Evaluation of AFP surveillance indicators in polio-free Ghana, 2009–2013

BACKGROUND: Ghana recorded the last case of indigenous wild poliovirus in 1999 but suffered two more outbreaks in 2003 and 2008. Following the World Health Organization (WHO) guidelines, transmission was interrupted through high routine immunisation coverage with live-attenuated oral polio vaccine (OPV), effective acute flaccid paralysis (AFP) surveillance and supplementary immunisation activities (SIA). This article describes the results of a five-year surveillance of AFP in polio-free Ghana, evaluate the surveillance indicators and identify areas that need improvement. METHODS: We investigated 1345 cases of AFP from children aged less than 15 years reported to the Disease Surveillance Department from January 2009 to December 2013. Data on demographic characteristics, vaccination history, clinical presentation and virological investigation on stool specimens collected during investigation were analysed. RESULTS: Of the specimens analysed, 56% were from males and 76.3% were from children less than 5 years of age. Twenty-four percent of the children received up to 3 doses of OPV, 57% received at least 4 doses while the status of 19% was unknown. Core AFP surveillance indicators were partly met for non-polio AFP rate while the WHO target for stool adequacy and timeliness was exceeded over the period of study. All the cases were classified virologically, however no wild polio was found. Sixty-day follow-up was conducted for 56.3% of cases and 8.6% cases classified as compactible with polio. CONCLUSION: Both laboratory and epidemiological surveillance for AFP were efficient and many WHO targets were met. However, due to the risk of poliovirus importation prior to global eradication, longterm surveillance is required to provide a high degree of confidence in prevention of poliovirus infection in Ghana. Thus, efforts should be made to strengthen regional performance and to follow–up on all AFP cases in order to establish proper diagnoses for the causes of the AFP leading to proper care

Prevalence, Placenta Development, and Perinatal Outcomes of Women with Hypertensive Disorders of Pregnancy at Komfo Anokye Teaching Hospital

AbstractBackgroundOne of the most common medical problems associated with pregnancy is hypertension. Hypertensive disorders of pregnancy (HDP), which has been attributable to abnormal placentation may have adverse effects on both mother and foetus if left unchecked. The objective of this study was to determine the prevalence of Hypertensive Disorders of Pregnancy (HDP), the morphological variations of human placenta in HDP, and maternal and perinatal outcomes in HDP.Materials and MethodsThis was a prospective case-control study, conducted at Komfo Anokye Teaching Hospital (KATH), Ghana. The progression of pregnancy in normotensive and hypertensive pregnant women, and the eventual perinatal outcomes were closely followed. Statistical analysis was performed using IMB-SPSS version 23. Associations were considered significant at p values of ≤ 0.05.ResultsFrom a total of 214 deliveries recorded during the period of study, 84 (39.25%) were hypertensives. Forty four (52%) of the hypertensives had preeclampsia, 28 (33.3%) had gestational hypertension, 6 (7.1%) had eclampsia, 4 (4.8%) had chronic hypertension, and 2 (2.4%) had preeclampsia superimposed on chronic hypertension. The frequency of placental haematoma, placental infarction, and placental calcification in the normotensives were significantly (p=0.001) lower than that of the hypertensives. The mean placental weight (p = 0.01), placental volume (p = 0.001), placental diameter (p = 0.03), and placental thickness (p = 0.001) of the normotensives were significantly higher than those of the hypertensives. The number of normotensives in whom labour was induced, who had their babies delivered by caesarean section, and who were admitted after they had given birth were significantly (p=0.001) lower than that of hypertensives who underwent similar procedures. No stillbirths were recorded in the normotensives compared with four in the hypertensives. The number of babies delivered to the normotensives who were admitted to the NICU was significantly (p=0.001) lower than those delivered by hypertensives.ConclusionThere was a high prevalence of hypertensive disorders of pregnancy in the study site. The condition adversely affected placental development and perinatal outcomes. These adverse effects can be curtailed by embarking on a vigorous health education drive.</jats:sec

Improved optical limiting in dispersible carbon nanotubes and their metal oxide hybrids

The mechanism and performance of optical limiting in carbon nanotubes (CNTs) and their metal oxide hybrids are presented. The mechanism of nonlinear absorption (NLA) in dispersed CNTs was an effective three-photon absorption arising due to sequential transitions between the real excited states. The effect of nonlinear scattering was minimal, and it was found that the metal oxide immobilization on the CNT surface does not alter either the mechanism of NLA, or the optical limiting threshold. With limiting thresholds in the range of 0.37-0.46 J/cm2, these highly dispersible MWCNTs and their hybrids are excellent optical liming nanocarbons. © 2011 Elsevier Ltd. All rights reserved