Assessing health-seeking behaviour and malaria prevention practices among communities in four districts of the Volta Region of Ghana.

BACKGROUND: Malaria is a preventable disease that causes huge morbidity and mortality in malaria-endemic areas, especially among children and pregnant women. The malaria control programme focuses on the prevention of mosquito bites using insecticide-treated nets (ITNs) and mosquito aerosol sprays and coils, as well as prevention of severe disease among those infected through prompt and adequate treatment. The success of the malaria control programme in Ghana is dependent on the malaria prevention practices of people in the community. Therefore, this study evaluated the malaria prevention practices of participants in four districts of the Volta Region of Ghana. METHODS: This was a cross-sectional study conducted in Ketu South, Nkwanta South, Hohoe Municipality and Ho West districts of the Volta Region of Ghana. Questionnaire were administered to adults who consented to each household visited. Questions were asked on the socio-demographics and malaria prevention practices of the households. Data analysis was done using SPSS version 23 with frequency distribution done for all the variables. Pearson chi-square was used to determine the significant association between socio-demographics and malaria prevention practices, and Multivariate nominal logistic regression analysis was used to model the relationship between dichotomous dependent variables (ITN ownership and usage) and independent variables. RESULTS: Out of the 2493 participants; 2234 (89.6%) owned ITN and 1528 (68.4%) used ITN a night before this study, 768 (30.8%) used mosquito aerosol spray and 368 (15%) used mosquito coil. More females significantly owned ITN than males (1293, 92.4%, p ≤ 0.001). Participants from Ketu South had 1.5 times higher odds of owning an ITN compared to Ho West whose odds are not different from Nkwanta South or Hohoe (AOR, 1.56 [95% 1.09-2.22]; p = 0.01). In terms of ITN usage, participants in Nkwanta South were less likely to use ITN compared to the other districts; AOR, 0.434 [95% CI 0.31-0.62, p < 0.001]. Also, of the 668 participants that had a fever within the past 3 days, 268 (40.1%) visited a patent medicine store and 156 (23.4%) visited health facilities. CONCLUSION: There is high ownership of ITNs, but relatively low utilization among the community members. Education on malaria prevention practices should be intensified and continuous among the population of the Volta Region to ensure the success of malaria control in the region.

Eosinophilia in school-going children with Plasmodium falciparum and helminth infections in the Volta Region of Ghana.

INTRODUCTION: eosinophilia is seen in children infected with parasitic organisms. This study aimed at evaluating eosinophilia in children infected with Plasmodium falciparum, Schistosoma haematobium and intestinal helminths in the Volta Region of Ghana. METHODS: five hundred and fifty primary school children were selected for this study from 5 primary schools in 2 districts and a municipal area of the Volta Region of Ghana. Blood, stool and urine samples were obtained and screened for P. falciparum, intestinal helminths and S. haematobium respectively. Socio-demographic information were obtained using a standardized questionnaire administration. Pearson chi square analysis was used to evaluate the association between eosinophilia and parasitic infections, and multivariate logistics regression analysis was used to identify factors independently associated with increased risk of eosinophilia. RESULTS: a total of 145(26.36%) children had eosinophilia of which 107(73.79%) were infected with P. falciparum infection, (p=0.016); 18(12.41%) with S. haematobium infection, (p=0.016); and 3(2.07%) children were infected with intestinal helminth, (p=0.36). Children infected with P. falciparum had 2 times increased risk of eosinophilia (AOR=2.01, 95% CI, [1.29-3.2], p=0.02); while children from Davanu primary school had 4 times increased risk of eosinophilia (AOR=4.3, 95% [2.41-10.10], p<0.001). CONCLUSION: there was significantly high prevalence of eosinophilia among children infected with P. falciparum infection. A longitudinal study is needed to further understand the immune response of these children to parasitic infections.

Prevalence of Polyparasitic Infection Among Primary School Children in the Volta Region of Ghana.

BACKGROUND: Polyparasitic infection is a possibility in areas where parasites are endemic, especially among children. This study looked at the prevalence of polyparasitic infections among children in the Volta Region of Ghana. METHODS: This was a cross-sectional study, among 550 primary school children (aged 6-14 years) in 3 districts in the Volta Region. Questionnaires were administered, and blood, stool, and urine samples were collected. Blood samples were screened for Plasmodium falciparum with rapid diagnostic test and microscopy, together with hemoglobin estimation. Stool and urine samples were microscopically examined using wet mount and sedimentation methods to detect intestinal parasites and Schistosoma haematobium, respectively. Pearson χ2 test was used to evaluate the association between parasitic infections and socioeconomic variables, and multivariate logistic regression to evaluate paired associations among parasites. RESULTS: The most prominent infection among the children was P. falciparum (present in 383 children [69.6%]), followed by S. haematobium (57 [10.36%]). There was low prevalence of intestinal protozoa (present in 11 children [2%]), Ascaris lumbricoides (7 [1.27%]), and hookworm (5 [0.91%]). A total of 62 children had polyparasitic infection, with P. falciparum and S. haematobium having significant paired association (both present in 46 children [74.19%]; adjusted odds ratio, 2.45; P = .007). CONCLUSION: The prevalence of polyparasitic infection was low in this study, and significant coinfection was seen with P. falciparum and S. haematobium.

Asymptomatic Plasmodium falciparum infection and poor school performance in primary school children in the Volta Region of Ghana.

BACKGROUND: This study aimed to evaluate the association between asymptomatic Plasmodium falciparum infection and poor intellectual development in primary school children in the Volta Region of Ghana. METHODS: This was a cross-sectional study conducted among children from 5 primary schools in 3 districts in the Volta region of Ghana. Questionnaires were administered, and blood samples collected for malaria investigation using Rapid diagnostic test (RDT) and microscopy. School performance was used to assess intellectual development in the children. Arithmetic was the subject of choice for the standardized test. Pearson chi square test was used to evaluate the association between Plasmodium falciparum and poor school performance. Multivariate analysis was used to identify factors independently associated with risk of poor school performance. RESULTS: Out of 550 children, 305(55.45%) tested positive for malaria with RDT and 249(45.27%) positive with microscopy. Children from the Evangelical Presbyterian (EP) primary school in Afegame had the highest prevalence of Plasmodium falciparum infection with both RDT (92, 74.80%) and microscopy (73, 59.35%). Two hundred and fifteen students (39.09%) failed the arithmetic school test. EP primary school in Afegame recorded the highest frequency of poor school performance among the children (53.66%). School performance was significantly associated with RDT malaria diagnosis with failure rate higher among children who were RDT positive (135, 62.79%, p=0.005). Lower mean scores were seen in children with positive RDT result (47.35, [SD 30.85], p=0.021). Plasmodium falciparum infection (RDT) was independently associated with increased risk of poor school performance (AOR, 1.92, p=0.003). CONCLUSION: An urgent scale-up of malaria control program targeting school-going children in this region is needed to mitigate the possible negative impact of Plasmodium falciparum infection on their intellectual development.

Anti-asthmatic property and possible mode of activity of an ethanol leaf extract of Polyscias fruticosa.

CONTEXT: Polyscias fruticosa (L.) Harms (Araliaceae) is used as a traditional remedy for asthma in Ghana. OBJECTIVE: The objective of this study is to establish the anti-asthmatic property and a possible mode of activity of an ethanol leaf extract of P. fruticosa (PFE). MATERIALS AND METHODS: The time (min) for pre-convulsive dyspnea, and time for recovery, after sensitization with 150 µg OVA and induction of bronchospasm with 1% acetylcholine or histamine in normal, and 100, 250, and 500 mg/kg PFE-treated Dunkin Hartley guinea pigs, were recorded. Atropine (0.1 mg), mepyramine (0.1 mg), and PFE (1 mg) effect on a contractile response of 2.0 × 10(-2) µg/ml acetylcholine and 5.8 × 10(-2) µg/ml histamine on the isolated guinea pig ileum was investigated. Cytological and histological studies were conducted using guinea pig peritoneal mast cells and mesenteric cells, respectively, to establish PFE effect on compound 48/80-induced mast cell degranulation. RESULTS: PFE (100-500 mg/kg) prolonged the onset of pre-convulsive dyspnea by 76.1-180.2% (p ≤ 0.01-0.001), and decreased recovery time by 71.9-78.5% (p ≤ 0.01-0.001). It also enhanced percentage protection against histamine-induced bronchospasm by 15.8-80.1-fold (p ≤ 0.05-0.01), and decreased percentage recovery time 2.5-3.3-fold (p ≤ 0.05-0.01). PFE significantly inhibited (60.4 ± 8.3%) contractile responses of histamine and produced significant inhibition (56-79%: p ≤ 0.001) of mast cell degranulation. CONCLUSION: PFE has anti-asthmatic, antihistaminic, and mast cell stabilization effect making it useful in traditional asthma management.