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Background: Stroke is a devastating complication of Sickle Cell Disease (SCD) with significant mortality and substantial morbidity. The burden of prevalent stroke in SCD is highest in sub-Saharan Africa and estimated at 4.2 % to 6.4 % in the era where evidence-based prevention strategies such as use of hydroxyurea therapy and transcranial doppler ultrasound were not routine care., Purpose: To assess the contemporary frequency and factors associated with prevalent stroke across the lifespan in an SCD registry at the tertiary medical center in Ghana., Methods: This is a cross-sectional study conducted at the Komfo Anokye Teaching Hospital, a tertiary medical center in the middle belt of Ghana. The center has comprehensive Sickle Cell Clinics for children, adolescents, and adults with a patient registry established as part of the Sickle Pan-African Research Consortium (SPARCo)-Ghana study from 2017 to date. Data captured in the registry and analyzed for the present study include demographics, stroke status using the WHO criteria supplemented by the Questionnaire for Verifying Stroke Free Status (QVSFS), use of hydroxyurea, and complete blood count. Logistic regression modeling was utilized to assess factors associated with stroke., Results: Among a registry cohort of 4115 individuals with confirmed SCD, 35 (0.85 %, 95 % CI: 0.59-1.18 %) had overt or clinically confirmed stroke. The frequency of stroke differed significantly across the lifespan being 0.38 % (95 % CI: 0.12-0.64 %) among children <10 years, 1.23 % (95 % CI: 0.73-1.94 %) among adolescents aged 10 to 17 years, and 1.44 % (95 % CI: 0.66-2.71 %) among adults 18 years or more, p = 0.007. In adjusted analysis, each 10-year increase in age was associated with odds ratio, OR (95 % CI) of 1.90 (1.42-2.54) and hydroxyurea use, OR of 6.09 (2.65-13.99). The association between hydroxyurea and stroke observed in this cross-sectional study is not causal., Conclusion: Approximately 1 in 120 SCD patients in this large Ghanaian cohort had clinically overt stroke. The gradual uptake of hydroxyurea therapy into routine care for SCD in this resource-limited setting, may partly explain the lower frequency of stroke., Competing Interests: Declaration of competing interest None to declare., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: Contact lens (CL) practice is relatively new in Ghana; a country where the geographical location (warm climate) lends itself to harsh environmental conditions (high humidity) known to influence CL wear. Recent studies suggest an increase in CL wear (corrective and cosmetic), yet, there are no studies about CL-related complications. This study sought to determine the complications associated with CL wear in Ghana., Methods: This was a retrospective cohort study. The medical records of contact lens wearers from five CL clinics in the two largest metropolises in Ghana, Accra and Kumasi, were reviewed. Included in the study were records of individuals who visited the clinics within the period of 2013-2016. Data on patients with contact lens-related complications were analyzed., Results: The prevalence of CL complications was 29.06 %. The mean ± SD age of patients with CL complications was 35 ± 15 years. Contact lens complications were more common in females (52.90 %). The majority of complications were in soft contact lens wearers (82.35 %). Refractive error correction was the most common indication for CL wear (61.76 %) among those with complications, followed by keratoconus (14.71 %), scarred blind eye (14.71 %), corneal ulcer (5.88 %) and anterior staphyloma (2.94 %). Contact lens complications reported were giant papillary conjunctivitis (41.18 %), corneal infiltrates (23.53 %), bacterial keratitis (14.71 %), corneal abrasion (11.76 %), dry eye (5.88 %) and corneal oedema (2.94 %). The causes of CL complication were inappropriate lens cleaning (29.41 %), poor hygiene (23.53 %), overnight contact lens wear (17.64 %), poor lens fit (14.71 %) and reaction to contact lens solution (14.71 %)., Conclusion: Contact lens complications were more common in soft contact lens wearers in Ghana. Giant papillary conjunctivitis was the most common contact lens complication reported. Adherence to CL wear care regimen and good personal hygiene may prevent the majority of CL complications observed in Ghana., (Copyright © 2019 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

A significant population within the Lower Volta River Basin of Ghana relies solely on untreated groundwater (GW) and surface water (SW) for various purposes. However, negative practices associated with increasing human activities pose threats to particularly GW quality in the basin. Using NO 3 - as a proxy, this study mainly focused on the status of GW contamination, origins of NO 3 - and potential human health risks through integrated hydrochemistry, correlation analysis, isotopes ( 15 N, δ 18 O), Bayesian and USEPA human health risk models. Slightly acidic to alkaline GW and SW environments were observed. Electrical conductivity (EC) values above 1000 μS/cm were recorded in 45% of the GW with a maximum of 19370 μS/cm. NO 3 - in GW ranged from 0.12 to 733 mg/L with average 59.6 mg/L and positively correlated with K + , Ca 2+ , Mg 2+, Cl - , Na + and EC. In SW, a maximum of 5.3 mg/L of NO 3 - was observed. Largely, 75% of the GW exceeded local background NO 3 - value of 2.1 mg/L, while 35% were above the WHO recommended value of 50 mg/L. Bivariate and correlation relationships elucidated human contributions to sources of NO 3 - , Cl - , SO 4 2- and K + to GW in the basin. From NO 3 - /Cl - ratio, 43% of the GW and 21% of SW were affected by effluents and agrochemicals. Values for δ 15 N-NO 3 - and δ 18 O-NO 3 - ranged from +4.2‰ to +27.5‰ and +4.5‰ to +19.9‰ for GW, and from +3.8‰ to +14.0‰ and +10.7‰ to +25.2‰ for SW. Manure, septic effluents and mineralized fertilizers are sources of NO 3 - contamination of water in the basin. The Bayesian model apportioned 80% of GW NO 3 - contamination to sewage/manure. Hazard index indicated 70%, 50% and 48% medium to high-risk levels for infants, children and adults respectively, with 79% high-risk of SW NO 2 - contamination to infants. Immediate measures for GW and SW quality protection are recommended., Competing Interests: Declaration of competing interests There is no conflict of interest issue regarding the publication of this manuscript., (Copyright © 2020 Elsevier Inc. All rights reserved.)