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Acceptability of Multiple Micronutrient-Fortified Bouillon Cubes among Women and Their Households in 2 Districts in The Northern Region of Ghana
(Current Developments in Nutrition, 2024) Wessells, K. R.; Nyaaba, K. W.; Adu-Afarwuah, S.; et al
Background: Bouillon is a promising large-scale food fortification vehicle, but there is uncertainty regarding the types and concentrations of micronutrients that are feasible to add without compromising consumer acceptability. Objective: The objective of this study was to evaluate the acceptability of 2 different multiple micronutrient-fortified bouillon cube for mulations, compared with a bouillon cube fortified with iodine only. Methods: We conducted a double-blind, randomized, controlled acceptability study in 2 districts in northern Ghana. Two nonproprietary, noncommercialized formulations of multiple micronutrient-fortified bouillon cubes containing iron, zinc, folic acid, vitamins A and B12, and iodine at “upper-level” (45-125% CODEX NRV/2.5g) or “lower-level” (15-50% CODEX NRV/2.5g) concentrations, and a control cube that contained iodine only (50% CODEX NRV/2.5g) were evaluated. Eligible women (n ¼ 84) were invited to participate in 1) center-based sensory evaluations designed to permit within-individual comparisons among the different study products; and 2) in-home evaluation of bouillon acceptability and use, in which participants were randomized to receive 1 of the 3 study products to use in household cooking for a 2-wk period. Acceptance test ratings were based on a 5-point Likert scale (1 ¼ dislike very much, 5 ¼ like very much). Results: In the center-based evaluations, overall liking of the 3 bouillon cube formulations both dry and in prepared dishes ranged from 4.3 to 4.6 on the 5-point Likert scale and did not differ among formulations (P > 0.05). After the 2-wk in-home trial, 93.8% of index participants (n ¼ 75/80) rated their overall liking of the bouillon product formulation to which they were randomly assigned as “like” or “like very much” (4–5 on the 5-point Likert scale) and median apparent intake of study-provided bouillon over 2 wk was 3.6 g/capita/d; neither value differed by study group (P ¼ 0.91 for both). Conclusions: All 3 formulations of bouillon cubes assessed were acceptable to women and their households in 2 districts in northern Ghana. This trial was registered at www.clinicaltrials.gov as NCT05177614.
Acceptability of Multiple Micronutrient-Fortified Bouillon Cubes among Women and Their Households in 2 Districts in The Northern Region of Ghana
(Current Developments in Nutrition, 2024) Wessells, K. R.; Adu-Afarwuah, S.; Nyaaba, K. W.; et al
Background: Bouillon is a promising large-scale food fortification vehicle, but there is uncertainty regarding the types and concentrations of micronutrients that are feasible to add without compromising consumer acceptability. Objective: The objective of this study was to evaluate the acceptability of 2 different multiple micronutrient-fortified bouillon cube for mulations, compared with a bouillon cube fortified with iodine only. Methods: We conducted a double-blind, randomized, controlled acceptability study in 2 districts in northern Ghana. Two nonproprietary, noncommercialized formulations of multiple micronutrient-fortified bouillon cubes containing iron, zinc, folic acid, vitamins A and B12, and iodine at “upper-level” (45-125% CODEX NRV/2.5g) or “lower-level” (15-50% CODEX NRV/2.5g) concentrations, and a control cube that contained iodine only (50% CODEX NRV/2.5g) were evaluated. Eligible women (n ¼ 84) were invited to participate in 1) center-based sensory evaluations designed to permit within-individual comparisons among the different study products; and 2) in-home evaluation of bouillon acceptability and use, in which participants were randomized to receive 1 of the 3 study products to use in household cooking for a 2-wk period. Acceptance test ratings were based on a 5-point Likert scale (1 ¼ dislike very much, 5 ¼ like very much). Results: In the center-based evaluations, overall liking of the 3 bouillon cube formulations both dry and in prepared dishes ranged from 4.3 to 4.6 on the 5-point Likert scale and did not differ among formulations (P > 0.05). After the 2-wk in-home trial, 93.8% of index participants (n ¼ 75/80) rated their overall liking of the bouillon product formulation to which they were randomly assigned as “like” or “like very much” (4–5 on the 5-point Likert scale) and median apparent intake of study-provided bouillon over 2 wk was 3.6 g/capita/d; neither value differed by study group (P ¼ 0.91 for both). Conclusions: All 3 formulations of bouillon cubes assessed were acceptable to women and their households in 2 districts in northern Ghana. This trial was registered at www.clinicaltrials.gov as NCT05177614.
Adapting to Changing Climate: Understanding Coastal Rural Residents’ Relocation Intention in Response to Sea Level Rise
(MDPI, 2023-05) Klutse, A. B.; Adade, R.; Jaiye, D.; et al
Ex situ adaptation in the form of relocation has become inevitable in some low-lying coastal zones where other adaptation strategies become impractical or uneconomical. Although relocation of coastal low-lying communities is anticipated globally, little is still known about the factors that influence household-level adoption. This study draws on an extended version of Protection Motivation Theory (PMT) to assess the factors influencing the relocation intention of three highly vulnerable coastal rural communities in Ghana. A total of 359 household heads were randomly selected for a questionnaire survey. The study employed binary logistic regression to identify key factors that influence residents’ readiness to relocate. The results indicated that cognitive and compositional factors were more important than contextual factors in explaining the intention to relocate among coastal rural communities in Ghana. However, contextual factors mediated or attenuated the influence of cognitive and compositional factors on relocation intention. Based on the findings, this study advocates for intensive education on the effects of future sea-level rise impacts on communities as well as structural and non-structural measures to improve the socio-economic capacity of rural communities.
The ambiguities of social inclusion in mental health: learning from lived experience of serious mental illness in Ghana and the occupied Palestinian territory
(Social Psychiatry and Psychiatric Epidemiology, 2023) Read, U.M.; Osei‑Tutu, A.; Kienzler, H.; et al
Purpose Social inclusion of people living with serious mental illness is widely promoted. However, only limited consideration has been given to the meanings of social inclusion within different settings and the ways in which it is envisioned, negotiated, and practised. In this paper, we explore meanings and practises of social inclusion from the perspectives of people living with serious mental illness and their families in Ghana and Palestine and how this is shaped by differing political and socio-cultural contexts. Methods This paper draws on comparative ethnographic research including participant observation and interviews with people living with mental illness and family members in Ghana and the occupied Palestinian territory. Data were triangulated and analysed using thematic analysis. Results Participants described experiences of social inclusion and participation within communities, home and family life, friendships and social life, and work and livelihoods. This revealed how such experiences were variously shaped by differing political contexts and socio-cultural norms and expectations within the two settings. These in turn intersected with aspects such as gender roles, age, and socio-economic status. Aspirations for inclusion included greater awareness and understanding within society, accompanied by opportunities and support for meaningful inclusion at the political as well as community level. Conclusion Findings point to the value of a contextual understanding of social inclusion, taking account of the impact of the wider socio-cultural, political, and economic environment. They also point to the need for an intersectoral approach, beyond communities and mental health services, to provide meaningful opportunities and support for social inclusion.
The Association between Household Air Pollution and Blood Pressure in Obuasi Municipality, Ghana
(Atmosphere, 2022) Quansah, R.; Tawiah, T.; Shupler, M.; Gyaase, S.; Cuevas, R.A.; Saah, J.; Nix, E.; et al
Emerging evidence suggests a possible link between exposure to household air pollution (HAP) from a reliance on polluting solid fuels (SFs) (e.g., wood and charcoal) for cooking and high blood pressure. As part of the CLEAN-Air(Africa) project, we measured the blood pressure among 350 cooks in Obuasi Municipality, Ghana after 24 h exposure to particulate matter (PM2.5) from the combustion of either solid fuels (n = 35) or liquefied petroleum gas (LPG) (n = 35). Multinomial regression models were used to describe the relationship between different stages of blood pressure (mmHg) and the respondents’ main fuel type used, adjusting for key covariates. A linear regression model was used to describe the relationship between personal exposure to PM2.5 and the respondent’s systolic as well as diastolic blood pressure, adjusting for key covariates. Blood pressure was higher in cooks using SFs for cooking than in those using LPG. A significant exposure–response relationship was not observed between increasing exposure to PM2.5 and increasing blood pressure (systolic: β = −2.42, 95% CI: −8.65, 3.80, p-value = 0.438, and diastolic: β = −0.32, 95% CI: −5.09; 4.45, p-value = 0.893).
Barriers to Timely Administration of Hepatitis B Birth Dose Vaccine to Neonates of Mothers With Hepatitis B in Ghana: Midwives’ Perspectives
(Sage, 2023) Adjei, C.A; Suglo, D.; Ahenkorah, A.Y.; et al
Background: The global health sector strategy on viral hepatitis aims to reduce new hepatitis B infections by 90% by 2030. Yet, hepatitis B birth dose (HepB-BD) vaccination, which is effective in preventing mother-to-child transmission of hepatitis B, remains low in sub-Saharan Africa. Given the essential role that midwives play in infants’ birth dose immunisation, we explore their perspectives on the reasons for delays and non-administration of HepB-BD to eligible neonates in Ghana. Methods: We conducted interviews with 18 midwives, stratified by region (Greater Accra and Northern regions). Participants were selected purposively. The data were transcribed, coded, and analysed following the Braun and Clarke data analysis procedure. Results: The participants conveyed a broad range of barriers to HepB-BD vaccination in Ghana. These include the mother’s denial of hepatitis B seropositivity; the mother’s ignorance of the impact of hepatitis B on their newborn; partners’ noninvolvement in post-test counselling; and the high cost of hepatitis B immunoglobulin and hepatitis B monovalent vaccine. Other reasons included vaccine unavailability and midwives’ oversight and documentation lapses. Conclusion: We recommend educating expectant mothers on the importance and effectiveness of HepB-BD vaccination during antenatal care (ANC) visits, as well as educating midwives on HepB-BD vaccination procedures. In addition, ensuring sufficient supplies and administering hepatitis B vaccines in the delivery ward should be done to guarantee that babies receive the vaccines on time. Importantly, Ghana needs policies that require HepB-BD vaccination as part of the Expanded Programme on Immunisation (EPI) to ensure the investments and funding it needs.
Biological sample donation and informed consent for neurobiobanking: Evidence from a community survey in Ghana and Nigeria
(PLOS ONE, 2022) Singh, A; Arulogun, O; Akinyemi, J; Nichols, M; Calys-Tagoe, B; Asibey, S; et al
Introduction Genomic research and neurobiobanking are expanding globally. Empirical evidence on the level of awareness and willingness to donate/share biological samples towards the expansion of neurobiobanking in sub-Saharan Africa is lacking. Aims To ascertain the awareness, perspectives and predictors regarding biological sample donation, sharing and informed consent preferences among community members in Ghana and Nigeria. Methods A questionnaire cross-sectional survey was conducted among randomly selected community members from seven communities in Ghana and Nigeria. Results Of the 1015 respondents with mean age 39.3 years (SD 19.5), about a third had heard of blood donation (37.2%, M: 42.4%, F: 32.0%, p = 0.001) and a quarter were aware of blood sample storage for research (24.5%; M: 29.7%, F: 19.4%, p = 0.151). Two out of ten were willing to donate brain after death (18.8%, M: 22.6%, F: 15.0%, p<0.001). Main reasons for unwillingness to donate brain were; to go back to God complete (46.6%) and lack of knowledge related to brain donation (32.7%). Only a third of the participants were aware of informed consent (31.7%; M: 35.9%, F: 27.5%, p<0.001). Predictors of positive attitude towards biobanking and informed consent were being married, tertiary level education, student status, and belonging to select ethnic groups. Conclusion There is a greater need for research attention in the area of brain banking and informed consent. Improved context-sensitive public education on neurobiobanking and informed consent, in line with the sociocultural diversities, is recommended within the African sub region.
Caffeic Acid Inhibits Proliferation, Migration, and Stemness of DU-145 Prostate Cancer Cells
(Natural Product Communications, 2023) Aikins, A.R.; Birikorang, P.A.; Tetteh, J.K.A; et al
The issue of toxicity associated with existing cancer drugs necessitates the exploration of the anticancer potentials of natural products such as caffeic acid (CA). Here, we determined the effect of CA on the proliferation, migration, and stem cell-like properties of DU 145 prostate cancer cells. Tetrazolium-based colorimetric assay and flow cytometric analysis showed that CA decreased cell prolif eration in a dose- and time-dependent manner without affecting cell cycle progression. CA also inhibited cell migration and repressed epithelial-to-mesenchymal transition by upregulating the expression of cadherin 1 (CDH1) and downregulating the expression of cad herin 2 (CDH2). Furthermore, CA reduced the cancer stem cell population from 95% to 63% and 47% at concentrations of 1.25 and 2.5 mg/mL, respectively; and inhibited stem cell-like properties by downregulating the expression of NANOG and octamer-binding transcription factor 4 (OCT4) genes. These findings suggest that CA could be considered in the development of improved chemother apy against prostate cancer
Call detail record aggregation methodology impacts infectious disease models informed by human mobility
(PLOS Computational Biology, 2023) Gibbs, H.; Musah, A.; Ampofo, W.; et al
This paper demonstrates how two different methods used to calculate population-level mobility from Call Detail Records (CDR) produce varying predictions of the spread of epidemics informed by these data. Our findings are based on one CDR dataset describing inter-district movement in Ghana in 2021, produced using two different aggregation methodologies. One methodology, “all pairs,” is designed to retain long distance network connections while the other, “sequential” methodology is designed to accurately reflect the volume of travel between locations. We show how the choice of methodology feeds through models of human mobility to the predictions of a metapopulation SEIR model of disease transmission. We also show that this impact varies depending on the location of pathogen introduction and the transmissibility of infections. For central locations or highly transmissible diseases, we do not observe significant differences between aggregation methodologies on the predicted spread of disease. For less transmissible diseases or those introduced into remote locations, we find that the choice of aggregation methodology influences the speed of spatial spread as well as the size of the peak number of infections in individual districts. Our findings can help researchers and users of epidemiological models to understand how methodological choices at the level of model inputs may influence the results of models of infectious disease transmission, as well as the circumstances in which these choices do not alter model predictions.
Co-Occurrence of G6PD Deficiency and SCT among Pregnant Women Exposed to Infectious Diseases
(Journal of Clinical Medicine, 2023) Helegbe, G.K.; Wemakor, A.; Ameade, E.P.K.; et al
bstract: During pregnancy, women have an increased relative risk of exposure to infectious diseases. This study was designed to assess the prevalence of the co-occurrence of glucose-6-phosphate dehydrogenase deficiency (G6PDd) and sickle cell trait (SCT) and the impact on anemia outcomes among pregnant women exposed to frequent infectious diseases. Over a six-year period (March 2013 to October 2019), 8473 pregnant women attending antenatal clinics (ANCs) at major referral hospitals in Northern Ghana were recruited and diagnosed for common infectious diseases (malaria, syphilis, hepatitis B, and HIV), G6PDd, and SCT. The prevalence of all the infections and anemia did not differ between women with and without G6PDd (χ 2 < 3.6, p > 0.05 for all comparisons). Regression analysis revealed a significantly higher proportion of SCT in pregnant women with G6PDd than those without G6PDd (AOR = 1.58; p < 0.011). The interaction between malaria and SCT was observed to be associated with anemia outcomes among the G6PDd women (F-statistic = 10.9, p < 0.001). Our findings show that anemia is a common condition among G6PDd women attending ANCs in northern Ghana, and its outcome is impacted by malaria and SCT. This warrants further studies to understand the impact of antimalarial treatment and the blood transfusion outcomes in G6PDd/SCT pregnant women.
Contamination of herbal medicinal products in low-and-middle-income countries: A systematic review
(Heliyon, 2023) Opuni, K. F.M.; Kretchy, J-P.; Agyabeng, K.; et al
The use of herbal medicinal products (HMPs) has grown significantly across low-and-middleincome countries (LMICs). Consequently, the safety of these products due to contamination is a significant public health concern. This systematic review aimed to determine the prevalence, types, and levels of contaminants in HMPs from LMICs. A search was performed in seven online databases, i.e., Africa journal online (AJOL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Directory of Open Access Journals (DOAJ), Health Inter-Network Access to Research Initiative (HINARI), World Health Organization Global Index Medicus (WHO GIM), Scopus, and PubMed using appropriate search queries and reported as per the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines. Ninety-one peer-reviewed articles published from 1982 to 2021 from 28 different countries across four continents were included in the study. Although metals, microbial, mycotoxins, pesticides, and residual solvents were the reported contaminants in the 91 articles, metals (56.0%, 51/91), microbial (27.5%, 25/91), and mycotoxins (18.7%, 17/91) were the most predominant. About 16.4% (1236/7518) of the samples had their contaminant levels above the regulatory limits. Samples tested for microbial contaminants had the highest proportion (46.4%, 482/1039) of contaminants exceeding the regulatory limit, followed by mycotoxins (25.8%, 109/423) and metals (14.3%, 591/4128). The proportion of samples that had their average non-essential metal contaminant levels above the regulatory limit was (57.6%, 377/655), 18.3% (88/480), 10.7% (24/225), and 11.3% (29/257) for Pb, Cd, Hg, and As, respectively. The commonest bacteria species found were Escherichia coli (52.3%, 10/19) and Salmonella species (42.1%, 8/19). This review reported that almost 90% of Candida albicans and more than 80% of moulds exceeded the required regulatory limits. HMP consumption poses profound health implications to consumers and patients. Therefore, designing and/or implementing policies that effectively regulate HMPs to minimize the health hazards related to their consumption while improving the quality of life of persons living in LMICs are urgently needed.
Correction: Sensoy Bahar et al. “ANZANSI Program Taught Me Many Things in Life”: Families’ Experiences with a Combination Intervention to Prevent Adolescent Girls’ Unaccompanied Migration for Labor. Int. J. Environ. Res. Public Health 2022, 19, 13168
(Int. J. Environ. Res. Public Health, 2023) Bahar, O.S.; Boateng, A.; Ibrahim, A.; et al
There was an error in the original publication [1]. The second paragraph in Section 3.3 of the results section was misplaced. A correction has been made to the Results section, Section 3.3, and the second paragraph was moved to the end of Section 3.2. Adolescent girls also mentioned the content of the sessions as one of the reasons that motivated them to come to the sessions. For instance, when asked about what made it easy for her to attend the sessions, Ayat said, “They were teaching us how you will save money, how to fill the deposit slip, and what you supposed to do when you go to a bank. . . . They were educating us on how a child should live.” She added that she experienced no challenges in attending the sessions. Similarly, Patricia, who never missed a session, shared, “We never missed a session because we know it is something that is going to help us in relation to our family and education”. A correction was also made to the data collection period in the Methods section, Section 2.3, in the first paragraph. Face-to-face semi-structured interviews were conducted with adolescent girls and their caregivers separately following the completion of the ANZANSI intervention, between December 2021 and January 2022. The authors apologize for any inconvenience caused and state that the scientific conclusions are unaffected. The original publication has also been updated.
COVID-19 responses restricted abilities and aspirations for mobility and migration: insights from diverse cities in four continents
(HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS, 2023) Abu, M.; Jolivet, D.; Fransen, S.; et al
Research on the impacts of COVID-19 on mobility has focused primarily on the increased health vulnerabilities of involuntary migrant and displaced populations. But virtually all migration flows have been truncated and altered because of reduced economic and mobility opportunities of migrants. Here we use a well-established framework of migration decisionmaking, whereby individual decisions combine the aspiration and ability to migrate, to explain how public responses to the COVID-19 pandemic alter migration patterns among urban populations across the world. The principal responses to COVID-19 pandemic that affected migration are: 1) through travel restrictions and border closures, 2) by affecting abilities to move through economic and other means, and 3) by affecting aspirations to move. Using indepth qualitative data collected in six cities in four continents (Accra, Amsterdam, Brussels, Dhaka, Maputo, and Worcester), we explore how populations with diverse levels of education and occupations were affected in their current and future mobility decisions. We use data from interviews with sample of internal and international migrants and non-migrants during the 2020 COVID-19 pandemic outbreak to identify the mechanisms through which the pandemic affected their mobility decisions. The results show common processes across the different geographical contexts: individuals perceived increased risks associated with further migration, which affected their migration aspirations, and had reduced abilities to migrate, all of which affected their migration decision-making processes. The results also reveal stark differences in perceived and experienced migration decision-making across precarious migrant groups compared to high-skilled and formally employed international migrants in all settings. This precarity of place is particularly evident in low-income marginalised populations.
Development of a diarrhoea severity scoring scale in a passive health facility-based surveillance system
(PLOS ONE, 2022) St Jean, D.T; Chilyabanyama, O.N; Bosomprah, S; Asombang, M; Velu, R.M; Chibuye, M; et al
Abstract Background Diarrhoeal disease remains a leading cause of death among children mostly in low and middle- income countries. Factors contributing to disease severity are complex and there is currently no consensus on a scoring tool for use in community-based studies. Methods Data were collected during a passive surveillance system in an outpatient health facility in Lusaka, Zambia from March 2019 to July 2019. Diarrhea episodes were assessed for severity using an in-house severity scoring tool (CIDRZ) and previously published scores (Vesikari, Clark, CODA, and DHAKA). The CIDRZ score was constructed using fieldworker-reported clinical signs and exploratory factor analysis. We used precision-recall curves measuring severe diarrhoea (i.e., requiring intravenous rehydration or referred for hospital admission) to determine the best performing scores. Then, we used Cronbach’s alpha to assess the scale’s internal consistency. Finally, we used Cohen’s kappa to assess agreement between the scores. Results Of 110 diarrhea episodes, 3 (3%) required intravenous rehydration or were referred for hospital admission. The precision-recall area under the curve of each score as a predictor of severe diarrhoea requiring intravenous rehydration or hospital admission was 0.26 for Vesikari, 0.18 for CODA, 0.24 for Clark, 0.59 for DHAKA, and 0.59 for CIDRZ. The CIDRZ scale had substantial reliability and performed similarly to the DHAKA score. Conclusions Diarrhoea severity scores focused on characteristics specific to dehydration status may better predict severe diarrhea among children in Lusaka. Aetiology-specific scoring tools may not be appropriate for use in community healthcare settings. Validation studies for the CIDRZ score in diverse settings and with larger sample sizes are warranted.
Economic evaluations of non-communicable diseases conducted in Sub-Saharan Africa: a critical review of data sources
(Cost Effectiveness and Resource Allocation, 2023) Hollingworth, S.A.; Nonvignon, J.; Fenny, A.P.; et al
Background Policymakers in sub-Saharan Africa (SSA) face challenging decisions regarding the allocation of health resources. Economic evaluations can help decision makers to determine which health interventions should be funded and or included in their benefits package. A major problem is whether the evaluations incorporated data from sources that are reliable and relevant to the country of interest. We aimed to review the quality of the data sources used in all published economic evaluations for cardiovascular disease and diabetes in SSA. Methods We systematically searched selected databases for all published economic evaluations for CVD and diabetes in SSA. We modified a hierarchy of data sources and used a reference case to measure the adherence to reporting and methodological characteristics, and descriptively analysed author statements. Results From 7,297 articles retrieved from the search, we selected 35 for study inclusion. Most were modelled evaluations and almost all focused on pharmacological interventions. The studies adhered to the reporting standards but were less adherent to the methodological standards. The quality of data sources varied. The quality level of evidence in the data domains of resource use and costs were generally considered of high quality, with studies often sourcing information from reliable databases within the same jurisdiction. The authors of most studies referred to data sources in the discussion section of the publications highlighting the challenges of obtaining good quality and locally relevant data. Conclusions The data sources in some domains are considered high quality but there remains a need to make substantial improvements in the methodological adherence and overall quality of data sources to provide evidence that is sufficiently robust to support decision making in SSA within the context of UHC and health benefits plans. Many SSA governments will need to strengthen and build their capacity to conduct economic evaluations of interventions and health technology assessment for improved priority setting. This capacity building includes enhancing local infrastructures for routine data production and management. If many of the policy makers are using economic evaluations to guide resource allocation, it is imperative that the evidence used is of the feasibly highest quality.
Effectiveness of digital health interventions on blood pressure control, lifestyle behaviours and adherence to medication in patients with hypertension in low-income and middle-income countries: a systematic review and meta-analysis of randomised controlled trials
(Review, 2024) Boima, V.; Doku, A.; Agyekum, F.; et al
Background Digital health interventions can be effective for blood pressure (BP) control, but a comparison of the effectiveness and application of these types of interventions have not yet been systematically evaluated in low- and middle-income countries (LMICs). This study aimed to compare the effectiveness of digital health interventions according to the World Health Organization (WHO) classifications of patients in terms of BP control, lifestyle behaviour changes, and adherence to medication in patients with hypertension in LMICs. Methods: In this systematic review and meta-analysis, we searched PubMed, Scopus, Web of Science, Embase, CINAHL and Cochrane Library databases for randomised controlled trials (RCTs) published in English comprise of adults (≥18 years old) with hypertension and the intervention consisted of digital health interventions according to WHO’s classifications for patients in LMICs between January 1, 2009, and July 17, 2023. We excluded RCTs that considered patients with hypertension comorbidities such as diabetes and hypertension-mediated target organs damage (HMTOD). The references were downloaded into Mendeley Desktop and imported into the Rayyan web tool for deduplication and screening. The risk of bias was assessed using Cochrane Risk of Bias 2. Data extraction was done according to Cochrane’s guidelines. The main outcome measures were mean systolic blood pressure (SBP) and BP control, which were assessed using the random-effect DerSimonian-Laird and Mantel-Haenszel models. We presented the BP outcomes, lifestyle behaviour changes and medication adherence in forest plots, as well as summarized them in tables. This study is registered with PROSPERO, CRD42023424227. Findings We identified 9322 articles, of which 22 RCTs from 12 countries (n = 12,892 respondents) were included in the systematic review. The quality of the 22 studies was graded as high risk (n = 7), had some concerns (n = 3) and low risk of bias (n = 12). A total of 19 RCTs (n = 12,418 respondents) were included in the meta-analysis. Overall, digital health intervention had significant reductions in SBP [mean difference (MD) = −4.43 mmHg (95% CI −6.19 to −2.67)], I 2 = 92%] and BP control [odds ratio (OR) = 2.20 (95% CI 1.64–2.94), I2 = 78%], respectively, compared with usual care. A subgroup analysis revealed that short message service (SMS) interventions had the greatest statistical significant reduction of SBP [MD = −5.75 mm Hg (95% Cl −7.77 to −3.73), I2 = 86%] compared to mobile phone calls [MD = 3.08 mm Hg (−6.16 to 12.32), I2 = 87%] or smartphone apps interventions [MD = −4.06 mm Hg] (−6.56 to −1.55), I2 = 79%], but the difference between groups was not statistically significant (p = 0.14). The meta-analysis showed that the interventions had a significant effect in supporting changes in lifestyle behaviours related to a low salt diet [standardised mean difference (SMD) = 1.25; (95% CI 0.64–1.87), I2 = 89%], physical activity [SMD = 1.30 (95% CI 0.23–2.37), I2 = 94%] and smoking reduction [risk difference (RR) = 0.03; (95% CI 0.01–0.05), I2 = 0%] compared to the control group. In addition, improvements in medication adherence was statistically significant and higher in the intervention group than in the control group [SMD]. = 1.59 (95% CI 0.51–2.67), I2 = 97% Interpretation Our findings suggest that digital health interventions may be effective for BP control, Changes in lifestyle behaviours, and improvements in medication adherence in LMICs. However, we observed high heterogeneity between included studies, and only two studies from Africa were included. The combination of digital health interventions with clinical management is crucial to achieving optimal clinical effectiveness in BP control, Changes in lifestyle behaviours and improvements in medication adherence. Funding None.
Efficacy of Lemon Extracts in Controlling Mealy Bugs of Stored Yam (Dioscorea rotundata)
(Agricultural Science Digest, 2023-04) Adu-Acheampong, S.; Adu-Gyamfi, R.; Ankutse, E.; et al
Background: The use of plant extracts in controlling mealy bugs is widespread especially on stored products. Despite this, research on lemon extracts, which is known to be very effective against some insect pests are limited. We assessed the repellent ability of lemon extracts in controlling mealy bug infestation and observed if there was any added benefit of the extract in retarding sprouting of yams in storage. Methods: We used the complete randomized design with three treatments and three replications. The treatments consisted of lemon peels, lemon leaf extracts and a control. Ten tubers of Pona white yam variety were rubbed on the periderm with each treatment and placed on a shelf. Two yam tubers naturally infested with mealy bugs were placed at the edges of each replication to serve as sources of infestation. Result: Results showed that yam tubers treated with lemon peel extracts recorded relatively low mealy bug counts compared to untreated ones and, tubers treated with lemon extracts recorded relatively higher weights compared to those without any treatment. Furthermore, there were no significant differences in neither counted mealy bugs nor yam weight per treatment between extracts from leaves or peels. Lemon extract treatments did not affect sprouting and shelf life of tubers in storage. We conclude that lemon extracts are effective repellents of mealy bugs and can be promoted as a safe bio pesticide for stored yam against mealy bug infestation.
Ethnobotanical Survey and Cercaricidal Activity Screening of Medicinal Plants Used for Schistosomiasis Treatment in Atwima- Nwabiagya District, Ashanti Region, Ghana
(Journal of Parasitology Research, 2023) Asante-Kwatia, E.; Gyimah, L.; Anyan, W.K.; et al
This study focused on documenting and evaluating the cercaricidal activity of medicinal plants used for schistosomiasis treatment in an endemic area in Ghana. Through semistructured questionnaires, personal interviews with herbalists in communities surrounding the Barekese dam in the Atwima-Nwabiagya district, where the disease is endemic, were carried out. Thirty medicinal plants distributed in 19 families were reported to be used for schistosomiasis treatment in the survey. Information on the plants, including scientific names, common names, families, and the used plant part were recorded. The families Apocynaceae and Euphorbiaceae recorded the highest number of plants (14% each), followed by Asteraceae (10%), Loranthaceae (7%), and Rubiaceae (7%). In vitro cercaricidal activity of methanol extracts of nine out of the thirty plants was performed by exposing human Schistosoma mansoni cercariae obtained from Biomphalaria pfeifferi to various concentrations of extracts over a duration of 240 minutes. All the plants tested demonstrated time- and concentration-dependent cercaricidal activity. With lethality being set at <1000 μg/mL, the cercaricidal activity in order of decreasing potency was as follows: Withania somnifera (LC50 = 1.29) > Balanites aegyptiaca (LC50 = 7.1) > Xylia evansii (LC50 = 11.14) > Jathropha multifida (LC50=12.9) > Justicia flava (LC50 = 22.9) > Anopyxis klaineana (LC50 = 182.81) > Ximenia americana (LC50 = 194.98) > Loranthus lecardii (LC50=223.87) > Bridelia tenufolia (LC50=309.03) > Zanthoxylium zanthoxyloides (LC50 = 851.94). Phytochemicals, including alkaloids, tannins, triterpenes, saponins, phytosterols, and flavonoids were identified in the plants. The result of this study gives scientific credence to the traditional use of these plants in the treatment of schistosomiasis and proves that the rich botanical knowledge of medicinal plants provides an incredible starting point for the discovery of new anti-schistosomal drugs for the local population.
Evaluating circulating soluble markers of endothelial dysfunction and risk factors associated with PE: A multicentre longitudinal case control study in northern Ghana
(Heliyon, 2023) Ahenkorah, B.; Helegbe, G.; Ofosu, W.; Amoah, L.E.; et al
Serpin E1/PAI-1, N-terminal pro-brain natriuretic peptide (NTpro-BNP) and neuropilin-1 are markers which have been associated with endothelial dysfunction. However, data on the levels of these markers in PE is limited. The limited data on the pathophysiology of PE in relation to these markers necessitated the study. This was a multicentre case-control study conducted at the Obstetrics and Gynaecology Department of the Tamale Teaching Hospital, the Bawku Presbyterian Hospital and the Bolgatanga Regional Hospital. Out of 520 consenting pregnant women, 127 pregnant women met the inclusion criteria (53 with PE and 74 controls) and were included in this study. Venous, placental, cord and peripheral blood were collected for biomarker assay, haematological parameters and placental parasite determination. Placental tissue sections were obtained for placental malaria and histopathological lesions associated with hypoperfusion. Maternal heart rate and foetal.
Evidence of Rift Valley Fever Virus Circulation in Livestock and Herders in Southern Ghana
(MDPI, 2023-06) Mensah, I.G.; Johnson, S.A.M; Asmah, R.; et al
Rift Valley fever (RVF) is a re-emerging zoonotic disease of domestic ruminants and humans. While neighbouring countries have reported outbreaks of RVF, Ghana has not yet identified any cases. The aim of this study was to determine whether RVF virus (RVFV) was circulating in livestock and herders in the southern part of Ghana, to estimate its seroprevalence, and to identify associated risk factors. The study surveyed 165 livestock farms randomly selected from two districts in southern Ghana. Serum samples of 253 goats, 246 sheep, 220 cattle, and 157 herdsmen were tested to detect IgG and IgM antibodies against RVFV. The overall seroprevalence of anti-RVF antibodies in livestock was 13.1% and 30.9% of farms had RVFV seropositive animals. The species-specific prevalence was 24.1% in cattle, 8.5% in sheep, and 7.9% in goats. A RVFV IgG seroprevalence of 17.8% was found among the ruminant herders, with 8.3% of all herders being IgM positive. RVFV was shown, for the first time, to have been circulating in southern Ghana, with evidence of a recent outbreak in Kwahu East; however, it was clinically undetected despite significant recent human exposure. A One Health approach is recommended to better understand RVF epidemiology and socio-economic impact in Ghana.