AAMUSTED Knowledge Manager

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    Assessing Chemical Insecticide Susceptibility/Resistance Profiles of Malaria Vectors in Three Districts of the Upper West Region of Ghana, and their Public Health Implications.
    (ARTHUR, Isaac, 2025-12) ARTHUR, Isaac
    Malaria remains a major public health concern in Ghana, including the Upper West Region, where the intensity of its transmission persists at high levels. The increasing emergence of insecticide resistance in Anopheles gambiae sensu lato vector populations is a major threat to the effectiveness of malaria vector control strategies. The current study assessed the susceptibility of malaria vector populations in Wa, Nadowli, and Lawra districts to older classes of key synthetic chemical insecticides, including pyrethroid (deltamethrin and permethrin), carbamate (bendiocarb), and organophosphate (pirimiphos-methyl); as well as a newer class: neonicotinoid (clothianidin). The evaluation of insecticide resistance in the malaria vector population was conducted using the WHO susceptibility bioassay guidelines and kits. Mosquito larvae were collected from selected breeding sites and reared to adults. Overall, 300 female Anopheles gambiae s.l. were exposed to varying concentrations of insecticides. Knockdowns and mortalities were recorded. Results revealed considerable variability in susceptibility across sites and insecticide classes. Knockdown rates (KDRs) ranged from 4.0% to 16.0% at lower deltamethrin concentrations but reached 100% at higher doses. Higher KDT₅₀ and KDT₉₅ values were estimated for wild mosquito populations compared with the standard Kisumu susceptible strain. The highest KDTs were calculated for the pyrethroid-based bioassays, with resistance ratios for KDT50 >5. This suggests significant physiological resistance in the wild mosquito population. For pyrethroid-based bioassays, mortality rates ranged from 20.0% for 0.05% deltamethrin to 100% for 0.50% deltamethrin. In addition, mortality rates for the permethrin ranged from 38.0% to 99.0%. For the carbamate and organophosphate bioassays, respectively, 0.10% bendiocarb induced mortalities ranging from 59.0% to 84.0% while pirimiphosmethyl achieved higher rates (87-99%). However, 2% clothianidin-based bioassays yielded 100% mortality within 24 hours. These findings suggest considerable resistance in the wild An. gambiae s.l. populations to the older classes of insecticides but high susceptibility to the newer insecticide class, justifying the choice of indoor residual spraying insecticide formulation that includes clothianidin for the Upper West Region.
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    Transmission Dynamics of Typhoid Fever in the Ejura/Sekyedumase Municipality of The Ashanti Region, Ghana: A Ten-Year Retrospective Trend Analysis.
    (APPIAH, Stephen, 2025-09) APPIAH, Stephen
    This study examined the transmission dynamics and temporal trends of typhoid fever in Ejura/Sekyedumase over ten years (2013–2023), with specific objectives to (1) determine the prevalence and trends of typhoid fever; (2) analyze socio-demographic patterns across age and gender; and (3) evaluate the influence of seasonality and climate on disease incidence using predictive time-series models. A retrospective design was employed, utilizing secondary health data from the Ejura/Sekyedumase Municipal Health Directorate. Monthly reported typhoid cases were aggregated, cleaned, and analyzed using R (version 4.3.2). Time-series modelling involved Seasonal-Trend decomposition (STL) and Auto-Regressive Integrated Moving Average (ARIMA) modelling, with further validation using Error-Trend-Seasonal (ETS) and Prophet forecasting techniques. The findings revealed a persistent endemic trend with recurrent seasonal peaks, particularly during the rainy months (May–August). Young adults aged 20 years and above (≥ 20) exhibited the highest burden, accounting for over two-thirds of reported cases, followed by adolescents (15-19 years old). A gender analysis revealed a slightly higher incidence among females, reflecting gendered exposure patterns associated with water collection, domestic food preparation, and childcare. The Augmented Dickey–Fuller (ADF) and KPSS tests confirmed non-stationarity in the original series (ADF p = 0.207; KPSS p = 0.039), leading to first differencing before modelling. The ARIMA (1,1,1)(1,1,1)[12] model provided the best fit (AIC = 1451.72, RMSE = 95.51), capturing both short-term fluctuations and strong annual seasonality. The study concludes that typhoid fever in Ejura/Sekyedumase is driven by a combination of seasonal climatic variability, poor sanitation, and socio-cultural practices that facilitate faecal–oral transmission.
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    Microbial Carriage and Antibiotic Resistance Profile of Bacteria in Cockroaches in Public Places And Households in Ashanti Mampong, Ghana.
    (AYEMGAH, Esther, 2025-09) AYEMGAH, Esther
    Cockroaches are common pests in human environments and important carriers of pathogenic microorganisms. This cross-sectional study was conducted to examine the microbial carriage and antibiotic resistance profiles of bacteria isolated from cockroaches collected from hospitals, eateries, and households in the Ashanti Mampong Municipality, Ghana. A total of 358 cockroaches were collected and examined for parasite and bacterial carriage, as well as antimicrobial resistance patterns of the bacteria isolated. The results showed that 242 (67.6%) of the cockroaches carried at least one parasite, with Ascaris being the most prevalent, found in 199 (55.6%) of the cockroaches, and Toxoascaris in 172 (48.0%) of the cockroaches. Co-carriage were common, with 66 (18.4%) carrying two parasites and 28 (7.8%) carrying three or more. Bacterial prevalence was also high, with 217 (74.6%) of samples testing positive. Salmonella 214 (73.5%) and Enterococcus 201 (69.1%) were the most frequently isolated, while E. coli 68 (23.4%) and Proteus 58 (19.9%) were relatively less common. Antibiotic susceptibility testing revealed high resistance to chloramphenicol, ampicillin, and clindamycin, ranging between 55% and 75%. Moderate resistance was observed for erythromycin and amoxicillin-clavulanate (45–67%), while ciprofloxacin and azithromycin showed the lowest resistance levels (below 27% and 11%, respectively). Klebsiella and Salmonella were the most resistant bacteria, while Proteus and Shigella exhibited moderate resistance. The findings confirm that cockroaches act as reservoirs and vectors of medically important and antibiotic-resistant microorganisms in different environments. This poses a significant threat to both community- and hospital-acquired infections. Effective cockroach control and improved sanitation practices are crucial for reducing the spread of resistant pathogens in both public and domestic settings.
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    Comparative Diagnosis of Typhoid Fever using Typhidot and Widal Methods with Culture At The Korle Bu Teaching Hospital in the Greater Accra Region, Ghana.
    (ASAGA, Eunice, 2025-09) ASAGA, Eunice
    Typhoid fever remains a persistent public health challenge in many low- and middle income countries, including Ghana. Accurate and timely diagnosis is crucial for effective case management and prevention of antimicrobial resistance. Although stool culture is considered the gold standard, limited laboratory capacity has necessitated reliance on rapid serological methods such as Widal and Typhidot tests, whose diagnostic accuracy remains uncertain in the Ghanaian context. The current study compared the diagnostic performance of Typhidot and Widal tests with stool culture for the detection of typhoid fever at Korle-Bu Teaching Hospital, Accra. Furthermore, this study examined the relationships between socio-demographic factors, clinical symptoms, personal hygiene practices, antibiotic use, and typhoid infection. A crosssectional study was conducted among 234 suspected typhoid patients. Blood and stool samples were tested using Widal, Typhidot, and stool culture methods. Sensitivity, specificity, predictive values, and agreement were calculated. In addition, logistic regression was used to examine the associations between infection and risk factors. The prevalence of typhoid fever varied widely by method: Typhidot (50.4%), Widal (35.9%), and stool culture (5.1%). Typhidot detected all culture-positive cases, showing 100% sensitivity and 52.3% specificity, while Widal recorded 83.3% sensitivity and 32.4% specificity. Both tests had poor PPVs (approximately 10.2% and 6.3% respectively) but high NPVs (>97%). Agreement between Typhidot and Widal was moderate (κ = 0.47, p < 0.001). Socio-demographic variables (age, sex, marital status, and insurance status) and most clinical symptoms showed no significant associations with infection. However, a prior history of typhoid was associated with a higher positivity rate (AOR = 2.06, p = 0.008). Typhidot outperformed Widal in terms of sensitivity; however, both tests exhibited low specificity and predictive values compared to stool culture, thereby limiting their reliability as standalone diagnostic tools. Strengthening culture-based diagnostics and promoting rational antibiotic use are crucial for enhancing case management and reducing antibiotic resistance.
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    Prevalence and Factors Associated with Anaemia in Pregnancy among Antenatal Attendants at the Mampong Municipal Hospital.
    (AGYEMANG, Gyanea Sandra, 2025-03) AGYEMANG, Gyanea Sandra
    Anaemia in pregnancy remains a major public health concern, particularly in resource-limited settings. This study assessed the prevalence and associated factors of anaemia among pregnant women attending antenatal care at the Mampong Municipal Hospital. A cross-sectional study design was employed, involving 381 participants. A structured questionnaire was designed to collect data from pregnant women. The findings revealed a high prevalence of anaemia (60.6%), with severe anaemia (23.6%) being the most common form. The study identified significant associations between anaemia and socio demographic factors, including age, educational level, occupation, and income. Women aged 35–44 years had the highest prevalence (77.5%), and those with no formal education were at greater risk (85.5%). Also, unemployed women (93.5%) and those earning below 500 GHS per month (93.3%) were disproportionately affected. Advanced statistical analysis, including logistic regression, revealed that women with no formal education had 3.25 times higher odds of anaemia (p=0.006), and unemployed women had 7.12 times higher odds (p=0.001) compared to those employed. Household income was a key determinant, with women earning less than 500 GHS having 5.88 times higher odds of anaemia (p<0.001). Furthermore, nutritional factors significantly influenced anaemia risk, with regular iron-rich food intake showing a protective effect (r = -0.22, p = 0.001) and daily iron supplementation reducing anaemia risk (r = -0.30, p = 0.0005).Antenatal education and healthcare practices also played a role, as women who did not receive iron supplements during ANC visits had nearly twice the odds of anaemia (OR = 1.90, p < 0.001). Lack of adherence to iron supplementation increased the risk significantly (OR = 1.72, p < 0.The study indicates the need for comprehensive interventions, including improved nutrition education, enhanced antenatal care services, and socioeconomic support programmes to mitigate anaemia among pregnant women.