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Several studies conducted worldwide have reported on the effectiveness of consistent condom use with lubricants in preventing HIV transmission and acquisition; however, men who have sex with men (MSM) in Ghana continue to be disproportionately affected by the HIV burden. They are stigmatized, discriminated against, and criminalized, leading to social isolation, reduced access to health care, and inadequate targeted interventions. The dissemination of HIV prevention tools such as condoms and lubricants is also mainly focused on the general population, and this approach overlooks the specific needs and vulnerabilities of MSM. This study aimed to determine the prevalence and associated factors of consistent condom use with lubricants among MSM in Ghana. We analyzed cross-sectional data from the Ghana Men’s Study II dataset involving 4095 MSM aged 18 years and above. De-identified data were imported into STATA (College Station, TX, USA, software version 17) for data analysis. Descriptive analysis was performed to describe relevant characteristics of the study population. Multivariable logistic regression analysis was performed for significant variables in bivariate analysis to determine the associated factors of consistent condom use with lubricants. All the statistical analyses were performed at a 95% confidence interval, with significant differences at p < 0.05. The prevalence of consistent condom use with lubricants during penetrative anal sex was highest with male partners (44.9%), followed by female partners (40.0%), and all sexual partners (38.9%), respectively. In multivariable logistic regression analysis, having a senior high school education (AOR: 1.76; 95% CI: 0.88–3.12, p = 0.039), tertiary education or higher (AOR: 2.24; 95% CI: 0.86–3.23, p = 0.041), being an insertive sex partner (AOR: 1.26; 95% CI: 1.02–1.56, p = 0.029), being a sex worker (AOR: 1.41; 95% CI: 1.00–1.98, p = 0.048), buying sex from other males (AOR: 1.32; 95% CI: 1.03–1.70, p = 0.027), being a light drinker (AOR: 0.54; 95% CI: 0.42–0.68, p < 0.001), being a moderate drinker (AOR: 0.48; 95% CI: 0.30–0.78, p = 0.003), and possessing good HIV knowledge (AOR: 1.79; 95% CI: 1.46–2.20, p < 0.001) had higher odds of consistent condom use with lubricants. Being Islamic (AOR: 0.65; 95% CI: 0.49–0.87, p = 0.004), having a low income (AOR: 0.57; 95% CI: 0.42–0.77, p < 0.001), and easy access (AOR: 0.52; 95% CI: 0.37–0.72, p < 0.001) to condoms were positively associated with consistent condom use. This study found a low prevalence of consistent condom use with lubricants among the MSM population in Ghana. The study also found a range of socio-demographic, behavioral, and structural factors associated with consistent condom use with lubricants. This calls for very specific and unique public health interventions, such as developing a predictive model to identify and mitigate barriers to consistent condom use with lubricants.

Background Plasmodial transketolase (PTKT) enzyme is one of the novel pharmacological targets being explored as potential anti-malarial drug target due to its functional role and low sequence identity to the human enzyme. Despite this, features contributing to such have not been exploited for anti-malarial drug design. Additionally, there are no anti-malarial drugs targeting PTKTs whereas the broad activity of these inhibitors against PTKTs from other Plasmodium spp. is yet to be reported. This study characterises different PTKTs [ Plasmodium falciparum ( PfTKT ), Plasmodium vivax ( PvTKT ), Plasmodium ovale ( PoTKT ), Plasmodium malariae ( PmTKT ) and Plasmodium knowlesi ( PkTKT ) and the human homolog ( HsTKT )] to identify key sequence and structural based differences as well as the identification of selective potential inhibitors against PTKTs. Methods A sequence-based study was carried out using multiple sequence alignment, phylogenetic tree calculations and motif discovery analysis. Additionally, TKT models of Pf TKT, Pm TKT, Po TKT, Pm TKT and Pk TKT were modelled using the Saccharomyces cerevisiae TKT structure as template. Based on the modelled structures, molecular docking using 623 South African natural compounds was done. The stability, conformational changes and detailed interactions of selected compounds were accessed viz all-atom molecular dynamics (MD) simulations and binding free energy (BFE) calculations. Results Sequence alignment, evolutionary and motif analyses revealed key differences between plasmodial and the human TKTs. High quality homodimeric three-dimensional PTKTs structures were constructed. Molecular docking results identified three compounds (SANC00107, SANC00411 and SANC00620) which selectively bind in the active site of all PTKTs with the lowest (better) binding affinity ≤ − 8.5 kcal/mol. MD simulations of ligand-bound systems showed stable fluctuations upon ligand binding. In all systems, ligands bind stably throughout the simulation and form crucial interactions with key active site residues. Simulations of selected compounds in complex with human TKT showed that ligands exited their binding sites at different time steps. BFE of protein–ligand complexes showed key residues involved in binding. Conclusions This study highlights significant differences between plasmodial and human TKTs and may provide valuable information for the development of novel anti-malarial inhibitors. Identified compounds may provide a starting point in the rational design of PTKT inhibitors and analogues based on these scaffolds.

The continual rise in sulfadoxine (SDX) resistance affects the therapeutic efficacy of sulfadoxine-pyrimethamine; therefore, careful monitoring will help guide its prolonged usage. Mutations in Plasmodium falciparum dihydropteroate synthase (Pfdhps) are being surveilled, based on their link with SDX resistance. However, there is a lack of continuous analyses and data on the potential effect of molecular markers on the Pfdhps structure and function. This study explored single-nucleotide polymorphisms (SNPs) in Pfdhps that were isolated in Africa and other countries, highlighting the regional distribution and its link with structure. In total, 6336 genomic sequences from 13 countries were subjected to SNPs, haplotypes, and structure-based analyses. The SNP analysis revealed that the key SDX resistance marker, A437G, was nearing fixation in all countries, peaking in Malawi. The mutation A613S was rare except in isolates from the Democratic Republic of Congo and Malawi. Molecular docking revealed a general loss of interactions when comparing mutant proteins to the wild-type protein. During MD simulations, SDX was released from the active site in mutants A581G and A613S before the end of run-time, whereas an unstable binding of SDX to mutant A613S and haplotype A437A/A581G/A613S was observed. Conformational changes in mutant A581G and the haplotypes A581G/A613S, A437G/A581G, and A437G/A581G/A613S were seen. The radius of gyration revealed an unfolding behavior for the A613S, K540E/A581G, and A437G/A581G systems. Overall, tracking such mutations by the continuous analysis of Pfdhps SNPs is encouraged. SNPs on the Pfdhps structure may cause protein–drug function loss, which could affect the applicability of SDX in preventing malaria in pregnant women and children.

The continual rise in sulfadoxine (SDX) resistance affects the therapeutic efficacy of sulfadoxine-pyrimethamine; therefore, careful monitoring will help guide its prolonged usage. Mutations in Plasmodium falciparum dihydropteroate synthase (Pfdhps) are being surveilled, based on their link with SDX resistance. However, there is a lack of continuous analyses and data on the potential effect of molecular markers on the Pfdhps structure and function. This study explored single-nucleotide polymorphisms (SNPs) in Pfdhps that were isolated in Africa and other countries, highlighting the regional distribution and its link with structure. In total, 6336 genomic sequences from 13 countries were subjected to SNPs, haplotypes, and structure-based analyses. The SNP analysis revealed that the key SDX resistance marker, A437G, was nearing fixation in all countries, peaking in Malawi. The mutation A613S was rare except in isolates from the Democratic Republic of Congo and Malawi. Molecular docking revealed a general loss of interactions when comparing mutant proteins to the wild-type protein. During MD simulations, SDX was released from the active site in mutants A581G and A613S before the end of run-time, whereas an unstable binding of SDX to mutant A613S and haplotype A437A/A581G/A613S was observed. Conformational changes in mutant A581G and the haplotypes A581G/A613S, A437G/A581G, and A437G/A581G/A613S were seen. The radius of gyration revealed an unfolding behavior for the A613S, K540E/A581G, and A437G/A581G systems. Overall, tracking such mutations by the continuous analysis of Pfdhps SNPs is encouraged. SNPs on the Pfdhps structure may cause protein–drug function loss, which could affect the applicability of SDX in preventing malaria in pregnant women and children.

Background An increase in the proportion of older employees over the coming decades is an outcome of ageing of the world’s population. Workplace interventions that enable older employees to maintain work productivity and avoid illness are, therefore, increasingly important. An aspect of these interventions is Workplace Support for Health (WSH), which fosters Occupational Health Literacy (OHL) and encourages health behaviours in an organization. Common health behaviours are healthy diet and physical activity, both of which protect physical functioning and well-being. Employees are more likely to avoid illness and maintain physical functioning if they receive enough WSH and improve their OHL. Aim This study aimed to investigate whether there is a moderated mediation by functioning in the relationship between WSH, OHL, and illness avoidance. Methods A cross-sectional design with sensitivity analyses and measures against common methods bias was adopted. The participants were 1015 middle-aged and older adult employees aged 50 to 85 years. The participants were workers of public and private organizations in Accra, Ghana. The main variables (i.e., WSH, OHL, functioning, and illness avoidance) were measured with Likert-type scales adopted in whole from the literature. Data were analysed with Hayes’ Process Model through structural equation modelling. Results WSH had a positive effect on functioning (β = 0.29; p  < 0.001) and illness avoidance (β = 0.25; p  < 0.001) in the whole sample. Functioning had a positive effect on illness avoidance (β = 0.45; p  < 0.001). A positive indirect effect of WSH (through functioning) on illness avoidance was confirmed. Evidence of a moderated mediation was found, suggesting that the indirect effect of WSH on illness avoidance was stronger at higher OHL. Our sensitivity analysis yielded similar effects in men and women. Conclusion WSH can enable older employees to improve their physical functioning and avoid illness, especially if it fosters higher OHL. WSH can be an appropriate way to protect employee health in response to ageing of the workforce.

Prescribers must possess extensive knowledge and maintain a positive attitude towards the rational use of medicines to achieve desirable treatment outcomes and effectively prevent treatment failures, increased costs, drug toxicities, and interactions. The objective of this study was to evaluate prescribers' understanding and perception concerning the rational use of medicines in public hospitals. Additionally, the study aimed to identify the factors that influence rational prescribing practices. A structured data instrument was developed to collect demographic data and evaluate participants' knowledge and perception of rational medicine use, in line with the study objectives. Chi-squared statistics and Fisher's exact test were utilized to identify factors associated with good knowledge and perception among participants. Logistic regression was then employed to assess the strength of the associations, with odd ratios reported at a significant level of 0.05. Out of 192 participants, 85.4% held a positive view of rational medicine use, stressing patient safety and recognizing risks like antimicrobial resistance and polypharmacy. Perception was influenced by factors such as prescriber profession, access to references, and drug bulletin updates. Additionally, 65.6% demonstrated good knowledge of rational medicine use, which was notably influenced by factors like using standard prescribing guidelines, having a functional Drug and Therapeutics Committee, prescriber profession, and the frequency of drug bulletin updates. The study emphasizes the critical need to address knowledge gaps among healthcare professionals, especially nurses and other prescribers, to ensure the safe and effective use of medications. It highlights the positive influence of utilizing preferred prescribing references and the existence of functional Drug and Therapeutics Committees in hospitals on knowledge levels. However, the unexpected findings regarding the limited impact of frequent updates of drug bulletins require further investigation.

Background: Rational prescribing optimizes medicine use, reduces costs, and improves patient outcomes. However, adherence to rational prescribing practices varies, particularly in low- and middle-income countries like Ghana, where healthcare systems differ across urban, peri-urban, and rural settings. Objectives: This study assessed adherence to WHO/INRUD prescribing indicators in public hospitals and determined each hospital’s Index of Rational Drug Prescribing (IRDP). Design: A retrospective descriptive study was conducted in 25 public hospitals across rural, peri-urban, and urban settings in the Ashanti Region of Ghana. Methods: Data from 5091 patient encounters were analyzed to assess prescribing indicators, including the average number of medicines per encounter, generic prescribing, adherence to the Essential Medicines List (EML), antibiotic use, and injection prescribing. IRDP scores were calculated, and geographic comparisons were performed using analysis of variance (ANOVA), with p < 0.05 considered statistically significant. Results: No hospital met the WHO target of <2 medicines per encounter (regional average: 3.63 ± 0.62). Generic prescribing averaged 72.26%, and EML adherence was 91.85%, with no hospital achieving 100%. Antibiotic prescribing exceeded the <30% target, averaging 60.84%. Injection use aligned best with WHO standards (average: 13.42%), with 22 of 25 hospitals meeting the <20% threshold. The regional IRDP was 3.67, with rural hospitals scoring lowest (3.63), followed by peri-urban (3.64) and urban hospitals (3.81). No significant geographic differences in IRDP scores were observed (p > 0.05). Conclusion: While injection use aligns with WHO standards, gaps remain in generic prescribing, antibiotic use, and EML adherence. Strengthening prescriber training, antimicrobial stewardship programs, and policy enforcement is essential to improving prescribing practices and patient outcomes in public hospitals in the Ashanti Region. Plain language summary Improving medicine prescribing practices in public hospitals: insights from the Ashanti Region, Ghana Doctors and other healthcare providers must prescribe medicines in a way that is safe, effective, and affordable for patients. This study looked at how well hospitals in Ghana’s Ashanti Region follow international guidelines for good prescribing practices. Researchers collected data from 25 hospitals across rural, peri-urban, and urban areas, analyzing 5,091 patient records to assess key prescribing patterns. The study found that, on average, patients received more medicines per visit than recommended, and the use of generic medicines (cheaper, equally effective alternatives) was lower than ideal. While most hospitals prescribed medicines from the approved Essential Medicines List, none fully met the 100% target. A major concern was the high use of antibiotics—double the recommended limit—raising the risk of antibiotic resistance. However, the use of injectable medicines was mostly appropriate, meeting international standards. Overall, prescribing quality varied slightly between rural and urban hospitals, but the differences were not statistically significant. The study suggests that better training for prescribers, stricter policies, and improved access to essential medicines could help hospitals improve their prescribing practices, leading to better patient care.

Head and neck cancers include carcinomas of the oral cavity, larynx, sinonasal tract and nasopharynx. Studies on molecular expression of prognostic tumour markers in Ghana are scarce. The purpose of this study was to determine the expression of p53, p16, EGFR, Cyclin-D1 and HER2 among patients with non-oropharyngeal head and neck squamous cell carcinoma (HNSCC). Tissue microarrays from 154 histologically confirmed non-oropharyngeal HNSCC at the Komfo Anokye Teaching Hospital from 2006-2014 were constructed using duplicate cores of representative and viable areas from tumours. Expression of EGFR, p53, p16, Cyclin-D1 and HER2 was evaluated using immunohistochemistry. For non-oropharyngeal HNSCC, majority of the cases (66.2%; 102/154) had stage IV disease. EGFR was the most expressed molecular marker (29.4%; 25/85) followed by p53 (24.0%; 29/121), p16 (18.3%; 23/126) and Cyclin-D1 (10.0%; 12/120). HER2 was not expressed in any of the cases. There was a significantly (p = 0.022) higher expression of Cyclin-D1 in tumours of the oral cavity (19.6%; 9/46) than in those of the larynx (4.7%; 2/43) and nose (3.2%; 1/31). Tumours in stages I-III were more frequently positive for p16 (28.6%; 12/42) than tumours in stage IV (13.1%; 11/84). Expression of p53, EGFR, p16 and Cyclin-D1 in non-oropharyngeal HNSCC in Ghana is largely similar to what has been reported in published studies from other countries.

The declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana. Swab samples collected from suspected COVID-19 patients were transported to the Zipline office by health workers. Information on the samples were sent to laboratory personnel located at KCCR through a WhatsApp platform to get them ready to receive the suspected COVID-19 samples while Zipline repackaged samples and transported them via drone. Time of take-off was reported as well as time of drop-off. A total of 2537 COVID-19 suspected samples were received via drone transport from 10 districts between April 2020 to June 2021 in 440 deliveries. Ejura-Sekyedumase District Health Directorate delivered the highest number of samples (765; 30%). The farthest district to use the drone was Pru East, located 270 km away from KCCR in Kumasi and 173 km to the Zipline office in Mampong. Here, significantly, it took on the average 39 minutes for drones to deliver samples compared to 117 minutes spent in transporting samples by road (p<0.001). The use of drones for sample transport during the COVID-19 pandemic significantly reduced the travel time taken for samples to be transported by road to the testing site. This has enhanced innovative measures to fight the pandemic using technology.

Background Workplace Age Discrimination Experienced (WADE) can be disorientating and detrimental to well-being. Hence, older employees would like to avoid it, but those who experience it may discriminate against their older peers. WADE may be associated with Age Discrimination of Peers (ADP), and this relationship can be moderated by Occupational Health Literacy (OHL). Aim This study aimed to assess the association of WADE with ADP and to ascertain whether this relationship is moderated by OHL. Methods A cross-sectional design based on a research-reporting checklist was adopted. Measures against confounding and common methods bias were utlised to avoid or minimise bias. The participants were 1025 middle-aged and older employees (average age = 58 years) who were permanent residents of Accra, Ghana. Hierarchical Linear Regression (HLR) analysis was utilised to analyse the data. Curve estimation was among the methods used to assess assumptions governing HLR analysis. Results WADE and OHL were positively associated with ADP, but OHL was negatively associated with WADE in the ultimate models incorporating the covariates. WADE was more positively associated with ADP at moderate and higher OHL, which signified positive moderation of the WADE-ADP relationship by OHL. Conclusion Older employees who experience higher age discrimination at work are more likely to discriminate against peers. OHL can be associated with lower WADE but higher ADP. Qualitative studies are needed to understand why OHL may be related to higher ADP.