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Treponemal infections can be blood-borne with great public health consequences. This study is aimed at comparatively describing the five-year (2013-2017) regional epidemiology of treponemal infection using pregnant women in the sentinel survey and apparently healthy blood donors as a proxy for the general population at four sentinel sites in the Volta and Oti Regions of Ghana. We analyzed retrospective data from 17,744 prospective blood donors aged 18 to 58 years and 7,817 pregnant women in a sentinel survey with ages from 15 to 49 years at Hohoe, Ho, Tongu, and Krachi West sentinel sites in the Volta and Oti Regions. Laboratory data extracted include variables such as age, gender, date of blood donation, and Treponema pallidum chromatographic immunoassay results from the blood banks of the four study sites. The five-year treponemal infection rate among the pregnant women in the sentinel survey and prospective blood donors was 0.79% and 2.38%, respectively. Site-specific infection rate for population-based/sentinel survey was 4.6%/1.1%, 2.0%/0.5%, 1.3%/1.1, and 1.2%/0.3% for Hohoe, Ho, Krachi West, and Tongu, respectively. Significant gender disparity in Treponemal infection rate exists with a male preponderance. The regional infection rate in the sentinel survey is lower compared to the general population. Therefore, the use of pregnant women as a proxy for population estimates could underestimate the burden in the study jurisdiction.

Hyperthermia exposure is associated with poor neurological outcomes in patients with severe traumatic brain injury (TBI). Our aim was to describe fever in children with severe TBI admitted to a pediatric intensive care unit (PICU) for at least 72 hours and to evaluate associations between fever using a novel approach to describe thermal exposure and neurobehavioral outcomes. The cohort included children from birth to 17 years of age admitted to the PICU between 2000 and 2012 for at least 72 hours who had severe TBI with intracranial pressure monitoring. Patients with non-accidental TBI or pre-existing developmental delays were excluded. Hyperthermia was defined as a core temperature37.5°C. Hourly temperature measurements were used to calculate the area under the curve (AUC) using the linear trapezoidal rule. Each participant was followed up at the Brain Injury Clinic 6 and 18 months postinjury. Neurobehavioral outcome scores were analyzed against AUC using standard statistical methods. Ninety-eight patients admitted with severe TBI met the study inclusion criteria. Hyperthermia/fever was common (89.7%), and patients remained hyperthermic for a median of 9.4 hours. However, no statistically significant association was found between AUC and abnormal neurological outcomes. The follow-up rates were good at 6 (86.7%) and 18 months (83.7%). The neurological deficit improved with time, with "favorable outcomes" increasing from 72% to 94% at the respective follow-up months. Our study used a novel method to describe patients' fever, providing a different indicator of thermal exposure than that previously reported. In addition, the AUC was well correlated with the maximum temperature recorded and the proportion of time37.5°C, indicating that it is a good surrogate for thermal exposure. Interestingly, the neurological disabilities of the patients improved over time.

Abstract Background: Treponemal infection is contagious and one of the oldest blood-borne infections, with great public health consequences. This study aimed to comparatively describe the five–year (2013-2017) regional epidemiology of Treponemal infection using pregnant women in the Sentinel Survey and apparently healthy blood donors as proxy for the general population at the four sentinel sites in the Volta Region of Ghana. Method: We analysed retrospectively data from 17,744 prospective blood donors aged between 18 to 58 years and 7,805 pregnant women in a Sentinel Survey who fell within the 15 and 49 years age bracket at Hohoe, Ho, Tongu and Krachi-West sentinel sites in the Volta Region. Data extracted included age, gender, date of blood donation and Treponena pallidum chromatographic immunoassay results from the blood banks of the four study sites. Published reports of Sentinel Surveys conducted at the four sentinel sites from the years 2013-2017 were retrieved. Results: The cumulative five-year prevalence of Treponemal infections among the pregnant women in the Sentinel Survey and prospective blood donors was 0.38% and 2.38% respectively. Site-specific prevalence for population-base/Sentinel survey was 4.6%/0.4%, 2.0%/0.2%, 1.3%/0.8 and 1.2%/0.2 for Hohoe, Ho, Krachi-West and Tongu respectively. Treponemal infection rates among the younger age groups (15-24years) were 0.31% in the sentinel survey and 2.22% in the general population. Significant gender disparity in Treponemal infection exist with male preponderance. Conclusion: The regional prevalence of Treponemal infection in the Sentinel Survey is lower compared to the general population. Therefore, the use of pregnant women as proxy for population estimate could lead to underestimation of the burden in the study jurisdiction.

Background: Syphilis is contagious and one of the oldest sexually transmitted infections, with great public health consequences. This study aimed to comparatively describe the five–year (2013-2017) regional epidemiology of syphilis infection using pregnant women in the Sentinel Survey and apparently healthy blood donors as proxy for the general population at the four sentinel sites in the Volta Region of Ghana. Method: We analysed retrospectively data from 17,744 prospective blood donors aged between 18 to 58 years and 7,805 pregnant women in a Sentinel Survey who fell within the 15 and 49 years age bracket at Hohoe, Ho, Tongu and Krachi-West sentinel sites in the Volta Region. Data extracted included age, gender, date of blood donation and Treponena pallidum chromatographic immunoassay results from the blood banks of the four study sites. Published reports of Sentinel Surveys conducted at the four sentinel sites from the years 2013-2017 were retrieved. Results: The cumulative five-year prevalence of syphilis infections among the pregnant women in the Sentinel Survey and prospective blood donors was 0.38% and 2.38% respectively. Site-specific prevalence for population-base/Sentinel survey was 4.6%/0.4%, 2.0%/0.2%, 1.3%/0.8 and 1.2%/0.2 for Hohoe, Ho, Krachi-West and Tongu respectively. New Syphilis infection rate was 0.31% in the sentinel survey and 2.22% in the general population. Significant gender disparity in syphilis infection exist with male preponderance. Conclusion: The regional prevalence of syphilis infection in the Sentinel Survey is lower compared to the general population. Therefore, the use of pregnant women as proxy for population estimate could lead to underestimation of the burden in the study jurisdiction.

Context Rural chicken production in most developing countries is based mainly on scavenging systems with indigenous chickens that have not been properly characterised and classified into well-defined breeds. Aims This study was conducted to identify the variant forms of qualitative phenotypic traits of local chickens in Tolon District, northern Ghana. Methods About 320 adult birds were sampled and data collected by using observation and a chicken colour chart. Traits included head shape; comb type, size and colour; feather distribution; and earlobe, eye, plumage, skin and shank colours. Chi-squared goodness of fit test was used to test whether variant phenotypes of each qualitative trait were equally distributed. The hypothesis of no associations between pairs of traits was tested by using Cramér’s V. Key results There were highly significant (P < 0.01) differences in the distributions of variant phenotypes of all traits. The main comb type observed was single (85.9%), followed by pea (8.8%) and rose (5.3%). A majority of birds had small combs (57.8%), although others had medium (28.4%) and large (13.8%) combs. Females had small to medium combs, whereas males had medium to large combs. A majority of the chickens had white earlobe colour (60.3%), followed by pied red and white (22.5%). Feather distributions observed were normal feathered (84.4%), naked neck (8.4%) and frizzled (7.2%). Five plumage colours were observed, although some were in combinations. White plumage was the most common (22.5%), followed by black (18.8%), with brown/ash the least common (0.03%). Community was significantly (P < 0.01) associated with comb type, size and colour, and eye, shank and skin colours. Also, comb size was significantly associated with sex and comb type. Conclusions Generally, local chickens exhibited heterogynous phenotypes for qualitative traits. Local chickens in the district could be described as normally feathered with wide variation in plumage colours and having mainly single comb type. Implications The knowledge of these variant phenotypes and their associations will serve as baseline information for the characterisation and conservation of local chicken types. It could also provide guidelines in selecting bird ecotypes and/or communities for breed improvement programs in the study area.

Most deepwater high rate wells are completed with sand control to avoid sanding issues, especially for a subsea development. However, sand control adds significant Capex to the development besides causing additional pressure drop across the completion. In addition, experiences to date have shown that sand control completions tend to increase in mechanical skin over time due to solids plugging or scaling leading to additional Opex required to stimulate these wells. This paper describes the key steps taken for two major subsea deepwater developments in Ghana, in order for a paradigm shift towards Cased and Perforated (C&P) completions for full field implementation. Oil production and water injection in both fields are primarily from sand facies associated with Clustered Frontal Splays and Confined Channel Complex. All completions deployed initially were equipped with downhole sand control (mainly Frac and Packs), but driven by well impairment issues early in field life, a thorough review of completion type was initiated which lead to a staged implementation and move towards C&P design for all high rate oil producer and water injector wells. Modified API RP 19-B Section IV tests were performed using core material from the fields for catastrophic sanding risk evaluation over well lifecycle, and examination of sanding under steady state flow conditions with varying fluid type. Laboratory test results and simulation data were then used to determine safe operating envelopes for the designs. A staged implementation commenced with C&P completions in two wells with the use of High Set Screens (HSS) with capability of bypassing the screens if required and ‘real-time’ downhole gauges to monitor pressure drop across the screens over time. Based on the confidence attained from the sand free production data from both these wells, HSS were removed altogether from subsequent completions. Well performance data have demonstrated the successful application of C&P completions in typical deepwater turbidite setting. C&P completions have significantly lower skin than other completion types applied in the same fields and are capable of delivering more than 20,000 stb/d oil rates and more than 50,000 b/d water injection rates.