West Region Research Articles

ASSESSING THE IMPACT OF SUPERVISION AND MANAGEMENT TRAINING ON POLICE OFFICER PERFORMANCE AT NKURENKURU POLICE STATION

This research explores the impact of supervision and management training on the performance of police officers at Nkurenkuru Police Station, focusing on improving law enforcement effectiveness. Conducted in the Kavango West Region of Namibia, the study aims to understand how training programs influence personnel performance. Qualitative research methods were employed, using semi-structured interviews and thematic analysis for data interpretation. The findings highlight a complex relationship between supervision and management training and police officer performance. While acknowledging some positive impacts of the training, the study identifies various obstacles that hinder its full effectiveness. These challenges include resource limitations, lack of follow-up support, administrative burdens, resistance to change, inadequate integration of training, and heavy workloads. The study suggests the importance of a comprehensive approach to supervision and management training tailored to the needs of law enforcement agencies. Recommendations include customising training programs, increasing participant engagement, and establishing consistent follow-up mechanisms. These insights are not only relevant to Nkurenkuru Police Station but also offer valuable lessons for law enforcement agencies worldwide seeking to optimise their performance through effective training strategies.

Effective Project Delivery Method for Public Construction: Case in the Oromia Region, West Wallaga Zone

This thesis is to identify and evaluate effective delivery methods and assess their applicability to the local situations in the Oromia region of the West Wallaga Zone. The significance of the research is that the broadening of the service packages is believed to enable the optimization of the process and the product as a whole in the construction industry, as well as facilitate the development of the infrastructure sectors. The objective of this research is to identify effective project delivery methods for public works construction in the Oromia Region West Wallaga Zone. The data collection process used in the research had the option of two basic methods: primary data collection and secondary data collection. Accordingly, four project delivery methods based on their relevance to the local situation have been evaluated; their merits, demerits, and requirements have been identified. These methods are: the design-bid-build, construction managers (at resk and at fee), the design-build, and the design-build-operate-transfer methods. Based on these findings of the study, the design-bid-Build method has been the most widely used effective project delivery method in the Oromia Region West Wallaga Zone. Performance-based project delivery methods are thought to offer a way to develop the sector and to benefit all stakeholders. In order to benefit all parties involved in the building sector, this will serve as a beneficial addition to the current techniques.

Applying MALDI-TOF MS to resolve morphologic and genetic similarities between two Dermacentor tick species of public health importance

Hard ticks (Acari: Ixodidae) have been historically identified by morphological methods which require highly specialized expertise and more recently by DNA-based molecular assays that involve high costs. Although both approaches provide complementary data for tick identification, each method has limitations which restrict their use on large-scale settings such as regional or national tick surveillance programs. To overcome those obstacles, the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been introduced as a cost-efficient method for the identification of various organisms, as it balances performance, speed, and high data output. Here we describe the use of this technology to validate the distinction of two closely related Dermacentor tick species based on the development of the first nationwide MALDI-TOF MS reference database described to date. The dataset obtained from this protein-based approach confirms that tick specimens collected from United States regions west of the Rocky Mountains and identified previously as Dermacentor variabilis are the recently described species, Dermacentor similis. Therefore, we propose that this integrative taxonomic tool can facilitate vector and vector-borne pathogen surveillance programs in the United States and elsewhere.

Risk factors associated with meningitis outbreak in the Upper West Region of Ghana: A matched case-control study.

The Northern part of Ghana lies within the African meningitis belt and has historically been experiencing seasonal meningitis outbreaks. Despite the continuous meningitis outbreak in the region, the risk factors contributing to the occurrence of these outbreaks have not been clearly identified. This study, therefore, sought to describe the clinical characteristics and possible risk factors associated with meningitis outbreaks in the Upper West Region (UWR). A 1:2 matched case-control study was conducted in May-December 2021 to retrospectively investigate possible risk factors for meningitis outbreak in the UWR of Ghana between January and December 2020. Cases were persons with laboratory confirmed meningitis, and controls were persons of similar age and sex without meningitis living in the same house or neighborhood with a confirmed case. Both primary and secondary data including clinical, socio-demographic and laboratory information were collected and entered on standard questionnaires. Data was analyzed using descriptive statistics and conditional logistic regression. Meningitis cases were mostly due to Streptococcus pneumoniae (67/98; 68.37%), followed by Neisseria meningitides serogroup X (27/98; 27.55%). Fever occurred in 94.03% (63/67) of Streptococcus pneumoniae cases and 100% in both Neisseria meningitidis serogroup X (27/27) and Neisseria meningitidis serogroup W groups (3/3). CSF white cell count was significantly associated with the causative agents of meningitis. Conditional logistic regression analysis showed that, passive exposure to tobacco [AOR = 3.65, 95%CI = 1.03-12.96], bedrooms with 3 or more people [AOR = 4.70, 95%CI = 1.48-14.89] and persons with sore throat infection [AOR = 8.97, 95%CI = 2.73-29.43] were independent risk factors for meningitis infection. Headache, fever and neck pain continue to be the most common symptoms reported by meningitis patients. Education and other preventive interventions targeting exposure to tobacco smoke and crowded rooms would be helpful in reducing meningitis outbreaks in the Upper West Region of Ghana.

Limited sensitivity of Antarctic GIA mass change estimates to lateral viscosity variations

The Gravity Recovery and Climate Experiment (GRACE) has revealed spatiotemporal mass changes in the Antarctic Ice Sheet. However, GRACE data must be corrected for the gravity changes due to glacial isostatic adjustment (GIA). Here we investigate the sensitivity of GIA-induced gravity changes in Antarctica to the lithospheric thickness and upper mantle viscosity using a one-dimensional (1-D) model that assumes a radially varying Earth structure. The sensitivity is assessed using several Antarctic ice-history models that have been widely used to correct GRACE data. The results indicate a trade-off between lithospheric thickness and upper mantle viscosity in evaluating the Antarctic GIA correction. This trade-off exists for all ice-history models; however, the reason for the trade-off differs among models. Furthermore, since there is a sharp contrast in the Earth structure between West and East Antarctica, the adopted ice histories are separated into West and East Antarctic components to examine their contributions to the Antarctic GIA correction. We consider 1-D Earth structures that are averaged from the seismically derived three-dimensional Earth structure for West and East Antarctica. These results indicate that the contributions of the East and West Antarctic loads do not significantly affect the GIA corrections for the West and East Antarctic regions, respectively, and that the trade-off between lithospheric thickness and upper mantle viscosity results in minimal divergence in the assessment of the Antarctic GIA correction between the averaged Earth models of West and East Antarctica. Therefore, the contrast in Earth structure beneath Antarctica may have a limited effect on the ice-mass change estimates for the entire Antarctic Ice Sheet.

Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in South West Region governmental hospitals, South West Ethiopia: Prospective follow-up study

BackgroundThe Ethiopian Federal Ministry of Health has been working by introducing vaccines, and integrating the management of newborn and child illnesses to prevent pneumonia, pneumonia-related hospitalization, and mortality. Despite these attempts, the prevalence of pneumonia and the proportion of hospitalizations have increased. Little is known about recovery time from severe pneumonia and its predictors in pediatric patients in the study area. Therefore, this study aimed to determine the time to recovery from severe pneumonia and its predictors in pediatric patients admitted to government hospitals in the southwest Region. Methods and MaterialsA hospital-based prospective follow-up study was conducted among 791 pediatric patients admitted with severe pneumonia at a governmental hospital in the South West Region, of Ethiopia. A systematic sampling technique was used to recruit participants. Data were entered into Epi-data 4.4.2.1 and exported to STATA 14 for analysis. The assumptions of Cox proportional hazard models and goodness of fit were assessed using the Shoenfield residual and Cox-Snell, respectively. Bivariate and multivariable Cox regression models were used to identify the predictors of time to recovery. Variables with a p-value of <0.05 at a 95 % confidence level in multivariable Cox regression model analysis were declared statistically significant predictors of time to recovery. ResultsThis study revealed that 641 (81.04 %) participants recovered with an incidence rate of 12.48 per 100 person-day observations. The median time to recovery was 5 days. Rural residence [AHR=0.82; 95 % CI 0.69–0.97], hypoxemia [AHR=1.25; 95 % CI 1.01- 1.55], danger sign, [AHR=1.77; 95 % CI 1.28- 2.45], comorbidity [AHR=0.60; 95 % CI 0.50- 0.7] and history of previous respiratory infections [AHR=0.76; 95 % CI 0.64- 0.90] were found significant predictors of time to recovery from severe pneumonia. ConclusionIn this study, the recovery rate from severe pneumonia among pediatric patients was low and the time to recovery was slightly prolonged with a median time to recovery of five days. Rural residence, hypoxemia, danger signs, comorbidity, and history of previous respiratory infections were independent predictors of time to recovery among pediatric patients. Therefore, the Ethiopian Federal Ministry of Health, family, community leaders, healthcare providers, and other stakeholders should provide timely initiation of advanced diagnosis, appropriate therapeutic interventions, and proper follow-up for pediatric patients with severe pneumonia to reduce mortality.

Large-scale agro-industries and host community land restitution demands: understanding the land-use conflicts between the CDC and Fako elites in the south west region, Cameroon

Large-scale land acquisition has been frequent in most parts of Africa. This frequently led to extensive dispossession among other pitfalls of violation of indigenous land ownership rights. A significant proportion of Fako division’s fertile slopes and plains were expropriated by the Germans for implantation and development of plantations. Ownership rights of indigenous community lands were transferred without the legal consent of the rightful native authorities. Against the backdrop of this colonial intrusion and consequential violations of local customary tenure rights, the growing need for justice and restoration of dignity has been a shared value among a preponderant proportion of the local Bakweri ethnic group. This culminated to a restitution decision of CDC leased lands to the Bakweri by the African Commission on Human and People’s Rights. Nonetheless, the proportion of restituted lands has not been significant and satisfactory enough to conciliate the expropriated host communities of the extensive CDC leaseholds. As such, landownership contestations and its consequential socio-political tensions still persist in Fako. This paper is centered on yet a more frequently expressed contestation: encroachment into and occupancy of CDC leaseholds by natives of Fako as a whole and Ndongo of Tiko sub-division in particular. Prior extensive documentary review was done which pointed to the locality of Ndongo as a suitable case of interest. Contrary to the general land grabbing tendencies of agro-businesses, community members here are accused of unauthorized intrusion into and tenancy of lands with legal ownership rights belonging to the CDC. The study was ethnographic comprising of individual in-depth interviews and observations.

Accumulation of microplastics by the Siberian frog Rana amurensis (Anura, Amphibia) in the West Baikal region

Accumulation of microplastics by the Siberian frog Rana amurensis (Anura, Amphibia) in the West Baikal region

Integrated health services for refugee and host populations in Uganda: A qualitative study of stakeholder's perspectives.

Integration has emerged as a key strategy for promoting equitable access to health services for refugees and host populations. This study explored the perceptions and experiences of stakeholders on the integration of health services for refugees and host populations in two purposefully selected refugee-hosting districts of Adjumani and Obongi in the West Nile region, Uganda. This study used a case study design. Key informant interviews were conducted with 28 purposefully selected respondents. Data were analysed thematically. Quirkos software was used to manage and analyse data. Respondents indicated that integration is enhancing health services, providing an opportunity to strengthen them and improve coverage and access for refugees and host populations. Factors affecting integration include gaps in policy and implementation, ineffective systems and structures for service delivery, inadequate coordination and management and inadequate funding. At the service level challenges including inadequate infrastructure, shortage of health workers and stock out of medicines and essential supplies affect the integration of health services. Overall, structural and systemic issues continue to affect the integration of health services. It is important to strengthen policy implementation and build the capacity of districts to support the integration of health services.

Patient characteristics associated with frequent telehealth utilization in 2022: Evaluation of a national virtual integrated medical and behavioral health practice within the United States

ObjectivesAs permanent telehealth policies are considered in the United States (U.S.), it is important to understand who uses telehealth most often following the pandemic. We described patients who used a national virtual care practice frequently, identified how they differed from patients who used it less often, and characterized the types of care frequent telehealth patients utilized. MethodsWe used video visit data for commercially-insured patients, aged 18+, from a national virtual integrated medical and behavioral health practice in 2022 in the U.S. Patients were categorized into three groups: one visit (’minimal use’), two to four visits (’some use’), and five or more visits (’frequent use’). We compared patient and geographic characteristics between the three groups and estimated an ordinary least squares linear regression to identify predictors of ‘frequent’ use relative to ‘minimal’ or ‘some’ use. ResultsThe probability of being a frequent user declined with age (−0.4 percentage points (p.p.) per year; 95 % CI, −0.4 – −0.3), was higher for females (5.4 p.p.; 95 % CI, 4.1 – 6.7) and patients with greater clinical complexity (7.9 p.p. for highest relative to lowest quartile risk score; 95 % CI, 5.9 – 10.0), and lower for patients in the Northeast (−9.2 p.p.; 95 % CI, −15.5 – −2.9) or West (−3.2 p.p.; 95 % CI, −5.7 – −0.7) regions relative to the Southern region of the U.S. The five most common diagnoses were mental health conditions. ConclusionsOur results highlight the need for comprehensive telehealth policy that enables access, particularly for patients who rely on it as their primary source of care.

Revisiting the risk of introduction of Japanese encephalitis virus (JEV) into the United States – An updated semi-quantitative risk assessment

Japanese encephalitis virus (JEV) is associated with encephalitis in humans and reproductive and neurological illness in pigs. JEV has expanded beyond its native distribution in southeast Asia, with identifications in Europe (2010) and Africa (2016), and most recently, its spread into mainland Australia (2021−2022). The introduction of JEV into the United States (US) is a public health risk, and could also impact animal health and the food supply. To efficiently and cost-effectively manage risk, a better understanding of how and where diseases will be introduced, transmitted, and spread is required. To achieve this objective, we updated our group's previous qualitative risk assessment using an established semi-quantitative risk assessment tool (MINTRISK) to compare the overall rate of introduction and risk, including impacts, of JEV in seven US regions. The rate of introduction from the current region of distribution was considered negligible for the Northeast, Midwest, Rocky Mountain, West, Alaska, and Hawaii regions. The South region was the only region with a pathway that had a non-negligible rate of introduction; infected mosquito eggs and larvae introduced via imported used tires (very low; 95% uncertainty interval (UI) = negligible to high). The overall risk estimate for the South was very high (95% UI = very low to very high). Based on this risk assessment, the South region should be prioritized for surveillance activities to ensure the early detection of JEV. The assumptions used in this risk assessment, due to the lack of information about the global movement of mosquitoes, number of feral pigs in the US, the role of non-ardeid wild birds in transmission, and the magnitude of the basic reproduction ratio of JEV in a novel region, need to be fully considered as these impact the estimated probability of establishment.

The burdens attributable to headache disorders in Cameroon: national estimates from a population-based door-to-door survey, including a headache-care needs assessment

BackgroundWe have previously shown headache to be highly prevalent in Cameroon. Here we present the attributed burden. We also perform a headache-care needs assessment.MethodsThis was a cross-sectional survey among adults (18–65 years) in the general population. Multistage cluster-sampling in four regions (Centre, Littoral, West and Adamawa), home to almost half the country’s population, generated a representative sample. We used the standardised methodology of the Global Campaign against Headache, including the HARDSHIP questionnaire, with diagnostic questions based on ICHD-3 and enquiries into symptom burden, impaired participation (lost productivity and disengagement from social activity), quality of life (QoL) using WHOQoL-8, and willingness to pay (WTP) for effective care. We defined headache care “need” in terms of likelihood of benefit, counting all those with probable medication-overuse headache (pMOH) or other headache on ≥ 15 days/month (H15 +), with migraine on ≥ 3 days/month, or with migraine or tension-type headache (TTH) and meeting either of two criteria: a) proportion of time in ictal state (pTIS) > 3.3% and intensity ≥ 2 (moderate-to-severe); or b) ≥ 3 lost days from paid and/or household work in the preceding 3 months.ResultsAmong 3,100 participants, mean frequency of any headache was 6.7 days/month, mean duration 13.0 h and mean intensity 2.3 (moderate). Mean pTIS was 9.8%, which (with prevalence factored in) diluted to 6.1–7.4% of all time in the population. Most time was spent with H15 + (5.3% of all time), followed by TTH (1.0%) and migraine (0.8%). For all headache, mean lost days/3 months were 3.4 from paid work, 3.0 from household work and 0.6 from social/leisure activities, diluting to 2.5, 2.2 and 0.6 days/3 months in the population. QoL (no headache: 27.9/40) was adversely impacted by pMOH (25.0) and other H15 + (26.0) but not by migraine (28.0) or TTH (28.0). WTP (maximally XAF 4,462.40 [USD 7.65] per month) was not significantly different between headache types. An estimated 37.0% of adult Cameroonians need headache care.ConclusionHeadache disorders in Cameroon are not only prevalent but also associated with high attributed burden, with heavily impaired participation. Headache-care needs are very high, but so are the economic costs of not providing care.

Towards sustainable exploitation of European pilchard (Sardina pilchardus) stocks off West African waters

European pilchard (Sardina pilchardus), herein referred to as “sardine” or “European sardine”, is the most productive and economically important small pelagic fish in the Northwest African waters. Thus far, very little is known about its stock status in the West African region despite the rapid decadal increase in its catch production. The present study provides avenues vital to improving guidance for sustainable species management. In this region, sardine is divided administratively into three stocks (northern: stock N, central: stock A + B, and southern: stock C). Thus, the present study used two Surplus Production Models (SPM) to evaluate sardine's stock status. Sardine's catch and scientific survey biomass data obtained from FAO-CECAF's (Fishery Committee for the Eastern Central Atlantic (CECAF)) latest reports were used in this analysis to fit the SPMs and investigate the effectiveness of the available catch-per-unit-effort (CPUE) trends in setting the total allowable catch (TAC) for sustaining the different sardine stocks in the region. Results from the SPMs indicate that the sardine stock in the north is fished at optimum levels. Meanwhile, the SPMs output based on the scientific survey biomass indices indicated a healthy state for the central and southern sardine stocks. Similarly, the fishery CPUE indices for the central and southern stocks showed similar biomass trends compared to the survey biomass index, indicating healthy stock status. Therefore, in cases where survey biomass index data is unavailable to run stock assessments, this study suggests that sardine fishery CPUEs could be used in SPMs to monitor biomass trends over time and may also provide stock status proxies. Additionally, with rapid climate and other environmental changes, sardine stocks must be regularly monitored with consistent and comparable scientific methodologies and updated fisheries time series data.

Do Teenagers Believe in Anthropogenic Climate Change and Take Action to Tackle It?

Regardless of their nationality, all children are unfortunately at risk since nations across the world are not doing enough to reduce the impacts of climate change. However, teenagers in developing countries face more severe challenges as a consequence of climate change. This research portrays teenagers living in a rural area in terms of their awareness, beliefs, attitudes, and actions relevant to climate change. Beliefs regarding climate change are reflected in the context of skepticism about the existence, causes, and impacts of climate change as well as belief in climate change mitigation. We also magnify ecocentrism and anthropocentrism, as a socio-psychological factor, and gender, a demographic variable, when exploring their power as the antecedents of climate change-related actions. The data were gathered from 650 students attending a middle school selected from a rural area located in the inner west region of Türkiye. The results indicated that less than half of the teenagers believed in the notion that something could be done to tackle climate change. According to discriminant analysis, female teenagers tend to believe in climate change more and have stronger ecocentric attitudes compared to males. Furthermore, female teenagers seemed to engage in climate change-related actions more than males. This study provided further evidence on the role of beliefs and attitudes in relation to this issue. To be more specific, teenagers believing that anthropogenic factors lead to climate change and that we, as humans, should therefore do our bit to reduce climate change, also tend to take the necessary actions to combat climate change. Furthermore, these individuals, valuing the natural environment for its own sake, engage in actions for climate change mitigation. By examining the awareness, beliefs, attitudes, and actions of teenagers in rural areas towards climate change, this research underscores the critical role of the quality of formal education in equipping teenagers to effectively engage with climate change issues.

Impact of the COVID-19 Pandemic on the Delivery of Congenital Syphilis Care in the Military Health System.

Congenital syphilis (CS) case rates have increased significantly in the United States over the past 20 years, accelerating during the COVID-19 pandemic. Increasing rates may relate to access to care but have not been evaluated in a fully-insured population, such as the Military Health System. We performed a repeated monthly cross-sectional study of CS cases and total encounters (care rates) using the queried Military Health System database. We defined CS by International Classifications of Diseases 10th Revision Clinical Modification diagnosis codes in beneficiaries ≤ 2 years old. We evaluated pre-COVID-19 (March 2018 to February 2020), pandemic year 1 (March 2020 to February 2021), and pandemic year 2 (March 2021 to February 2022) periods. We performed change-point and trend analyses and Poisson regression to evaluate differences by sponsor rank, TRICARE region, and pandemic period. The Uniformed Services University Institutional Review Board approved the study. A total of 69 unique CS cases were identified with a median monthly care rate of 0.90/100,000 eligible beneficiaries. The CS care rate showed a 5.8% average monthly percent increase throughout the study period (P < .001) and a 20.8% average monthly percent increase in year 2 (P < .05). Compared to the pre-pandemic era, CS care rates increased in pandemic years 1 and 2 (adjusted rate ratio [aRR] 2.76 [95% CI: 1.95-3.92], 5.52 [95% CI: 4.05-7.53], respectively). Congenital syphilis care rates were lower in children of senior enlisted sponsors versus junior enlisted, aRR 0.24 (95% CI: 0.17-0.33), and higher in the West and North regions versus South, aRR 2.45 (95% CI: 1.71-3.53) and aRR 2.88 (95% CI: 2.01-4.12), respectively. Congenital syphilis care rates were substantially lower in this insured group than national rates but increased significantly during the COVID-19 pandemic. Higher care rates were seen in children of military members of lower rank. Regional trends differed from national data. These findings suggest that, even in a fully-insured population, income and regional differences impact CS, and the COVID-19 pandemic may have exacerbated differences in care delivery.

Structural Racism and HIV Pre-exposure Prophylaxis Use in the Nationwide US: A County-Level Analysis.

Structural racism contributes to geographical inequalities in pre-exposure prophylaxis (PrEP) coverage in the United States (US). This study aims to investigate county-level variability in PrEP utilization across diverse dimensions of structural racism. The 2013-2021 nationwide county-level PrEP rate and PrEP-to-need ratio (PNR) data were retrieved from AIDSVu. PrEP rate was defined as the number of PrEP users per 100,000 population, and PNR was defined as the ratio of PrEP users to new HIV diagnoses per calendar year. Linear mixed effect regression was employed to identify associations of county-level structural racism (e.g., structural racism in housing and socioeconomic status) with PrEP rate and PNR on a nationwide scale of the US. From 2013 to 2021, the mean PrEP rate and PNR increased from 3.62 to 71.10 and from 0.39 to 10.20, respectively. Counties with more structural racism in housing were more likely to have low PrEP rates (adjusted β = - 5.80, 95% CI [- 8.84, - 2.75]). Higher PNR was found in counties with lower structural racism in socioeconomic status (adjusted β = - 2.64, 95% CI [- 3.68, - 1.61]). Regionally, compared to the Midwest region, counties in the West region were more likely to have higher PrEP rate (adjusted β = 30.99, 95% CI [22.19, 39.80]), and counties in the South had lower PNR (adjusted β = - 1.87, 95% CI [- 2.57, - 1.17]). County-level structural racism plays a crucial role in understanding the challenges of scaling up PrEP coverage. The findings underscore the importance of tailored strategies across different regions and provide valuable insights for future interventions to optimize PrEP implementation.

Spatiotemporal analysis of malaria in the state of Mato Grosso-Legal Amazon, Brazil: identification of high-risk áreas

The objective of the study was to analyze temporal and geographic data to identify high-risk areas for malaria occurrence in the state of Mato Grosso within the Legal Amazon. High-risk areas were identified through scan statistics, and the relative risk (RR) was characterized using cluster maps. Statistical temporal trend analysis was conducted using Prais-Winsten autoregression. A total of 20,819 cases were identified, with higher incidence rates among men. Malaria was predominantly diagnosed via thick blood smear microscopy, with Plasmodium vivax being the most prevalent species. The average incidence ranged from 0.01 to 2,849.85, with higher averages observed in the North, West, and Northwest regions. The Global Moran analysis revealed a positive correlation (0.47) between incidence rates and regions with a higher number of cases, while Local Moran identified distinct infection clusters. Eight risk clusters were delineated using scan statistics, with the highest RR recorded at 90.09. The spatiotemporal scan classified three statistically significant high-risk clusters exhibiting stationary temporal trends. These findings highlight the delineation of high-risk areas for malaria infection in Mato Grosso.

Epidemiological Model of the Regional Distribution and Analysis of Hepatitis B in Ghana: A Sub-Saharan African Country

Hepatitis B (HB) is a global public health burden which has impacted economies of many countries, particularly in sub-Saharan Africa. The effect is worse where there is lack of definite information regarding policy direction and capacity towards implementing interventions to control the transmission and spread of the infection. In this study, a SEIR deterministic compartmental model and a hybrid optimisation method for parameter estimation, similar to that of Awuah-Mensah et al. (2022), were used to analyse the regional distribution of HB in Ghana, a sub-Saharan African country. The regional epidemiological threshold parameters [Formula: see text] and herd immunity threshold parameters [Formula: see text] computed based on the estimated parameters for each of the regions ranged from a minimum of [Formula: see text] for Volta region in the southeast to a maximum of [Formula: see text] for Upper West region in the northwest of Ghana. These values of [Formula: see text] and [Formula: see text] indicated that HB persists in Ghana and the transmission and spread and the associated burden were found to generally increase from south to north of the country. Based on the estimated parameters, only Western region recorded a recovery rate of [Formula: see text]. The remaining nine regions recorded zero recovery rates. The trend of transmission and spread of the infection was also found to be positively related to poverty and health sector inequalities across the regions of the country.

Association between Epstein-Barr virus reactivation and severe malaria in pregnant women living in a malaria-endemic region of Cameroon.

Malaria kills nearly 619,000 people each year. Despite the natural immunity acquired to malaria, pregnant women and children under five die from severe forms of the disease in sub-Saharan Africa. Co-infection with acute Epstein-Barr Virus (EBV) infection has been shown to suppress the anti-malarial humoral responses, but little is known about the impact of EBV reactivation on malaria-associated morbidity. This study investigated the association between EBV reactivation and malaria severity in pregnant women living in a malaria-endemic region in Cameroon. A cross-sectional study was conducted on 220 pregnant women attending antenatal consultations in three health facilities in the West region of Cameroon. Malaria was diagnosed by microscopy, and Plasmodium species were identified by Nested PCR. Plasma samples were analyzed by ELISA for the presence of EBV nuclear antigen, EBV viral capsid antigen, and EBV early antigen to determine EBV reactivation. All statistics were performed using GraphPad Prism and SPSS software. The prevalence of malaria among pregnant women was 23.2%, of which 18.6% were P. falciparum mono-infections and 4.5% mixed infections (3.6% P. falciparum and P. malariae; 0.9% P. falciparum and P. ovale). 99.5% of the women were EBV seropositive, and 13.2% had EBV reactivation. Pregnant women with reactivated EBV were more likely to develop severe malaria than pregnant women with latent EBV (OR 4.33, 95% CI 1.08-17.25, p = 0.03). The median parasitemia in pregnant women with latent EBV was lower than in those with EBV reactivation (2816 vs. 19002 parasites/μL, p = 0.02). Our study revealed that lytic reactivation of EBV may be associated with the severity of malaria in pregnant women. Suggesting that, like acute infection, EBV reactivation should be considered a risk factor for severe malaria in pregnant women in malaria-endemic regions or could serve as a hallmark of malaria severity during pregnancy. Further detailed studies are needed.

Stroke Death Rates Among Adults Ages 45-64 by Region and Race and Hispanic Origin: United States, 2002-2022.

This Data Brief presents trends in stroke death rates among people ages 45-64, in total and by sex, for 2002 to 2022. Trends are also presented for men and women by region (Northeast, Midwest, South, and West) from 2002 to 2022. For 2022, stroke death rates are presented for men and women by race and Hispanic origin within each region. Mortality data for 2002-2017 are from the National Center for Health Statistics' 1999-2020 Underlying Cause of Death by Bridged-Race Categories and data for 2018-2022 are from the 2018-2022 Underlying Cause of Death by Single-Race Categories. Stroke deaths are for people ages 45-64 and are identified by International Classification of Diseases, 10th Revision underlying cause-of-death codes I60-I69. The four regions of the United States are: Northeast, Midwest, South, and West. The four race and Hispanic-origin groups in this report are: Asian non-Hispanic; Black non-Hispanic; White non-Hispanic, and Hispanic. These groups had at least 20 stroke deaths among men and women in all regions to compute reliable rates. Line trends were evaluated using the National Cancer Institute's Joinpoint Regression Program. Pairwise comparisons were tested using the z test statistic at p < 0.05. After declines between 2002 and 2012, stroke death rates for adults ages 45-64 increased 7% between 2012 (20.2 per 100,000) and 2019 (21.7) and an additional 12% through 2021 (24.4). Throughout the period, the highest stroke death rates for both men and women were in the South and the lowest were in the Northeast. In each region, differences in stroke death rates by race and Hispanic origin were seen, as Black men and women had rates that were at least twice those of all other groups.