Poultry farming is a common practice in Ghana. Antibiotics are used, particularly in commercial poultry farming, as growth promoters and to prevent and cure infections. However, there is little information on antimicrobial usage in domestic poultry farming in Ghana. This study aimed to describe antimicrobial usage in commercial and domestic poultry farming. A cross-sectional survey was conducted within the Ashanti region of Ghana including 33 commercial farms and 130 households with domestic poultry farming. The median poultry population on commercial farms was 1500 (IQR: 300–3000) compared with 18 (IQR: 10–25) on domestic farms. The majority (97%, n = 32) of commercial farms used antimicrobials, compared with 43% (n = 56) of the domestic farms. Commercial farmers were 6.1 (CI: 3.2–11.8) times more likely to read and follow instructions on antimicrobials in comparison with domestic poultry keepers. About 11% of domestic and 34% of commercial farmers had received education on antimicrobial usage. None of the commercial farmers used herbal remedies; however, 40% (n/N = 52/130) of domestic farmers administered herbs. The misuse of antimicrobials in domestic poultry production calls for stricter regulations and training to limit the emergence and spread of antimicrobial-resistant bacteria among poultry.

Campylobacter species are one of the leading causes of gastroenteritis in humans. This review reports on the prevalence and antibiotic resistance data of Campylobacter spp. isolated from humans and food-producing animals in West Africa. A systematic search was carried out in five databases for original articles published between January 2000 and July 2021. Among 791 studies found, 38 original articles from seven (41%) out of the 17 countries in West Africa met the inclusion criteria. For studies conducted in food-producing animals, the overall pooled prevalence of Campylobacter spp. was 34% (95% CI: 25–45). The MDR prevalence was 59% (95% CI: 29–84) and half (50%, 13/26) of the animal studies had samples collected from the market. The human studies recorded a lower pooled prevalence of Campylobacter spp. (10%, 95% CI: 6–17), but a considerably higher rate of MDR prevalence (91%; 95% CI: 67–98). The majority (85%, 11/13) of the human studies took place in a hospital. Campylobacter jejuni and Campylobacter coli were the most common species isolated from both animals and humans. Our findings suggest that Campylobacter spp. is highly prevalent in West Africa. Therefore, improved farm hygiene and ‘One Health’ surveillance systems are needed to reduce transmission.

Artificial intelligence (AI) methods in hepatology have proliferated since the mid-2010s, with numerous publications and some regulatory approvals. Yet, adoption of AI methods in real-world clinical practice and clinical research remains limited. Despite clear benefits of using AI to analyse complex data types in hepatology, such as histopathology, radiology images, multi-omics and more recently, natural language patient data, there are still substantial barriers and challenges to its integration into routine clinical workflows. In this position paper, we assess limitations and propose a set of clear recommendations aimed at both the development of AI systems and the broader hepatology environment to facilitate the transition of AI-based diagnostic, prognostic, and predictive tools into clinical care. In particular, we argue that the use of AI in clinical trials, seamless integration into hospital information systems and building AI literacy among clinicians will ultimately drive clinical adoption. We validate this perspective through a Delphi consensus involving 34 international experts from hepatology, AI, and data science, ensuring a comprehensive and consensus-driven evaluation of our recommendations.

Malaria is the leading cause of morbidity in Ghana representing 40-60% of outpatient hospital attendance with about 10% ending up on admission. Microscopic examination of peripheral blood film remains the most preferred and reliable method for malaria diagnosis worldwide. But the level of skills required for microscopic examination of peripheral blood film is often lacking in Ghana. This study looked at determining the extent to which haematological parameters and demographic characteristics of patients could be used to predict malaria infection using logistic regression. The overall prevalence of malaria in the study area was determined to be 25.96%; nonetheless, 45.30% of children between the ages of 5 and 14 tested positive. The binary logistic model developed for this study identified age, haemoglobin, platelet, and lymphocyte as the most significant predictors. The sensitivity and specificity of the model were 77.4% and 75.7%, respectively, with a PPV and NPV of 52.72% and 90.51%, respectively. Similar to RDT this logistic model when used will reduce the waiting time and improve the diagnosis of malaria.

Worldwide, farm animals, in particular poultry, are an important reservoir for Campylobacter spp. However, information on Campylobacter colonization in farm animals in Africa is scarce. Hence, this cross-sectional study determined antibiotic-resistant Campylobacter from both commercial and smallholder farm animals in the Asante Akim North Municipality of Ghana. Fecal samples from poultry and livestock kept by commercial and smallholder farms were collected and analyzed using standard microbiological methods. The overall Campylobacter frequency was 20.3% (n/N = 322/1,585), and frequencies detected were similarly high in isolates from commercial (21.0%, n/N = 169/805) and smallholder (19.6%, n/N = 153/780) farms. Species isolated were C. coli (67.7%, n/N = 218/322) and C. jejuni (32.3%, n/N = 104/322). However, the frequency of C. coli was 2.1 (95% CI: 1.8–2.5) times higher than what was found for C. jejuni. Campylobacter frequencies in the rainy season was 22.2% (n/N = 258/1,160) and 15.1% (n/N = 64/425) in the dry season (prevalence ratio = 1.48, 95% CI: 1.2–1.9). About 1.7% (n/N = 6/322) of the Campylobacter isolates, all from smallholder farms, were susceptible to all antibiotics tested. Multidrug resistance was observed for 4.7% (n/N = 15/322) of the Campylobacter isolates, of which 93.3% (n/N = 14/15) occurred in isolates from commercial farms. This study highlights the need for the implementation of control programs, in commercial farming but also at the smallholder farm level, to formulate clear guidelines aimed at decreasing Campylobacter contamination of meat products and reducing the use of antibiotics in the farming sector.

Bacteremia in cirrhosis can rapidly progress to sepsis and multiorgan failure, contributing to significant morbidity and mortality. This systematic review and meta-analysis assess global trends in antimicrobial resistance (AMR) among bacterial pathogens causing bacteremia in patients with cirrhosis. We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD42024539347). Searches across PubMed, Embase, Web of Science, and Scopus were completed up to December 15, 2024. Pooled proportions and 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed with the I² statistic, and subgroup analyses were performed by region, bacterial species, and AMR type. Twenty-six studies, comprising 5610 bacteremia cases, were included. The pooled bacteremia rate was 20% (95% CI, 12%-33%), with 76% (95% CI, 64%-86%) classified as nosocomial. Escherichia coli and Staphylococcus aureus accounted for 27% (95% CI, 17%-39%) and 16% (95% CI, 12%-20%) of cases, respectively. Multidrug-resistant infections were reported in 31% (95% CI, 19%-44%), with comparable rates observed in Asia (35%; 95% CI, 22%-49%) and Europe (35%; 95% CI, 26%-45%). Methicillin-resistant S. aureus was reported in 13% (95% CI, 0%-38%) of cases in Asia and 10% (95% CI, 3%-20%) in Europe. The pooled global proportion of extended-spectrum beta-lactamase-producing E. coli was 14% (95% CI, 7%-22%), with a higher estimate in Asia (21%; 95% CI, 12%-31%). Carbapenem-resistant Enterobacteriaceae were identified in 5% (95% CI, 1%-11%) of cases. Bacteremia poses a significant global burden in cirrhosis, with geographic variability in AMR patterns. These findings highlight the urgent need for region-specific infection control, antibiotic stewardship, and enhanced AMR surveillance.