozoites in intact schizonts. Dual immunofluorescence assays with markers for the inner membrane complex (IMC) and microtubules suggest partial colocalization in both asexual and sexual stage parasites. Using the soluble recombinant PfATRP in a screen of plasma samples revealed that malaria-infected children have naturally acquired PfATRP-specific antibodies., (Copyright © 2020 Amlabu, Ilani, Opoku, Nyarko, Quansah, Thiam, Anim, Ayivor-Djanie, Akuh, Mensah-Brown, Rayner and Awandare.)

Objective: The psychiatrist workforce has been identified as an area in need of development, especially in low- to middle-income countries. The purpose of this project is to assess the perceptions of Ghanaian medical students of a novel mental health inter-medical school speaking competition on career interest in psychiatry and mental health education and advocacy., Methods: The study employed quantitative and qualitative methods in a cross-sectional design. A paper-based survey was administered to medical students from four schools in Ghana, and focus groups were conducted., Results: A 52% response rate (545/1041 fifth- and sixth-year medical students from the four public medical schools in Ghana) was achieved. The competition was successful in stimulating interest in psychiatry as a subject (25%) and as a career (14%) and was viewed as serving an important public health and mental health advocacy function (65% and 66% respectively). The competition stimulated interest in students who were undecided or had previously ruled out psychiatry specialization, in both those who had and had not already completed a psychiatry clerkship (23% and 13% before and after completing a clinical rotation in psychiatry, respectively). Overall, 29% of respondents who participated in at least one competition-related activity reported that the competition stimulated their interest in psychiatry, compared to 4% who did not participate in any competition-related activity (Ӽ 2  = 80, p = 0.0). Analysis of focus group content echoed these themes and highlighted opportunities for improvement., Conclusion: The innovative public speaking competition was successful in stimulating interest in psychiatry and furthering mental health education and advocacy. Implications are discussed.

Background: Cholera has been endemic in Ghana since its detection in 1970. It has been shown that long-term survival of the bacteria may be attained in aquatic environments. Consequently, cholera outbreaks may be triggered predominantly in densely populated urban areas. We investigated clinical and environmental isolates of Vibrio cholerae O1 in Accra to determine their virulence genes, antibiotic susceptibility patterns and environmental factors maintaining their persistence in the environment., Methods: Water samples from various sources were analyzed for the presence of V. cholerae O1 using culture methods. Forty clinical isolates from a previous cholera outbreak were included in the study for comparison. Antibiotic susceptibility patterns of the bacteria were determined by disc diffusion. Virulence genes were identified by analyzing genes for ctx, tcpA (tcpA El Tor tcpA Cl ), zot, ompW, rbfO1 and attRS using PCR. Physicochemical characteristics of water were investigated using standard methods. One-way ANOVA and student t - test were employed to analyze the relationship between physicochemical factors and the occurrence of V. cholerae O1., Results: Eleven V. cholerae O1 strains were successfully isolated from streams, storage tanks and wells during the study period. All isolates were resistant to one or more of the eight antibiotics used. Multidrug resistance was observed in over 97% of the isolates. All isolates had genes for at least one virulence factor. Vibrio cholerae toxin gene was detected in 82.4% of the isolates. Approximately 81.8% of the isolates were positive for tcpA El Tor gene, but also harbored the tcpA cl gene. Isolates were grouped into thirteen genotypes based on the genes analyzed. High temperature, salinity, total dissolved solids and conductivity was found to significantly correlate positively with isolation of V. cholerae O1. V. cholerae serotype Ogawa biotype El tor is the main biotype circulating in Ghana with the emergence of a hybrid strain., Conclusions: Multidrug resistant V. cholerae O1 with different genotypes and pathogenicity are present in water sources and co-exist with non O1/O139 in the study area.

Plasmodium falciparum erythrocyte invasion is a multistep process that involves a spectrum of interactions that are not well characterized. We have characterized a 113-kDa immunogenic protein, PF3D7&#95;1431400 (PF14&#95;0293), that possesses coiled-coil structures. The protein is localized on the surfaces of both merozoites and gametocytes, hence the name Plasmodium falciparum surface-related antigen (PfSRA). The processed 32-kDa fragment of PfSRA binds normal human erythrocytes with different sensitivities to enzyme treatments. Temporal imaging from initial attachment to internalization of viable merozoites revealed that a fragment of PfSRA, along with PfMSP119, is internalized after invasion. Moreover, parasite growth inhibition assays showed that PfSRA P1 antibodies potently inhibited erythrocyte invasion of both sialic acid-dependent and -independent parasite strains. Also, immunoepidemiological studies show that malaria-infected populations have naturally acquired antibodies against PfSRA. Overall, the results demonstrate that PfSRA has the structural and functional characteristics of a very promising target for vaccine development.