Background Vaccine-preventable diseases (VPDs) persist globally with a disproportionately high burden in Low and Middle-Income Countries (LMICs). Although this might be partly due to the failure to sustain vaccination coverage above 90% in some WHO regions, a more nuanced understanding of VPD transmission beyond vaccination coverage may unveil other important factors in VPD transmission and control. This study identified VPDs hotspots and explored their relationships with ecology, urbanicity and land-use variations (Artisanal and Small-scale Gold Mining (ASGM) activities) in Ghana. Methods District-level disease count data from 2010 to 2014 from the Ghana Health Service (GHS) and population data from the Ghana Population and Housing Census (PHC) were used to determine clustering patterns of six VPDs (Measles, Meningitis, Mumps, Otitis media, Pneumonia and Tetanus). Spatial and space-time cluster analyses were implemented in SaTScan using the discrete Poisson model. P-values were estimated using a combination of sequential Monte Carlo, standard Monte Carlo, and Gumbel approximations. Results The study found a preponderance for VPD hotspots in the northern parts of Ghana and northernmost ecological zones (Sudan Savannah and Guinea Savannah). Incidence of meningitis was higher in the Sudan Savannah ecological zone relative to: Tropical Rain Forest (p = 0.001); Semi Deciduous Forest (p < 0.0001); Transitional Zone (p < 0.0001); Coastal Savannah (p < 0.0001) and Guinea Savannah (p = 0.033). Except for mumps, which recorded a higher incidence in urban districts (p = 0.045), incidence of the other five VPDs did not differ across the urban-rural divide. Whereas spatial analysis suggested that some VPD hotspots (tetanus and otitis media) occur more frequently in mining districts in the southern part of the country, a Mann-Whitney U test revealed a higher incidence of meningitis in non-mining districts (p = 0.019). Pneumonia and meningitis recorded the highest (722.8 per 100,000) and least (0.8 per 100,000) incidence rates respectively during the study period. Conclusion This study shows a preponderance of VPD hotspots in the northern parts of Ghana and in semi-arid ecoclimates. The relationship between ASGM activities and VPD transmission in Ghana remains blurred and requires further studies with better spatial resolution to clarify.

Introduction: Most febrile illnesses in Ghana are often misdiagnosed and presumptively treated as malaria. This situation may be due to the inappropriate diagnostic tool, clinical oversight and lack of awareness of some of the disease conditions that might have been present in the country. This study sought to investigate the seroprevalence of dengue virus, geographical location of participants with circulating antibodies and finally evaluate the diagnostic accuracy of a Rapid diagnostic kit (RDT) using Enzyme Linked Immuno-Sorbent Assay (ELISA) as a gold standard for confirmation. Method: A hospital-based cross-sectional study was conducted among adults (≥18) attending the University of Cape Coast Hospital. From each participant, 3-4 ml of venous blood was drawn and serum was tested for IgG and IgM using RDT methods. Positive samples were selected for ELISA confirmation. Statistical analysis was performed using SPSS (v.20) and STATA (v.14) software. Results: A total of 270 participants were enrolled in the study. The geometric mean age was 32 years. Overall, Dengue virus (DENV) IgG seroprevalence by RDT was 10 (3.7%). Seroprevalence of IgG and IgM by the ELISA method was 34 (12.6%) and 6 (2.2%) respectively. Females recorded a high seroprevalence (7.4%) than males (5.2%) in terms of past exposure (IgG). On current exposure (IgM), females recorded a high seroprevalence (1.5%) than males (0.7%). Seroprevalence of individuals with dual positivity ((IgG + IgM+) (acute secondary infection) was 1.9%. Those with primary and recent infection (IgM+ only) were 0.4% whiles those with past and probably secondary infection (IgG+ only) were 10.7%. The odds of dengue exposure were significantly high among participants with ages 50-59 as compared to their other counterparts (AOR = 3.5, p = 0.03).

Type 2 diabetes mellitus (T2DM) continues to increase in incidence within the ageing population of the globe. Patients with T2DM have a 2-4 times higher risk of experiencing an adverse cardiovascular event than their non-diabetic counterparts. Total cholesterol, low-density lipoprotein (LDL), triglycerides and high-density lipoprotein (HDL) cholesterol levels have been the routine biomarkers for lipid-based cardiovascular disease diagnostic and prognostic decisions in clinical practice. Recent evidence elsewhere suggests remnant cholesterol (RC) and Non-HDL cholesterol (Non-HDL-c) can serve as biomarkers with a higher predictive power for cardiovascular disease (CVD) than the aforementioned routine ones. In our context, there is limited information on the suitability and superiority of these emerging biomarkers for the assessment of CVD risk in T2DM. The current study therefore sought to examine the relationship between RC and non-HDL-c for predicting CVD in T2DM patients in the context of the obesity paradox. Apart from adiponectin level which was lower (P < 0.05), overweight/obese respondents exhibited higher (P < 0.05) mean levels for all the measured indices. Insulin resistance was independently predicted (R2 = 0.951; adjusted R2 = 0.951; P < 0.001) by RC, duration and fasting plasma glucose. However, Non-HDL-c predicted CVD risk (AOR = 4.31; P <0.001), hypertension (AOR = 2.24; P <0.001), resistin (AOR = 2.14; P <0.001) and adiponectin (AOR = -2.24; P <0.001) levels. Our findings point to different mechanisms by which RC and non-HDL-c contribute to the development of CVD.

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