Editor's choice: COVID-19 and other infections in Africa

Background Ghanaian female youth aged 15-24 years are especially vulnerable to sexually transmitted infections (STIs) compared to their male counterparts. Objectives This study examined the association between educational attainment and risky sexual behavior among Ghanaian female youth. Method A cross-sectional study was conducted using a nationally representative sample of youth from the 2014 Ghana Demographic and Health Survey (n=1702). The outcome of interest was risky sexual behavior, defined as having last intercourse with a non-marital partner without condoms. Descriptive and inferential statistical tests were utilized. Results Overall, the prevalence of risky sexual behavior was 66.9%. In the bivariate analysis, risky sexual behavior differed by level of education. Compared to women with a college-level education, a significantly higher proportion of women with secondary education reported risky sexual behavior (72.9%), followed by those with primary education (65.7%) (p<0.001). In the multivariable-adjusted model, there was a significant interaction between education and household wealth index (P =0.030) and between education and the type of place of residence (P =0.045) on risky sexual behavior. Conclusion Culturally appropriate and targeted interventions are warranted to increase condom use among these subgroups and curb the rising rates of STIs among Ghanaian female youth.

Background Little is known about community knowledge and practice towards malaria prevention in Ghindae, Eritrea. Methodology A community based cross-sectional study design was employed among 380 households. Participants were selected systematically. Result More than eight-tenth (86.5%) of the respondents had heard information about malaria preceding the survey; health facilities (54.1%), television (23.7%). Majority (94.2%) mentioned mosquito bite as the main mode of malaria transmission. Fever was the predominantly (89.2%) identified sign/symptoms of malaria. ITN (84.4%) and environmental sanitation (67.3%) were well recognized preventive measures for malaria. Though most households (91%) possess bed nets, but only 37% were ragged on observation. Overall, 64% of the respondents have satisfactory knowledge and 57.3% had adequate practice towards malaria prevention. Malaria knowledge was significantly associated with increased age (p=0.001) and district areas (p=0.022). Malaria prevention practice was significantly associated with Tigrigna and Saho ethnic group (p=0.013), and districts (p=0.02). Districts showed significant difference with an OR=4.56 (95%CI, 1.29-16.09) on knowledge for district 04 and OR=1.98(95%-CI, 1.21-3.26) on practice for district 03 compared to district 01. Knowledge was associated with prevention (OR=1.99, 95%CI, 1.28-3.09). Conclusion Overall community knowledge and practice towards malaria prevention were satisfactory. Furthermore, comprehensive community interventions are paramount for effective sustainable control.

Background The progression of COVID-19 has different clinical presentations, which raises a number of immunological questions. Objectives This study aimed to investigate MMP-9 and TIMP-1 levels in patients diagnosed with COVID-19 and whether the MMP-9/TIMP-1 ratio is associated with lung involvement in COVID-19. Methods This study was conducted with 192 patients and 45 healthy controls. ELISA was used to measure the MMP-9 and TIMP-1. Results The MMP-9 and TIMP-1 levels of the patients were found to be higher than those of the controls. MMP-9 and TIMP-1 were detected more in patients with lung involvement on chest CT scans than in those with no lung involvement on chest CT scans. A comparison of lung involvement levels revealed no difference was found between the groups. The MMP-9/TIMP-1 ratio was 5.8 in the group with lung involvement on chest CT scans and 6.1 in the group without lung involvement on chest CT scans. No difference was found between the two groups. A comparison with respect to lung involvement levels showed that the MMP-9/TIMP-1 ratio difference was found between the groups. Conclusion Diagnostic and treatment methods targeting MMP-9 activity or neutrophil activation may be important in predicting lung involvement in COVID-19 and directing clinical outcomes.