scholarly journals Inter-rater Variability in Malaria Microscopy at the LEKMA Hospital, Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Andrew Nii Adzei Bekoe ◽  
Emmanuel Alote Allotey ◽  
Elliot Elikplim Akorsu ◽  
Albert Abaka-Yawson ◽  
Samuel Adusei ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Medical Laboratory ◽  
Rater Agreement ◽  
Laboratory Personnel ◽  
Parasite Count ◽  
Laboratory Staff ◽  
Significant Difference ◽  
Expected Outcome ◽  
Sub Saharan ◽  
Group B

Background. Malaria remains a major cause of morbidity and mortality worldwide and particularly in sub-Saharan Africa where it is endemic. As such, it is important that a proper diagnosis is made before treatment is initiated. Malaria parasite count plays a key role in the diagnosis and management of malaria. Variations in ratings by laboratory personnel can impact negatively on the treatment regimen for malaria-infected patients. The study is thus aimed at evaluating and comparing the proficiency and parasitaemia counts by two different categories of laboratory staff at the LEKMA Hospital, Ghana. Materials and Methods. A total of 200 confirmed malaria-positive samples were used in the study. Six thick and thin films were prepared from each sample and uniquely labelled. Two of the six slides were given to two WHO-accredited malaria microscopists to examine and report their respective parasite count/μl ( parasite   count / WBC × 8000 ). These were used as the reference for the two categories of laboratory staffs: rater A being diploma holders (Technical Officers referred to as untrained rater) and rater B being degree holders (Medical Laboratory Scientist referred to as trained rater) at the LEKMA Hospital. Results. In comparison to the expected outcome, the parasite count by the rater group A (190 (151-239)]) and the rater group B (177 (140-224)) demonstrated significant positive correlation ( r = 0.995 , p < 0.0001 vs. r = 0.995 , p < 0.0001 , respectively) with the expected outcome in the cases of heavy parasitaemia. A statistically significant difference ( p < 0.05 ) between counts by the different raters in low parasitemia was observed in this study. A persistent nosedive inter-rater agreement from k = 0.82 to k = 0.40 with increasing density cutoff was observed in this study. Conclusion. The study observed that the degree of inter-rater agreement of parasite density count by various categories of laboratory personnel is almost perfect. However, the parasite count between raters varied significantly with very low levels of parasitemia but better correlated with heavy parasitemia.

scholarly journals Unravelling the Perspectives of Day and Night Traders in Selected Markets within a Sub-Saharan African City with a Malaria Knowledge, Attitude and Practice Survey

2021 ◽  
Vol 18 (7) ◽  
pp. 3468
Author(s):  
Patience B. Tetteh-Quarcoo ◽  
Nicholas T. K. D. Dayie ◽  
Kevin Kofi Adutwum-Ofosu ◽  
John Ahenkorah ◽  
Emmanuel Afutu ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
African City ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Treatment Type ◽  
Significant Difference ◽  
High Knowledge ◽  
Sub Saharan

Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. Methods: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. Results: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria KAP. Although the market traders had an overall moderate knowledge (54.0% of the day traders and 56.5% of the night traders), misconceptions about malaria (especially that it could be caused by exposure to the sun) still existed among the traders. Moreover, the majority of the traders who demonstrated high knowledge (43.98%, n = 250) did not always take laboratory tests to confirm their suspicion, indicating poor attitude. Furthermore, the market traders’ choice of drug for malaria treatment (p = 0.001) and preferred malaria treatment type (orthodox or herbal) (p = 0.005) were significantly associated with their knowledge level. Conclusions: Despite the observation that no significant difference in KAP exists between day and night market traders, appropriate health education programs and interventions still need to be directed at misconceptions, poor attitudes, and poor practices revealed by this study. This will ultimately help in the prevention and control of malaria in Ghana, and globally.

scholarly journals Control trial of porcine cysticercosis in Uganda using a combination of the TSOL18 vaccination and oxfendazole

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Zachary Nsadha ◽  
Chris Rutebarika ◽  
Chrisostom Ayebazibwe ◽  
Bukenya Aloys ◽  
M. Mwanja ◽  
...  
Keyword(s):  
Taenia Solium ◽  
Control Program ◽  
Control Area ◽  
Sub Saharan Africa ◽  
Intermediate Hosts ◽  
Porcine Cysticercosis ◽  
Intervention Area ◽  
Significant Difference ◽  
Sub Saharan ◽  
Village Communities

Abstract Background Neurocysticercosis caused by Taenia solium when the parasite lodges in the central nervous system, is an important cause of human seizures and mortality in sub-Saharan Africa. The parasite is prevalent in many regions of Uganda. Pigs are intermediate hosts for T. solium, and we evaluated a T. solium control program in pigs, involving vaccination of pigs with the TSOL18 vaccine and treatment with oxfendazole. Methods The study was conducted in two districts of Eastern Uganda involving the rural village communities of Bukedea (intervention area) and Kumi (control area) during 2016–2017. Seven hundred and thirty-four households were enrolled in the study. Pigs in the intervention area received intramuscular immunizations with TSOL18 (Cysvax™) and an oral medication with 30 mg/kg oxfendazole (Paranthic™) at approximately 3-monthly intervals for 18 months. Porcine cysticercosis was evaluated by post-mortem examination. At the beginning of the study, 111 pigs were examined. In an interim evaluation in the intervention area, 55 pigs were evaluated 12 months after starting the project. At the end of the study approximately 3 months after the final intervention, 55 pigs from the intervention area and 56 pigs from the control area were evaluated. Results The prevalence of porcine cysticercosis for the two sites was 16.2% at the beginning of the study (17.2% in the intervention area and 15.1% in the control area) with no statistically significant difference (P = 0.759) between the two study sites. Among the 110 animals assessed from the intervention site (55 at the interim evaluation and 55 at the final evaluation), no pig with viable T. solium cysts was found. There was a statistically significant difference between the prevalence at baseline (17.2%) and at the end of the study (0%) in the intervention area (P = 0.001) and a statistically significant difference between the intervention (0%) and control areas (5.4%) (P = 0.041) at the end of the study. Conclusions Three-monthly concurrent vaccination of pigs with the TSOL18 vaccine and medication with oxfendazole eliminated T. solium transmission by the animals involved in the study. Application of vaccination with medication in pigs has the potential to reduce transmission of T. solium in Uganda and other endemic countries.

scholarly journals A cross-case analyses of laboratory professionals-patients interaction for patients accessing laboratory services at University of Cape Coast hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patrick Adu
Keyword(s):  
Laboratory Testing ◽  
Sampling Period ◽  
Turnaround Time ◽  
Sub Saharan Africa ◽  
Cape Coast ◽  
Microsoft Excel ◽  
Laboratory Staff ◽  
Laboratory Services ◽  
Staff Interactions ◽  
Sub Saharan

Abstract Background There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana. Methods This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25. Results Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the test requester has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing. Conclusion There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-test requester engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing.

scholarly journals Potential of Spirulina Platensis as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study

2011 ◽  
Vol 4 ◽  
pp. NMI.S5862 ◽  
Author(s):  
M. Azabji-Kenfack ◽  
S. Edie Dikosso ◽  
E.G. Loni ◽  
E.A. Onana ◽  
E. Sobngwi ◽  
...  
Keyword(s):  
Body Composition ◽  
Viral Load ◽  
Serum Albumin ◽  
Spirulina Platensis ◽  
Sub Saharan Africa ◽  
Nutritional Rehabilitation ◽  
Group A ◽  
The Mean ◽  
Sub Saharan ◽  
Group B

Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods Undernourished patients, naïve of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4 ± 4.9 years (Group A) and 28.7 ± 4.8 (Group B) with no significant difference between groups ( P = 0.10). After 12 weeks, weight and BMI significantly improved in both groups ( P < 0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, ( P = 0.68) and 1.3 vs. 1.90 Kg/m2, ( P = 0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P = 0.56 for Group A; 39.2 vs. 39.0 Kg, P = 0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P = 0.01). The haemoglobin level rose significantly within groups ( P < 0.001 for each group) with no difference between groups ( P = 0.77). Serum albumin level did not increase significantly within groups ( P < 0.90 vs. P < 0.82) with no difference between groups ( P = 0.39). The increase in CD4 cell count within groups was significant ( P < 0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study ( P = 0.02). Within each group, HIV viral load significantly reduced at the end of the study ( P < 0.001 and P = 0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study ( P = 0.02). Conclusion We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed.

scholarly journals Etude de l’effet rémanent de Mavi MNPV dans un champ de niébé

2020 ◽  
Vol 14 (6) ◽  
pp. 2219-2229
Author(s):  
A. Kindozandji ◽  
B.D. Datinon ◽  
K. Amevoin ◽  
A.N. Nondichao ◽  
A.I. Glitho ◽  
...  
Keyword(s):  
Research Work ◽  
Residual Effect ◽  
Maruca Vitrata ◽  
Sub Saharan Africa ◽  
Important Food ◽  
Food Legumes ◽  
Significant Difference ◽  
Sub Saharan ◽  
Rate Of Emergence ◽  
And Control

Le niébé est l’une des légumineuses alimentaires la plus importante dans toutes les régions de l’Afrique Sub-saharienne. L’objectif de ce travail était d’étudier l’effet rémanent de Mavi Multinucléo polyhedrovirus (Mavi MNPV) après la récolte du niébé au champ. Le champ a été traité 5 fois au biopesticide Mavi MNPV à la fréquence de sept jours. Deux semaines après la récolte, deux plants ainsi que les graines de chaque traitement sur chaque unité parcellaire ayant reçu les traitements de Mavi MNPV de 107, 108 et 109 virions/ml ont été collectés et amenés au laboratoire avec le substrat de développement de la plante (sable). Aucune des formulations issues des substrats sable, racines, feuilles, tiges et graines n’a affecté la mortalité des larves L2 et L3 de Maruca vitrata et aucune différence significative n’a été observée entre les traitements et le témoin. Quels que soient les traitements, le taux d’émergence des adultes est élevé ; ce qui signifie que la variation de la concentration de Mavi MNPV ne conditionne pas sa présence dans le sol, les tiges, les feuilles, les racines et les graines. Le biopesticide Mavi MNPV n’est pas persistant dans la nature.Mots clés : Niébé, Mavi MNPV, Maruca vitrata, Effet rémanent   English Title: Study of the residual effect of Mavi MNPV in a cowpea field Cowpea is one of the most important food legumes in all regions of Sub-Saharan Africa. The objective of this research work was to study the persistence effect of Mavi Multinucleus polyhedrovirus (Mavi MNPV) after field harvest of the cowpea. The field was treated 5 times with Mavi MNPV biopesticide at seven days. Two weeks after harvest, two plants as well as the seeds from each treatment on each plot unit that received Mavi MNPV treatments of 107, 108 and 109 virions / ml were removed and brought to the laboratory with the plant development substrate (sand). None of the formulations from sand, root, leaf, stem and seed substrates did not affect the mortality of L2 and L3 larvae of Maruca vitrata and no significant difference was observed between treatments and control. Regardless of the treatments, the rate of emergence of adults is high; this means that the variation in the concentration of Mavi MNPV does not condition its presence in soil, stems, leaves, roots and seeds. Mavi MNPV biopesticide is not persistent in nature.Keywords: Cowpea, Mavi MNPV, Maruca vitrata, Residual effect.      

scholarly journals After the lockdown: macroeconomic adjustment to the COVID-19 pandemic in sub-Saharan Africa

2020 ◽  
Vol 36 (Supplement_1) ◽  
pp. S338-S358 ◽  
Author(s):  
Christopher Adam ◽  
Mark Henstridge ◽  
Stevan Lee
Keyword(s):  
Low Income ◽  
Poverty Reduction ◽  
Sub Saharan Africa ◽  
Policy Options ◽  
Macroeconomic Adjustment ◽  
The Public ◽  
Global Recession ◽  
Significant Difference ◽  
Short Run ◽  
Sub Saharan

Abstract The COVID-19 pandemic is ripping around most of the world, but not in Africa; at least, not yet. At the same time, the policy response is remarkably uniform: most of sub-Saharan Africa went into lockdown from the second week in March. What happens next for the pandemic across Africa is uncertain, but the March lockdowns are unlikely to have contained the epidemic by themselves. What is clear is that the combination of domestic lockdowns and the spill-over from the global recession means immediate and severe hardship. This paper looks beyond the public health aspects of the pandemic to examine the medium-term macroeconomic adjustment challenge confronting domestic policy-makers and international donors. We combine epidemiological and macroeconomic models to calibrate the scale of the combined shock to a representative low-income African economy and to show how alternative policy options for slowing transmission of COVID-19 impact on public revenue, and on GDP in the short run, and hence shape the path to recovery. Noting that the first lockdown, however costly, does not by itself eliminate the likelihood of a re-emergence of the epidemic, we then frame the agenda for key macroeconomic and public finance policies to sustain recovery, growth, and poverty reduction in sub-Saharan Africa. The initial hit to consumption will be up to one-third. All the public policy options are grim. International donor finance of US$40–50 billion, together with domestic reform to accelerate recovery, would make a significant difference to the outlook for poverty.

scholarly journals A Cross-Case Analyses of Laboratory Professionals-Patients Interaction for Patients Accessing Laboratory Services at University of Cape Coast Hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana

2020 ◽  
Author(s):  
Patrick Adu
Keyword(s):  
Laboratory Testing ◽  
Sampling Period ◽  
Turnaround Time ◽  
Sub Saharan Africa ◽  
Cape Coast ◽  
Microsoft Excel ◽  
Laboratory Staff ◽  
Laboratory Services ◽  
Staff Interactions ◽  
Sub Saharan

Abstract Background: There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana. Methods: This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25. Results: Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the prescriber has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations from their respective prescribers. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing. Conclusion: There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-prescribers engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing.

scholarly journals INFLUENCE OF DIETARY INTAKES, ‘WASH’ AND DIARRHEAL MORBIDITY ON STUNTING AMONG CHILDREN BELOW FIVE YEARS IN NAKURU COUNTY: A CASE STUDY OF KAPTEMBWO AND MILIMANI, KENYA

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Daniel Matoke Ayienda ◽  
Muthuka J. Kyalo ◽  
Job O. Mapesa ◽  
Lawrence Mugambi ◽  
Eglah J. Kiplagat
Keyword(s):  
Descriptive Analysis ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Dietary Intakes ◽  
Risk Of Death ◽  
Sanitation And Hygiene ◽  
Significant Difference ◽  
Sub Saharan ◽  
Adult Earnings ◽  
High Level

Stunting is the most prevalent and pervasive form of under nutrition worldwide. In 2019, an estimate of 144 million (21.3%) of children under the age of 5 years are stunted globally. In sub-Saharan Africa, 34% of children fewer than 5 years are stunted and the burden of stunting is most prevalent in the Eastern Africa region with 37% (FAO, 2017). In Kenya, out of a total of 7 million under 5 years, 1.82 million (26%) children are suffering from stunting; out of which 11.4% are severely stunted. Stunting is associated with greater risk of death from infectious diseases in childhood, poorer cognition, poorer educational outcomes and lower adult earnings. The study population was a total of 314 children aged 0-59 months. Data was collected using survey CTO questionnaire. Use of pesticides, hygiene practices and sanitation (human waste disposal), hand washing practices, water sources and means of water treatment were examined and adequately described in relation to EED and stunting. Survey CTO programme was installed in tablets and or smart phones, in which a questionnaire with closed ended questions was programmed and used to collect a no-paper work data. The Survey CTO programmed questionnaire only allowed the researcher to key in a response for one question before moving to the next question. Data was analyzed using SPSS version 22 software. Descriptive analysis was done using SPSS while regression was done using STATA. There was no significant difference in dietary intakes between children in Kaptembwo and Milimani, and that the dietary intakes in both Milimani and Kaptembwo were adequate and balanced. Out of 202 children sampled in Kaptembwo, 40.59% had experienced diarrhea in the last four weeks to data collection while out of 112 children sampled in Milimani, only 17% had experienced diarrhea in the last four weeks. In spite of the same dietary intakes in Kaptembwo and Milimani, stunting is high in Kaptembwo than in Milimani. Out of a total of 314 children sampled, 25% were stunted in Kaptembwo, while only 3.33% were stunted in Milimani. Diarrhea increases loss of dietary nutrients thereby making the nutrients required for growth inadequate. High level of stunting in Kaptembwo is associated with poor environmental conditions (poor sanitation and hygiene) which contribute to diarrhea. Diarrhea could be key contributor to Environmental Enteric Dysfunction (EED), which is too a contributor to stunting. It is recommended that residents of Kaptembwo and Milimani are educated on the importance of good sanitation and hygiene in order to curb diarrhea, which is a contributor to the development of EED. In the same spirit, understand the importance of proper use of pesticides. Experimental research was done in the same area involving the use of biological markers for EED. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0720/a.php" alt="Hit counter" /></p>

USING COUPLES’ DISCORDANT REPORTS TO ESTIMATE FEMALE COVERT USE OF MODERN CONTRACEPTION IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (3) ◽  
pp. 326-346 ◽  
Author(s):  
Natalie C. Gasca ◽  
Stan Becker
Keyword(s):  
Contraceptive Use ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Couple Communication ◽  
Significant Difference ◽  
Contraceptive Prevalence ◽  
Sub Saharan

SummarySubstantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.

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