: Schistosoma haematobium continues to pose a significant public health burden despite ongoing global control efforts. One of several barriers to sustained control (and ultimately elimination) is the lack of access to highly sensitive diagnostic or screening tools that are inexpensive, rapid, and can be used at the point of sample collection. Here, we report an automated point-of-care diagnostic based on mobile phone microscopy that rapidly images and identifies S. haematobium eggs in urine samples. Parasite eggs are filtered from urine within a specialized, inexpensive cartridge that is then automatically imaged by the mobile phone microscope (the “SchistoScope”). Parasite eggs are captured at a constriction point in the tapered cartridge for easy imaging, and the automated quantification of eggs is obtained upon analysis of the images by an algorithm. We demonstrate S. haematobium egg detection with greater than 90% sensitivity and specificity using this device compared with the field gold standard of conventional filtration and microscopy. With simple sample preparation and image analysis on a mobile phone, the SchistoScope combines the diagnostic performance of conventional microscopy with the analytic performance of an expert technician. This portable device has the potential to provide rapid and quantitative diagnosis of S. haematobium to advance ongoing control efforts.

Mercury is a toxic metal with its effects on human health ranging from acute to chronic in a very short time of exposure. Artisanal and small-scale gold mining (ASGM) is the main source of direct human exposure to mercury. To access the effect of mercury exposure on the renal function and level of personal protective equipment (PPE) compliance among small-scale gold miners in Bibiani District of the Western Region of Ghana 110 consenting male gold miners were purposively recruited for this study. A structured questionnaire was used to collect socio-demographic information from the participants. Work place assessment and interviews were conducted. Urine samples were analysed for protein; blood was analysed for mercury and creatinine. Estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease-epidemiology collaboration (CKD-EPI) equation. Of the 110 participants, 61(55.5%) exceeded the occupational exposure threshold (blood mercury <5μg/L). Urine protein (41.72±68.34, P<0.0001), serum creatinine (2.24±1.19, P<0.0001) and blood mercury (18.37±10.47, P<0.0001) were significantly elevated among the exposed group compared to the non-exposed group. However, the exposed group had a significantly reduced eGFR (P<0.0001). There was a significant correlation (r=0.7338, p<0.0001) between blood mercury concentration and urine protein concentration. An increase in blood mercury correlated negatively (r = −0.8233, P<0.0001) with eGFR among the exposed group. High urine protein (P< 0.0001) and high serum creatinine (P< 0.0001) were significantly associated with increased mercury exposure. Increased mercury exposure was significantly associated with burning of amalgam (P=0.0196), sucking of excess mercury (P=0.0336), longer work duration (P=0.0314) and low educational background (P=0.0473). Small scale miners at the Bibiani work site are exposed to excess mercury. Proteinuria and reduced eGFR is common in mine workers exposed to excess mercury. We found poor PPE compliance among the study population.

Background: Adequate knowledge and proper practices coupled with knowledge of the burden of disease are necessary for the eradication of Schistosoma infection. This study assessed knowledge, attitude, and practice (KAP) as well as health outcomes related to Schistosoma haematobium infection at Kwahu Afram Plains North District (KAPND). Methods: A cross-sectional survey using a structured questionnaire was carried out among 140 participants from four local communities in KAPND in August 2021. From these participants, 10ml of urine was collected for determination of the presence of S. haematobium and urine routine examination. In addition, 4ml of blood was collected and used for haematological examination. Descriptive statistics and logistic regression analysis using IBM SPSS were used to describe and represent the data collected. Results: The study reports a gap in knowledge about schistosomiasis in the study area with the majority indicating that they have not heard of schistosomiasis (60.7%), do not know the mode of transmission (49.3%), and do not know how the disease could be spread (51.5%). The overall prevalence of urinary schistosomiasis was 52.9%. This was associated with age, occupation, perceived mode of Schistosoma transmission, knowledge of Schistosoma prevention, awareness that schistosomiasis can be treated, frequency of visits to water bodies, and water usage patterns. In multivariate analysis, factors that remained significantly associated with S. haematobium infection were age 21–40 (OR = 0.21, 95% CI: 0.06–0.76), 41–60 (OR = 0.01, 95% CI: 0.01–0.52) and ≥ 60 (OR = 0.02, 95% CI: 0.02–0.87), informal employment (OR = 0.01, 95% CI: 0.01–0.69) and awareness of transmission by drinking water from river body (OR = 0.03, 95% CI: 0.03–0.92). In Schistosoma infection, reduced haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, lymphocytes and eosinophils were observed. White blood cells, neutrophils, and monocytes were significantly elevated in infected states. Urine analysis revealed high pus cells and red blood cells counts among Schistosoma-positive participants. Conclusion: Schistosoma infection is endemic among inhabitants in KAPND, and is associated with a gap in knowledge, awareness, and practice possibly due to inadequate education in the area. Poor clinical outcomes associated with Schistosoma infection have been demonstrated in the area. A well-structured public education, nutritional intervention, and mass drug administration will be necessary to eradicate this menace.

The need to study the outcome of Antiretroviral Therapy (ART) among Human Immunodeficiency Virus (HIV) infected individuals in Ghana, a sub-Saharan African country crucial in the era of the “Treat All” policy. The aim of this study was to analyze selected determinants of immunological and virological response to ART among HIV infected individuals in a tertiary facility in Cape Coast, Ghana. An analytical cross sectional study with a retrospective component was conducted in the Cape Coast Teaching Hospital (CCTH), Central Region. Clients aged 18 years and above attending the HIV Clinics for ART and who were on ART for 6 months or more were recruited. The viral loads, CD4 count and other socio-demographic data were analyzed using STATA version 13 (STATA Corp, Texas USA). Descriptive analysis was done and presented with appropriate measures of central tendencies. In addition, bivariate and multivariate analysis was carried out with p value of 0.05 interpreted as evidence of association between variables. A total of 440 participants were included in this study with a mean age of 45.5 (±11.6) years. The mean CD4 count at baseline, 6 months on ART and currently at study recruitment were 215.1 cells/mm3 (±152.6), 386.6 cells/mm3 (±178.5), and 579.6 cells/mm3 (±203.0) respectively. After 6 months and 12 months on ART, the number who had achieved viral copies < 1000/ml were 149 (47.0%) and 368 (89.6%) respectively. There was strong evidence of an association between having CD4 count < 350 cells/mm3 after 6 months on ART and having a diagnosis of tuberculosis since HIV diagnosis (aOR 8.5, 95% CI 1.1–73.0, p = 0.05) and clients having plasma viral load > 1000 copies/ml after 6 months on ART (aOR 2.0, 95% CI 1.2–3.2, p = 0.01). There was good response to ART among clients, high virological suppression and immunological recovery hence low rates of change to second line ART regimen in this cohort studied. With strict adherence to the national policy on HIV testing, management of positive clients and full implementation of the “Treat All” policy, Ghana could achieve, if nothing at all, the third “90, 90, 90” target by 2020.

Cervical cancer (CC) continues to be a global burden, and a disease of public health interest, especially in low- and middle-income countries. This study explored the knowledge and awareness of human papillomavirus (HPV) infection and CC and the risk-behavioural characteristics of an adult female population in rural Ghana. A total of 274 women, aged 21 years and above were recruited through multi-stage sampling. A questionnaire was used to obtain data on their socio-demographic and socio-economic characteristics and assess their knowledge and awareness of HPV and CC through face-to-face interviews. In all, 187 (68.2%) participants had poor knowledge of HPV and CC with 87 (31.8%) having good knowledge. Only 18.2% and 48.9% of them had prior awareness of HPV infection and CC, respectively. Their primary source of information was the broadcast media (TV and Radio stations) (60.1%). Regarding risky lifestyle behaviours, the mean age at sexual debut was 18.52 ± 2.39 years, 82.8% have had more than one lifetime sexual partner, 81.0% were multiparous with 51.5% using oral contraceptives. Women with higher educational attainment (cOR = 0.41; 95%CI = 0.20-0.81), monthly income (cOR = 0.31; 95%CI = 0.10-1.02), and lifetime sexual partners (aOR = 0.46; 95%CI = 0.21-1.00) were less likely to have poor CC and HPV knowledge compared to their counterparts. In conclusion, adult females in the rural population have limited knowledge and awareness of HPV infection and CC with low CC screening. Intensive educational campaigns should be organised and spearheaded on multiple platforms by the Ghana Health Service and civil societies to sensitise and educate women, in the rural parts of the country, on CC and its related preventive measures.

Background. Urogenital schistosomiasis is a widely contracted parasitic helminth infection often associated with haematological abnormalities.Aim. We investigated the relationship between the haematological profile and the intensity of schistosomiasis among children in the Yeji district.Materials and Methods. A total of 100 participants comprising 50Schistosoma haematobium(S. haematobium) infected and 50 noninfected controls aged 6–17 years matched for age and sex were recruited into the study. Blood and urine samples were collected and haematological profile and presence ofS. haematobiumeggs were assessed using standard protocols.Results. Haemoglobin (HGB) (P<0.0001), haematocrit (HCT) (P<0.0001), mean cell volume (MCV) (P=0.0053), mean cell haemoglobin (MCH) (P<0.0001), and mean cell haemoglobin concentration (MCHC) (P=0.005) levels were reduced in cases compared to controls. Mixed cell percentage (MXD) (P=0.018) and red blood cell distribution width (RDW-CV) (P=0.012) were significantly elevated among cases as compared to controls. Haematuria was a clinical characteristic of heavy infection.Conclusion.S. haematobiuminfection creates an imbalance in the haematological profile. We found low HGB, HCT, MCV, MCH, and MCHC levels coupled with increased % MXD count and RDW-CV. Also, low MCV, MCH, and MCHC and high % MXD count are independently associated withS. haematobiuminfection among our study participants.