Background: Several environmental factors are associated with the risk of acute lower respiratory infections (ALRIs) and upper respiratory infections (URIs) in children under 5 years of age (YOA). Evidence implicating chemical pesticides remains equivocal. There are also no data on this subject in these children in Ghana. This study investigated the association between urinary pesticide residual levels and the risk for ALRIs/URIs in children under 5 YOA. Methods: The participants for this study were from the Offinso North Farm Health Study, a population-based cross-sectional study. Two hundred and fifty four parents/guardians who had answered affirmatively to the question “Has your child ever accompanied you to the farm?” were interviewed on household socio-demographic and environmental factors, being breastfed, child education, age, gender, and respiratory infection. One hundred fifty children were randomly selected to provide the first void urine. Results: The proportion of children with ALRI was 22.1% and those with URI was 35.8%. We observed a statistically significant exposure-response relation of p,p′-DDE (tertile) with ALRI (1.7-3.2 µg/L urine: prevalence ratio [PR] = 1.22 [1.05-1.70], ⩾3.2 µg/L urine: 1.50 [1.07-3.53] [ P-for trend = .0297]). This observation was in children older than two YOA ( P-for trend = .0404). Delta-HCH and beta-HCH (2-levels) were significantly associated with ALRI but not URI. The risk of ALRI increased with deltamethrin levels in an exposure-response manner (2.5-9.5 µg/L urine: 2.10 [1.37-3.24], ⩾9.5 µg/L urine: 4.38 [1.87-10.32] [ P-for trend = .0011]) and this was also observed in children older than two YOA. Similar observation was noted for URI. Bifenthrin (>0.5 µg/L urine) was positively associated with ALRI and URI whereas permethrin (⩾1.2 µg/L urine) was not associated only with URI. Conclusions: The present study supports the hypothesis that exposure to chemical pesticides is associated with respiratory infections in children under 5 YOA.

Background: Healthcare waste management (HCWM) system in healthcare facilities is essential in dealing with the spread of infectious diseases, especially during an outbreak period such as the COVID-19 pandemic. The study assessed health care waste management situation in selected healthcare facilities in the greater Accra and Ashanti regions of Ghana during the COVID-19 pandemic.Methods: This was a multi-facility-based cross-sectional study that used a monitoring tool of the health facilities regulatory agency of Ghana to collect information on health care waste management practices at the peak of the COVID-19 pandemic. Data was gathered from 501 healthcare facilities in the greater Accra (335) and Ashanti (151) regions. Descriptive, Chi-square and multiple logistic regression were performed. All statistical analyses were considered significant at an alpha level of 0.05.Results: Less than half (45.7%) of the health facilities were assessed as having HCWM systems with majority (54.3%) having effective infectious waste management system. The health facilities in the greater Accra region (38.8%) and Ashanti region (60.9%) were categorized as poor on healthcare waste management system. The assessment levels of governance/leadership, management, quality assurance system, human resource, infection prevention and control equipment and water management were all significantly associated with the adherence to good HCWM systems.Conclusions: Health facilities were assessed as having good healthcare waste management systems, especially in the greater Accra region compared to the Ashanti, however treatment and safe disposal should be improved.

BackgroundMass treatment with praziquantel is currently the main strategy used to control the morbidity due to schistosomiasis. Many age groups are at risk of the disease; however, the mass treatment focus mainly on school age children.ObjectivesThe objective of this review is to estimate the morbidity in at risk groups and identify key groups that should be targeted for preventive chemotherapy treatment with PZQ to control morbidity for schistosomiasis.Data sourcesPUBMED and SCOPUS were systematically searched from their inception to 23/11/2020.Study eligibility criteria, participants, and interventionWe searched for studies that evaluated PC in the entire population or a subgroup (PSAC, SAC including adolescents, adults and pregnant women). The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to assess the certainty of the evidence.Study appraisal and synthesis methodsThe systematic review followed a pre established protocol. Summary ORs were estimated using the random-effects model. Heterogeneity was assessed by inspecting forest plots and quantified using the I-squared statistic. Subgroup /sensitivity analyses explored heterogeneity.Results59 studies met the a priori inclusion criteria and 45 were meta-analyzed. Treatment with PZQ resulted in reductions in right sided hepatomegaly (OR=0.43, 95% CI: 0.22-0.82), hematuria (0.40, 0.25-0.63) hematuria, anaemia (0.70, 0.63-0.79), proteinuria (0.36, 0.22-0.59), and urinary tract pathology (0.37, 0.24-0.56) in SACs; reductions in blood in stool (0.26, 0.14-0.63), splenomegaly (0.56, 0.42-0.55), and urinary bladder lesions (0.26, 0.14-0.49) in entire population were noted. No significant reduction was noted concerning periportal fibrosis, left-sided hepatomegaly, no specific lobe hepatomegaly, and diarrhea prevalence in all age groups. Data were scarce on PSAC.ConclusionPC with PZQ reduces some infection-related morbidity outcomes in SAC. There is suggestive evidence that PSAC and adult populations may benefit from some outcomes. This assertion was based on low certainty evidence.Author summaryPraziquantel (PZQ) is the main drug used for the mass treatment of morbidity related to schistosomiasis. Current treatment has focused on school-aged children. However, other age groups are also at risk of the disease. We conducted a systematic review and a meta-analysis of 59 studies in PUBMED database (published from inception up to November 2020) to identify key age groups that should be targeted for preventive chemotherapy treatment with PZQ to effectively control diseases related to schistosomiasis infections. Our data suggested that treatment with PZQ in school-aged children led to reductions in certain diseases related to schistosomiasis infection. Pre-school aged children and adults may also benefit from treatment with PZQ. Findings from our study were based on studies with low certainty evidence.