Signatures of adaptation at key insecticide resistance loci in Anopheles gambiae in Southern Ghana revealed by reduced-coverage WGS.

Resistance to insecticides and adaptation to a diverse range of environments present challenges to Anopheles gambiae s.l. mosquito control efforts in sub-Saharan Africa. Whole-genome-sequencing is often employed for identifying the genomic basis underlying adaptation in Anopheles, but remains expensive for large-scale surveys. Reduced coverage whole-genome-sequencing can identify regions of the genome involved in adaptation at a lower cost, but is currently untested in Anopheles mosquitoes. Here, we use reduced coverage WGS to investigate population genetic structure and identify signatures of local adaptation in Anopheles mosquitoes across southern Ghana. In contrast to previous analyses, we find no structuring by ecoregion, with Anopheles coluzzii and Anopheles gambiae populations largely displaying the hallmarks of large, unstructured populations. However, we find signatures of selection at insecticide resistance loci that appear ubiquitous across ecoregions in An. coluzzii, and strongest in forest ecoregions in An. gambiae. Our study highlights resistance candidate genes in this region, and validates reduced coverage WGS, potentially to very low coverage levels, for population genomics and exploratory surveys for adaptation in Anopheles taxa.

Investigation of Factors Influencing Infant Mortality at Greater Accra Regional Hospital, Ghana.

Background: Annually, 5.4 million children under five face mortality, with 2.5 million deaths in the first month, 1.6 million between one and eleven months, and 1.3 million aged one to four. Despite global strides, sub-Saharan Africa, including Ghana, grapples with persistent high child mortality. This study employs statistical methods to pinpoint factors driving under-five mortality in the Greater Accra Regional Hospital. Methods: The data was acquired from Greater Accra Regional Hospital, Ghana, spanning January to December 2020. The data comprised all under-five deaths recorded in the hospital in 2020. The statistical tools employed were the chi-square test of association and the multinomial logistic regression model. Results: In 2020, there were 238 cases of under-five mortality recorded in the hospital, with males constituting the majority (55%). About 85% of these cases occurred within the first month of birth, primarily attributed to respiratory distress, prematurity, and sepsis. Notably, meconium aspiration was the least common among grouped diagnoses. The test of association and multinomial logistic model emphasised the child's age, birth type, and weight at birth as significant factors influencing child mortality. Conversely, attributes like sex, marital status, and mother's age displayed no notable association with the diagnosis of death. Conclusion: The study on child mortality at the Greater Accra Regional Hospital unveils key factors shaping child health outcomes, emphasising the role of age, birth type, and weight. While specific demographics show no significant association, identified predictors are vital for targeted interventions. Proposed strategies encompass education programs, improved care, birthing practices, and data-driven policies.

Contrasting carbon cycle along tropical forest aridity gradients in West Africa and Amazonia.

Tropical forests cover large areas of equatorial Africa and play a substantial role in the global carbon cycle. However, there has been a lack of biometric measurements to understand the forests' gross and net primary productivity (GPP, NPP) and their allocation. Here we present a detailed field assessment of the carbon budget of multiple forest sites in Africa, by monitoring 14 one-hectare plots along an aridity gradient in Ghana, West Africa. When compared with an equivalent aridity gradient in Amazonia, the studied West African forests generally had higher productivity and lower carbon use efficiency (CUE). The West African aridity gradient consistently shows the highest NPP, CUE, GPP, and autotrophic respiration at a medium-aridity site, Bobiri. Notably, NPP and GPP of the site are the highest yet reported anywhere for intact forests. Widely used data products substantially underestimate productivity when compared to biometric measurements in Amazonia and Africa. Our analysis suggests that the high productivity of the African forests is linked to their large GPP allocation to canopy and semi-deciduous characteristics.

Predictors of quality of life of TB/HIV co-infected patients in the Northern region of Ghana.

BACKGROUND: Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-morbidity continues to be a serious worldwide health issue, particularly in Sub-Saharan Africa. Studies on the quality of life (QOL) of TB/HIV co-infected patients guide stakeholders on the delivery of patient-centred healthcare. This study evaluated QOL of TB/HIV co-infected individuals and its contributing factors. METHODS: We conducted a cross-sectional study among TB/HIV co-infected patients, receiving treatment at clinics in the Northern Region of Ghana. Simple random sampling technique was used to select 213 patients from 32 clinics. We gathered information on patients' QOL using the World Health Organization QOL-HIV BREF assessment tool. At a 5% level of significance, multiple logistic regression analyses were carried out to find correlates of QOL among the patients. RESULTS: The mean age of the patients was (38.99 ± 14.00) years with most, 33.3% (71/213) aged 30-39 years. Males constituted 54.9% (117/213). About 30.0% (64/213) of the patients reported a good QOL. Being employed (aOR = 5.23, 95% CI: 1.87 - 14.60), and adhering to treatment (aOR = 6.36, 95% CI: 1.51 - 26.65) were significantly associated with a good QOL. Being depressed (aOR = 0.02, 95% CI: 0.03 - 0.29), stigmatized (aOR = 0.31, 95% CI : 0.11 - 0.84), and not exercising (aOR = 0.28, 95% CI: 0.12 - 0.67) were negatively associated with a good QOL. CONCLUSION: Less than one-third of TB/HIV co-infected patients in the region have good QOL. To guarantee good QOL, modifiable predictors such as patients' physical activity and medication adherence should be targeted by the National AIDS and TB Control Programs.

Oral health knowledge, practice and associated factors among Junior High School students of Koforidua, Ghana: a cross-sectional study.

BACKGROUND: Oral disease poses a significant public health burden for many countries and affects individuals throughout their lifetime, causing pain, disfigurement, impairment of function and reduced quality of life. Among children and adolescents globally, there is a recognized trend of poor oral hygiene, attributed to the accumulation of plaque and calculus deposits that increase with age. This study assessed the knowledge, practice and factors associated with the practice of oral hygiene among Junior High School students (JHS) in Koforidua, in the Eastern Region of Ghana. METHODS: A school-based cross-sectional study design was conducted among 233 JHS students in Koforidua township using a multistage sampling technique. Descriptive and inferential statistics, including frequency, percentage, and Pearson's Chi-square test, were conducted. The results were interpreted using tables and graphs. RESULTS: Findings from the study revealed that more than half 126 (54.1%) of the respondents had a good level of knowledge of oral hygiene. The majority 130 (55.8%) of them also had good oral hygiene practice. The findings further indicated that a significant relationship was found between the class or education level of students and good oral hygiene practice (χ2 = 17.36, p < 0.001). CONCLUSION: Overall, the current study found that over half of the JHS students had good knowledge as well as practice of oral hygiene. This reinforces the significance of oral health education and awareness campaigns, especially in school settings, to improve knowledge, attitudes, and behaviours related to oral hygiene. The study however found only class or education level of students to be statistically associated with the practice of oral hygiene. While other variables did not reach statistical significance, our research serves as a starting point for further investigation and exploration of the various factors that may contribute to oral hygiene practices.

Stakeholder opinions on perceived sub-standard emergency obstetric and newborn care in Ghana.

BACKGROUND: Sub-Saharan Africa is unlikely to achieve sustainable development goal (SDG) 3 on maternal and neonatal health due to perceived sub-standard maternal and newborn care in the region. This paper sought to explore the opinions of stakeholders on intricacies dictating sub-standard emergency obstetric and newborn care (EmONC) in health facilities in Northern Ghana. METHODS: Drawing from a qualitative study design, data were obtained from six focus group discussions (FGDs) among 42 health care providers and 27 in-depth interviews with management members, clients and care takers duly guided by the principle of data saturation. Participants were purposively selected from basic and comprehensive level facilities. Data analysis followed Braun and Clarke's qualitative thematic analysis procedure. RESULTS: Four themes and 13 sub-themes emerged as root drivers to sub-standard care. Specfically, the findings highlight centralisation of EmONC, inadequate funding, insufficient experiential training, delay in recruitment of newly trained essential staff and provider disinterest in profession. CONCLUSION: Setbacks in the training and recruitment systems in Ghana, inadequate investment in rural health coupled with extent of health provider inherent disposition to practice may be partly responsible for sub-standard obstetric care in the study area. Interventions targeting the afore-mentioned areas may reduce events of sub-standard care.

Occupational injury prevalence and predictors among small-scale sawmill workers in the Sokoban Wood Village, Kumasi, Ghana.

BACKGROUND: Sawmill workers are at increased risk of occupational injuries due to their exposure to workplace hazards. However, little is known about the burden of occupational injuries among them in Ghana. Understanding its prevalence and associated factors is necessary to design appropriate interventions to improve workers' health and safety. This study sought to determine the prevalence and factors associated with occupational injuries among small-scale sawmill workers at Sokoban Wood Village, Kumasi. METHODS: A cross-sectional study was conducted among 138 small-scale sawmill workers from December 2020 to January 2021. Data was collected on demographic and work-related characteristics including age, sex, personal protective equipment (PPE), workspace design, and lighting. The primary outcome was the prevalence of occupational injuries in the 12 months preceding the survey. Logistic regression method was used to assess for independent predictors of occupational injuries, and associations were deemed statistically significant at p < 0.05. RESULTS: Approximately 66.7% of the workers experienced occupational injuries within the 12 months preceding the study. Cuts (69.6%) were the most commonly reported injuries. Injuries were mainly caused by machine parts/sharp objects (47.8%) and being hit by logs/objects (46.8%). Only 40.7% of the workers reported always using PPE while legs (38.0%) and hands (37.0%) were the most common body parts injured. The worker's monthly income, poor workspace design and poor lighting had increased odds of occupational injuries while an increase in age was associated with a 5% decreased odds of occupational injuries. CONCLUSION: The prevalence of occupational injuries among the sawmill workers at the Sokoban Wood Village was high, and this calls for prioritization of health and safety at the workplace. Essential measures required include improvements in the safety of machine tools, workspace design and lighting.

Joined-up governance for more complementary interactions between expanding artisanal small-scale gold mining and agriculture: Insights from Ghana.

Rising gold prices have led artisanal and small-scale gold mining (ASGM) operations to proliferate in sub-Saharan Africa, extending into agricultural areas. Little is known about the interactions between agriculture and mining in these new frontiers. This study aimed to investigate the impacts of ASGM on natural and physical livelihood capitals, ASGM's interactions with agriculture at household, community and institutional levels and the drivers underpinning those interactions, and the policy implications for the co-existence of sustainable agriculture and ASGM. Alongside literature review, field-work took place in Atiwa West District and Koforidua, Ghana using environmental field surveys, questionnaires, focus group discussions and interviews. Questionnaire and field survey data were analysed using descriptive statistics, with thematic analysis of interviews and focus group data. Findings revealed that most miners were unregulated, mined irresponsibly and degraded land, waterways, and farm roads. Over one-third of farmers (38%) suffered land degradation, and 79% of affected farmers' lands were not reclaimed. Farmers diversified into ASGM, and mining proceeds boosted farming. Young farmers (18-40 years) shifted into ASGM full-time because it is more lucrative. Yet, ASGM is not replacing agriculture: cocoa farming remains a vital economic activity. Informal ASGM generates short-term income at household level for some but imposes long-term costs at community level, linked to cumulative loss of agricultural land and degradation of forest areas and water bodies, creating tensions, and increasing vulnerability. Financial hardships faced by farmers, landowners' desire to benefit directly from gold and lack of law enforcement drive informal ASGM. There are no institutional linkages between the agricultural and mining sectors. More joined up governance across agriculture and mining is needed and between formal and informal (traditional) institutions. ASGM should be incorporated into broader rural development policy reforms that support farmers, incentivise miners to operate legally and responsibly and ensure effective stakeholder engagement.

Primary caregivers' experiences of caring for people living with dementia in Ghana: a phenomenological study.

BACKGROUND: Dementia is often associated with functional impairments that limit the independence of persons living with dementia (PwD). As such, many PwD often require a higher level of support provided by persons referred to as caregivers. Such caregiving activities tend to strain and stress the caregiver. Nonetheless, Ghana lacks empirical evidence and understanding of the effects of caring for PwD on the lives of primary caregivers. To help narrow this knowledge gap, we explored the perspectives of primary caregivers about the impacts of caring for PwD in Ghana. METHODS: Using a descriptive phenomenological design, we conducted in-depth interviews with primary caregivers in the Ashanti region, Ghana. A semi-structured interview guide was used as the data collection instrument. The data analysis followed Collazi's thematic analysis framework. All coding and categorization were done in NVivo-12. RESULTS: Five themes emerged from the analysis. These themes included (a) sacrifice of personal interests, and time commitments; (b) financial strain and negative impact on job; (c) feelings of stress and burnout; (d) experience of abuse and stigma; and (e) perceived blessing of caregiving. CONCLUSION: The study's findings resonate with existing literature, highlighting the consistent struggles faced by caregivers. Sacrificing personal interests, navigating financial strains, and grappling with stress and burnout emerged as pervasive themes. We conclude that despite the negative impacts of caring for PwD, caregivers perceived their role as associated with blessings, deriving positive meaning and fulfilment from their caregiving journey. This study underscores a need to build more compassionate communities in rural settings of Ghana.

Food safety knowledge and practices among raw meat handlers and the microbial content of raw meat sold at Kumasi Abattoir Butchery Shops in Kumasi, Ghana.

BACKGROUND: Foodborne diseases affect nearly 600 million people each year, that is, one in every ten people, and their outbreaks are most common in low- and middle-income countries, particularly in Africa. This study investigated the food safety practices among raw meat handlers and the microbial quality of the meat from the butchery shops in Kumasi Abattoir, Ghana. METHODS: This study employed a descriptive cross-sectional study and collected quantitative data on factors associated with food safety and hygienic practices among raw meat handlers and the microbial quality of the raw meat using a structured questionnaire and standard laboratory methods, respectively. The study used all 50 beef vending shops in the butchery for questionnaire aspect and fresh beef samples were obtained from 10 vendors in the butchery shop. Appropriate methods were followed to analyse questionnaire data and meat samples. RESULTS: Most of the butchers (72%) were between the ages of 31 and 45, and they were predominantly Muslims (68%). Most of the respondents (48%) had basic education. All the respondents had food safety certificates from the local authority but needed adequate knowledge of meat safety. Most respondents (90%) handled meat and money with the same bare hands, thus contaminating the meat. The study showed that the maximum Total Viable Count (TVC), Total Staphylococcus Count (TSC), and Total Escherichia coli Count (TEC) were 5.60, 4.39 and 5.13 cfu/g, respectively. The study also revealed that all the meat samples were Salmonella species-free. CONCLUSIONS: Microorganisms in raw beef indicate a public health hazard. It gives a signal of a possible occurrence of food-borne intoxication and infection if not controlled. Environmental health officers in the Greater Kumasi area should organize food safety training and educate raw meat handlers on the importance of food safety and its consequences.

Unlocking gender dynamics in food and nutrition security in Ghana: assessing dietary diversity, food security, and crop diversification among cocoa household heads in the Juaboso-Bia cocoa landscape.

BACKGROUND: Malnutrition is a worldwide problem that impacts every country, affecting one in three individuals, including Ghana. According to estimates from the Food and Agriculture Organization (FAO), 690 million people were undernourished globally in 2019. Malnutrition is no exception in rural cocoa communities in Ghana. The expansion of cocoa is causing food insecurity and low dietary diversity in most cocoa-growing areas. There is little information on the food security status and dietary diversity among male-headed and female-headed cocoa households in the Juaboso-Bia cocoa landscape. Thus, this study sought to explore the dietary diversity distribution, food security status, sources of staple food, food unavailability periods, food production status, themes contributing to low dietary diversity and food insecurity, and perception of the impact of cocoa expansion on crop diversification among male-headed and female-headed cocoa households in the study area. METHODS: Both quantitative and qualitative research methods were employed to address the research questions. The study collected 200 semi-structured questionnaire data and 14 in-depth interview data from cocoa household heads in the Juaboso-Bia landscape. The survey data was cleaned and analysis, such as household dietary diversity status, food security status, and binary logistic regression were performed in the Statistical Package for Social Scientists (SPSS). The in-depth interviews were analyzed using thematic analysis. RESULTS: Through this study, it was revealed that 62.8% of the male-headed cocoa households had medium to high dietary diversity compared to their female counterparts 39.3%. About 47.9% of the male-headed households were food secure than the female-headed households (29.1%). Moreover, the months that both male and female-headed households recalled facing severe food unavailability were July and June. In addition, climate change/variability, unavailable lands, poverty, large household size, and gender stereotypes were themes promoting low dietary diversity and food insecurity among male and female-headed households. Furthermore, sex, total household income, and cropland conversion to cocoa were the variables influencing household heads' perception of the impact of cocoa expansion on crop diversification. CONCLUSIONS: The study showed that the male-headed cocoa households had high dietary diversity and were food secure than the female-headed cocoa households, lending credence to the conceptual framework applied in this study. There is a significant relationship between household head gender and food security status. Therefore, this study recommends the following interventions to improve dietary diversity and food security among male and female-headed cocoa households: raise awareness about the need for diverse diets and provide practical information on how to incorporate a greater variety of food groups into their daily meals; and promote gender equity and inclusivity in food security interventions. Future research could investigate how gender mainstreaming policies in agriculture have helped empower and improve the food security of female-headed households in Ghana.

First Molecular Detection of SARS-CoV-2 in Sewage and Wastewater in Ghana.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is shed in the stool of infected individuals and can be detected in sewage and wastewater contaminated with infected stool. This study is aimed at detecting the virus and its potential survival in sewage and wastewater in Ghana. The cross-sectional study included samples from 16 validated environmental surveillance sites in 7 regions of Ghana. A total of 354 samples composed of wastewater (280) and sewage (74) were collected from November 2020 to November 2022. Overall, 17% of the samples were positive for SARS-CoV-2 by real-time PCR, with 6% in sewage and 11% in wastewater. The highest number of positive samples was collected from the Greater Accra Region (7.3%) with the least recorded in the Bono East Region (0.6%). Further characterization of the positive samples using the next-generation sequencing (NGS) approach yielded two variants: Alpha (B.1.1.7) and Delta (AY.36). Attempts to isolate SARS-CoV-2 in the Vero cell line were not successful probably due to the low viral load concentrations (Ct values > 35) or prolonged exposure to high temperatures rendering the virus noninfectious. Our findings suggest that SARS-CoV-2 RNA in sewage and wastewater may not be infectious, but the prevalence shows that the virus persists in the communities within Ghana.

Association of Filifactor alocis and its RTX toxin gene ftxA with periodontal attachment loss, and in synergy with Aggregatibacter actinomycetemcomitans.

The Gram-positive bacterium, Filifactor alocis is an oral pathogen, and approximately 50% of known strains encode a recently identified repeat-in-toxin (RTX) protein, FtxA. By assessing a longitudinal Ghanaian study population of adolescents (10-19 years of age; mean age 13.2 years), we recently discovered a possible correlation between deep periodontal pockets measured at the two-year follow-up, presence of the ftxA gene, and a high quantity of F. alocis. To further understand the contribution of F. alocis and FtxA in periodontal disease, we used qPCR in the present study to assess the carriage loads of F. alocis and the prevalence of its ftxA gene in subgingival plaque specimens, sampled at baseline from the Ghanaian cohort (n=500). Comparing these results with the recorded clinical attachment loss (CAL) longitudinal progression data from the two-year follow up, we concluded that carriers of ftxA-positive F. alocis typically exhibited higher loads of the bacterium. Moreover, high carriage loads of F. alocis and concomitant presence of the ftxA gene were two factors that were both associated with an enhanced prevalence of CAL progression. Interestingly, CAL progression appeared to be further promoted upon the simultaneous presence of F. alocis and the non-JP2 genotype of Aggregatibacter actinomycetemcomitans. Taken together, our present findings are consistent with the notion that F. alocis and its ftxA gene promotes CAL during periodontal disease.

Modelling spatiotemporal variation in under-five malaria risk in Ghana in 2016-2021.

BACKGROUND: Ghana is among the top 10 highest malaria burden countries, with about 20,000 children dying annually, 25% of which were under five years. This study aimed to produce interactive web-based disease spatial maps and identify the high-burden malaria districts in Ghana. METHODS: The study used 2016-2021 data extracted from the routine health service nationally representative and comprehensive District Health Information Management System II (DHIMS2) implemented by the Ghana Health Service. Bayesian geospatial modelling and interactive web-based spatial disease mapping methods were employed to quantify spatial variations and clustering in malaria risk across 260 districts. For each district, the study simultaneously mapped the observed malaria counts, district name, standardized incidence rate, and predicted relative risk and their associated standard errors using interactive web-based visualization methods. RESULTS: A total of 32,659,240 malaria cases were reported among children < 5 years from 2016 to 2021. For every 10% increase in the number of children, malaria risk increased by 0.039 (log-mean 0.95, 95% credible interval = - 13.82-15.73) and for every 10% increase in the number of males, malaria risk decreased by 0.075, albeit not statistically significant (log-mean - 1.82, 95% credible interval = - 16.59-12.95). The study found substantial spatial and temporal differences in malaria risk across the 260 districts. The predicted national relative risk was 1.25 (95% credible interval = 1.23, 1.27). The malaria risk is relatively the same over the entire year. However, a slightly higher relative risk was recorded in 2019 while in 2021, residing in Keta, Abuakwa South, Jomoro, Ahafo Ano South East, Tain, Nanumba North, and Tatale Sanguli districts was associated with the highest malaria risk ranging from a relative risk of 3.00 to 4.83. The district-level spatial patterns of malaria risks changed over time. CONCLUSION: This study identified high malaria risk districts in Ghana where urgent and targeted control efforts are required. Noticeable changes were also observed in malaria risk for certain districts over some periods in the study. The findings provide an effective, actionable tool to arm policymakers and programme managers in their efforts to reduce malaria risk and its associated morbidity and mortality in line with the Sustainable Development Goals (SDG) 3.2 for limited public health resource settings, where universal intervention across all districts is practically impossible.

Undiagnosed and uncontrolled hypertension in rural African adults: a scoping review protocol of primary health care interventions.

INTRODUCTION: Non-communicable diseases cause 74% of global deaths, with cardiovascular diseases as the major contributor. Hypertension, a primary risk factor for cardiovascular disease, is highly prevalent in Africa. Diagnosis, treatment and control rates are notably limited in rural areas. This limitation results in increased risks of premature mortality and complications such as stroke due to socioeconomic, cultural and geographical challenges. Progress in African countries enhancing hypertension services through primary health care interventions exists. However, a comprehensive review of all primary health care interventions addressing undiagnosed and uncontrolled hypertension in rural African settings is lacking. This scoping review aims to categorise primary health care interventions targeting undiagnosed and uncontrolled hypertension in rural African adults. Intervention components will be mapped to the four stages outlined in the hypertension care cascade to develop a pilot intervention logic model for rural African adults with hypertension. METHOD AND ANALYSIS: The scoping review protocol will adhere to the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Studies considered for inclusion will include any intervention delivered by any healthcare provider in a rural African primary care setting targeting any stage of hypertension care. Eight databases will be searched without date restrictions, supplemented by grey literature and reference list searches. A two-stage screening process (title/abstract and full text) will determine evidence source eligibility. All eligible sources of evidence will be extracted, charted and evaluated using the Template for Intervention Description and Replication checklist. A pilot logic model categorising and mapping interventions to the four stages of the hypertension care cascade will be visually presented and analysed using narrative synthesis. ETHICS AND DISSEMINATION: No primary data will be collected; therefore, ethics approval is not required. Findings will be disseminated to local health authorities in Ghana and other African Regions and through national and international conferences and publications in peer-reviewed journals.

Agricultural education in Africa using YouTube multilingual animations: A retrospective feasibility study assessing costs to reach language-diverse populations.

There is a critical need for widespread information dissemination of agricultural best practices in Africa. Literacy, language and resource barriers often impede such information dissemination. Culturally and linguistically localized, computer-animated training videos placed on YouTube and promoted through paid advertising is a potential tool to help overcome these barriers. The goal of this study is to assess the feasibility of reaching language-diverse populations in Africa using this new type of information dissemination channel. As a case study, cost estimates were obtained for YouTube ad campaigns of a video to prevent post-harvest loss through safe food storage using sanitized jerrycan containers. Seventy-three video variants were created for the most common 16 languages in Ghana, 35 languages in Kenya, and 22 languages in Nigeria. Using these videos, campaigns were deployed country wide or focused on zones of influence that represent economically underdeveloped regions known to produce beans suitable for jerrycan storage. Using data collected from YouTube ad campaigns, language-specific models were created for each country to estimate how many viewers could be reached per US dollar spent. Separate models were created to estimate the number of viewers who watched 25% and 75% of the video (most of video without end credits), reflecting different levels of engagement. For language campaigns with both country wide and zone of influence areas of deployment, separate region-specific models were created. Models showed that the estimated number of viewers per dollar spent varied considerably amongst countries and languages. On average, the expected number of viewers per dollar spent were 1.8 (Range = 0.2-7.3) for 25% watched and 0.8 (Range = 0.1-3.2) for 75% watched in Ghana, 1.2 (0.2-4.8) for 25% watched and 0.5 (Range = 0.1-2.0) for 75% watched in Kenya, and 0.4 (Range = 0.2-1.3) for 25% watched and 0.2 (Range = 0.1-0.5) for 75% watched in Nigeria. English versions of the video were the most cost-effective in reaching viewers in Ghana and Nigeria. In Kenya, English language campaigns ranked 28 (country wide) and 36 (zones of influence) out of 37 analyzed campaigns. Results also showed that many local language campaigns performed well, opening the possibility that targeted knowledge dissemination on topics of importance to local populations, is potentially cost effective. In addition, such targeted information dissemination appears feasible, even during regional and global crises when in-person training may not be possible. In summary, leveraging multilingual computer-animations and digital platforms such as YouTube shows promise for conducting large-scale agricultural education campaigns. The findings of the current study provides the justification to pursue a more rigorous prospective study to verify the efficacy of knowledge exchange and societal impact through this form of information dissemination channel.

Purpose in life, loneliness and depression among patients with substance use disorders in the psychiatric hospitals in Ghana.

Substance use disorder is a global mental health issue. Purpose in life, Loneliness and depression are key indicators of poor mental health, and people with substance use disorder are more likely to experience low purpose in life, depression, and loneliness. This study aims to further the understanding of purpose in life, depression and loneliness among substance use disorders (SUD) patients in three hospitals in Ghana. It uses a cross-sectional survey design. A total of 425 SUD inpatients were screened. Beck Depression Inventory-II, the revised UCLA Loneliness Scale, and the Purpose in Life Test were utilised to measure depression, loneliness, and purpose in life respectively. Data were analysed using the SPSS version 23 for Windows. Data from 378 participants were collected for this study using a cross sectional survey design; after data cleaning, frequency tables (for categorical variables) and descriptive statistics (for continuous variables) were used to summarise the demographics and the three outcome variables depression, purpose in life, and loneliness. Our findings indicate that overall, participants are more likely to experience low sense of purpose in life, depression, and loneliness compared to the general population. There was no statistically significant relationship between depression and loneliness (r = 0.030, p = 0.567). There was a statistically significant negative relationship between depression and purpose in life (r = -0.514, p < 0.001). There was a statistically significant positive relationship between purpose in life and loneliness (r = 0.147, p = 0.004). There was no gender difference in depression, purpose in life, and loneliness among SUDs patients in psychiatric hospitals. There were no significant differences in purpose in life, depression and loneliness based on marital status. It is anticipated that the findings of this study will inform policies and clinical practice regarding service provision for patients with SUDs.

Expression of RAS and RAB interactor 1 (RIN1) in head and neck tumors at selected hospital in Ghana.

BACKGROUND: Head and neck tumors (HNT) are tumors of the paranasal sinuses, the salivary glands and the upper aerodigestive tract. RIN1 is a Ras effector protein regulating epithelial cell properties and has been implicated in a number of cancers. METHOD: The aim of this study was to investigate the expression of RIN1 in head and neck tumors. RIN1 expression was assessed using quantitative real-time PCR (qRT-PCR) and immunohistochemical staining on archival head and neck tissue samples between 2014 and 2020. RESULTS: RIN1 expression was low in tissue samples as compared with the normal head and neck tissues. High and low RIN1 levels were compared with ages ≤40, >40 in the head and neck tumors of p-value 0.02. There was a significant difference with p-values of 0.001 when poor and well-moderate malignant tumors were compared. CONCLUSION: Our data suggests that RIN1may play an important role in head and neck tumor progression and that its expression may provide baseline data to facilitate identification of new molecular targeted therapeutics.

Sex-related inequalities in crude and age-standardized suicide rates: trends in Ghana from 2000 to 2019.

BACKGROUND: Suicide represents a major public health concern, affecting a significant portion of individuals. However, there remains a gap in understanding the age and sex disparities in the occurrence of suicide. Therefore, this study aimed to investigate the sex-related inequalities in suicide rates in Ghana from 2000 to 2019. METHODS: We utilized data from the WHO Health Equity Assessment Toolkit (HEAT) online software. We analysed sex differences in both crude and age-standardized suicide rates in Ghana spanning from 2000 to 2019. Crude and age-adjusted suicide rates were calculated based on the International Classification of Diseases (ICD) definition and coding of suicide mortality. We measured inequality in terms of sex. Two inequality indicators were used to examine the suicide rates: the difference (D) and the ratio (R). RESULTS: Age-standardized and crude suicide rates in Ghana were higher among men from 2000 to 2019. Between 2000 and 2007, the age-standardized suicide rate for women rose steadily and declined slightly between 2008 and 2019. Age-standardized suicide rates for men increased consistently from 2000 to 2010, then declined steadily from 2011 to 2019. The crude suicide rates among men and women followed similar patterns. The widest absolute inequality in crude suicide rates (D) was recorded in 2013 (D=-11.91), while the smallest difference was observed in 2000 (D=-7.16). We also found the greatest disparity in age-standardized rates in 2011 (D=-21.46) and the least in 2000 (D=-14.32). The crude suicide rates increased with age for both men and women aged 15-54 years and 55-85+ years respectively. However, the increased rate was higher in men than in women across all age groups surveyed. A similar pattern was observed for relative inequality in both crude and age-standardized rates of suicide. CONCLUSION: The suicide rate in Ghana has declined over time. Suicide is more common among older men. Inequalities in suicide rates, in both absolute and relative terms, are similar. There is a need to monitor suicide trends in Ghana, especially among older men. Moreover, the findings could serve as a basis for future studies on suicide in Ghana.

Moderated moderation modelling of subjective social status, pocket money and depressive symptoms of university students in Ghana.

Introduction: Although the relationship between subjective social status and depression in university students has been well-established, this association could be seen as a spurious one. Previous studies have shown that key variables like financial resources and age could play key roles in explaining the variances in social status and mental health outcomes. In this research, we assessed the complex interrelationships between subjective social status, financial resources at their disposal and depressive symptoms among university students within their young and middle adulthood stages. Methods: A cross-sectional survey was conducted in a university in Ghana to sample 1134 university students through accidental sampling. The McArthur Scale and WHO-5 Well-being measure were used for the data collection. Results: The results revealed that higher levels of subjective social status were associated with lower levels of depression. It was further found that the interaction between students' pocket money and age played unique roles in the relationship between subjective social status and depression. Conclusion: The study findings call on stakeholders in education to explore funding opportunities and to examine ways of empowering parents (financially) to adequately support the students. Health educationists and promoters, including psychologists, school counsellors and parents could compliment these efforts by helping to train and empower students through self-regulation or management skills to help improve their well-being. Continuous efforts are required to improve the financial status and mental health of students.