24To reduce child mortality and improve health in Ghana boreholes and wells are being installed across 25 the country by the private sector, NGOs and the Ghanaian government. Water quality is not generally 26 monitored once a water source has been improved. Water supplies were sampled across Ghana from 27 mostly boreholes, wells and rivers as well as some piped water from the different regions and analysed 28for the chemical quality. Chemical water quality was found to exceed the WHO guidelines in 38% of 29 samples, while pH varied from 3.7 to 8.9. Excess levels of nitrate (NO 3 -) were found in 21% of the 30 samples, manganese (Mn) and fluoride (F -) in 11% and 6.7%, respectively. Heavy metals such as lead 31 (Pb), arsenic (As) and uranium (U) were localised to mining areas. Elements without health based 32 guideline values such as aluminium (Al, 95%) and chloride (Cl, 5.7%) were found above the 33 provisional guideline value. 34 35Economic information was gathered to identify water costs and ability to pay. Capital costs of wells 36and boreholes are about £1200 and £3800 respectively. The majority of installation costs are generally 37 paid by government or NGO, while the maintenance is expected to be covered by the community. At 38 least 58% of the communities had a water payment system in place, either an annual fee/one-off fee or 39 "pay-as-you-fetch". The annual fee was between £0.3-21, while the boreholes had a water collection 40 fee of £0.07-0.7/m 3 , many wells were free. Interestingly, the most expensive water (£2.9-3.5/m 3 ) was 41 brought by truck. Many groundwater sources were not used due to poor chemical water quality. 42Considering the cost of unsuccessful borehole development, the potential for integrating suitable water 43 treatment into the capital and maintenance costs of water sources is discussed. Additionally, many 44 sources were not in use due to lack of water capacity, equipment malfunction or lack of economic 45 resources to repair and maintain equipment. Those issues need to be addressed in combination with 46 water quality, coordinated water supply provision and possible treatment to ensure sustainability of 47 improved water resources. 48 49 50

Background Onchocerciasis is a neglected tropical disease which is still of immense major public health concern in several areas of Africa and the Americas. The disease manifests either as ocular or as dermal onchocerciasis with several symptoms including itching, nodules, skin thickening, visual impairment and blindness. Ivermectin has been an efficient microfilaricide against the causative agent of the disease ( Onchocerca volvulus ) but reports from some areas in Africa suggest the development of resistance to this drug. The aim of this study was to determine the prevalence of onchocerciasis and associated clinical conditions frequently associated with the disease in three endemic communities in Ghana which have been subjected to 18 to 20 rounds of mass drug administration of ivermectin. This was to help determine whether or not onchocerciasis persists in these communities. Methods A cross-sectional study design was adopted. Three communities (Tanfiano, Senya and Kokompe) in the Nkoranza North District of Ghana where mass drug administration of ivermectin had been ongoing for more than two decades were selected for the study. The population was randomly sampled and 114 participants recruited for the study based on the eligibility criteria. The study participants were examined for the presence of parasites and clinical manifestations of onchocerciasis following established protocols. Results The study showed that the prevalence of microfilaria in the Tanfiano, Senya, Kokompe communities were 13.2, 2.4, and 2.9%, with nodule prevalence being 5.3, 4.9 and 14.3% respectively. Females in the study communities had a higher prevalence of microfilaria carriers (5.17%) relative to males (2.44%), but this difference was not statistically significant ( p = 0.2800, unpaired t test ). The most frequent clinical manifestation observed in this study among all participants was dermatitis (25.4%), followed by visual impairment & nodules (7.9% each) and then by blindness (4.4%). Conclusion The study showed that despite several years of mass drug administration with ivermectin, infection with onchocerciasis and the commonly associated clinical manifestations of the disease still persist in the study communities. This calls for a greater urgency for research and development aimed at discovering new or repurposed anti-filarial agents which will augment ivermectin if global onchocerciasis eradication targets are to be achieved.

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Purpose The objectives of this study were to assess the black soldier fly larvae (BSFL) composting potential and to analyse the quality of organic fertilizer produced for agricultural purposes. Methods The waste biodegradation was determined by varying waste feed treatment (2, 2.5, 3.0, 3.5, to 4 kg) and control treatment of (2 kg) of heterogeneous mixture of municipal organic solid waste from market, restaurant and households. Each of the setups received equal number of viable larvae (i.e. 2000) which were 5-6 days old. To analyse the nutrient concentration of the compost residues with BSFL, the substrate and final compost were evaluated based on the levels of NPK as well as the C:N ratio. To evaluate the toxic levels of the final compost in terms of heavy metals, the presence and levels of As, Cd, Fe, Pb and Ni were investigated. Results The analysis showed that there was high percentage increase of nitrogen, phosphorus and potassium levels, i.e. 41.2% (SD ± 0.71%), 32.4% (SE ± 0.2%) and 77.1% (SE ± 0.19%), respectively. It was found that the larvae degraded more than half of the total substrate within 2 weeks. The study showed a decrease in heavy metal concentrations after larvae composting. Conclusion The study revealed that the concentration of NPK increased significantly among the treatment groups. The study further revealed that some of the heavy metals under investigation had reduced to an acceptable level according to the standards of both local and international regulatory bodies.