Microplastics have become a significant environmental concern. However, information on toxicity of microplastics in terrestrial organisms is limited. In this study, the chronic toxic effects of polystyrene microplastics (PS-MPs) on the reproductive system and serum antioxidants of male albino Wistar rats fed for 90 days with standard rat feed containing 1-10% granules of crushed polystyrene disposable plates were evaluated. Significant reductions in volume, motility, epididymal sperm count and serum testosterone level were observed. Histological examination of testicular architecture showed distorted testes with vacuolated seminiferous tubules at the highest percentage, together with increased catalase and decreased superoxide dismutase activities. This study showed that ingestion of PS-MPs caused reproductive dysfunction in male rats and contributes to understanding the potential toxicity of microplastics in terrestrial animals.

Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in low- and middle-income countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists from a UK NHS hospital and in Ho Teaching Hospital with the aim of enhancing antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed-method approach that included an initial survey on knowledge and awareness before and after training, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in two phases in Ho Teaching Hospital with healthcare professionals, including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 healthcare providers, including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists, were interviewed in the second phase and demonstrated greater awareness of AMS practices, particularly the role of education for patients, as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs; however, through AMR-focused training, we demonstrated improved AMS skills and practice among healthcare providers in Ho Teaching Hospital. There is a need for continuous AMR training sessions for healthcare professionals in resource-limited settings.

A standardised Global Point Prevalence Survey (PPS) tool was used to determine the antimicrobial prescription pattern in the Ho Teaching Hospital on two separate occasions in a total of 14 wards in the hospital, including dedicated wards for paediatrics and neonates. Manually collected and anonymised data were entered, validated, analysed and reported using a web-based global PPS application. With 147 and 153 patients considered in the July 2019 and January 2020 surveys, respectively, 98 patients (66.7%) and 84 patients (54.9%) had received one or more antimicrobials. The prevalence of antimicrobial use in the adult wards was 64.3% (72/112) and 53.4% (63/118) in the first and second surveys, respectively. The prevalence in the paediatric wards was 60.0% (12/20) and 62.5% (10/16), respectively, in the two surveys, while that in the neonatal wards was 93.3% (14/15) and 57.9% (11/19), respectively. β-lactams were the most used antibiotics in both periods. Malaria was the most common diagnosis requiring the use of antimicrobials in July 2019, accounting for 19.4% of the diagnoses, whereas in January 2020, it was skin and soft-tissue conditions (28.1%). This reflects a seasonal association between malaria and rainfall patterns. Out of the antimicrobials prescribed during each of the survey periods, 95% were used for empirical treatment, and this could be attributed to a number of reasons, including logistical challenges, among others, that require further exploration in the context of local, national and international policy recommendations.

Unsafe disposal of unused and expired antimicrobial drugs increases their presence in the environment, thereby contributing to the emergence and spread of antimicrobial resistance. This study addressed the lack of sufficient data on unused and expired antimicrobial disposal practices among peri-urban residents in Ghana. This knowledge–attitude–practice (KAP)-based study offers context-specific insights to inform public health education and antimicrobial disposal policy interventions. A cross-sectional study was conducted among 310 residents in the Ho municipality using a well-structured questionnaire. Data was collected on the knowledge, attitudes, and practices of households on how they dispose of unused and leftover antimicrobials. Origin Pro 2022 software was used to analyze the data. Many respondents were males (n = 175, 56.5%) and aged between 18 and 30 years (n = 196, 63.2%). About 87.1% (n = 270) of the respondents agreed that improper disposal of unused antimicrobials could negatively affect the environment. Most of the respondents (71.9%, n = 223) had not received counseling on recommended antimicrobial disposal; 75.5% (n = 234) of respondents were not aware of institutions collecting unused or expired medicines; and 73.5% (n = 228) had never participated in a medicine-return program. Discarding antimicrobials into household trash bins was the most common way of disposal among respondents. The preferred sites to return unused/leftover antimicrobials were community pharmacies and hospitals. Although respondents showed some knowledge and positive attitudes toward safe antimicrobial disposal, further education is needed. Furthermore, most respondents disposed of antimicrobials in household trash, highlighting the need for take-back programs and community pharmacy-based collection. Incorporating disposal guidance into medication counseling and patient information leaflets can enhance awareness and promote appropriate practices.

Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. Aim: This study sought to understand healthcare professionals’ experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. Methods: A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. Results: Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. Conclusions: The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities.