Hepatitis E seroprevalence and risk factors in humans and pig in Ghana.

BACKGROUND: Although Hepatitis E virus (HEV) infection has significant negative impact on the health and wellbeing of underprivileged populations, the burden of HEV in Ghana is still unclear, despite widespread water, sanitation, and hygiene (WASH) related conditions that predispose people to the risk of infection. METHODS: A cross-sectional study was conducted to explore rates of HEV seroprevalence and HEV prevalence, as well as risk factors in humans and domestic pigs in Ghana. These were determined using ELISAs manufactured by Wantai Beijing Biopharmaceuticals, China. The study involved 1365 community members, 105 pig farmers and 474 domestic pigs from four administrative regions of Ghana. RESULTS: Results showed overall seroprevalence and prevalence of 12.4% and 0.7% in community members and 15.2% and 2.9% in pig farmers respectively. There was no significant difference in the seroprevalence between the two groups (Z = 0.851; p = 0.3953). However, the prevalence in pig farmers was significantly higher than in community members (Z = 2.412; p = 0.016). Age (OR = 1.369, CI = 1.243 - 1.508; p = 0.0000), gender (OR = 1.419, CI = 1.101 - 1.991; p = 0.043), and the region of residence (OR = 1.569, CI = 1.348 - 1.827; p = 0.0000) were significant risk factors for HEV seroprevalence in a multivariate regression model. In pigs, overall seroprevalence and prevalence of 62.4% and 5.5% were recorded respectively. A significant difference in seroprevalence was found between confined (6.7%) and free-range pigs (88.3%), (Z = 7.492; p < 0.00001) in the Volta Region. Multivariate logistic regression showed a significant association between seroprevalence and husbandry (OR = 7.051, CI = 3.558- 13.972; p = 0.0000) and region (OR = 4.602, CI = 2.300 - 9.205; p = 0.0000) in pigs in the Volta and Greater Accra Region. CONCLUSION: From this study, HEV is endemic in Ghana with high seroprevalence in humans and pig populations. This underscores the need for awareness creation and action for prevention and control.

Hepatitis E in Sub Saharan Africa - A significant emerging disease.

Hepatitis E is an emerging endemic disease found across the African continent, but there are clear differences in epidemiology between North Africa and countries south of the Sahara. In this systematic review, Google scholar and PubMed databases were searched for peer-reviewed articles on HEV epidemiology. Publications meeting our inclusion criteria were critically reviewed to extract consistent findings and identify knowledge gaps. Hepatitis E has been reported in 25 of the 49 countries in Sub Saharan Africa. Mortality rates of 1-2% in the general population and ~ 20% in pregnant women. Outbreaks were closely linked to refugees and Internally Displaced Persons in camps which accounted for 50% of reported outbreaks. There was very little research and concrete evidence for sources of contamination and transmission routes. There are indications of zoonotic transmission of Hepatitis E Virus infection but further research in these fields is required.

Integrated value-chain and risk assessment of Pig-Related Zoonoses in Ghana.

The marked increase in the pig-trade in Ghana has raised concerns about increased transmission of related zoonotic diseases. A study on pig-related zoonoses along the pork value-chain was conducted in Greater Accra and Upper East Regions of Ghana. Results showed significant taenia (60%) and trichinella (8%) seroprevalence in pigs in Upper East with little evidence of transmission to humans. Sero-prevalence of HEV was high in both pigs (85%) and humans (37%). Sero-prevalence rates were significantly higher in Upper East than Greater Accra. Pig handlers in Accra had significantly higher sero-prevalence rates (58%) than other community members (18%) but there was no such association in the Upper East. Given the high rates of mortality, miscarriage and stillbirth associated with HEV in pregnancy, it is a cause for concern that 31% women of child-bearing age tested sero-positive for HEV.

Patterns of passage into protected areas: Drivers and outcomes of Fulani immigration, settlement and integration into the Kachia Grazing Reserve, northwest Nigeria.

Increasing land use and associated competition for natural resources in the wake of high human and livestock population pressures have been major challenges confronting pastoralists of West Africa. This is especially true in Nigeria where Fulani make up 4% of the national population and prevailing national insecurity issues are impacting on pastoral livelihoods, including violent conflicts over land and ethnic, religious and political disparities. This study examined the dynamics of immigration within the Kachia Grazing Reserve (KGR), an exclusively Fulani pastoralist community in Kaduna State, northwest Nigeria, prompted by concerns from both the farming communities and the authorities about mounting pressure on existing limited resources, particularly in regard to availability of cattle grazing resources. Drawing from a household census conducted in 2011 and employing a range of qualitative methods (focus group discussions and key informant interviews), this study explored the drivers and consequences of immigration and subsequent integration within the KGR community. The study revealed two types of immigration: a steady trickle of pastoralists migrating to the reserve to settle and acquire land, secure from the stresses of competition from cultivators, and the sudden influx of internally displaced persons fleeing violent clashes in their areas of origin. Population pressure within the reserve has risen steadily over the past three decades, such that it is severely overgrazed (as evidenced by reports from the KGR community that the animals run short of pasture even during the wet season due to desertification and the spread of non-edible weeds). The newer immigrants, fleeing conflict, tended to arrive in the reserve with significantly larger herds than those kept by established residents. Pastoralists in the reserve have been forced back into the practice of seasonal transhumance in both wet and dry seasons to support their herds, with all the attendant risks of theft, clashes with cultivators and increased disease transmission.