Point-of-care circulating cathodic antigen positivity and associated factors in school children one year after mass praziquantel administration in an endemic district in Ghana.

Background: Mass drug administration of praziquantel is expected to reduce Schistosome carriage in treated children in endemic communities. However, the effectiveness of this annual exercise has not been assessed in Ghana. Therefore, this study aimed to detect viable Schistosoma mansoni infection using point-of-care circulating cathodic antigen (POC-CCA) positivity as proxy and associated factors in children previously treated with praziquantel in an endemic municipality in Ghana. Materials and methods: This cross-sectional study was done in the Assin Central municipality in the Central Region of Ghana. School children, less than 16 years of age, treated with 40 mg/kg of praziquantel (treatment period: February-March 2019), provided early morning urine (∼40 mL) and stool (∼4 g) samples. Immediately, POC-CCA (ICT International, South Africa) was done, while S. mansoni ova were detected in formalin fixed samples using microscopy later. Additionally, participant's socio-demographic information and factors associated with S, mansoni infection transmission were collected from each child. Results: A total of 520 children participated in the study (males-51.9%, majority age range [9-11 years, 34.4%]). Overall, 244 (46.9%) were positive for urinary CCA with no S. mansoni detected by microscopy. POC-CCA positivity was higher in females (48.4%), children with 2-3 siblings (49.3%), children aged 6-8-year range (55.4%) and residents of Brofoyedur (52%). However, age (x2 = 16.1, p = 0.0003) and town of residence (x2 = 11.7, p = 0.019) associated with CCA positivity. Further, location of water body (x2 = 16.4, p = 0.008), frequency of water contact (x2 = 12.3, p = 0.015) and handling of the Biomphalaria intermediate host (x2 = 5.1, p = 0.024) associated with POC-CCA outcome. Conclusion: About 47% of the school children were positive for CCA, one year after mass praziquantel administration in the Assin Central municipality. Varied factors associated with the post-praziquantel administration POC-CCA positivity. This study should be replicated in other endemic areas to identify groups at risk of parasite persistence or reinfection to inform modification of control and preventive measures.

Determination of aflatoxin levels in bokina beverage.

Objective: The main aim of this study was to investigate levels of total aflatoxin and aflatoxin M1 in bokina, a home-made non-alcoholic beverage prepared from dairy milk, millet and sugar. Methods: Bokina, dairy milk and millet were purchased monthly over a period of 7 months from bokina producers at Ashaiman and Nima, in Ghana. Total aflatoxin and aflatoxin M1 levels in these samples were measured using a fluorometric procedure and High-Performance Liquid Chromatography. Results: Aflatoxin levels in bokina samples ranged from 1.0 to 21.0 ppb for Ashaiman samples and 1.0 to 23.0 ppb for Nima samples. Out of 21 samples from each site 1 from Ashiaman and 2 from Nima had levels total aflatoxin above the acceptable limit of 20 ppb. Similarly, total aflatoxin levels millet samples ranged from 1.0 to 55.0 ppb for Ashaiman and 5.0 to 53.0 ppb for Nima samples, with 2 samples from Ashiaman and 6 from Nima having levels above 20ppb. The levels of Aflatoxin M1 in milk ranged from 0.09 to 6.20 ppb for Ashaiman samples and 0.13 to 12.55 ppb for Nima samples. Out of the samples, 12 from Ashiaman and 10 from Nima (n=21) had levels of Aflatoxin M1 above the acceptable limit of 0.5 ppb. Conclusion: Bokina samples tested were contaminated with aflatoxin. All doses of aflatoxin have a cumulative effect on the risk of cancer. Therefore, farmers and bokina producers must be educated on good storage practices and monitored to protect the public from aflatoxin exposure and toxicity. Funding: The study was self-funded.