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Background and Aim: The COVID-19 booster dose has been cited as an important supplement for the control of the COVID-19 pandemic due to reports of waning immunity among fully vaccinated persons. Determining factors that would affect its acceptability is necessary for initiating successful vaccination programs. In this study, we aimed to evaluate the factors associated with the acceptability of the COVID-19 booster dose in Ghana. Methods: We conducted an online cross-sectional survey among the public. A self-administered questionnaire was used to collect information on demographic characteristics, willingness to vaccinate, perceptions toward COVID-19 vaccines, and trust in the government. Participants provided reasons and sources of advice that may affect their willingness to accept a booster dose. Using IBM SPSS and R Statistic; descriptive, univariate, and multivariate analyses were performed. Results: Out of 812 respondents, 375 (46.2%) intended to accept the booster dose. Individuals who were males (adjusted odds ratio [aOR] 1.63, 95% confidence interval [CI] 1.07-2.48), had previously received other forms of vaccination twice (aOR 1.96, 95% CI 1.07-3.57) or in most years (aOR 2.51, 95% CI 1.38-4.57), tested positive for COVID-19 (aOR 3.46, 95% CI 1.23-10.52), have high trust in government (aOR=1.77, 95% CI: 1.15-2.74) and had positive perceptions regarding COVID-19 vaccines (OR = 14.24, 95% CI: 9.28-22.44) were more likely to accept a booster dose. Experiencing side effects from the primer dose (aOR 0.12, 95% CI 0.08-0.18) was associated with reduced acceptance. Concerns about vaccine safety and efficacy were the common reasons impeding willingness, while advice from health professionals would be the most considered. Conclusion: Low intention to accept the booster dose which is associated with a range of factors including the perception of vaccines and trust in the government, is a cause for concern. Thus, more effort would have to be taken through education and policy interventions to increase booster vaccine acceptability.
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Reactive case detection (RACD) is the screening of household members and neighbors of index cases reported in passive surveillance. This strategy seeks asymptomatic infections and provides treatment to break transmission without testing or treating the entire population. This review discusses and highlights RACD as a recommended strategy for the detection and elimination of asymptomatic malaria as it pertains in different countries. Relevant studies published between January 2010 and September 2022 were identified mainly through PubMed and Google Scholar. Search terms included "malaria and reactive case detection", "contact tracing", "focal screening", "case investigation", "focal screen and treat". MedCalc Software was used for data analysis, and the findings from the pooled studies were analyzed using a fixed-effect model. Summary outcomes were then presented using forest plots and tables. Fifty-four (54) studies were systematically reviewed. Of these studies, 7 met the eligibility criteria based on risk of malaria infection in individuals living with an index case < 5 years old, 13 met the eligibility criteria based on risk of malaria infection in an index case household member compared with a neighbor of an index case, and 29 met the eligibility criteria based on risk of malaria infection in individuals living with index cases, and were included in the meta-analysis. Individuals living in index case households with an average risk of 2.576 (2.540-2.612) were more at risk of malaria infection and showed pooled results of high variation heterogeneity chi-square = 235.600, (p < 0.0001) I2 = 98.88 [97.87-99.89]. The pooled results showed that neighbors of index cases were 0.352 [0.301-0.412] times more likely to have a malaria infection relative to index case household members, and this result was statistically significant (p < 0.001). The identification and treatment of infectious reservoirs is critical to successful malaria elimination. Evidence to support the clustering of infections in neighborhoods, which necessitates the inclusion of neighboring households as part of the RACD strategy, was presented in this review.
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BACKGROUND: Mercury can be very toxic to human health even at low dose of exposure. Artisanal small-scale miners (ASGMs) use mercury in gold production, hence are at risk of mercury-induced organ dysfunction. AIM: We determined the association between mercury exposure, thyroid function and work-related factors among artisanal small-scale gold miners in Bibiani- Ghana. METHOD: We conveniently recruited 137 consenting male gold miners at their work site in Bibiani-Ghana, in a comparative cross-sectional study. Occupational activities and socio-demographic data of participants were collected using a questionnaire. Blood sample was analysed for total mercury and thyroid hormones. RESULTS: Overall, 58.4% (80/137) of the participants had blood mercury exceeding the occupational exposure threshold (blood mercury ≥5µg/L). T3(P<0.0001) and T4(P<0.0001) were significantly reduced among the exposed group compared to the non-exposed. TSH showed no significant variation between the exposed and non-exposed groups. Longer work duration (≥5years), gold amalgamation, gold smelting and sucking of excess mercury with the mouth were associated with increased odds of mercury exposure. Blood mercury showed negative correlation with T3(r = -0.29, P<0.0001), and T4(r = -0.69, P<0.0001) and positive correlation with work duration (r = 0.88, P<0.001). Even though a positive trend of association between blood mercury and TSH levels was recorded, it was not significant (r = 0.07, P = 0.4121). CONCLUSION: Small scale miners in Bibiani are exposed to mercury above the occupational threshold which may affect thyroid hormone levels.