Understanding the distribution of breeding populations of migratory animals in the non-breeding period (migratory connectivity) is important for understanding their response to environmental change. High connectivity (low non-breeding population dispersion) may lower resilience to climate change and increase vulnerability to habitat loss within their range. Very high levels of connectivity are reportedly rare, but this conclusion may be limited by methodology. Using multiple tracking methods, we demonstrate extremely high connectivity in a strongly declining, peripheral breeding population of a long-distance migrant, the Common Nightingale in the UK. Non-breeding population dispersion is lower than for previously tracked populations of this and other species and likely lower than can usually be detected by light-level geolocation, the main tracking method for small bodied species. Extremely low levels of population mixing were also detected, so any impacts on this population on the non-breeding grounds are unlikely to be shared with more distant breeding populations, corresponding to the observed patterns of European population change. According to a species distribution model using independent field data, this population’s non-breeding grounds had lower suitability than others and likely declined before the period we were able to assess. These results support hypotheses that climatic and habitat-related deterioration of non-breeding grounds contributes to population declines in peripheral and high-connectivity breeding populations of long-distance migrants, including the one studied here.

The White-necked Rockfowl Picathartes gymnocephalus (family Picathartidae) is endemic to the Upper Guinea forest and has a global population of <10 000 mature individuals. This species is listed as Vulnerable on the IUCN Red List owing to its declining population, mainly as a result of habitat fragmentation, degradation and predation within its range states. Previous studies showed that many nesting colonies of the species in Ghana have disappeared following extensive loss of forest cover. However, recent field visits identified nesting colonies in several forest reserves, including the Nyamibe Bepo Forest Reserve where a significant proportion of the species’ population in the country is reported to occur. This study investigated the population size of the White-necked Rockfowl in Nyamibe Bepo to compare the extent of the current nesting colonies to those documented in 2011. A survey of nesting sites in the Bronko area of the reserve returned a total of 54 nests distributed across 10 rock-faces, and 88 individuals. Compared with the 53 nests reported in 2011, this indicates a stable population over the past decade in this section of the reserve. In contrast, colonies within the Ashilvikrom and Amanokrom sections have declined significantly. Thus, this indicates an overall population decline of the species within the Nyamibe Bepo Forest Reserve. By hosting 3.3% of the global minimum population and 41 reproductive units of the Vulnerable White-necked Rockfowl, the Nyamibe Bepo Forest Reserve could qualify as an Important Bird Area (IBA) under criterion A1a and a Key Biodiversity Area (KBA) under criterion A1b. We advocate that further steps be taken to engage conservation organisations and the government for more-formal protection of the site for the conservation of this Vulnerable species.

In Ghana, a severe mental healthcare gap of 95–98% exists due to limited services. Ghana Somubi Dwumadie set out to address this by developing district mental healthcare plans (DMHPs) in three demonstration districts. Following the Programme for Improving Mental Healthcare model, district mental health operations teams were formed and used Theory of Change (ToC) to develop DMHPs. Key elements included training non-specialist health workers and enrolling individuals in relevant healthcare programmes. Evaluation methods included routine data, health facility surveys, and qualitative analysis within the ToC framework. Results showed improved integration of mental health services, enhanced case management through training, and increased service utilisation, shown through 691 service user enrollments. However, there was limited commitment of new resources and no significant improvement in primary care workers’ capacity to detect priority mental health conditions. The study concludes that DMHPs, implemented with an integrated approach, can improve mental health service utilisation, contingent on committed leadership, resource availability, and stakeholder engagement.

AbstractHalf of all migratory bird species have declined over the past 30 years, with intercontinental migrants declining faster than their short‐distance migratory counterparts. One potential cause of these declines is habitat loss and degradation on tropical wintering grounds, where agricultural conversion of natural habitats and intensification of traditional, low‐intensity agricultural systems are frequently occurring. Although the broad patterns of wintering migrant abundance are well understood along most flyways, how species' habitat associations vary across disturbance gradients in agricultural landscapes remains a key question, with implications for landscape‐level farm management and restoration activities. We used 328 point count locations and associated habitat assessments targeted at a cohort of eight severely declining Afro‐Palaearctic migratory passerines in the Guineo–Congolian transition zone of Western Africa to model the probability of the presence of migrants within grass, shrub, forb and forest‐covered areas. We found support for the widespread use of early successional habitats retained within traditionally managed farmland by migrants. Most species utilize scrubland on fallows within the agricultural mosaic, especially Spotted Flycatcher, Garden Warbler, Melodious Warbler, Whinchat and Common Nightingale. Only Pied Flycatcher relied upon mature forested areas. The avoidance of mature forested habitats by most species suggests that habitat requirements of severely declining migrant birds must be explicitly considered within conservation and restoration schemes, via mechanisms to retain low‐intensity farming, especially short‐term abandoned fallows that regenerate scrubby areas within the agricultural matrix. Any habitat management within the agricultural matrix should be considered in the context of the needs of local communities.

Abstract In Ghana, a staggering mental health treatment gap of 95–98% exists due to limited mental healthcare services. To address this gap, Ghana Somubi Dwumadie programme implemented district mental healthcare plans (DMHPs) in three demonstration districts. Collaborating with local stakeholders, the study followed the Programme for Improving Mental Healthcare model, establishing district mental health operations teams. These teams, with representatives from various sectors, utilized a Theory of Change approach to enhance mental health service accessibility. Key components included training non-specialist health workers and enrolling individuals in relevant healthcare programs. Results showed successful integration of mental health services in primary care, improved case detection and care through training sessions, and enrolment of 691 service users in mental health services. The study concludes that DMHPs, implemented with an integrated approach, can significantly reduce the care gap for individuals with mental health conditions, attributing success to committed leadership, resource availability, and stakeholder engagement.

Abstract Background Wilms tumor (WT) disease-free survival at 2 years approached only 44% between 2005-2014 in Ghana, slightly improving to 50% in the next 4 years (versus 90% in high-resource countries). This study aimed to uncover socioeconomic and clinical factors that lead to preventable WT death in Ghana. Objective We endeavored to describe changes in WT outcome in Ghana in recent years by studying patients diagnosed with WT at Korle-Bu Teaching Hospital (KBTH; Accra) - the country's largest tertiary hospital. We analyzed socioeconomic factors, disease characteristics and treatment course to determine which social determinants of health impact treatment regimen, response, completion, and outcomes. Methods WT patient records (August 2014-June 2022) at KBTH were reviewed retrospectively. Demographics, social determinants of health, clinical course, and tumor characteristics were analyzed. Groups were compared using t-tests, Pearson Chi-square tests, and multivariate Cox logistic regression. Results: 127 WT patients (65 female) were identified (median age, 44 months [IQR 25-66]). Distance greater than 40 km from KBTH associated with delayed referral from outside hospitals (p=0.03). 48 patients (38%) presented with distant metastasis (75% lung, 25% liver), which associated with caregiver employment in the informal economy (p=0.003) and larger tumor size at presentation (p=0.002). Hypoalbuminemia also associated with larger tumor size (p=0.02) and metastasis (p=0.009). Although 84% of tumors regressed with neoadjuvant chemotherapy, larger initial size associated with incomplete R1/R2 resection (p=0.046). 110 patients had nephrectomy: 6 tumor rupture, 5 tumor spill, 11 lymphadenopathy, and 33 R1/R2 residual disease, which negatively impacted survival (p=2.7x10-5). Under-staging was likely since lymphadenectomy was only documented in 52% of cases. Hypoalbuminemia (p=0.005) and post-operative stage IV (p=1.2x10-5) also negatively impacted survival. 22 patients (17%) abandoned treatment (13 stage IV), with 6 eventually returning for care. 11 patients (50%) abandoned treatment before nephrectomy and were considered deceased. 11 patients (50%) abandoned treatment after nephrectomy, with 7 lost to follow-up (LTFU). Among patients presenting with metastases, 43% died, but 8% were LTFU. If no metastases, 28% died (4% LTFU). Multivariate analysis of distant metastasis at presentation, tumor size, distance from KBTH, employment status, histopathological risk status, and post-operative distant metastasis demonstrated a statistically significant association with survival (p=0.002). Excluding LTFU, 2- and 4-year overall survival were 67% and 56%, respectively. Including treatment abandonment, relapse, and death as negative events, 2- and 4-year event-free survival were 56% and 55%, respectively. Conclusion: Although WT survival in Ghana has improved, social factors impacting secure employment, distance from KBTH, and adherence to care predisposed patients to greater tumor burden, poorer nutritional status, R1/R2 resections, LTFU, and lower survival. Citation Format: Nelly-Ange T. Kontchou, Emmanuel Amankwah, Issah Seidu, Laura Stafman, Afua O. Abrahams, William Appeadu-Mensah, Harold N. Lovvorn, Lorna A. Renner. Current realities of Wilms tumor burden and therapy in Ghana [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A094.

Cyberbullying as deviant behavior is a growing public health concern and affects cyber victims in many ways. This study sought to examine cyberbullying victimization, perpetration, and psychosomatic health symptoms (PHS) among students in a Ghanaian university. The aim was to explore the extent of cyberbullying among students and the association between demographic factors and cyberbullying victimization, perpetration, and PHS of cyberbully victims. The study was a cross-sectional survey of 420 students in a public university in Ghana. The survey results show that female students were less likely than male students to suffer from cybervictimization. There was no gender difference in cyberbullying perpetration and experiencing PHS. Also, students from intact families were less likely to be victimized than students from single-parent families. Bystanders who tried to intervene in cybervictimization were less inclined to perpetrate cyberbullying but were more likely to experience PHS when cyberbullied. Students who lived alone or with friends were four times more likely to experience PHS after being cyberbullied. These findings point to the far-reaching effects of cyberbullying and the need for educators and other stakeholders to devise policies to mitigate the phenomenon and put in place structures to help cyberbully victims.

The death of many people in tropical countries can be attributed to microbial infection, probably, because synthetic antibiotics are failing in the treatment of most microbial infections, attributed to the ability of the microorganisms to mutate and adapt to harsh conditions. This study evaluated, in vitro, the antimicrobial activities, antioxidant potentials, and the total phenolic as well as phytochemical contents of aqueous and ethanol extracts of the root of Cryptolepis sanguinolenta (Lindl.) and the crude sap of Pycnanthus angolensis (Welw) using selected standard bacteria strains (Staphylococcus aureus (ATCC 25,923), Staphylococcus saprophyticus (ATCC 15,305), Escherichia coli (ATCC 25,922), Salmonella typhi (ATCC 19,430), Pseudomonas aeruginosa (ATCC 27,853), and Proteus mirabilis (ATCC 49,565). The modified agar well diffusion method was used to evaluate the antimicrobial activities of the plant extracts. Chloramphenicol and tetracycline were used as positive controls. The extracts were screened for specific phytochemicals with total phenolic contents were determined using Folin Ciocalteu reagent test. The phytoconstituents observed were alkaloids, cardiac glycosides, and saponins in both Cryptolepis sanguinolenta and Pycnanthus angolensis. For the antimicrobial activities, all the test bacteria were susceptible to the crude sap of Pycnanthus angolensis except Proteus mirabilis. In the case of the Cryptolepis sanguinolenta, only S. aureus was susceptible to both aqueous and ethanol extracts. The total phenolic content, expressed in g/100 g GAE, recorded values of 55.427 ± 4.248 for the crude sap of Pycnanthus angolensis, and 11.642 ± 4.248 and 26.888 ± 4.248 for the aqueous and ethanol extracts of Cryptolepis sanguinolenta, respectively. It is concluded that Cryptolepis sanguinolenta and Pycnanthus angolensis are excellent candidates for further development of antimicrobial agents in the fight against microbial infections given the pressing need for novel efficacious agents.

Access to quality mental health services in Ghana remains poor, yet little is known about the extent of the access gaps and provision of mental health services at the district level in Ghana. We aimed to conduct an analysis of mental health infrastructure and service provision in five districts in Ghana. A cross-sectional situation analysis was conducted using a standardised tool to collect secondary healthcare data, supplemented by interviews with key informants, across five purposively selected districts in Ghana. The Programme for Improving Mental Health Care (PRIME) situation analysis tool was adapted to the Ghanaian context and used for data collection. The districts are predominantly rural (>60%). There were severe challenges with the provision of mental healthcare: there were no mental healthcare plans, supervision of the few mental health professionals was weak and unstructured, access to regular supplies of psychotropic medications was a major challenge, and psychological treatments were extremely limited given the lack of trained clinical psychologists. There were no available data on treatment coverage, but we estimate this to be <1% for depression, schizophrenia, and epilepsy across districts. Opportunities for mental health systems strengthening include: the commitment and willingness of leadership, the existence of the District Health Information Management System, a well-established network of community volunteers, and some collaboration with traditional and faith-based mental health service providers. There is poor mental health infrastructure across the five selected districts of Ghana. There are opportunities for strengthening mental health systems through interventions at the district healthcare organisation, health facility, and community levels. A standardised situation analysis tool is useful for informing district-level mental healthcare planning in low-resource settings in Ghana and potentially other sub-Saharan African countries.