Search

Ghana has made significant strides in maternal healthcare under the National Health Insurance Scheme, but more effort is required to achieve the Sustainable Development Goal 3.1 target of A total of 1295 consenting pregnant women participated in the study. Information on sociodemographic characteristics, knowledge about ANC, IPTp and knowledge about malaria were collected by questionnaire. Chi-square tests were used to compare proportions of variables across the two study sites.Higher proportion (70.8%) of participants accessing Battor Catholic Hospital showed adequate knowledge about ANC than 38.1% in Adidome Government Hospital (X2(7) =105.11; pX2(2) =83.37; p80%) possess and use mosquito bed nets for malaria prevention. A lower proportion (46.6%) of participants in Battor Catholic Hospital made the WHO recommended 4-7 visits compared to 50.2% participants in Adidome Government Hospital. Age, marital status, employment and education influenced utilization of antenatal and delivery services. More sensitization on the importance of ANC and hospital delivery is needed in the study areas.

BackgroundSoil Transmitted helminths and schistosomiasis may have implications for pregnancy outcomes especially, in rural communities. In Adidome (a rural community) and Battor (a semi-rural community), soil and water contact activities expose inhabitants to helminth infections. There is, however, limited information on the prevalence and determinants among pregnant women in these areas. The present study was conducted to access the prevalence, knowledge and perceptions about helminthiasis among pregnant women accessing obstetric care at Adidome Government Hospital and Battor Catholic Hospital in the Volta region of Ghana.Methodology/Principal FindingsA cross-sectional survey was conducted by recruiting 1,295 pregnant women out of which only 616 representing 47.5% provided stool samples for analysis. Sociodemographic characteristics and participant knowledge on helminth infection transmission, symptoms and prevention were collected by questionnaire and analyzed using STATA. Preserved stool specimen were processed and examined for helminth eggs by Kato Katz, and genomic DNA extracted from aliquots, was tested forS. mansoniandN. americanus. Prevalence of helminths and participant knowledge were expressed in proportions. Chi-square and Fisher’s exact test were used to show association at P < 0.05 significant level. Intestinal helminth infections found among participants at ANC wereT. trichiura(0.4%),N. americanus(0.4%) andS. mansoni(0.4%). At delivery, a PCR prevalence of 5% was observed forS. mansoni. A high proportion of study participants, 82.5% in Adidome and 87.1% in Battor do not take dewormers on regular basis. Also, a high proportion of participants did not receive any dewormer prior to sample collection. Although knowledge on helminth transmission, risks and prevention were low, levels of prevalence of infection with helminths were also low.Conclusion/SignificanceIntensifying health education as community-based interventions is necessary for the total and effective control and elimination of schistosomiasis and STH in the study area.Author summaryAdidome and Battor are two communities sited close to the Volta Lake which is known to be infested with intermediate hosts for schistosomiasis. Consequently, there has been continued efforts towards control by mass deworming especially among pre-school and school-going children. Despite these control efforts, infections persist as older age groups including pregnant women are often left out of such programs. The fertile soil in the Volta basin encourages farming activities which further expose the people to soil transmitted helminths. There is therefore a need to evaluate community knowledge on helminth infection and precautions to be taken to improve on the control efforts in the areas. The study selected two district Hospitals (a private Hospital in Battor and a government Hospital in Adidome) as study sites. Stool samples collected from pregnant women reporting for the first antenatal care and for delivery were examined for the presence of helminths. Knowledge about helminths among participants were collated by questionnaire. Although prevalences of helminth infections were low, knowledge about helminth infections were also low. However, participants from Battor appear more knowledgeable about helminth infections than those in Adidome. Our study therefore suggests intensive public health education as an intervention for control.

BackgroundThe human host elicits specific immune responses after exposure to various life stages of the malaria parasite as well as components of mosquito saliva injected into the host during a mosquito bite. This study describes differences in IgG responses against antigens derived from the sporozoite (PfCSP), asexual stage parasite (PfEBA175) and the gametocyte (Pfs230) in addition to anAnopheles gambiaesalivary gland antigen (gSG6-P1) in two communities in Ghana with similar blood stage malaria parasite prevalence.MethodologyThis study used archived plasma samples collected from an earlier cross-sectional study that enrolled volunteers aged from 6 months to 70 years from Simiw, peri-urban community (N=347) and Obom, rural community (N=291). An archived thick and thin blood smear for microscopy was used for the estimation ofPlasmodiumparasite density and species and DNA extraction from blood spots andP. falciparumconfirmation was performed using PCR. This study used the stored plasma samples to determine IgG antibody levels toPlasmodium falciparumandAnophelessalivary antigens using indirect ELISA.ResultsIndividuals from Simiw had significantly higher levels of IgG against mosquito gSG6-P1 (median (95%CI)) (2.590 (2.452-2.783) ng/mL) compared to those from Obom (2.119 (1.957-2.345) ng/mL), p0.05).ConclusionIn conclusion, malaria transmission dynamics is highly complex. The similar malaria transmission intensity identified in the two communities resulted from a different combination of vector, environmental and host factors. With one community likely having a higher prevalence of uninfected mosquitoes and the other a larger reservoir of gametocyte carriers.

The RTS,S/AS01E vaccine targets the circumsporozoite protein (CSP) of the Plasmodium falciparum parasite. Using protein microarrays, levels of IgG to 1,000 P. falciparum antigens were measured in 2,138 infants (age 6-12 weeks) and children (age 5-17 months) from 6 African sites of the phase 3 trial, sampled before and at four longitudinal visits after vaccination. One month post-vaccination, IgG responses to 17% of all probed antigens showed differences between RTS,S/AS01E and comparator vaccination groups, whereas no pre-vaccination differences were found. A small subset of antigens presented IgG levels reaching 4- to 8-fold increases in the RTS,S/AS01E group, comparable in magnitude to anti-CSP IgG levels (∼11-fold increase). They were strongly cross-correlated and correlated with anti-CSP levels, waning similarly over time and re-increasing with the booster dose. Such an intriguing phenomenon may be due to cross-reactivity of anti-CSP antibodies with these antigens. RTS,S/AS01E vaccinees with strong off-target IgG responses had an estimated lower clinical malaria incidence after adjusting for age group, site and post-vaccination anti-CSP levels. RTS,S/AS01E-induced IgG may bind strongly not only to CSP, but to unrelated malaria antigens, and this seems to either confer, or at least be a marker of, increased protection from clinical malaria.