Predictors of HIV status disclosure among people living with HIV (PLHIV) in Ghana: the disclosure conundrum and its policy implications in resource limited settings.

BACKGROUND: Globally, over 40 million lives have been claimed by HIV/AIDS. In Ghana, more than 350,000 people are living with HIV. Non-disclosure of HIV status is a major barrier to HIV/AIDS eradication; yet, little is known of the determinants of HIV status disclosure in resource limited settings in Africa like Ghana. OBJECTIVE: Determine the predictors of HIV status disclosure among people living with HIV (PLHIV) and stimulate policy discourse on support systems for self-disclosure in Africa. METHODS: This is a descriptive cross-sectional study among PLHIV (n = 181) in sub-Saharan Africa, specifically the Volta region of Ghana. Bivariate probit regression was run to determine factors associated with HIV status disclosure among PLHIV. RESULTS: HIV status self-disclosure was reported by 50% of the respondents; nearly 65% disclosed their status to non-family members and non-partners. Significant correlates of HIV status disclosure either to partners or non-partners were marital status, monthly income, type of occupation, and being divorced due to HIV status (p < 0.05). CONCLUSIONS: HIV status disclosure remains low in Ghana like many African countries. There is the need for a renewed policy debate on tailored guidelines for HIV status self-disclosure and targeted support systems for PLHIV to ameliorate their predicaments and promote eradication of the epidemic in Africa.

Use and Quality of Blood Cultures for the Diagnosis of Bloodstream Infections: A Cross-Sectional Study in the Ho Teaching Hospital, Ghana, 2019-2021.

Blood Culture and Drug Susceptibility Testing (CDST) remains vital for the diagnosis and management of bloodstream infections (BSIs). While the Ghana National Standard Treatment Guidelines require CDST to be performed in each case of suspected or clinically diagnosed BSI, these are poorly adhered to in the Ho Teaching Hospital (HTH). This study used secondary medical and laboratory records to describe blood CDST requests by clinicians and the quality of CDST processes for the diagnosis of BSI among patients admitted to HTH from 2019 to 2021. Of 4278 patients, 33% were infants. Pneumonia and neonatal sepsis cases were 40% and 22%, respectively. Only 8% (351/4278) had blood CDST requested. Of 94% (329/351) blood CDST processed and reported, only 7% (22/329) were culture-positive, with likely contaminants being recovered from 16% (52/329) of the specimens. The duration from admission to request was 2 days (IQR: 0-5), and Further qualitative studies must be conducted to understand the reasons for low blood CDST utilisation among clinicians and the patient outcomes. Targeted interventions are required to enhance the utilisation of blood CDST by clinicians and the quality of laboratory processes.

Evaluating the impact of COVID-19 pandemic on complicated malaria admissions and outcomes in the paediatric Ho Teaching Hospital of the Volta Region of Ghana.

Since Ghana recorded its first cases of COVID-19 in early March 2020, healthcare delivery in the country has been hugely affected by the pandemic. Malaria continues to be an important public health problem in terms of morbidity and mortality among children, and it is responsible for significant hospital visits and admission. It is likely that, as with other illnesses, the COVID-19 pandemic may have impacted health seeking behaviour, hospital visits, and admissions of malaria among the paediatric population in Ghana. The aim of this study was to evaluate the impact of COVID-19 pandemic on the admissions and outcome of complicated malaria in the Ho Teaching Hospital of the Volta Region of Ghana. The medical records of children admitted for complicated malaria (cerebral and severe malaria) from 2016 to 2020, were obtained from the admission records of the children. Both demographics and clinical details were collected, and data was analysed using SPSS version 25 statistical software. The yearly differences in the trend and proportions of complicated malaria admissions were performed using rate comparison analysis and Pearson chi-square was used to assess the association between the various demographic factors and yearly admission rates. Clopper-Pearson test statistic was employed to determine the 95% confidence intervals of outcome variables of interest. The year 2020 had the lowest admission for complicated malaria (149, 11.5%; 95% CI: 9.7-13.5) but proportionally had, more cases of cerebral malaria (25, 16.8%; 95% CI: 10.9-24.8), and more deaths (6, 4.0%; 95% CI: 1.5-8.8), compared to the years under review. Children admitted in 2020 had the shortest mean stay on admission (4.34 ±2.48, p<0.001). More studies are needed to further elucidate the impact of the COVID-19 pandemic on the health of children in malaria endemic areas.

Is malaria immunity a possible protection against severe symptoms and outcomes of COVID-19?

Malaria-endemic areas of the world are noted for high morbidity and mortality from malaria. Also noted in these areas is the majority of persons in the population having acquired malaria immunity. Though this acquired malaria immunity does not prevent infection, it resists the multiplication of Plasmodium parasites, restricting disease to merely uncomplicated cases or asymptomatic infections. Does this acquired malaria immunity in endemic areas protect against other diseases, especially outbreak diseases like COVID-19? Does malaria activation of innate immunity resulting in trained or tolerance immunity contribute to protection against COVID-19? In an attempt to answer these questions, this review highlights the components of malaria and viral immunity and explores possible links with immunity against COVID-19. With malaria-endemic areas of the world having a fair share of cases of COVID-19, it is important to direct research in this area to evaluate and harness any benefits of acquired malaria immunity to help mitigate the effects of COVID-19 and any possible future outbreaks. FUNDING: None declared.