: Filarial lymphedema (LE) remains a significant global problem despite the progress made toward elimination of lymphatic filariasis (LF). In Ghana, the main approach to LF is preventive chemotherapy, but this has minimal impact on individuals who have already developed LE. In 2018–2020, a 24-month randomized, double-blind, placebo-controlled trial was conducted to evaluate the efficacy of stringent hygiene measures using the Essential Package of Care with or without additional administration of doxycycline (DOX) to improve filarial leg LE. This study enrolled 356 participants with LE stages 1–3 from two districts in the Upper East Region of Ghana. In addition to regular training on appropriate care for their affected legs, participants were randomized to receive 6 weeks of either 200 mg/day DOX (n = 117), 100 mg/day DOX (n = 120), or matching placebo (n = 119). Participants were seen every 2 months, with clinical measurements done at 6, 12, 18, and 24 months to assess the status of affected legs. There was a trend toward later appearance of acute attacks after DOX, but surprisingly, DOX showed no effect on LE stage progression. In all groups, leg LE improvement was more common (DOX 200 mg: n = 23 [20%]; DOX 100 mg: n = 23 [19.5%]; placebo: n = 32 [27.4%]) than LE worsening (DOX 200 mg: n = 2 [1.7%]; DOX 100 mg: n = 3 [2.5%]; placebo: n = 2 [1.7%]). Overall, these data show a strong benefit from adherence to a strict hygiene protocol, with some added potential benefit for DOX in preventing acute attacks.

Background. Health care workers (HCWs) constantly stand at a high risk of exposure to the hepatitis B virus because of the nature of their work. Hence, it is mandatory for HCWs to undergo hepatitis B vaccination. However, most HCWs in Ghana do not check their HBsAb titre after completion of their primary vaccination. This study assessed the prevalence of HBsAg and the seroconversion rate among vaccinated health care workers in the Ashanti Region, Ghana. Materials and Methods. A semistructured open-ended questionnaire was pretested and administered to 424 HCWs. Two (2) ml of blood was drawn and qualitative analyses (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb) were done on the blood samples. Samples that tested positive to HBsAb were quantified using ELISA. Data obtained were analysed using GraphPad Prism 9. Results. Out of the 424 study participants, 271 (63.9) were females and 153 (36.1) were males. Seroconversion (1mIU/mL) and seroprotection (10mIU/mL) through vaccination only among study participants were 67.5 (n/N=286/424) and 58.0 (n/N=246/424), respectively. Prevalence of hepatitis B viral infection was 2.4 (n/N=10/424). Anti-HBc seropositivity was 13.2, and anti-HBs seronegativity was 24.1. 2.4 (n/N=10/424) of study participants were negative to HBsAg but positive to HBcAb. In addition, 8.5 (n/N=36/424) of the study participants were seroprotected due to exposure and recovery from previous HBV infection. Age, the number of doses received, taking a booster dose, and keeping a vaccination record card were significant factors influencing seroconversion status. Conclusion. This study reaffirms the need for HCWs to undergo a supervised primary hepatitis B vaccination course. Postvaccination serological testing should be done for all HWCs to confirm immunity and reduce their chances of contracting HBV infection.

Background: As part of efforts to reach the elimination target by 2030, the WHO and CDC recommend that all HCWs adhere to the three‐dose Hepatitis B vaccination schedule to protect themselves against the infection. This study assessed Hepatitis B vaccination coverage and associated factors among personnel working in health facilities in Kumasi, Ashanti Region, Ghana.Materials and Methods: A cross‐sectional study involving 530 HCWs was conducted in four hospitals in Kumasi from September to November 2023. An investigator‐administered questionnaire was employed in gathering participant demographics and other information related to vaccination coverage. IBM SPSS Version 26.0 and GraphPad Prism 8.0 were used for analysing the data.Results: Even though the majority (70.6%) reported having taken at least one dose of the vaccine, only 43.6% were fully vaccinated (≥ 3 doses). More than a quarter (29.4%) had not taken any dose of the HBV vaccine. Close to a quarter (23.6%) had not screened or tested for HBV infection in their lifetime. The statistically significant variables influencing vaccination status were age, marital status, profession, and status in the hospital. Nearly one‐half (44.9%) of the participants who have not taken the vaccine reported they do not have a reason for not taking it, and a high proportion (80.1%) were willing to take the vaccine when given for free.Conclusion: To combat the low Hepatitis B vaccination coverage among healthcare workers in Kumasi, Ghana, amidst the significant public health threat of HBV infection, comprehensive measures are necessary. These include implementing infection prevention control programmes, enhancing occupational health and safety, and conducting health promotion campaigns in healthcare facilities. Extending and intensifying Hepatitis B screening and vaccination initiatives to tertiary institutions and encouraging employers, supervisors, or team leaders to provide these services nationwide are also recommended.

Hepatitis B virus (HBV) infection remains major public health concern in Ghana, where prevalence is high despite the availability of an effective vaccine. Informal sector workers represent a large proportion of the national workforce but have limited access to preventive health services. This study assessed hepatitis B vaccination coverage and its predictors among informal sector workers in Kejetia market, Kumasi, Ghana. A cross-sectional analytical study was conducted among 809 market workers selected using stratified random sampling across different occupational groups. Data were collected using structured interviewer-administered questionnaires covering sociodemographic characteristics, HBV awareness and knowledge, and vaccination history. Vaccination uptake was categorized as at least one dose (≥1) and full coverage (≥3 doses). Logistic regression analyses were used to identify predictors of vaccination uptake. Overall, only 137 (16.9%) had completed the three-dose schedule, though 256 (31.6%) of participants reported having received at least one dose of HBV vaccine. While 718 (88.8%) of respondents had heard of HBV infection, 619 (76.5%) reported very little or no knowledge about the disease, and 402 (49.7%) did not know its routes of transmission. Vaccination uptake was significantly higher among those who had received HBV-related health education, 175 (62.7%) compared to those who had not 18 (15.3%, p < 0.001). In the multivariate logistic regression model, ≤ 30 years (aOR = 2.209, 95% CI [1.140–4.282], p = 0.019), secondary education (aOR = 2.426, 95% CI [1.220–4.824], p = 0.012), and tertiary education (aOR = 4.796, 95% CI [2.121–10.845], p < 0.001) were the independent predictors of vaccination status. HBV vaccination coverage among informal sector workers in Kejetia Market is alarmingly low despite high general awareness of the infection. Sociodemographic factors and receipt of HBV-related health education strongly influenced uptake. These findings underscore the urgent need for targeted health education and subsidized vaccination programs tailored to informal sector workers in Ghana to achieve national HBV elimination goals.

Background: The lack of a short-course of safe and effective macrofilaricidal therapy for lymphatic filariasis (LF) hinders elimination efforts, especially in the endgame scenario. Preclinical studies in mice demonstrated that high-dose rifampicin (RIF) plus albendazole (ALB) produced macrofilaricidal effects within seven days, prompting this randomised, open-label, parallel-group, interventional phase II pilot trial to determine the efficacy of high-dose RIF plus ALB against LF in humans. Methods: In three LF-endemic districts of Ghana’s Upper East Region, circulating filarial antigen (CFA)-positive individuals aged 18 to 55 years identified using the Alere Filariasis Test Strip were enrolled into the study. The participants were randomised through a centralized computer-generated randomisation into four treatment arms. They were treated according to the arm they were assigned to and followed up at 4-, 6-, 12-, and 18-months post-treatment to monitor changes in CFA status and levels, as well as adverse events. Outcome assessors were blinded to minimize assessment bias. Results: A total of 69 eligible participants were randomised into four treatment arms: RIF (35 mg/kg/day) + ALB (400 mg/day) for 7 days (n = 17), RIF (35 mg/kg/day) + ALB (400 mg/day) for 14 days (n = 18), ALB alone for 14 days (n = 17), and an untreated controlled group participating in standard mass drug administration (n = 17). All regimens were well tolerated, with no serious adverse events. Even though CFA positivity declined across all groups, with maximal reductions at 18 months, the RIF + ALB 7-day regimen consistently showed the highest decline, while ALB alone was the least effective. RIF + ALB groups exhibited early antigen decline by 4 months, unlike comparator groups, where reductions occurred from 12 months. Conclusions: These findings suggest macrofilaricidal activity of high-dose RIF plus ALB, supporting further trials in larger, microfilaraemic populations. The trial was registered in the Pan African Clinical Trials Registry on 9 September 2020 under the code PACTR202009704006025.Funding was by the European and Developing Countries Clinical Trials Partnership 2 (EDCTP2), with grant code TMA2018SF-2451-ASTAWOL, and by the German Federal Ministry of Education and Research (Bundesministerium fur Bildung und Forschung-BMBF) under agreement with Gesellschaft für Internationale Zusammenarbeit (GIZ) through agreement number: 81204851.

Background Health care workers (HCWs) constantly stand a high risk of exposure to the hepatitis B virus because of the nature of their work. Hence, it is mandatory for HCWs to undergo hepatitis B vaccination. However, most HCWs in Ghana do not check their HBsAb titre after completion of their primary vaccination. This study assessed the prevalence of HBsAg and the seroconversion rate among vaccinated health care workers in the Ashanti Region, Ghana. Materials and methods A semi-structured open-ended questionnaire was pretested and administered to 424 HCWs. Two (2) ml of blood was drawn and qualitative analyses (HBsAg, HBsAb, HBeAg, HBeAb and HBcAb) were done on the blood samples. Samples that tested positive to HBsAb were quantified using ELISA. Data obtained were analysed using GraphPad Prism 9. Results Out of the 424 study participants, 271 (63.9%) were females and 153 (36.1%) were males. Seroconversion (≥1 mIU/mL) and seroprotection (≥10 mIU/mL)through vaccination onlyamong study participants were 67.5% (n/N = 286/424) and 58.0% (n/N =246/424) respectively. Prevalence of hepatitis B viral infection was 2.4% (n/N = 10/424). Anti-HBc sero-positivity was 13.2% and anti-HBs seronegativity was 24.1%. 2.4% (n/N = 10/424) of study participants were negative to HBsAg but positive to HBcAb. Additional 8.5% (n/N = 36/424) of the study participants were seroprotected due to exposure and recovery from previous HBV infection. Age, the number of doses received, taking a booster dose and keeping a vaccination record card were significant factors influencing seroconversion status. Conclusion This study reaffirms the need for HCWs to undergo a supervised primary hepatitis B vaccination course. Post-vaccination serological testing should be done for all HWCs to confirm immunity and to reduce their chances of contracting HBV infection.