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Pesticides are chemicals used to enhance crop production. However, their residues can persist and accumulate in various environmental settings. This study assessed the occurrence of pesticide residues and ecological risks in surface water and sediment from the Libga and Builpela dams in northern Ghana. A total of 42 pesticides were analysed. Toxic units were used to assess the acute risk to sediment-dwelling organisms and aquatic biota. Risk quotients were employed to assess the chronic risk to aquatic organisms. Chlorpyrifos, atrazine, profenofos, and chlorfenvinphos were the main chemicals found in surface water. The concentrations were highest near the Builpela dam (0.413μg/L, 2.927μg/L, 0.304μg/L, 0.692μg/L, 0.073μg/L, 0.290μg/L, 0.06μg/L, and absent in the Libga dam). In the sediment, the organophosphates pyrimiphos-methyl and chlorpyrifos were found at high concentrations. They were found in higher quantities in the Libga dam (0.554mg/kg and 0.052mg/kg, respectively) and Builpela dam (0.051mg/kg and 0.043mg/kg, respectively). For organochlorines, p,p'-DDE and p,p'-DDD were the main residues detected at high concentrations. However, concentrations were higher for p,p'-DDD at Builpela than for p,p'-DDE. Additionally, high concentrations of atrazine were detected in this study. The toxic units showed a high acute risk for organisms that live in sediment as a result of chlorpyrifosfos and chlorfenvinphos residues. Similarly, pirimiphos-methyl and chlorfenvinphos, followed by chlorpyrifos, contributed to high acute risk in aquatic invertebrates. Risk quotients showed that both dams had a high long-term risk for aquatic life; however, the risk was higher at the Builpela dam due to Pirimiphos-methyl and Chlorfenvinphos. Ghana's pesticide regulations are less comprehensive and enforcement is often weaker in protecting aquatic organisms. It is recommended to enforce strict limits on pesticide residues. Additionally, there is a need to regularly review and update these regulations based on new scientific data to protect aquatic ecosystems. [ABSTRACT FROM AUTHOR]

Background: Screening for type 2 diabetes (T2DM) and individuals at risk of diabetes has been advocated, yet information on the response rate and diagnostic yield of different screening strategies are lacking. Methods: Studies (from 1998 to March/2015) were identified through Medline, Embase and the Cochrane library and included if they used oral glucose tolerance test (OGTT) and WHO-1998 diagnostic criteria for screening in a community setting. Studies were one-step strategy if participants were invited directly for OGTT and two, three/four step if participants were screened at one or more levels prior to invitation to OGTT. The response rate and diagnostic yield were pooled using Bayesian random-effect meta-analyses. Findings: 47 studies (422754 participants); 29 one-step, 11 two-step and seven three/four-step were identified. Pooled response rate (95% Credible Interval) for invitation to OGTT was 65.5% (53.7, 75.6), 63.1% (44.0, 76.8), and 85.4% (76.4, 93.3) in one, two and three/four-step studies respectively. T2DM yield was 6.6% (5.3, 7.8), 13.1% (4.3, 30.9) and 27.9% (8.6, 66.3) for one, two and three/four-step strategies respectively. The number needed to invite to the OGTT to detect one case of T2DM was 15, 7.6 and 3.6 in one, two, and three/four-step strategies. In two step strategies, there was no difference between the response or yield rates whether the first step was blood test or risk-score. There was evidence of substantial heterogeneity in rates across study populations but this was not explained by the method of invitation, study location (rural versus urban) and developmental index of the country in which the study was performed. Conclusions: Irrespective of the invitation method, developmental status of the countries and or rural/urban location, using a multi-step strategy increases the initial response rate to the invitation to screening for diabetes and reduces the number needed to have the final diagnostic test (OGTT in this study) for a definite diagnosis. [ABSTRACT FROM AUTHOR]

Background: There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a “usual care or no intervention” which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children. Methods: Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model. Results: 28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants. Conclusion: The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison prevention practices they wish to promote. Highlights: [ABSTRACT FROM AUTHOR]

Despite successes in malaria control interventions over the past two decades, malaria remains a major public health concern. Over 125 million women live in endemic areas and experience adverse pregnancy outcomes due to malaria. Understanding health workers' perspectives on malaria identification and management is important to informing policy changes on the control and eradication of the disease. This study explored the perspectives of health workers on malaria case identification and management among pregnant women in Savelugu Municipality, Ghana. A qualitative study with a phenomenology design was conducted among participants. Participants were purposively selected and interviewed using a semi-structured interview guide. Thematic analysis was performed and the results were presented as themes and sub-themes. Four themes and eight sub-themes regarding case identification and management of malaria in pregnancy were identified including malaria case identification training (trained and untrained), identification approach (signs/symptoms and routine laboratory test), diagnostic tools (rapid diagnostic test and microscopy) and management options. It revealed that attending malaria training programs was generally optional. Some of the participants had not undergone any refresher training for malaria identification after their formal training at health institutions. Participants identified malaria by its signs and symptoms. However, they often referred clients for routine laboratory tests for confirmation. When malaria is confirmed in pregnancy, quinine is used for first trimester treatment, while Artemisinin-based Combination Therapies are prescribed after the first trimester. Clindamycin was not used in the first trimester treatment. This study found that training programs were optional for health workers. Some participants have not received refresher training after graduating from health institutions. Treatment of confirmed cases did not include clindamycin for first trimester malaria infections. Malaria refresher training programs should be made mandatory for health workers. Every suspected case should be confirmed using Rapid Diagnostic Test or microscopy before treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)