Factors associated with COVID-19 knowledge among Ghanaians: A national survey.

BACKGROUND: Adequate knowledge about COVID-19 in a population may be relevant in the fight to control its spread among the populace. Thus, the aim of this study was to assess the factors associated with real knowledge of COVID-19 among Ghanaians to promote effective dissemination of appropriate information aimed at containing the spread. METHODS: A cross-sectional online survey and computer assisted telephone interviews (CATI) was conducted among Ghanaians aged 18 years and above across the 260 districts of Ghana. The survey assessed the level of knowledge of COVID-19 and its associated factors and compared differences between perceived and real knowledge. One district health promotion officer per district was trained for the data collection. Participants were recruited via use of phone directories of both organized and non-organized local district groups. Phone calls were made to randomly selected phone contacts to schedule options for participation in the study. We used multivariable logistic regression to investigate the associated factors of COVID-19 knowledge among respondents. RESULTS: Of the 2,721 participants who completed the survey, the majority (99.3%) were aware of the existence of the COVID-19 outbreak, had good knowledge on infection prevention (87.0%) and rated their knowledge about COVID-19 as good (81.7%). Factors associated with COVID-19 knowledge were: age ≥56 years (aOR = 0.5; CI: 0.3-0.8; p = 0.002), tertiary education (aOR = 1.8; CI: 1.2-2.6; p = 0.003), residing in Greater Accra region (aOR = 2.0; CI: 1.1-3.6; p = 0.019), not infected with the novel coronavirus (aOR = 1.5; Cl: 1.0-2.1; p = 0.045), knowing an infected person (aOR = 3.5; CI = 1.5-7.9; p = 0.003), good practice of effective preventive measures (aOR = 1.2: Cl: 1.1-1.5: 0.008), not misinformed (aOR = 0.7; Cl: 0.5-0.9; 0.015), and perceiving spreading speed of the virus as slow (aOR = 0.7; Cl: 0.5-0.9; 0.007). CONCLUSION: The study found good knowledge regarding COVID-19, control measures, and preventive strategies. The Ghana Health Service should continuously provide accurate information to educate the media and citizens to prevent misinformation, which is vital in stopping the spread of the COVID-19 virus.

Surveillance and laboratory collaboration in response to an outbreak of Vibrio parahaemolyticus, Plesiomonas shigelloides, and Aeromonas hydrophila in Sekondi-Takoradi, Ghana: a case series.

BACKGROUND: The detection of epidemic-prone pathogens is important in strengthening global health security. Effective public health laboratories are critical for reliable, accurate, and timely testing results in outbreak situations. Ghana received funding as one of the high-risk non-Ebola affected countries to build and strengthen public health infrastructure to meet International Health Regulation core capacities. A key objective was to build laboratory capacities to detect epidemic-prone diseases. CASE PRESENTATION: In June 2018, a local hospital received eight patients who presented with acute diarrhea. A sample referral system for Ghana has not been established, but the Sekondi Zonal Public Health Laboratory staff and mentors collaborated with Disease Surveillance Officers (DSOs) to collect, package, and transport stool specimens from the outbreak hospital to the Public Health Laboratory for laboratory testing. The patients included seven females and one male, of Fante ethnicity from the Fijai township of Sekondi-Takoradi Municipality. The median age of the patients was 20 years (interquartile range: 20-29 years). Vibrio parahaemolyticus was identified within 48 hours from four patients, Plesiomonas shigelloides from one patient, and Aeromonas hydrophila from another patient. There was no bacteria growth from the samples from the two other patients. All patients were successfully treated and discharged. CONCLUSION: This is the first time these isolates have been identified at the Sekondi Zonal Public Health Laboratory, demonstrating how rapid response, specimen transportation, laboratory resourcing, and public health coordination are important in building capacity towards achieving health security. This capacity building was part of the United States Centers for Disease Control and Prevention engagement of international and local partners to support public health laboratories with supplies, diagnostic equipment, reagents, and logistics.

Improved detection of microbiological pathogens: role of partner and non-governmental organizations.

BACKGROUND: Proper detection of disease-causing organisms is very critical in controlling the course of outbreaks and avoiding large-scale epidemics. Nonetheless, availability of resources to address these gaps have been difficult due to limited funding. This report sought to highlight the importance of in-country partners and non-governmental organizations in improving detection of microbiological organisms in Ghanaian Public Health Laboratories (PHLs). METHODS/CONTEXT: This study was conducted between June, 2018 to August, 2019. U. S CDC engaged the Centre for Health Systems Strengthening (CfHSS) through the Association of Public Health Laboratories to design and implement strategies for strengthening three PHLs in Ghana. An assessment of the three PHLs was done using the WHO/CDS/CSR/ISR/2001.2 assessment tool. Based on findings from the assessments, partner organizations (CfHSS/APHL/CDC) serviced and procured microbiological equipment, laboratory reagents and logistics. CfHSS provided in-house mentoring and consultants to assist with capacity building in detection of epidemic-prone infectious pathogens by performing microbiological cultures and antimicrobial susceptibility tests. RESULTS: A total of 3902 samples were tested: blood (1107), urine (1742), stool (249) and cerebrospinal fluid (CSF) (804). All-inclusive, 593 pathogenic bacteria were isolated from blood cultures (70; 11.8%); urine cultures (356; 60%); stool cultures (19; 3.2%) and from CSF samples (148; 25%). The most predominant pathogens isolated from blood, urine and stool were Staphylococcus aureus (22/70; 31%), Escherichia coli (153/356; 43%) and Vibrio parahaemolyticus (5/19; 26.3%), respectively. In CSF samples, Streptococcus pneumoniae was the most frequent pathogen detected (80/148; 54.1%). New bacterial species such as Pastuerella pneumotropica, Klebsiella oxytoca, Vibrio parahaemolyticus, and Halfnia alvei were also identified with the aid of Analytical Profile Index (API) kits that were introduced as part of this implementation. Streptococcus pneumoniae and Neisseria meningitidis detections in CSF were highest during the hot dry season. Antimicrobial susceptibility test revealed high rate of S. aureus, K. pneumoniae and E. coli resistance to gentamicin (35-55%). In urine, E. coli was highly resistant to ciprofloxacin (39.2%) and ampicillin (34%). CONCLUSION: Detection of epidemic-prone pathogens can be greatly improved if laboratory capacity is strengthened. In-country partner organizations are encouraged to support this move to ensure accurate diagnosis of diseases and correct antimicrobial testing.

Apolipoprotein L1 Variant Associated with Increased Susceptibility to Trypanosome Infection.

UNLABELLED: African trypanosomes, except Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, which cause human African trypanosomiasis, are lysed by the human serum protein apolipoprotein L1 (ApoL1). These two subspecies can resist human ApoL1 because they express the serum resistance proteins T. b. gambiense glycoprotein (TgsGP) and serum resistance-associated protein (SRA), respectively. Whereas in T. b. rhodesiense, SRA is necessary and sufficient to inhibit ApoL1, in T. b. gambiense, TgsGP cannot protect against high ApoL1 uptake, so different additional mechanisms contribute to limit this uptake. Here we report a complex interplay between trypanosomes and an ApoL1 variant, revealing important insights into innate human immunity against these parasites. Using whole-genome sequencing, we characterized an atypical T. b. gambiense infection in a patient in Ghana. We show that the infecting trypanosome has diverged from the classical T. b. gambiense strains and lacks the TgsGP defense mechanism against human serum. By sequencing the ApoL1 gene of the patient and subsequent in vitro mutagenesis experiments, we demonstrate that a homozygous missense substitution (N264K) in the membrane-addressing domain of this ApoL1 variant knocks down the trypanolytic activity, allowing the trypanosome to avoid ApoL1-mediated immunity. IMPORTANCE: Most African trypanosomes are lysed by the ApoL1 protein in human serum. Only the subspecies Trypanosoma b. gambiense and T. b. rhodesiense can resist lysis by ApoL1 because they express specific serum resistance proteins. We here report a complex interplay between trypanosomes and an ApoL1 variant characterized by a homozygous missense substitution (N264K) in the domain that we hypothesize interacts with the endolysosomal membranes of trypanosomes. The N264K substitution knocks down the lytic activity of ApoL1 against T. b. gambiense strains lacking the TgsGP defense mechanism and against T. b. rhodesiense if N264K is accompanied by additional substitutions in the SRA-interacting domain. Our data suggest that populations with high frequencies of the homozygous N264K ApoL1 variant may be at increased risk of contracting human African trypanosomiasis.

Cholera outbreak following a marriage ceremony in Medinya, Western Ghana.

INTRODUCTION: Cholera is a diarrhoea disease caused by the bacterium e. On 13th June 2011, there was a reported outbreak of acute watery diarrhoea at Medinya among people who eat at a mass traditional wedding ceremony in the Western Region of Ghana. We investigated to characterize the outbreak, and implement control and preventive measures. METHODS: We conducted a retrospective cohort study. We interviewed health workers, reviewed medical records, conducted environmental assessment and obtained water and stool samples for laboratory investigation. A suspected cholera-case defined as a person with acute watery diarrhoea, with or without vomiting, who ate food prepared at the mass traditional wedding in Medinya on 10th June 2011. We performed univariate and bivariate analysis. RESULTS: Of the 17 case-patients, 9 (52.9%) were males. The overall attack rate was 11.18% and case fatality rate was 5.9%. The most affected age group was 6-10 years (23.53%) with median age of 20 and ranged 6 to 38 years. Time of onset of symptoms was 2.00am and peaked at 10.am on 13th June. Compared to other food served, fufu with groundnut soup was more likely to have been contaminated (RR=7.3, 95%CI: 1.8-29.3). We isolated e serotype ogawa from stool samples. We observed open defaecation and poor personal hygiene. CONCLUSION: e serotype ogawa caused a high case-fatality outbreak in Medinya. Contaminated fufu and groundnut soup were the sources. Hand washing with soap was initiated and a make shift latrine constructed following our health education and recommendations.

Exposure of Small-Scale Gold Miners in Prestea to Mercury, Ghana, 2012.

INTRODUCTION: Small-scale gold miners in Ghana have been using mercury to amalgamate gold for many years. Mercury is toxic even at low concentration. We assessed occupational exposure of small-scale gold miners to mercury in Prestea, a gold mining town in Ghana. METHODS: We conducted a cross-sectional study in which we collected morning urine samples from 343 small-scale gold miners and tested for elemental mercury. Data on small-scale gold miner's socio-demographics, adverse health effects and occupational factors for mercury exposure were obtained and analyzed using SPSS Version 16 to determine frequency and percentage. Bivariate analysis was used to determine occupational factors associated with mercury exposure at 95% confidence level. RESULTS: The mean age of the small-scale gold miners was 29.5 ±9.6 years, and 323(94.20%) were males. One hundred and sixty (46.65%) of the small-scale gold miners had urine mercury above the recommended exposure limit (<5.0ug/L). Complaints of numbness were significantly associated with mercury exposure among those who have previously worked at other small-scale gold mines (χ2=4.96, p=0.03). The use of personal protective equipment among the small-scale gold miners was low. Retorts, which are globally recommended for burning amalgam, were not found at mining sites. CONCLUSION: A large proportion of small-scale gold miners in Prestea were having mercury exposure in excess of occupational exposure limits, and are at risk of experiencing adverse health related complications. Ghana Environmental Protection Agency should organize training for the miners.