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Rockson Adjei M, Longsignikuu A, Saeed Iddris I, Nang Suuri T, Asamoah B, Okoye M, Vanessa Baafi J, Kubio C, Ohene SA, Grobusch MP. Trend of measles-rubella vaccination coverage and impact on measles epidemiology in the Savannah Region, Ghana; 2018-2022: A secondary data analysis. Vaccine 2024; 42:1910-1917. [PMID: 38365480 DOI: 10.1016/j.vaccine.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Ghana witnessed an outbreak of measles in 2022 following the COVID-19 pandemic, and Savannah Region was among the regions severely impacted. The objective of this study was to conduct trend analysis of measles case incidence and measles-rubella (MR) vaccination coverage in the Savannah Region to identify gaps and propose remedial actions to mitigate future outbreaks of vaccine preventable diseases (VPDs). METHODS Analysis of measles surveillance and measles-rubella vaccination data for 2018-2022 was conducted to assess relationship between immunization coverage and measles case incidence. Data were extracted from the District Health Information Management System (DHIMS) platform and loaded into Microsoft Excel 16.0 spreadsheet for analysis. Coverages for first (MR1) and second (MR2) doses of measles-rubella vaccination, dropout rates, and measles incidence (per 100,000) were calculated. RESULTS The coverage trend for both vaccine doses followed similar trajectories, increasing from 2018 to a peak in 2019, and declining sequentially thereafter to the lowest (for the study period) in 2022. Generally, MR1/MR2 dropout rate was high across all districts during the entire study period. The regional incidence of confirmed measles rose sharply from less than 1/1,000,000 in 2018-2021 to 94 in 2022. Wide variations in vaccination coverage and dropout rates were observed among the districts. There was moderate to fairly strong negative correlation between MR vaccination coverage and measles case incidence. CONCLUSIONS The MR vaccination coverage in the Savannah Region declined probably due to pre-existing weaknesses in the immunization programme accentuated by impact of the COVID-19 pandemic. The lowered population immunity likely contributed to occurrence of the measles outbreak in 2022. Pragmatic actions are needed to catch-up on missed children, restore coverage to pre-pandemic levels, and strengthen the immunization programme as part of global efforts towards achieving the Immunization Agenda 2030 (IA2030) trajectory.
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Affiliation(s)
- Michael Rockson Adjei
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Iocation AMC, University of Amsterdam, Amsterdam, the Netherlands; World Health Organization, Country Office, Accra, Ghana.
| | - Amos Longsignikuu
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | - Ibrahim Saeed Iddris
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | - Thomas Nang Suuri
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | | | | | - Janet Vanessa Baafi
- Ghana Health Service, District Health Directorate, Sunyani West, Odumase, Ghana
| | - Chrysantus Kubio
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | | | - Martin Peter Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Iocation AMC, University of Amsterdam, Amsterdam, the Netherlands; Institute of Tropical Medicine, and German Center of Infectious Diseases (DZIF), University of Tuebingen, Tuebingen, Germany; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa; Centre de Recherches Médicales En Lambaréné (CERMEL), Lambaréné, Gabon; Masanga Medical Research Unit, Masanga, Sierra Leone
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Agbemafle E, Kubio C, Bandoh D, Odikro M, Azagba C, Issahaku R, Sackey S. Evaluation of the malaria surveillance system - Adaklu District, Volta Region, Ghana, 2019. Public Health Pract (Oxf) 2023; 6:100414. [PMID: 37564781 PMCID: PMC10410592 DOI: 10.1016/j.puhip.2023.100414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
Objectives We evaluated the malaria surveillance system in Adaklu District of the Volta Region of Ghana to determine if the system was meeting its objectives and assessed its usefulness and attributes. Study design Descriptive cross-sectional design was used in evaluating the surveillance system. Methods We interviewed stakeholders using a semi-structured questionnaire on case detection and reporting. We assessed the system attributes using the Centers for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems. We extracted and reviewed malaria surveillance data from the District Health Management Information System 2. Summary statistics and direct content analysis were performed on quantitative and qualitative data respectively. Results Of the 80,441 suspected malaria cases recorded in Adaklu District from 2014 to 2018, 47,917 (59.6%) cases were confirmed. The system was meeting its objective of detecting malaria cases and monitoring trends in the population however, the system missed an epidemic in August 2016. Data generated from the surveillance system is used by the NMCP to aid in the distribution of logistics such as LLINs, RDT test kits, and track malaria control progress in the district. Staff at all levels were able to detect, confirm, treat and report malaria. All sub-districts/health facilities reported to the district and reports were all accurate and timely. The predictive value positive was 62.9%. Conclusions The malaria surveillance system in Adaklu District was useful and meeting its set objective of monitoring trends of malaria in the population. It was simple, flexible, acceptable and representative; however, the system was not detecting epidemics. The District Health Management Team should set alert and epidemic thresholds to help detect promptly epidemics of malaria in the district.
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Affiliation(s)
- E.E. Agbemafle
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - C. Kubio
- Savannah Regional Health Directorate, Ghana Health Service, Damongo, Ghana
| | - D. Bandoh
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - M.A. Odikro
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - C.K. Azagba
- Adaklu District Health Directorate, Ghana Health Service, Volta Region, Ghana
| | - R.G. Issahaku
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - S.O. Sackey
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
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Bonney JHK, Sanders T, Pratt D, Agbodzi B, Laryea D, Agyeman NKF, Kumordjie S, Attiku K, Adams PL, Boateng GA, Ohene SA, Tamal C, Mawuli G, Yeboah C, Dadzie S, Kubio C, Asiedu-Bekoe F, Odoom JK. Molecular Characterization of Circulating Yellow Fever Viruses from Outbreak in Ghana, 2021-2022. Emerg Infect Dis 2023; 29:1818-1826. [PMID: 37610174 PMCID: PMC10461649 DOI: 10.3201/eid2909.221671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Yellow fever virus, transmitted by infected Aedes spp. mosquitoes, causes an acute viral hemorrhagic disease. During October 2021-February 2022, a yellow fever outbreak in some communities in Ghana resulted in 70 confirmed cases with 35 deaths (case-fatality rate 50%). The outbreak started in a predominantly unvaccinated nomadic community in the Savannah region, from which 65% of the cases came. The molecular amplification methods we used for diagnosis produced full-length DNA sequences from 3 confirmed cases. Phylogenetic analysis characterized the 3 sequences within West Africa genotype II; strains shared a close homology with sequences from Cote d'Ivoire and Senegal. We deployed more sensitive advanced molecular diagnostic techniques, which enabled earlier detection, helped control spread, and improved case management. We urge increased efforts from health authorities to vaccinate vulnerable groups in difficult-to-access areas and to educate the population about potential risks for yellow fever infections.
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Agbemafle EE, Addo-Lartey A, Odikro MA, Frimpong JA, Kubio C, Ameme DK, Sackey SO, Bonful HA. Adherence to the test, treat and track strategy for malaria control among prescribers, Mfantseman Municipality, Central Region, Ghana. PLoS One 2023; 18:e0279712. [PMID: 36802396 PMCID: PMC9942999 DOI: 10.1371/journal.pone.0279712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/13/2022] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND The test, treat, and track (T3) strategy is directed at ensuring diagnosis and prompt treatment of uncomplicated malaria cases. Adherence to T3 strategy reduces wrong treatment and prevents delays in treating the actual cause of fever that may otherwise lead to complications or death. Data on adherence to all three aspects of the T3 strategy is sparse with previous studies focusing on the testing and treatment aspects. We determined adherence to the T3 strategy and associated factors in the Mfantseman Municipality of Ghana. METHODS We conducted a health facility based cross-sectional survey in Saltpond Municipal Hospital and Mercy Women's Catholic Hospitals in Mfantseman Municipality of the Central Region, Ghana in 2020. We retrieved electronic records of febrile outpatients and extracted the testing, treatment and tracking variables. Prescribers were interviewed on factors associated with adherence using a semi-structured questionnaire. Data analyses was done using descriptive statistics, bivariate, and multiple logistic regression. RESULTS Of 414 febrile outpatient records analyzed, 47 (11.3%) were under five years old. About 180 (43.5%) were tested with 138 (76.7%) testing positive. All positive cases received antimalarials and 127 (92.0%) were reviewed after treatment. Of 414 febrile patients, 127 (30.7%) were treated according to the T3 strategy. Higher odds of adherence to T3 were observed for patients aged 5-25 years compared to older patients (AOR: 2.5, 95% CI: 1.27-4.87, p = 0.008). Adherence was low among physician assistants compared to medical officers (AOR 0.004, 95% CI 0.004-0.02, p<0.001). Prescribers trained on T3 had higher adherence (AOR: 99.33 95% CI: 19.53-505.13, p<0.000). CONCLUSION Adherence to T3 strategy is low in Mfantseman Municipality of the Central Region of Ghana. Health facilities should perform RDTs for febrile patients at the OPD with priority on low cadre prescribers during the planning and implementation of interventions to improve T3 adherence at the facility level.
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Affiliation(s)
- Ernestina Esinam Agbemafle
- Mercy Women’s Catholic Hospital, Mankessim, Ghana
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - Adolphina Addo-Lartey
- Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - Magdalene Akos Odikro
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
- Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - Joseph Asamoah Frimpong
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - Chrysantus Kubio
- Savannah Regional Health Directorate, Ghana Health Service, Damongo, Ghana
| | - Donne Kofi Ameme
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - Samuel Oko Sackey
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
- Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
| | - Harriet Affran Bonful
- Department of Epidemiology and Disease Control, School of Public Health, College of Health and Allied Sciences, University of Ghana, Legon, Ghana
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Nuhu AGK, Dwomoh D, Amuasi SA, Dotse-Gborgbortsi W, Kubio C, Apraku EA, Timbire JK, Nonvignon J. Impact of mobile health on maternal and child health service utilization and continuum of care in Northern Ghana. Sci Rep 2023; 13:3004. [PMID: 36810616 PMCID: PMC9944273 DOI: 10.1038/s41598-023-29683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Maternal and child mortality are of public health concern. Most of these deaths occur in rural communities of developing countries. Technology for maternal and child health (T4MCH) is an intervention introduced to increase Maternal and Child Health (MCH) services utilization and continuum of care in some health facilities across Ghana. The objective of this study is to assess the impact of T4MCH intervention on MCH services utilization and continuum of care in the Sawla-Tuna-Kalba District in the Savannah Region of Ghana. This is a quasi-experimental study with a retrospective review of records of MCH services of women who attended antenatal services in some selected health centers in the Bole (comparison district) and Sawla-Tuna-Kalba (intervention district) of the Savannah region, Ghana. A total of 469 records were reviewed, 263 in Bole and 206 in Sawla-Tuna-Kalba. A multivariable modified Poisson and logistic regression models with augmented inverse-probability weighted regression adjustment based on propensity scores were used to quantify the impact of the intervention on service utilization and continuum of care. The implementation of T4MCH intervention increased antenatal care attendance, facility delivery, postnatal care and continuum of care by 18 percentage points (ppts) [95% CI - 17.0, 52.0], 14 ppts [95% CI 6.0%, 21.0%], 27 ppts [95% CI 15.0, 26.0] and 15.0 ppts [95% CI 8.0, 23.0] respectively compared to the control districts. The study showed that T4MCH intervention improved antenatal care, skilled delivery, postnatal services utilization, and continuum of care in health facilities in the intervention district. The intervention is recommended for a scale-up in other rural areas of Northern Ghana and the West-African sub-region.
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Affiliation(s)
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana.
| | - Susan Ama Amuasi
- grid.442866.a0000 0004 0442 9971Department of Physician Assistantship and Public Health, School of Medicine and Health Sciences, Central University College, Accra, Ghana
| | - Winfred Dotse-Gborgbortsi
- grid.5491.90000 0004 1936 9297WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Chrysantus Kubio
- grid.434994.70000 0001 0582 2706Savannah Regional Health Directorate, Ghana Health Service, Damongo, Ghana
| | - Edward Anane Apraku
- grid.415375.10000 0004 0546 2044Kintampo Health Research Centre, Kintampo, Bono East Region, Ghana
| | - Jonas Kolong Timbire
- grid.434994.70000 0001 0582 2706Nabdam District Health Directorate, Ghana Health Service, Nangodi, Upper East Region, Ghana
| | - Justice Nonvignon
- grid.8652.90000 0004 1937 1485Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana
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Asumah MN, Abubakari A, Abdulai AM, Nukpezah RN, Adomako-Boateng F, Faridu AW, Kubio C, Padhi BK, Kabir R. Sociodemographic and Maternal Determinants of Postnatal Care Utilization: A Cross-Sectional Study. SAGE Open Nurs 2023; 9:23779608231206759. [PMID: 37830079 PMCID: PMC10566267 DOI: 10.1177/23779608231206759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/28/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Postnatal care (PNC) is critical for the newborn and the mother, as it offers the opportunity to examine the mother and child to ensure early and timely intervention of any obstetric anomalies that might have gone unnoticed during delivery. However, there is a lack of data on PNC utilization and associated determinants in Ghana. Meanwhile, it is suspected that the PNC service should be more patronized by mothers, particularly within the first 2 days after delivery; therefore, investigating PNC utilization and associated factors could inform policies to enhance PNC uptake. Objective The objective is to determine the level of utilization of PNC service and associated factors in the Savannah region of Ghana. Methods The study used a facility-based analytical cross-sectional study design. The study was carried out in 311 postnatal mothers using consecutive sampling. Data collection was carried out using a questionnaire. Univariate and multiple logistic regression was performed to establish the determinants of PNC. Variables/variable categories with P < .05 were significantly associated with PNC. The significance level is anchored at P < .05. Results The study showed that almost all respondents (98.7%) have heard about PNC services through health workers (39.7%), media (13.0%), and friends and relatives (47.2%). Most of the respondents (88.7%) have used PNC services within 48 h. Mothers aged 25-39 years were about seven times more likely to utilize PNC compared to those who were less than 25 years old (AOR [adjusted odds ratio] = 7.41, 95% CI [confidence interval]: 1.98-7.71); mothers with high school education (SHS) and above were also approximately four times more likely to use PNC compared to those who had no formal education (AOR = 3.65, 95% CI 1.97-13.66). In the same vein, married mothers were 10 times more likely to use PNC compared to those who are single mothers (AOR = 10.34, 95% CI: 3.69-28.97), whereas mothers who had at least four antenatal care (ANC) visits during pregnancy were approximately seven times more likely to use PNC compared to those who had less than four ANC visits (AOR = 6.92, 95% CI: 1.46-32.78). Reasons for not attending PNC include waiting time (40.5%), health workers' attitude (32.4%), being attended by a student (16.2%), being busy (27.0%), inadequate information on PNC (24.3%), and no family support (18.9%). Conclusion All mothers knew about the PNC services, with a higher proportion patronizing the services. The increasing age, the level of mothers, marital status, and participation in ANC were significant determinants of the use of PNC. More education during ANC on the importance of PNC service is required to achieve universal coverage of PNC.
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Affiliation(s)
- Mubarick Nungbaso Asumah
- Nurses’ and Midwives’ Training College, Ministry of Health, Tamale, Ghana
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
- Kintampo Municipal Hospital, Ghana Health Service, Kintampo, Ghana
| | - Abdulai Abubakari
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | | | - Ruth Nimota Nukpezah
- Department of General Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | | | - Abdul-Wadudu Faridu
- Department of Environmental and Occupational Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Chrysantus Kubio
- Savannah Regional Health Directorate, Ghana Health Service, Damongo, Ghana
| | - Bijaya Kumar Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Russell Kabir
- School of Allied Health, Anglia Ruskin University, Essex, UK
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Schneider KA, Bonney JHK, Kubio C, Awandare GA, Eichner M. Reconsidering the incubation period of Marburg virus disease. Lancet Infect Dis 2022; 22:1525-1526. [PMID: 36174591 DOI: 10.1016/s1473-3099(22)00647-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Kristan A Schneider
- Department of Applied Computer and Bioscience, Hochschule Mittweida, Mittweida 09648, Germany.
| | - Joseph H Kofi Bonney
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Chrysantus Kubio
- Savannah Regional Health Directorate, Ghana Health Service, Damongo, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Martin Eichner
- Institute for Clinical Epidemiology and Applied Biometrics, University of Tübingen, Tübingen, Germany; Epimos, Bischofsheim in der Rhön, Germany
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Adjei MR, Kubio C, Buamah M, Sarfo A, Suuri T, Ibrahim S, Sadiq A, Abubakari II, Baafi JV. Effectiveness of seasonal malaria chemoprevention in reducing under-five malaria morbidity and mortality in the Savannah Region, Ghana. Ghana Med J 2022; 56:64-70. [PMID: 37449257 PMCID: PMC10336463 DOI: 10.4314/gmj.v56i2.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE To assess the effectiveness of seasonal malaria chemoprevention (SMC) in reducing under-five malaria morbidity and mortality. DESIGN Under-five malaria data for confirmed episodes, deaths, and number of children dosed per cycle of SMC campaign were extracted from the District Health Information Management System (DHIMS-2) for 2018-2019. Data verification was done to compare extracted data with the source for completeness and consistency. Association between SMC and the main outcome variables (malaria cases and mortality) was computed from 2X2 tables and reported as rate ratios at a 95% confidence level. SETTING All seven (7) districts in Savannah Region, Ghana. PARTICIPANTS Children under five years. INTERVENTION Sulphadoxine-Pyrimethamine and Amodiaquine (SPAQ) prophylaxis given monthly, four times, durng the rainy season (July to October). MAIN OUTCOME MEASURES SMC coverage per cycle and under-five malaria morbidity and mortality ratios. RESULTS Over 370,000 dose packs of SPAQ were administered with an average cycle coverage of 93%. There was approximately 17% (p<0.01) and 67% (p=0.047) reduction in malaria-related morbidity and mortality, respectively, in the implementation year compared with the baseline. This translated into nearly 9,300 episodes of all forms of malaria and nine malaria-attributable deaths averted by the intervention. CONCLUSION SMC (combined with existing control measures) wields prospects of accelerating the regional/national malaria elimination efforts if the implementation is optimised. Expansion of the intervention to other high-prevalence regions with seasonal variation in disease burden may be worthwhile. FUNDING None declared.
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Affiliation(s)
- Michael R Adjei
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | - Chrysantus Kubio
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | - Marcel Buamah
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | - Adjei Sarfo
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | - Thomas Suuri
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | - Saeed Ibrahim
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | - Abubakari Sadiq
- Regional Health Directorate, Ghana Health Service, Damongo, Savannah Region, Ghana
| | | | - Janet V Baafi
- Sunyani West District Health Directorate, Ghana Health Service, Fiapre, Bono Region, Ghana
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Soliku O, Kyiire B, Mahama A, Kubio C. Tourism amid COVID-19 pandemic: impacts and implications for building resilience in the eco-tourism sector in Ghana's Savannah region. Heliyon 2021; 7:e07892. [PMID: 34493990 PMCID: PMC8412235 DOI: 10.1016/j.heliyon.2021.e07892] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/17/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
The novel coronavirus which first emerged in Wuhan, China has affected many sectors of the global economy particularly, the tourism sector. While prior studies have explored how pandemics and crisis in the tourism sector can be managed, only a few have tackled how the tourism industry, especially in developing countries can be restructured to withstand shocks and remain resilient in the face of crisis such as the COVID-19 pandemic in the future. This article sheds light on the socio-economic and ecological effects of the COVID-19 pandemic on the eco-tourism sector of Ghana's Savannah region while offering short and long term strategies for building resilience to withstand shocks. Between September and October 2020, data was collected in the tourism enclave of the Savannah region in Ghana using focus group discussions and interviews. Results show that the major socio-economic impact of the pandemic was the loss of livelihoods. Ecological impacts were however mixed – both positive and negative. The study concludes that socio-economic impacts have been severe because they are closely tied to tourism. The study therefore recommends that immediate measures including stimulus packages be offered to local enterprises affected by the pandemic. In the long term, efforts should be made to diversify the local economy and promote domestic tourism in the country.
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Affiliation(s)
- Ophelia Soliku
- Department of Community Development, Faculty of Planning and Land Management, University of Business and Integrated Development Studies, P.O. Box UPW3, Wa, U.W.R, Ghana
| | - Bona Kyiire
- Mole National Park, Wildlife Division of Forestry Commission, Mole, Savannah Region, Ghana
| | - Ali Mahama
- Mole National Park, Wildlife Division of Forestry Commission, Mole, Savannah Region, Ghana
| | - Chrysantus Kubio
- Regional Health Directorate, Ghana Health Service, Savannah Region, Damongo, Ghana
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Mwin PK, Kuffuor A, Nuhu K, Okine R, Kubio C, Wurapa F, Osei FA, Afari E. Predictors of placental malaria in Upper West Regional Hospital-Ghana. BMC Pregnancy Childbirth 2021; 21:403. [PMID: 34039288 PMCID: PMC8157656 DOI: 10.1186/s12884-021-03861-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 05/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Placental malaria (PM) poses life-threatening complications to pregnant women as they are at increased risk of maternal and perinatal morbidity and mortality associated with malaria. This study examined the factors associated with placental malaria in the Upper West Regional Hospital (UWR). Methods A cross-sectional hospital-based study was carried out among pregnant women delivering at Upper West Regional Hospital. A cross-sectional screening survey was conducted from January 2019 to April 2019. Three hundred eligible mothers were consecutively recruited. A record review of their maternal and child history was assessed using a checklist. Placental blood samples were taken for microscopy to determine placental malaria parasitemia. Logistic regression analysis was done to determine the factors associated with placental malaria at 95 % confidence level. Results The proportion of mothers with placental malaria was 7 % (21/300), (95 % CI, 4.3–10.5 %). Plasmodium falciparum was the only species identified in those with PM. Majority of the women 66.7 % (14/21) with placental malaria had parasite density in the range 501 to 5,000 parasites/µL. Obstetric and health service factors that were significantly associated with placental malaria were gravidity and antenatal care (ANC) attendance. Primigravida (aOR = 3.48, 95 %CI = 1.01–12.01) and having less than 4 ANC attendance (aOR = 9.78, 95 %CI = 2.89–33.11) were found to be significantly associated with placental malaria. Conclusions The proportion of women with PM was relatively low. Primigravid mothers reporting less than 4 ANC visits had the highest risk of placental malaria. Expectant mothers should be encouraged to attend at least 4 ANC visits prior to delivery.
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Affiliation(s)
- Pascal Kingsley Mwin
- Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, USA
| | - Afreh Kuffuor
- Ghana Health Service, Upper West Regional Health Directorate, Karaga, Ghana
| | - Kaamel Nuhu
- State University of New York - Cortland, Cortland, USA
| | - Rafiq Okine
- World Health Organization (WHO), Country Office for Ghana, Accra, Ghana
| | - Chrysantus Kubio
- Ghana Health Service, Karaga District Health Directorate, Karaga, Ghana
| | - Frederick Wurapa
- Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, USA
| | - Francis Adjei Osei
- Public Health Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana. .,KNUST School of Public Health, Kumasi, Ghana.
| | - Edwin Afari
- Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, USA
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Agbemafle E, Kubio C, Ameme D, Kenu E, Sackey S, Afari E. Evaluation of malaria surveillance system, Adaklu District, Volta Region, Ghana, 2019. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kaburi BB, Bio FY, Kubio C, Ameme DK, Kenu E, Sackey SO, Afari EA. Psychological working conditions and predictors of occupational stress among nurses, Salaga Government Hospital, Ghana, 2016. Pan Afr Med J 2019; 33:320. [PMID: 31692933 PMCID: PMC6815485 DOI: 10.11604/pamj.2019.33.320.16147] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/14/2018] [Indexed: 11/15/2022] Open
Abstract
Introduction Occupational stress is a recognized health problem among nurses. Globally, its prevalence varies between 9.2% and 68.0%. It detracts from nurses' quality of life and efficiency of job performance. In Ghana, we do not know the important contributory factors to this problem. Our study sought to identify the important predictors of occupational stress among nurses. Methods In January 2016, we conducted an institutional-based survey among nurses of Salaga Government Hospital. They completed a five-point Likert type questionnaire adopted from the British Psychological Working Conditions Survey, and the Nurse Stress Index. Across 30 predictor variables, a mean score of 4.00 to 5.00 represented high to extreme occupational stress. We performed bivariate and multivariate analyses to identify important predictors of occupational stress at 95% confidence level. Results Of 167 nurses, 58.1% (97) were females. Respondents who experienced high to extreme stress levels had a 2.3 times odds of reporting sickness absence (CI: 1.03-5.14). Sources of occupational stress included: manual lifting of patients and pieces of equipment (OR: 16.23; CI: 6.28 - 41.92), the risks of acquiring infections (OR: 14.67; CI 5.90 - 36.46), receiving feedback only upon unsatisfactory performance (OR: 28.00; CI: 9.72 - 80.64), and inadequate opportunities for continuous professional development (OR: 63.50; CI: 19.99 - 201.75). Conclusion The working conditions of nurses were stressful. The most significant predictors of occupational stress were poor supportive supervision by superiors, lack of adequate skills to perform routine tasks, uncertainty about their job role, and the lack of adequate opportunities for career advancements.
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Affiliation(s)
- Basil Benduri Kaburi
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Fred Yaw Bio
- Bramuo Medical Centre, Abrankese, Ashanti, Ghana
| | - Chrysantus Kubio
- Ghana Health Service, District Health Directorate, Soboba, Northern Region, Ghana
| | - Donne Kofi Ameme
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Samuel Oko Sackey
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Edwin Andrew Afari
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
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Kaburi BB, Kubio C, Kenu E, Ameme DK, Mahama JY, Sackey SO, Afari EA. Evaluation of bacterial meningitis surveillance data of the northern region, Ghana, 2010-2015. Pan Afr Med J 2017; 27:164. [PMID: 28904692 PMCID: PMC5567946 DOI: 10.11604/pamj.2017.27.164.11036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/29/2017] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Bacterial meningitis is a disease of major public health importance especially for countries such as Ghana; whose northern part lies within the meningitis belt. The Northern region of Ghana has been recording cases with outbreaks over the years. In order to generate evidence to improve surveillance, we described the epidemiology of bacterial meningitis using surveillance data of the northern region. METHODS Bacterial meningitis datasets from January 2010 to December 2015 for all the 26 districts of the Northern region were retrieved from line lists. Data were analyzed in terms of person, place, time, and identity of causative organisms using descriptive statistics. The results were presented as proportions, rates, tables and graphs. RESULTS A total of 1,176 cases were reported. Of these, 53.5% (629/1,176) were males. The proportion of cases aged 0 to 29 years was 77.4%. The Overall Case Fatality Rate (CFR) was 9.7% (114/1,176). About 65% of all cases were recorded from January to April. Only 23.7% (279/1,176) of cases were laboratory-confirmed. Neisseria meningitides and Streptococcus pneumonia accounted for 91.4% of confirmed cases. Over the period, the incidence reduced from 9.0/100,000 population to 3.8/100,000 population and CFR reduced from 16.6% to 5.7%. CONCLUSION Most cases of bacterial meningitis were recorded in the dry season and in persons younger than 30 years. Less than a quarter of cases were laboratory confirmed, and no new bacteria species were identified. Both morbidity and mortality rates were on the decline. There is the need to consolidate these gains by intensifying meningitis surveillance and improving on the rate of laboratory case confirmation.
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Affiliation(s)
- Basil Benduri Kaburi
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon
| | - Chrysantus Kubio
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon.,Ghana Health Service, West Gonja District Health Directorate, Damongo, Ghana
| | - Ernest Kenu
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon
| | - Donne Kofi Ameme
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon
| | | | - Samuel Oko Sackey
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon
| | - Edwin Andrew Afari
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon
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Kaburi BB, Kubio C, Kenu E, Nyarko KM, Mahama JY, Sackey SO, Afari EA. Evaluation of the enhanced meningitis surveillance system, Yendi municipality, northern Ghana, 2010-2015. BMC Infect Dis 2017; 17:306. [PMID: 28438133 PMCID: PMC5404286 DOI: 10.1186/s12879-017-2410-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 04/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meningitis is the inflammation of the meninges of the brain and or spinal cord. Global mortality rates vary from 2% to 30%. Epidemic meningitis remains a public health concern along the meningitis belt of Africa. Despite the operation of an enhanced meningitis surveillance system in Ghana, institutional mortality rates are estimated to range from 36% to 50%. In 2014, Yendi recorded 83 confirmed cases; with focal epidemics in some sub-municipals. We evaluated the system over a five-year period to find out whether it was achieving its objectives of systematic collection and analyses of data for the prevention or early detection of meningitis epidemics. METHODS We used cross-sectional design. Both qualitative and quantitative data from Yendi Municipality between January 2010 and December 2015 were collected and analyzed. The updated guidelines for evaluating surveillance systems from Centers for Disease Control and Prevention were used. Content analysis was performed on the responses of key informants. Surveillance data was analyzed using MS-Excel. RESULTS Fifteen healthcare workers were interviewed. For the period under evaluation, the annual incidence of meningitis ranged from 1.6/100,000 in 2012 to 62.6/100,000 in 2014. The average case fatality rate for the period was 8.3%. The system was sensitive, representative, and acceptable. The predictive value positive was 100% from 2010 to 2014 and 63.3% in 2015. Data quality was good, but timeliness of reporting was poor. CONCLUSIONS The enhanced meningitis surveillance system in Yendi Municipality is achieving most of its objectives. However, financial constraints and poor personnel motivation pose threats to the sustainability of the system.
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Affiliation(s)
- Basil Benduri Kaburi
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Chrysantus Kubio
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.,Ghana Health Service, West Gonja District Health Directorate, Damongo, Ghana
| | - Ernest Kenu
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
| | - Kofi Mensah Nyarko
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Samuel Oko Sackey
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Edwin Andrew Afari
- Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Badimsuguru AB, Nyarko KM, Afari EA, Sackey SO, Kubio C. Determinants of stillbirths in Northern Ghana: a case control study. Pan Afr Med J 2016; 25:18. [PMID: 28149443 PMCID: PMC5257014 DOI: 10.11604/pamj.supp.2016.25.1.6168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 05/10/2016] [Indexed: 12/13/2022] Open
Abstract
Introduction Stillbirths are more common than the death of a baby after birth. In 2012, Tamale Metropolitan Area in the Northern Region of Ghana reported 35 stillbirths per 1,000 deliveries. This study was therefore conducted to determine the sociodemographic, obstetric and maternal medical health related risk factors associated with stillbirths. Methods A 1:1 unmatched case control study was conducted in the Tamale Metropolis. Cases were defined as singleton lifeless babies delivered by resident mothers in Tamale Metropolis at or after 28 weeks of gestation from 1st January, 2012 to 31st December, 2013. Controls were those who had live babies within the same period. We abstracted data from maternal health record booklets used in index pregnancies. We also conducted personal interviews with mothers on home visits. We estimated both crude and adjusted odds ratios, 95% confidence intervals and p values. Results A total of 368 mothers (184 cases and 184 controls) participated in the study. Maternal age of ≤ 24 years, prolonged labour (> 12 hours) and diastolic blood pressure of less than 80mmHg in late pregnancy were significant determinants of stillbirths (aOR = 3.0, 95% CI 1.08 – 8.39; aOR = 3.5, 95% CI 1.94 – 6.61; aOR =2.2, 1.04 – 4.54 respectively). Conclusion Low diastolic blood pressure in late pregnancy, young maternal age and prolonged labour were the key determinants of stillbirths in the Tamale Meetropolis. Improvement of community moral practices and discouraging early marriage will help reduce the menace of stillbirths. Monitoring of blood pressure and labour should be prioritized.
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Affiliation(s)
- Adam Bukari Badimsuguru
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana; Ghana Health Service, Northern Regional Health Directorate, Tamale, Ghana
| | - Kofi Mensah Nyarko
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Edwin Andrew Afari
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Samuel Oko Sackey
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Chrysantus Kubio
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana; Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
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Adjei AA, Winch P, Laar A, Sullivan DJ, Sakyi KS, Stephens JK, Adjei GO, Boateng IA, Aubyn VNA, Kubio C, Tuakli J, Vanotoo L, Bortei BB, Amo-Addae M, Sorvor F, Coleman N, Dalglish S, Owusu R, Gebreyesus T, Essuman E, Greene R, Ankomah E, Houston K, Bart-Plange C, Salamat S, Addison EA, Quakyi IA. Insights into the Affordable Medicines Facility-malaria in Ghana: the role of caregivers and licensed chemical sellers in four regions. Malar J 2016; 15:263. [PMID: 27160685 PMCID: PMC4862058 DOI: 10.1186/s12936-016-1307-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/23/2016] [Indexed: 12/03/2022] Open
Abstract
Background The Affordable Medicine Facility-malaria (AMFm) was an innovative global financing mechanism for the provision of quality-assured artemisinin-based combination therapy (ACT) across both the private and public health sectors in eight countries in sub-Saharan Africa. This study evaluated the effectiveness of AMFm subsidies in increasing access to ACT in Ghana and documented malaria management practices at the household and community levels during the implementation of the AMFm. Methods This study, conducted in four regions in Ghana between January, 2011 to December, 2012, employed cross-sectional mixed-methods design that included qualitative and quantitative elements, specifically household surveys, focus group discussions (FGD) and in-depth interviews. Results The study indicated high ACT availability, adequate provider knowledge and reasonably low quality-assured ACT use in the study areas, all of which are a reflection of a high market share of ACT in these hard-to-reach areas of the country. Adequate recognition of childhood malaria symptoms by licensed chemical seller (LCS) attendants was observed. A preference by caregivers for LCS over health facilities for seeking treatment solutions to childhood malaria was found. Conclusions Artemisinin-based combination therapy with the AMFm logo was accessible and affordable for most people seeking treatment from health facilities and LCS shops in rural areas. Caregivers and LCS were seen to play key roles in the health of the community especially with children under 5 years of age.
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Affiliation(s)
- Andrew A Adjei
- Office of Research, Innovation and Development, University of Ghana, Legon, Accra, Ghana
| | - Peter Winch
- Department of International Health, Social and Behavioural Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Amos Laar
- Department of Population, Family, and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - David J Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Kwame S Sakyi
- Department of International Health, Social and Behavioural Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Judith K Stephens
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - George O Adjei
- Centre for Tropical, Clinical, Pharmacology and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Isaac A Boateng
- Ashanti Akim Central Municipal Health Directorate, Ghana Health Services, Konongo, Ghana
| | | | | | | | - Linda Vanotoo
- Regional Health Directorate, Ghana Health Services, Accra, Ghana
| | - Bernard B Bortei
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Maame Amo-Addae
- Shama District Health Directorate, Ghana Health Services, Shama, Ghana
| | - Felix Sorvor
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Nathaniel Coleman
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Sarah Dalglish
- Department of International Health, Social and Behavioural Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Richmond Owusu
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Tsega Gebreyesus
- Department of International Health, Social and Behavioural Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Edward Essuman
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Rebecca Greene
- Department of Paediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ezekiel Ankomah
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Kiely Houston
- Department of International Health, Social and Behavioural Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | | | - Samuel Salamat
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Ebenezer A Addison
- Kpone Katamanso District Health Directorate, Ghana Health Services, Kpone, Tema, Ghana
| | - Isabella A Quakyi
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana.
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Bonney JHK, Osei-Kwasi M, Adiku TK, Barnor JS, Amesiya R, Kubio C, Ahadzie L, Ölschläger S, Lelke M, Becker-Ziaja B, Pahlmann M, Günther S. Hospital-based surveillance for viral hemorrhagic fevers and hepatitides in Ghana. PLoS Negl Trop Dis 2013; 7:e2435. [PMID: 24069490 PMCID: PMC3777898 DOI: 10.1371/journal.pntd.0002435] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 08/08/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Viral hemorrhagic fevers (VHF) are acute diseases associated with bleeding, organ failure, and shock. VHF may hardly be distinguished clinically from other diseases in the African hospital, including viral hepatitis. This study was conducted to determine if VHF and viral hepatitis contribute to hospital morbidity in the Central and Northern parts of Ghana. METHODOLOGY/PRINCIPAL FINDINGS From 2009 to 2011, blood samples of 258 patients with VHF symptoms were collected at 18 hospitals in Ashanti, Brong-Ahafo, Northern, Upper West, and Upper East regions. Patients were tested by PCR for Lassa, Rift Valley, Crimean-Congo, Ebola/Marburg, and yellow fever viruses; hepatitis A (HAV), B (HBV), C (HCV), and E (HEV) viruses; and by ELISA for serological hepatitis markers. None of the patients tested positive for VHF. However, 21 (8.1%) showed anti-HBc IgM plus HBV DNA and/or HBsAg; 37 (14%) showed HBsAg and HBV DNA without anti-HBc IgM; 26 (10%) showed anti-HAV IgM and/or HAV RNA; and 20 (7.8%) were HCV RNA-positive. None was positive for HEV RNA or anti-HEV IgM plus IgG. Viral genotypes were determined as HAV-IB, HBV-A and E, and HCV-1, 2, and 4. CONCLUSIONS/SIGNIFICANCE VHFs do not cause significant hospital morbidity in the study area. However, the incidence of acute hepatitis A and B, and hepatitis B and C with active virus replication is high. These infections may mimic VHF and need to be considered if VHF is suspected. The data may help decision makers to allocate resources and focus surveillance systems on the diseases of relevance in Ghana.
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MESH Headings
- Adolescent
- Adult
- Antibodies, Viral/blood
- Blood/virology
- Child
- Child, Preschool
- DNA, Viral/blood
- Epidemiological Monitoring
- Female
- Ghana/epidemiology
- Hemorrhagic Fevers, Viral/epidemiology
- Hemorrhagic Fevers, Viral/virology
- Hepatitis, Viral, Human/epidemiology
- Hepatitis, Viral, Human/virology
- Hospitals
- Humans
- Incidence
- Male
- Molecular Sequence Data
- RNA, Viral/blood
- Sequence Analysis, DNA
- Viruses/isolation & purification
- Young Adult
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Affiliation(s)
- Joseph Humphrey Kofi Bonney
- Virology Department, Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, Ghana
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Mubarak Osei-Kwasi
- Virology Department, Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, Ghana
| | | | - Jacob Samson Barnor
- Virology Department, Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, Ghana
| | | | | | - Lawson Ahadzie
- Disease Surveillance Department, Ghana Health Service, Accra, Ghana
| | - Stephan Ölschläger
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Michaela Lelke
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Beate Becker-Ziaja
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Meike Pahlmann
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Stephan Günther
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
- * E-mail:
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Kubio C, Tierney G, Quaye T, Nabilisi JW, Ziemah C, Zagbeeb SM, Shaw S, Murphy WG. Blood transfusion practice in a rural hospital in Northern Ghana, Damongo, West Gonja District. Transfusion 2012; 52:2161-6. [PMID: 22612858 DOI: 10.1111/j.1537-2995.2012.03709.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blood transfusion in rural sub-Saharan Africa presents special challenges. Transfusions are primarily given for emergencies--life-threatening blood loss or anemia; blood is usually collected from family or replacement donors; and facilities to store an adequate reserve in a hospital bank are constrained. We report the everyday and organizational practices in a medium-sized district hospital in Northern Ghana. STUDY DESIGN AND METHODS Information and data on blood transfusion practices at West Gonja Hospital, Damongo, were available from the laboratory reports, from day books and workbooks, and from direct observation in the following four areas: blood collection and blood donors; blood donation testing; blood storage and logistics; and clinical transfusion practice, adverse events, and follow-up. RESULTS The hospital serves a rural community of 86,000. In 2009, a total of 719 units of whole blood were collected, a rate of 8.36 units per 1000 population. All donors were family or replacement donors. Positivity rates for infectious disease markers were 7.5% (64/853) for hepatitis B surface antigen, 6.1% (50/819) for hepatitis C virus, 3.9% (33/846) for human immunodeficiency virus, and 4.7% (22/468) for syphilis. Supply of laboratory materials was sometimes problematic, especially for temperature-critical materials. Difficulties in sample labeling, storage of blood and laboratory supplies, and disposal of waste were also incurred by operational, material, and financial constraints. Follow-up for outcomes of transfusion is not currently feasible. CONCLUSIONS The operational, demographic, and financial environment pertaining in a rural hospital in Northern Ghana differs substantially from that in which much of current blood transfusion practice and technology evolved. Considerable effort and innovation will be needed to address successfully the challenges posed.
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