Prevalence and risk factors of human Balantidium coli infection and its association with haematological and biochemical parameters in Ga West Municipality, Ghana.

BACKGROUND: In Ghana, Balantidium coli (B. coli) has been identified in vegetables and in pigs, although there is a paucity of data regarding human balantidiosis. This study sought to assess human B. coli infection in Ghana, factors associated with the infection as well as its association with haematological and biochemical parameters. METHODS: Two pig rearing communities in the Ga West Municipality, Ghana, were involved in this study. Stool and blood samples were collected from pig farmers and their exposed household members as well as relevant information on potential associated factors. Eosin-saline wet preparation was done on the same day of stool samples were collected while formol ether concentration technique was performed later. Haematological, biochemical parameters and serum electrolytes were determined using Celltac MEK-6500 K, PKL-125 biochemical analyser, and FT-320 electrolyte analyser, respectively. RESULTS: The overall prevalence of balantidiosis was 10.4 %, significantly higher among farmers (21.7 %) than in exposed household members (5.8 %) (x2 = 17.8, p = 0.000025). Of the 43 infected individuals, 20.9 % were co-infected with either Entamoeba histolytica, Giardia lamblia, or Schistosoma mansoni. In B. coli infection, mild to moderate anaemia together with a reduction in levels of platelet, albumin and, sodium, chloride, and bicarbonate ions were observed. However, white blood cells were significantly elevated in infected states. Poor farming practices such as free-range systems, improper disposal of pig faeces, lack of use of protective farming clothing, and unavailability of dedicated farming clothing were found to be associated with B. coli infection status. Finally, frequent diarrhea (OR = 12.30, p = 0.006) with occult blood (OR = 25.94, p < 0.0001) were found to be predictors of B. coli infection. CONCLUSIONS: Human balantidiosis is endemic in Ga West Municipality, Ghana. Individuals living closed to pig rearing communities presenting with frequent diarrhea with occult blood in stool should be screened and treated for balantidiosis to mitigate the clinical consequences of the infection.

Leptin, resistin and visfatin as useful predictors of gestational diabetes mellitus.

BACKGROUND: Lipids and adipokines including leptin, resistin and visfatin play various roles in the pathophysiology of Gestational Diabetes Mellitus (GDM). This study was aimed at determining whether serum leptin, resistin and visfatin are significantly altered during the first trimester of pregnancies that subsequently develop GDM and whether such changes are useful in predicting the disease. METHODS: This was a case-case control study which compared first trimester biochemical and anthropometric parameters in 70 pregnant women who subsequently developed GDM and 70 pregnant women without GDM at the Volta Regional Hospital, Ho, Ghana. Lipid profile and some selected adipokines were analyzed and first trimester body mass index (BMI) was determined. RESULTS: There were significant differences (p < 0.05) in leptin, resistin, and visfatin as well as significant dyslipidemia among those with GDM compared to those without GDM. Furthermore, the area under the Receiver Operating Characteristic Curves (AUCs) for leptin, resistin and visfatin were; 0.812, 0.836 and 0.799 respectively. Increased first trimester leptin (OR = 1.166; CI = 1.104-1.233; p < 0.0001), resistin (p < 0.0001) and visfatin (p < 0.0001) were associated with GDM. CONCLUSION: Hyperleptinemia, hyperesistinemia and hypervisfatinemia precede GDM and can serve as good predictive indices for gestational diabetes mellitus.

Survey of knowledge, and attitudes to storage practices preempting the occurrence of filamentous fungi and mycotoxins in some Ghanaian staple foods and processed products.

Mycotoxigenic fungi can infect and produce potent mycotoxins in foodstuffs prior to harvest, during harvest (field fungi), and in storage after harvest (storage fungi), which when ingested, can result in adverse health effects. This study was aimed at assessing the knowledge, attitudes, and practices adopted by the Ghanaian populace to help mitigate the occurrence of molds and mycotoxins in foods. A cross-sectional survey involving a structured questionnaire was conducted with 642 respondents from twelve regions of Ghana. Descriptive statistics and analyses of variance were calculated. Correct Classification Rate (CCR) was measured to assess the utility of a logistic regression model. The results of the study showed that the majority of 299 (46.6%) of the respondents were between the ages of 18-25. Age and educational level were related to knowledge about the occurrence of fungi and mycotoxins in foods (p < 0.05). More than half the respondents, 50% indicated that they knew of aflatoxins as a major mycotoxin present in food. Higher education directly influenced on the knowledge of mycotoxicosis and the management of stored food to present intoxication by fungal metabolites. 502 (32.9%) knew that consuming foods with toxins could cause stomach aches. The most commonly consumed food commodity despite the presence of visible growth of fungi was bread (35.3%). The average KAP score for knowledge showed that, out of 100%, there was adequate knowledge (63.8%) among the members of the Ghanaian populace. Favorable environmental conditions of high humidity (> 85% ERH) and temperature (> 28-32 °C) enhance the proliferation of fungi in most foods and the attendant production of mycotoxins such as aflatoxins, ochratoxins, and fumonisins are associated with several severe human and animal health conditions; mycotoxicosis was associated with high fever, pain, vomiting, suppression of immunity, cancer, etc. when these foods are consumed on regular basis for a prolonged length of time. Future examination of the food items used for the School Feeding Programme in Ghana will offer opportunities to examine the risks of feeding youth with fungal-contaminated food preparations from providers.

Amyand's hernia- outcome of nylon darn repairs after complicated appendix surgeries in a district hospital: case series.

INTRODUCTION: Complicated appendix is a least expected sac content of inguinal hernias that always require appendix surgery and hernia repair. The current recommendations for posterior wall repairs however, continue to attract conflicting views as to which modality gives the best outcome in infected surgical wounds. New posterior wall repair methods with properties to withstand surgical site infections, minimise hernia recurrence, affordable and easy skill to acquire with a potential to be widely adopted are continuosly sort. AIM: To determine the surgical outcomes of complicated Amyand Hernias repaired using the open tissue base Nylon Darn posterior wall re-enforcement method. METHOD: A retrospective review of medical records of patients who had surgery for emergency inguinal hernia with intra-operative confirmation of complicated appendix in the hernia sac from January 2015 to December 2020 at the Margaret Marquart Catholic Hospital, Kpando were included. Data on age, sex, clinical presentation, surgical procedure, intra-operative findings, post operative complications were captured and presented as descriptive statistics. RESULTS: Twelve out of 286(4.6%) repairs were complicated Amyand Hernias in patients aged 6weeks to 76-years{median age 54.5-years}. Most of them were adults, long-standing hernias. All diagnosis were made on-table. Surgical site infections was the most frequent complication in types III and IV AHs which resolved with antibiotic treatment. CONCLUSION: The incidence of complicated AHs is higher and should be anticipated in surgeries for long-standing complicated inguinal hernias. Even though complications were significantly associated with longer hospital stay, no second procedure or mortality was recorded.

Serum adipocytokines and adiposity as predictive indices of preeclampsia.

BACKGROUND: This study was aimed at determining the levels of serum adiponectin, leptin, resistin, visfatin and lipids during the first trimester in pregnant women and to evaluate the relationship between these biochemical markers and preeclampsia (PE). Available evidence point to changes in the levels of these adipokines in PE hence this study examined the potential of using these biomarkers in the prediction of the disease. METHODS: This was a case-control study which compared first trimester serum biochemical and anthropometric parameters in pregnant women who subsequently developed PE and those who did not. Blood pressure and urine protein were determined after 20 weeks of gestation and diagnosis of PE performed according to the guidelines of the American Heart Association. RESULTS: There was no significant difference (p > 0.05) in the lipid profile with the exception of HDL cholesterol which was significantly lower (p = 0.043) in the PE group compared to the normotensive group. There were, however, significant differences (p <  0.05) in the adipokines between the PE group and those without PE. Analyses of area under the receiver operating characteristic curves (AUCs) for the adipokines, showed their ability to correctly predict PE even after controlling for body mass index (BMI) and family history of hypertension. CONCLUSION: Adiponectin, leptin, resistin and visfatin were found to be significant predictors of PE, with resistin being the best predictor after controlling for BMI. However, adiponectin was the best predictor after controlling for BMI, age, parity and family history of diabetes and preeclmapsia.

Survival pattern of first accident among commercial drivers in the Greater Accra Region of Ghana.

In this study, the average accident risk of commercial drivers in the Greater Accra region of Ghana and its associated risks were examined based on a survey data collected using paper-based questionnaires from 204 commercial drivers from the Greater Accra Region of Ghana. The Cox Proportional Hazards Model was used for multivariate analysis while the Kaplan-Meier (KM) Model was used to study the survival patterns of the commercial drivers. The study revealed that the median survival time for an accident to happen is 2.50 years. Good roads provided a better chance of survival than bad roads and experienced drivers have a better chance of survival than the inexperienced drivers. Age of driver, alcohol usage of driver, marital status, condition of road and duration of driver's license were found to be related to the risk of accident.