Introduction accurate and timely laboratory diagnosis of yellow fever (YF) is critical to the Eliminate Yellow Fever Epidemics (EYE) strategy. Gavi, the Vaccine Alliance recognized the need to support and build capacity in the national and regional laboratories in the Global YF Laboratory Network (GYFLN) as part of this strategy. Methods to better understand current capacity, gaps and needs of the GYFLN laboratories in Africa, assessments were carried out in national and regional reference laboratories in the 25 African countries at high risk for YF outbreaks that were eligible for new financial support from Gavi. Results the assessments found that the GYFLN in Africa has high capacity but 21% of specimens were not tested due to lack of testing kits or reagents and approximately 50% of presumptive YF cases were not confirmed at the regional reference laboratory due to problems with shipping. Conclusion the laboratory assessments helped to document the baseline capacities of these laboratories prior to Gavi funding to support strengthening YF laboratories.

Background Soil-transmitted helminths (STHs) pose a formidable health risk to school-age children in resource-limited settings. Unfortunately, mass deworming campaigns have been derailed since the onset of the coronavirus disease 2019 pandemic. The present study assessed the cross-sectional associations between STHs, nutritional status and academic performance of schoolchildren in the Banda District of Ghana. Methods Schoolchildren (5–16 y of age; n=275) were recruited through both school and household visits by community health workers using a multistage cluster sampling technique. In addition to school microscopy, anthropometric records were also taken. Results The prevalence of geohelminthiasis was 40.4% (95% confidence interval 34.6 to 46.2). STHs targeted for elimination by the World Health Organization and national programmes were detected among schoolchildren. Children with intestinal parasite infection (53.7 [standard deviation {SD} 11.5]) had lower mean academic scores compared with uninfected children (59.6 [SD 16.9]) (p=0.034). In multiple regression analysis, intestinal parasite infection status and z-scores for weight-for-age showed a collective significant effect on the academic score (F1117=8.169, p<0.001, R2=0.125). Conclusions Schoolchildren with STHs had poorer academic performance compared with uninfected children, despite their nutritional status. In addition to school feeding programmes, school-based mass drug administration campaigns may be critical for improving learning outcomes in young schoolchildren.

Yellow fever is endemic in Ghana and outbreaks occur periodically. The prodromal signs due to Yellow Fever Virus (YFV) infection are non-specific, making clinical signs unreliable as the sole criteria for diagnosis. Accurate laboratory confirmation of suspected yellow fever cases is therefore vital in surveillance programs. Reporting of ELISA IgM testing results by laboratories can delay due to late arrival of samples from the collection sites as well as limited availability of ELISA kits. In this study, the diagnostic performance characteristics of a rapid immunochromatographic Standard Q Yellow Fever IgM test kit (SD Biosensor) was evaluated for the rapid diagnosis of Yellow Fever infection in Ghana. A panel of 275 sera, comprising 81 confirmed YFV positives and 194 negatives were re-tested in this study using the Standard Q Yellow Fever IgM test kit. Using the CDC/WHO Yellow Fever IgM capture ELISA as a benchmark, the sensitivity, specificity and accuracy of the Standard Q Yellow Fever test kit were 96.3%, 97.9% and 97.5%, respectively. The false positivity rate was 5.1% and there was no cross-reactivity when the Standard Q Yellow Fever test kit was tested against dengue, malaria and hepatitis B and C positive samples. In addition, inter-reader variability and invalid rate were both zero. The results indicate that the diagnostic performance of the Standard Q Yellow Fever IgM test kit on serum or plasma is comparable to the serum IgM detection by ELISA and can be used as a point of care rapid diagnostic test kit for YFV infection in endemic areas.

Background The vast majority of women diagnosed with HIV/AIDS are found in the Sub-Saharan African region. These women have a high chance of being infected with human papillomaviruses (HPV), which causes cervical cancer and precursor lesions. Early initiation of HAART coupled with a high HAART compliance may reduce disease burden, but in Ghana, little is known about the distribution of HPV infections and epithelial changes in this vulnerable group. Methods This work was carried out to establish the distribution of genital HPV genotypes among women living with HIV attending a special HIV outpatient clinic at the Korle-Bu Teaching hospital Accra, Ghana. Pap smears were performed for 538 selected women. A highly sensitive nested multiplex PCR (NMPCR) assay was conducted for the detection and typing of human papillomavirus (HPV) genotypes. These included, 6/11, 16,18, 31, 33, 35, 39, 42, 43, 44, 45, 51, 52, 56, 58, 59, 66, and 68. Cervical smears were examined for cytologic abnormalities by two cytologists and verified by a pathologist. Results Coverage of HAART in this population was 84%. HPV DNA was detected in 280 out of the 538 individuals studied, 52.0% (95%CI 47.7–56.3). Out of these 129 (46.1%, 95%CI 40.1–52.1) had multiple HPV infections and 151 (53.9%, 95%CI 47.9–59.9) had single infections. The prevalence of LR HPV was 10.2% (95% CI: 11.3–17.6). while that of HR HPV was 29.7% (95% CI: 27.4–35.7). The commonest HR types were, 35 ,18 ,58 ,52 and 45 in descending order. The frequency of HPV 16 was 2.4%. Cytologically, 2.8% had ASCUS, 3.9% LGSIL and 2.8% HGSIL, none of the women was found to have atypical glandular cells or adenocarcinoma. The commonest HPV genotypes detected among women with ASCUS were HPV-18 (25% of all ASCUS cases), 52 (25% of all ASCUS cases) and 68 (25% of all ASCUS cases). Among women with LSIL most prevalent were HPV-52 (66.5% of all LSIL cases), HPV-18 (22.2% of all LSIL cases) and HPV 45 (22.2% of all LSIL cases). HPV-16, 52 and 42 were each found in 50% of all High-grade lesions., being the top three in that order for high grade intraepithelial/severe dysplasia lesions Conclusions There is a high burden of HPV infection in women living with HIV attending clinic at the KBTH. Given the high prevalence of HIV-HPV coinfection despite the high coverage of HAART, associated cervical lesions represent a major public health burden. These results show that currently available prophylactic vaccines have the potential to be useful in the primary prevention of HPV infections among immunocompromised women. This study also found a cross-sectional association between early age at first sex and the presence of precancerous cervical lesions. Efforts to make vaccines available to young girls before sexual debut should be prioritized along with education on safe sexual habits.

Background The vast majority of women diagnosed with HIV/AIDS are found in the Sub-Saharan African region. These women have a high chance of being infected with human papillomaviruses (HPV), which causes cervical cancer and precursor lesions. Early initiation of HAART coupled with a high HAART compliance may reduce disease burden, but in Ghana, little is known about the distribution of HPV infections and epithelial changes in this vulnerable group. Methods This work was carried out to establish the distribution of genital HPV genotypes among women living with HIV attending a special HIV outpatient clinic at the Korle-Bu Teaching hospital Accra, Ghana. Pap smears were performed for 538 selected women. A highly sensitive nested multiplex PCR (NMPCR) assay was conducted for the detection and typing of human papillomavirus (HPV) genotypes. These included, 6/11, 16,18, 31, 33, 35, 39, 42, 43, 44, 45, 51, 52, 56, 58, 59, 66, and 68. Cervical smears were examined for cytologic abnormalities by two cytologists and verified by a pathologist. Results Coverage of HAART in this population was 84%. HPV DNA was detected in 280 out of the 538 individuals studied, 52.0% (95%CI 47.7–56.3). Out of these 129 (46.1%, 95%CI 40.1–52.1) had multiple HPV infections and 151 (53.9%, 95%CI 47.9–59.9) had single infections. The prevalence of LR HPV was 10.2% (95% CI: 11.3–17.6). while that of HR HPV was 29.7% (95% CI: 27.4–35.7). The commonest HR types were, 35 ,18 ,58 ,52 and 45 in descending order. The frequency of HPV 16 was 2.4%. Cytologically, 2.8% had ASCUS, 3.9% LGSIL and 2.8% HGSIL, none of the women was found to have atypical glandular cells or adenocarcinoma. The commonest HPV genotypes detected among women with ASCUS were HPV-18 (25% of all ASCUS cases), 52 (25% of all ASCUS cases) and 68 (25% of all ASCUS cases). Among women with LSIL most prevalent were HPV-52 (66.5% of all LSIL cases), HPV-18 (22.2% of all LSIL cases) and HPV 45 (22.2% of all LSIL cases). HPV-16, 52 and 42 were each found in 50% of all High-grade lesions., being the top three in that order for high grade intraepithelial/severe dysplasia lesions Conclusions There is a high burden of HPV infection in women living with HIV attending clinic at the KBTH. Given the high prevalence of HIV-HPV coinfection despite the high coverage of HAART, associated cervical lesions represent a major public health burden. These results show that currently available prophylactic vaccines have the potential to be useful in the primary prevention of HPV infections among immunocompromised women. This study also found a cross-sectional association between early age at first sex and the presence of precancerous cervical lesions. Efforts to make vaccines available to young girls before sexual debut should be prioritized along with education on safe sexual habits.