Malaria-endemic areas of the world are noted for high morbidity and mortality from malaria. Also noted in these areas is the majority of persons in the population having acquired malaria immunity. Though this acquired malaria immunity does not prevent infection, it resists the multiplication of Plasmodium parasites, restricting disease to merely uncomplicated cases or asymptomatic infections. Does this acquired malaria immunity in endemic areas protect against other diseases, especially outbreak diseases like COVID-19? Does malaria activation of innate immunity resulting in trained or tolerance immunity contribute to protection against COVID-19? In an attempt to answer these questions, this review highlights the components of malaria and viral immunity and explores possible links with immunity against COVID-19. With malaria-endemic areas of the world having a fair share of cases of COVID-19, it is important to direct research in this area to evaluate and harness any benefits of acquired malaria immunity to help mitigate the effects of COVID-19 and any possible future outbreaks.

Globally, over 40 million lives have been claimed by HIV/AIDS. In Ghana, more than 350,000 people are living with HIV. Non-disclosure of HIV status is a major barrier to HIV/AIDS eradication; yet, little is known of the determinants of HIV status disclosure in resource limited settings in Africa like Ghana. Determine the predictors of HIV status disclosure among people living with HIV (PLHIV) and stimulate policy discourse on support systems for self-disclosure in Africa. This is a descriptive cross-sectional study among PLHIV (n = 181) in sub-Saharan Africa, specifically the Volta region of Ghana. Bivariate probit regression was run to determine factors associated with HIV status disclosure among PLHIV. HIV status self-disclosure was reported by 50% of the respondents; nearly 65% disclosed their status to non-family members and non-partners. Significant correlates of HIV status disclosure either to partners or non-partners were marital status, monthly income, type of occupation, and being divorced due to HIV status (p < 0.05). HIV status disclosure remains low in Ghana like many African countries. There is the need for a renewed policy debate on tailored guidelines for HIV status self-disclosure and targeted support systems for PLHIV to ameliorate their predicaments and promote eradication of the epidemic in Africa.

Blood Culture and Drug Susceptibility Testing (CDST) remains vital for the diagnosis and management of bloodstream infections (BSIs). While the Ghana National Standard Treatment Guidelines require CDST to be performed in each case of suspected or clinically diagnosed BSI, these are poorly adhered to in the Ho Teaching Hospital (HTH). This study used secondary medical and laboratory records to describe blood CDST requests by clinicians and the quality of CDST processes for the diagnosis of BSI among patients admitted to HTH from 2019 to 2021. Of 4278 patients, 33% were infants. Pneumonia and neonatal sepsis cases were 40% and 22%, respectively. Only 8% (351/4278) had blood CDST requested. Of 94% (329/351) blood CDST processed and reported, only 7% (22/329) were culture-positive, with likely contaminants being recovered from 16% (52/329) of the specimens. The duration from admission to request was 2 days (IQR: 0–5), and Further qualitative studies must be conducted to understand the reasons for low blood CDST utilisation among clinicians and the patient outcomes. Targeted interventions are required to enhance the utilisation of blood CDST by clinicians and the quality of laboratory processes.

Operational research (OR) published in 2023 revealed low utilisation and suboptimal quality of blood culture services at a tertiary hospital in Ghana. To address these, several interventions were implemented, including sensitisation of physicians, training of laboratory staff, use of automated incubation systems, and improved availability of laboratory consumables. To assess the impact of these interventions, we conducted a follow-up study in a cross-section of inpatients (n = 1080) with suspected bloodstream infections (BSI) admitted in 2024. There were three key changes. First, there was a five-fold increase in requests for blood culture from 8% pre-OR to 40% post-OR. Culture requests were more frequent from child health department (63%) and intensive care units (53%) compared to surgery department (15%). Second, there was a reduction in delays: time from hospital admission to culture request was reduced from 2 days to 1 day, and the laboratory turn-around time was reduced from 7 days to 5 days. Third, there was a marginal improvement (p = 0.692) in the quality of blood cultures: diagnostic yield improved from 7% to 10%, and the contamination rate was reduced from 16% to 14%. Achieving universal culture utilisation among eligible patients and lowering contamination rates will require a detailed gap analysis and targeted interventions.

Background: Proliferation of non-falciparum species of plasmodium into predominant falciparum populations compromises the utility of monobiomaker based malaria Rapid Diagnostic Test (mRDT). This study evaluated the validity of a mono-biomarker based Carestart®) and Paracheck™ mRDTs in use at a Military Medical Centre in Ghana. Methodology: The study was designed to assess the validity of named mRDTs in a setting in Ghana. Blood samples collected from a consecutive series of 207 febrile patients in the months of June and July 2020, were tested for malaria parasites, using the mRDTs and microscopy as the gold standard. Prevalence, validity, and reliability metrics were determined using Frequentist, Receiver Operating Characteristics (ROC), and Kappa statistics, respectively. Results: The prevalence was 23.2% and 12.3% using microscopy and candidate mRDT, respectively. Sensitivities and specificities were 53.2% and 98.1% (Carestart®), 45.8% and 99.4% (Paracheck), respectively. Neither ROC analysis showed a significant disparity between mRDTs (Carestart®: AUROC=0.75 vs Paracheck™: AUROC=0.73), nor the reliability index showed disagreement between both mRDTs (Cronbach’s α = 0.92). But there was significant disagreement between microscopy and mRDTs (Carestart®: Kappa=0.58 vs Paracheck™: Kappa=0.55). Conclusion: The use of a monobiomaker mRDTs in this study led to a significant variation between the ‘internal’ and ‘ecological’ validity metrics. Averagely, 84% mRDT false negatives was non-falciparum. It is therefore, critical to accelerate the implementation of WHO’s recommendation to switch from mono to multiple biomarker (s)-based mRDTs for detecting both falciparum and non-falciparum species. Extended research is needed to consolidate our understanding of the dynamics of malaria among our military personnel exposed to non-falciparum plasmodium.