Nicholas T. K. D. Dayie

Introduction: Malnutrition is a common but often overlooked problem among hospitalised older adults, particularly those admitted with acute infections such as pneumonia. Pneumonia can worsen nutritional status through inflammation, fever, poor appetite, breathlessness, fatigue, and reduced food intake, while malnutrition can, in turn, weaken immunity, reduce respiratory muscle strength, and delay recovery. This study assessed the spectrum of nutritional status among hospitalised older adults with pneumonia at the 37 Military Hospital in Accra, Ghana. Methods: A descriptive cross‐sectional study was conducted among 74 hospitalised adults aged 60 years and above with a confirmed diagnosis of pneumonia. Data were collected on socio‐demographic and health‐related characteristics, dietary intake, anthropometry, and haemoglobin status. Nutritional status was assessed using Body Mass Index (BMI), the Mini Nutritional Assessment (MNA), mid‐upper arm circumference (MUAC), calf circumference, dietary diversity score, and haemoglobin concentration. Associations between nutritional indicators were examined using chi‐square and Monte Carlo exact tests, and multivariable prevalence‐ratio regression was used to identify factors independently associated with MNA‐defined malnutrition and BMI‐defined underweight. Results: Participants had a mean age of 72.3 ± 8.6 years, with 38 males and 36 females. Based on BMI, 66.2% were underweight, 31.1% had a healthy weight, and 2.7% were overweight. The MNA classified 39.2% of participants as malnourished, 50.0% were at risk of malnutrition, and only 10.8% as well nourished. Among participants with haemoglobin data, 77.5% were anaemic. MUAC classified 9.5% as underweight and 32.4% as at risk, while 31.1% had a low calf circumference; 56.8% had inadequate dietary diversity. MUAC and calf circumference were significantly associated with both MNA classification ( p = 0.0047 and p = 0.0309) and BMI category ( p = 0.010 and p = 0.035), whereas MNA classification was not significantly associated with BMI category ( p = 0.142). In multivariable analysis, each 5‐year increase in age was associated with a 21% higher prevalence of MNA‐defined malnutrition (aPR = 1.21, 95% CI: 1.01–1.46, p = 0.040); no factor was independently associated with BMI‐defined underweight. Conclusion: Malnutrition was highly prevalent and manifested in multiple, only partly overlapping forms among hospitalised older adults with pneumonia. Because BMI, MNA, MUAC, calf circumference, and dietary diversity captured related but distinct dimensions of nutritional risk, reliance on a single indicator particularly BMI alone may underestimate the true burden of malnutrition. Routine screening with multiple, low‐cost indicators should be integrated into pneumonia care for older adults to support early detection, targeted intervention, and improved recovery.

Background: Streptococcus pneumoniae, also referred to as pneumococcus, is of immense public health significance. In particular, it causes severe invasive diseases among children. This has led to the recommendation of anti-pneumococcal prophylaxis, including the administration of penicillin and pneumococcal conjugate vaccines (PCVs), which have become available in about 90% of the countries in sub-Saharan Africa. Nonetheless, breakthrough disease still occurs. Also, PCVs can cause a shift in the distribution of pneumococcal serotypes, usually towards non-vaccine types. However, in many sub-Saharan African countries where PCVs have been introduced, there are hardly any comprehensive post-vaccination surveillance data on pneumococcus. Aim: To describe the post-vaccination epidemiology of invasive pneumococcal disease (IPD) in Ghana, including the prevalence, serotype distribution and antibiotic resistance. Methods: The study was cross-sectional and involved 14,597 patients recruited at the Korle Bu Teaching Hospital, Greater Accra Regional Hospital, Princess Marie Louise Children’s Hospital, Ho Regional Hospital, Eastern Regional Hospital, and Zonal Public Health and Reference Laboratory, Tamale. Specimens of cerebrospinal fluid (obtained by lumbar puncture) and blood were collected routinely from meningitis patients, while blood specimens were taken from pneumonia patients. These were cultured for S. pneumoniae following standard microbiological methods and subjected to antimicrobial susceptibility testing. The isolates were serotyped by the pneumotest latex agglutination kit, and the results confirmed by Quellung reaction, using serotype-specific antisera. Results: The overall prevalence of IPD was 0.66% (n = 97), varying across syndromes: bloodstream infections (0.53%, n = 38), meningitis (2.45%, n = 43), and pneumonia (0.28%, n = 16). The majority of the cases (56.70%, n = 55) occurred in the 11–20-year-old group. Ten pneumococcal serotypes were identified, with Serotype 1 being predominant (58.76%), followed by Serotypes 23B (11.34%), 33F (9.28%), and 12F (8.24%). Vaccine serotypes accounted for 81.44% of the isolates, while 18.56% were non-vaccine serotypes (23A, 23B, and 38). Antimicrobial resistance was highest against sulphamethoxazole-trimethoprim (52%), ampicillin (51%), and penicillin (46%). No resistance was observed against ciprofloxacin, levofloxacin, and vancomycin. The multidrug resistance proportion was 42.3% (n = 41). Conclusions: Even in the post-vaccination era, vaccine-type IPD remains a significant public health issue in Ghana. The observed serotype distribution and antimicrobial resistance patterns warrant sustained surveillance, more adaptive vaccination policies, and rigorous antibiotic stewardship to effectively mitigate IPD burden.

Avian influenza (AI) represents a persistent threat to public health, food security, and livelihoods in Ghana, where outbreaks of H5N1 and H9N2 have occurr

Acinetobacter baumannii ( A. baumannii ) is an emerging “superbug” whose infections have become extremely difficult to treat due to its diverse antimicrobial resistance mechanisms and resistance to last-resort antibiotics including carbapenems. Despite this, data on genetic determinants and genomic context of carbapenemase genes in A. baumannii are scarce in Ghana. This study investigated the genetic determinants of carbapenem resistance in clinical isolates of A. baumannii ( Ab ) and explored the genetic contexts of carbapenemase-encoding genes in extensively drug-resistant A. baumannii (XDR- Ab ). We analysed 65 archived clinical A. baumannii isolates. Identification and antimicrobial susceptibility profiles of the isolates were determined using a MALDI-TOF-MS and the Microscan device, respectively. Carbapenem resistant A. baumannii (CR- Ab ) isolates were screened for carbapenemase-encoding genes ( bla _NDM-1 , bla _KPC , bla _VIM , bla _OXA-48 , bla _OXA-23 , bla _OXA-58 , and bla _IMP ) using loop-mediated isothermal amplification (LAMP). Six XDR- Ab isolates were whole-genome sequenced (WGS) using Nanopore MinION. Carbapenem resistance was observed in 18/65 (27.7%) isolates. All CR isolates were resistant to penicillins, cephalosporins, fluroquinolones, aminoglycosides, sulfonamides and carbapenems (minimum inhibitory concentrations, MICs, > 2µg/ml - > 8µg/ml). The most predominant resistance gene, bla _NDM-1 (33.3% ) , was found to co-exist with bla _OXA-23 (27.8%) or bla _OXA-58 (16.7%), while bla _OXA-420 (12.5%) was the least prevalent gene detected. The sequence types identified among the isolates were ST2 (33.3%), ST164 (16.7%), ST214 (16.7%), ST52 (16.7%), and ST16 (16.7%) according to MLST-Pasteur scheme. The study highlights the carriage of multiple carbapenemase genes, other AMR-encoding genes and efflux pumps in XDR clinical A. baumannii isolates. To the best of our knowledge, the study reports for the first time, the detection of ST2 OXA-23, NDM-1 and ST164 OXA-58, NDM-1-producing A. baumannii strains at the Korle Bu Teaching Hospital. These strains belong to high-risk clones and continuous surveillance through molecular epidemiological studies and public health interventions are urgently needed to control their spread in Ghana.

Respiratory infections are prevalent among individuals with compromised immune systems. While these infections are typically self-limiting, they can cause

Background: Intestinal parasitic infections (IPIs) pose a significant public health burden in developing regions, disproportionately affecting children. This study investigated the prevalence, determinants, and co‐occurrence patterns of IPIs among schoolchildren in rural Krachi East Municipality, Oti Region, Ghana. Methodology: A cross‐sectional study (March–August 2024) enrolled 204 schoolchildren (aged 4–15 years) via simple random sampling. Sociodemographic and risk factor data were collected, using standardized questionnaires. Single fresh stool specimens were microscopically examined using direct wet mount, sedimentation, and Kato–Katz techniques. Data were analyzed with STATA version 18. Results: Overall IPI prevalence was 63.23% ( n = 129), with monoparasitism at 33.3% ( n = 68). Key parasites included Ascaris lumbricoides (57.4%), Hookworm (38.7%), and Giardia duodenalis (21.6%), Entamoeba dispar/histolytica (14.2%), and Trichuris trichiura (11.3%). Polyparasitism was common, with protozoan–helminth (19.38%) and helminth–helminth (27.13%) co‐infections. A. lumbricoides and Hookworm were predominant in co‐infections. Home‐cooked meals and awareness of IPIs reduced the odds of infection. Conversely, Kumasi Ventilated Improved Pit (KVIP) and pit latrines at school paradoxically increased G. duodenalis infection risk, whereas fingernail‐biting showed a counterintuitive protective association against G. duodenalis infections. Conclusion: A high IPI burden, including significant polyparasitism, exists among the schoolchildren in the study area. The findings underscore the urgent need for integrated deworming programs, improved sanitation, and targeted health education to reduce morbidity in this vulnerable population, directly contributing to SDG 3 (Good Health and Well‐being) by addressing preventable diseases and promoting health, and SDG 4 (Quality Education) by improving the health and educational outcomes of schoolchildren.

Background: Trichomoniasis is a non‐viral neglected sexually transmitted disease of public health importance. Undergraduate students, often experiencing newfound freedom from family oversight, may engage in risky sexual behaviors, predisposing them to trichomoniasis and other sexually transmitted infections (STIs). This study aimed to assess the knowledge, attitudes, and practices towards trichomoniasis and associated factors among the Central University students in the Greater Accra Region of Ghana. Methods: An institutional cross‐sectional study was conducted between March and July 2024, involving 387 undergraduate students from Central University who were selected using a simple random sampling technique. Data were collected using a structured researcher‐led interview with respondents in the Schools of Nursing and Midwifery, Pharmacy, and Medical Sciences. The study used bivariate and multivariable logistic regression (STATA MP Version 16) to identify factors linked to trichomoniasis, calculating odds ratios (95% confidence intervals [CI]) to measure associations. Multivariable analysis considered variables with a p value Trichomonas vaginalis infection. Results: The study included 387 participants (81.40% female, 18.60% male; mean age 20). About 171 (44.19%), 150 (38.76%), and 66 (17.05%) were pharmacy, nursing, and physician assistantship studies students, respectively. Significant associations with T. vaginalis infection were observed for gender ( p = 0.0169), age ( p < 0.0001), attitude ( p < 0.0001), and knowledge (68.0% good knowledge; 82.89% good attitude). Females exhibited twice the likelihood of higher knowledge (aOR = 2.022, 95%CI = 1.128–2.912, p = 0.012) compared to males. Conclusion: The study revealed a good level of knowledge, positive attitudes, and effective preventive practices regarding trichomoniasis among the students. Gender, age, program of study, knowledge, and attitudes were significantly associated with self‐reported risk behaviors. The study recommends targeted reproductive health education, particularly on trichomoniasis and STIs, to enhance safer sexual behaviors among tertiary students.

Surgical site infections (SSIs) caused by Pseudomonas aeruginosa pose significant challenges in healthcare, particularly in low and middle-income countries (LMICs). Understanding the genomic characteristics and antimicrobial resistance profiles of P. aeruginosa isolates is crucial for informing appropriate treatment and guiding infection prevention and control strategies. P. aeruginosa isolates recovered from SSIs were analyzed using whole-genome sequencing and antimicrobial susceptibility testing. The isolates were identified using matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-ToF MS) system, and their antibiotic susceptibilities were determined using the Kirby–Bauer disk diffusion method and interpreted with Clinical and Laboratory Standards Institute guidelines. Whole-genome sequencing was performed using the Illumina MiSeq platform, and sequence data were analyzed using free online bioinformatics tools, including CARD-RGI, ResFinder, PAst, VFDB, and MLST. Between July 2018 and September 2023, 563 patients were enrolled in a surgical site infection study, which led to the recovery of 82 P . aeruginosa isolates. The isolates were resistant to ciprofloxacin ( n = 23, 28.05%), gentamicin ( n = 20, 24.39%), piperacillin-tazobactam ( n = 13, 15.85%), cefepime ( n = 12, 14.63%), ceftazidime ( n = 12, 14.63%), meropenem ( n = 10, 12.20%), and amikacin ( n = 8, 9.76%). Multidrug resistance was noted in 10 isolates (12.20%), with three isolates resistant to all antibiotics tested ( n = 3, 3.7%). Sequence data revealed international high-risk clones: ST308 and ST773 ( n = 5 each, 6.10%), ST244 ( n = 4, 4.88%), ST446, ST357, and ST654 ( n = 2 each, 2.44%), and ST235 ( n = 1, 1.41%). Newly identified sequence types ST4287, ST4288, ST4289, ST4521, ST4522, ST4523, and ST4524 were also detected. Serotype O11 ( n = 28, 34.15%) was the most prevalent, followed by O5, O6, and O4. Key virulence genes, such as algD , lasB , exoS , plcH , toxA , and plcN , were also detected. The identification of both high-risk and novel clones, coupled with diverse resistance and virulence factors, underscores the need for continuous surveillance of circulating strains. Employing advanced technologies, such as whole-genome sequencing, is essential for guiding infection control and treatment strategies in Ghanaian hospital settings. IMPORTANCE: Surgical site infections (SSIs) caused by multidrug-resistant Pseudomonas aeruginosa are a major challenge to patient care, particularly in low-resource settings. This study reveals extensive genomic diversity, antimicrobial resistance, and virulence profiles among P. aeruginosa isolates from SSIs in Ghanaian hospitals. The detection of globally recognized high-risk clones ST235, ST308, and ST773, alongside several novel sequence types, suggests ongoing genomic evolution and the potential for regional dissemination. The presence of resistance to last-line antibiotics and key virulence factors highlights the therapeutic and public health challenges in low and middle-income countries. These findings underscore the urgent need for genomic surveillance, strengthened infection prevention and control, and targeted antimicrobial stewardship programs to inform treatment strategies and health policies across Ghana and the broader African region.

Syphilis, which is caused by Treponema pallidum, remains one of the most common congenital infection worldwide and has tremendous consequences for the mother and her developing foetus if left untreated. The complexity of the exposure to this pathogen extends beyond the well-established clinical manifestations, as it can profoundly affect placental histomorphology. This study aimed to compare T. pallidum-exposed placental villi structures with healthy placentae at term to evaluate the histomorphological differences using stereology. In this case-control study conducted at term (38 weeks ± 2 weeks), 78 placentae were collected from the hospital delivery suites, comprising 39 cases (T. pallidum-exposed) and 39 controls (non-exposed), who were gestational age-matched with other potential confounders excluded. Blood samples from the umbilical vein and placental basal plate were tested for syphilis, using rapid diagnostic test (RDT) kits for T. pallidum (TP) antibodies (IgG and IgM) to classify placentae as exposed to T. pallidum (cases) and non-exposed (controls). Tissue sections were prepared and stained with haematoxylin and eosin, and the mean volume densities of syncytial knots, foetal capillaries, syncytial denuded areas, and intervillous spaces were estimated using stereological methods. Statistical analysis was performed to compare the mean values between the case and control groups. Stereological assessment revealed significant differences between the T. pallidum-exposed and non-exposed groups with regard to syncytial knots (p < 0.0001), syncytial denudation (p < 0.0001), and foetal capillaries (p < 0.0001), but no significant difference in the intervillous space was found (p = 0.1592). Therefore, our study shows, for the first time, that the histomorphology of human placental villi appears to be altered by exposure to T. pallidum. It will, therefore, be interesting to determine whether these changes in the placental villi translate into long-term effects on the baby.

Background: Salmonella infections impose a substantial global health burden, with an estimated 95.1 million cases occurring annually. Pregnant women exhibit a heightened vulnerability due to pregnancy-specific immune adaptations and dietary habits that increase their risk of Salmonella exposure, facilitating possible damage to the placental barrier. Despite this significant burden, Salmonella-associated placental pathology remains poorly understood, particularly its impact on foetal development through microstructural alterations. Aim: This study utilised stereology to assess histomorphological and functional alterations in term placentae of Salmonella Typhi-exposed placentae, compared to unexposed controls. Methods: A hospital-based case-control study was conducted in Ghana. Of 237 screened women, 62 placentae were selected for analysis, comprising 31 Salmonella-exposed cases (IgG/IgM-positive in placental and cord blood) and 31 gestational age-matched controls (IgG/IgM-negative). Placental tissues were processed for histology and stereology. Neonatal birthweights were also compared. Results: Stereological assessment revealed significantly higher mean volume densities of syncytial knots in the study group (0.4755 ± 0.04) compared to the controls (0.3342 ± 0.04, p = 0.0219). Syncytial denudation was increased in the study group (0.8113 ± 0.09) relative to the controls (0.1975 ± 0.08, p < 0.0001). Foetal capillary volume density was also significantly elevated in the study group (5.1010 ± 0.32) compared to the controls (3.562 ± 0.47, p < 0.0001). In contrast, intervillous space volume was significantly reduced in the study group (9.5810 ± 0.05) compared to the controls (11.593 ± 0.26, p = 0.0053). Neonates of exposed mothers showed a non-significant reduction in birthweight. Conclusion: Salmonella Typhi exposure in pregnancy induces subtle, yet significant alterations in placental architecture, compromising villous integrity and vascular organisation. Although birthweight may appear unaffected, the observed changes point to reduced placental efficiency and merit further research into their developmental consequences and long-term effects on babies.