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Lartey M, Torpey K, Ganu V, Ayisi Addo S, Bandoh D, Abdulai M, Akuffo G, Kenu E. Hypertension Among Cohort of Persons With Human Immunodeficiency Virus Initiated on a Dolutegravir-Based Antiretroviral Regimen in Ghana. Open Forum Infect Dis 2024; 11:ofae061. [PMID: 38444823 PMCID: PMC10913832 DOI: 10.1093/ofid/ofae061] [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: 10/29/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
Background Dolutegravir (DTG), a new antiretroviral drug, is being integrated into antiretroviral regimens for people with human immunodeficiency virus (PWH) in Ghana. There is little evidence of the effect of DTG on blood pressure (BP) levels in sub-Saharan Africa, especially West Africa. Our aim was to assess the incidence and predictors of hypertension (HTN) among PWH initiated on a DTG-based antiretroviral regimen in Ghana. Methods An observational multicenter longitudinal study was conducted among PWH in Ghana from 2020 to 2022. BPs of nonhypertensive patients with BP ≤120/80 mm Hg at baseline were measured at 3, 6, 12, and 18 months post-DTG initiation. The primary outcome of the study was incidence of HTN, defined as BP ≥140/90 mm Hg. Kaplan-Meier estimator was used to estimate risk of developing HTN. Cox proportional hazards model with robust standard errors was used to estimate hazard ratios (HRs). Results HTN prevalence among PWH screened was 37.3% (1366/3664). The incidence of de novo HTN among nonhypertensive PWH at 72 weeks was 598.4 per 1000 person-years (PY) (95% confidence interval [CI], 559.2-640.3) with incidence proportion of 59.90 (95% CI, 57.30-62.44). A quarter of those with de novo HTN developed it by month 6. Obesity (adjusted HR [aHR], 1.27 [95% CI, 1.05-1.54]), abnormal serum urea (aHR, 1.53 [95% CI, 1.27-1.85]), and low high-density lipoprotein (aHR, 1.45 [95% CI, 1.22-1.72]) were risk factors for HTN. Conclusions Incidence of HTN was high among PWH on DTG. There is a need to monitor BP for HTN in adult PWH as well as traditional risk factors to reduce the burden of HTN and its complications.
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Affiliation(s)
- Margaret Lartey
- Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
- Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Kwasi Torpey
- Department of Population, Family, and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Vincent Ganu
- Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Delia Bandoh
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | | | - Golda Akuffo
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
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Boadu I, Manu A, Aryeetey RNO, Kesse KA, Abdulai M, Acheampong E, Akparibo R. Adherence to antiretroviral therapy among HIV patients in Ghana: A systematic review and meta-analysis. PLOS Glob Public Health 2023; 3:e0002448. [PMID: 37910452 PMCID: PMC10619784 DOI: 10.1371/journal.pgph.0002448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/12/2023] [Indexed: 11/03/2023]
Abstract
Maintaining a high level of adherence to antiretroviral therapy (ART) is critical to limiting rapid viral replication, drug resistance, and viral transmission. However, ART adherence remains a major challenge in HIV/AIDS treatment success. This systematic review and meta-analysis was aimed to synthesize available evidence on adherence to ART among HIV/AIDS patients in Ghana.This review followed the preferred reporting item for systematic review and meta-analysis (PRISMA) criteria. A comprehensive literature search was done using five online databases (PubMed, Google Scholar, Medline, Africa Index Medicus, and Willey Online Library) from 25th- 30th April 2023 to identify potential studies. In addition, references of related articles were manually searched to further identify relevant studies. Search records were managed in Endnote library where duplicates were removed prior to screening. Studies were eligible for inclusion if they were conducted in Ghana, designed as an observational or experimental study, and explicitly measured adherence to ART, either as a primary or secondary outcome. Studies were excluded if the proportion or prevalence of adherence to ART was not reported.A total number of 126 potential studies were identified from the literature search. Of these, 14 met the inclusion criteria and were included in the Meta-analysis. The studies involved a total number of 4,436 participants. The pooled estimate of adherence to ART was 70% (CI: 58-81%). In subgroup analysis, adolescents and young adults had a lower adherence rate (66%, CI: 46-84%) compared with adults (70%; CI: 58-81%). Publication bias was not observed among studies. The pooled estimate of optimal adherence to ART among HIV patients in Ghana was lower than is recommended (≥95%) to achieve viral suppression. Adherence was lower among young persons living with HIV/AIDS. To achieve the United Nation's Sustainable development goals and the UNAIDS "95-95-95" targets, there is a need to focus on improving adherence interventions among persons living with HIV/AIDS, especially among the younger cohort.
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Affiliation(s)
- Isaac Boadu
- Department of Population, Family and Reproductive Health, School of Public Health, Legon, University of Ghana, Accra, Ghana
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, Legon, University of Ghana, Accra, Ghana
| | - Richmond Nii Okai Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, Legon, University of Ghana, Accra, Ghana
| | - Kwame Adjei Kesse
- Department of Population, Family and Reproductive Health, School of Public Health, Legon, University of Ghana, Accra, Ghana
| | - Marijanatu Abdulai
- Department of Epidemiology and Disease Control, School of Public Health, Legon, University of Ghana, Accra, Ghana
- Ghana National AIDS/STI Control Programme (NACP), Accra, Ghana
| | - Emmanuel Acheampong
- Institute of Precision Health, University of Leicester, Leicester, United Kingdom
| | - Robert Akparibo
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
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Abdulai M, Owiredu D, Boadu I, Tabong PTN, Sarfo B, Bonful HA, Addo- Lartey A, Akuffo KO, Danso-Appiah A. Psychosocial interventions and their effectiveness on quality of life among elderly persons living with HIV in Africa South of the Sahara: Systematic review and meta -analysis protocol. PLoS One 2023; 18:e0291781. [PMID: 37729324 PMCID: PMC10511069 DOI: 10.1371/journal.pone.0291781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The number of elderly people living with HIV (EPLHIV) has increased significantly as a result of antiretroviral treatment (ART) and this has brought about a variety of psychosocial challenges that have an impact on their quality of life (QoL). Various psychosocial interventions have been tried or implemented in Sub-Saharan Africa (SSA) to improve QoL of EPLHIV. However, there is paucity of data on the types and effectiveness of these interventions. This systematic review, therefore, aims to explore available psychosocial interventions in SSA and their effectiveness in improving the QoL of EPLHIV. METHODS We will search PubMed, PsycINFO, LILACS, Cochrane Library, Google Scholar, HINARI, Africa Journals Online, Scopus and Web of Science to retrieve publications on psychosocial interventions implemented to improve QoL of EPLHIV from inception of the identified databases to 31st December 2023 without language restrictions. Also, supplementary sources such as conference proceedings, preprint repositories, databases of dissertations, as well as WHO and governmental databases can be explored for additional studies. For unpublished studies, trial registries and experts would be contacted, and reference lists of retrieved papers will be manually searched. Retrieved studies will be deduplicated using Mendeley and exported to Rayyan. At least two reviewers will independently select studies, extract data and assess the quality of the included studies using validated tools. Dichotomous outcomes data will be assessed and reported as odds ratio (OR) or risk ratio (RR) and for continuous outcomes, mean difference (MD) will be used; all reported with their 95% confidence interval (CI). Heterogeneity will be explored graphically by inspecting the overlapping of CIs and assessed quantitatively using the I2 statistic. EXPECTED OUTCOMES This systematic review will be the first to rigorously identify psychosocial intervention on QoL of EPLHIV in SSA and assess their effectiveness with the aim to provide regional and country- specific data that will inform the selection and implementation of appropriate and socially acceptable policies across countries in SSA. Key findings of the review are expected to contribute critical evidence on availability, types and effectiveness of psychosocial interventions for improving quality of life of vulnerable elderly persons in SSA living with HIV. Furthermore, the review will explore any variation and possible correlates of psychosocial interventions by age, sex, CD4 count (if available), setting and geographic location within SSA that will provide healthcare professionals with reliable evidence, with the ultimate goal of inspiring countries in SSA to adopt innovative interventions to improve HIV care. TRIAL REGISTRATION Systematic review registration: The systematic review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO), with registration ID CRD42021278218.
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Affiliation(s)
- Marijanatu Abdulai
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
- National AIDS/STI Control Programme, Public Health Division, Ghana Health Service, Accra, Ghana
| | - David Owiredu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
- Centre for Evidence Synthesis and Policy, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Isaac Boadu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Philip Teg-Nefaah Tabong
- Department of Social and Behavioural Science, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Bismark Sarfo
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Harriet Affran Bonful
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Adolphina Addo- Lartey
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
- Centre for Evidence Synthesis and Policy, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Abdulai M, Kenu E, Ameme DK, Bandoh DA, Tabong PT, Lartey AA, Noora CL, Adjei EY, Nyarko KM. Demographic and socio-cultural factors influencing contraceptive uptake among women of reproductive age in Tamale Metropolis, Northern Region, Ghana. Ghana Med J 2021; 54:64-72. [PMID: 33536671 PMCID: PMC7837347 DOI: 10.4314/gmj.v54i2s.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/17/2022] Open
Abstract
Background This study assessed some demographic and socio-cultural factors that influence contraceptive uptake among reproductive-aged women in Tamale Metropolis of the Northern Region, Ghana. Design This was a cross-sectional study conducted from February to March 2015. Setting All three sub Metropolis in Tamale. Participants All community members and women of reproductive age (15-49 years). Intervention The study used cluster sampling to recruit women who were interviewed using a structured questionnaire. Nine focus group discussions (FGDs) were also held among community members who were purposively selected. Main outcome measures contraceptive uptake (use of contraceptive). Results The mean age of the women was 26 years. The prevalence of contraceptive uptake among reproductive-age women was 36.8% (165/448). Women with secondary school education [AOR=4.4(95%CI:1.6-12.4)], and those in homes where decisions on having children were made by both partners [AOR=2.1(95%CI:1.1-04.42)] were more likely to use contraceptives. Unemployed women [AOR=0.3(95%CI:0.1-0.8)], women whose husbands were unaware of their contraceptive use [AOR=0.4(95%CI:0.2-0.9)] and those having a culture or religion that frowns on contraceptive use [AOR=0.4(95%CI:0.2-0.8)] were less likely to use contraceptive among women in the Tamale Metropolis. Conclusion The study found a contraceptive prevalence rate (CPR) in Tamale Metropolis, Northern Ghana to be 36.8%. Education and living in a home where childbearing decisions are made together were identified as positive factors influencing contraceptive uptake. Funding This work was funded by the authors.
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Affiliation(s)
- Marijanatu Abdulai
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.,National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Donne K Ameme
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Delia A Bandoh
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Phillip T Tabong
- School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra
| | - Adolphina Addo Lartey
- School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra
| | - Charles L Noora
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.,National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
| | - Eric Y Adjei
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kofi M Nyarko
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Lu CC, Wei RX, Deng DH, Luo ZY, Abdulai M, Liu HH, Kang B, Hu SQ, Li L, Xu HY, Hu JW, Wei SH, Han CC. Effect of different types of sugar on gut physiology and microbiota in overfed goose. Poult Sci 2021; 100:101208. [PMID: 34102480 PMCID: PMC8187246 DOI: 10.1016/j.psj.2021.101208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/02/2021] [Accepted: 04/11/2021] [Indexed: 01/11/2023] Open
Abstract
To explored the difference of goose fatty liver formation induced-by different types of sugar from the intestinal physiology and the gut microflora, an integrated analysis of intestinal physiology and gut microbiota metagenomes was performed using samples collected from the geese including the normal-feeding geese and the overfed geese which were overfed with maize flour or overfeeding dietary supplementation with 10% sugar (glucose, fructose or sucrose, respectively), respectively. The results showed that the foie gras weight of the fructose group and the sucrose group was heavier (P < 0.05) than other groups. Compared with the control group, the ileum weight was significantly higher (P < 0.01), and the cecum weight was significantly lower in the sugar treatment groups (P < 0.001). Compared with the control group, the ratio of villi height to crypt depth in the fructose group was the highest in jejunum (P < 0.05); the trypsin activity of the ileum was higher in the fructose group and the sucrose group (P < 0.05). At the phylum level, Firmicutes, Proteobacteria and Bacteroidetes were the main intestinal flora of geese; and the abundance of Firmicutes in the jejunum was higher in the sugar treatment groups than that of the maize flour group. At the genus level, the abundance of Lactobacillus in the jejunum was higher (P < 0.05) in the sugar treatment groups than that of the maize flour group. In conclusion, forced-feeding diet supplementation with sugar induced stronger digestion and absorption capacity, increased the abundance of Firmicutes and Bacteroidetes and the abundance of Lactobacillus (especially fructose and sucrose) in the gut. So, the fructose and sucrose had higher induction on hepatic steatosis in goose fatty liver formation.
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Affiliation(s)
- C C Lu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - R X Wei
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - D H Deng
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - Z Y Luo
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - M Abdulai
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - H H Liu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - B Kang
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - S Q Hu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - L Li
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - H Y Xu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - J W Hu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - S H Wei
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China
| | - C C Han
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan, 611130, P.R. China.
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Afari-Asiedu S, Hulscher M, Boamah-Kaali E, Abdulai M, Asante K, Wertheim H. All medicine is medicine; exploring inappropriate antibiotic use at the community level in rural Ghana. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.033] [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: 11/26/2022] Open
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Ayisi Addo S, Abdulai M, Yawson A, Baddoo AN, Zhao J, Workneh N, Okae I, Wiah E. Availability of HIV services along the continuum of HIV testing, care and treatment in Ghana. BMC Health Serv Res 2018; 18:739. [PMID: 30257660 PMCID: PMC6158882 DOI: 10.1186/s12913-018-3485-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 08/21/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Ghana has been providing HIV and AIDS services since the identification of the first case in 1986 and added highly active antiretroviral therapy to its comprehensive care in 2003.This study aimed at assessing availability of HIV services along the continuum of HIV care in Ghana. METHOD A cross sectional study was conducted among 172 (87%) of the total 197 ART canters in Ghana. Data was collected by self-administered questionnaire and analysed using STATA version 13. RESULTS Of the 172 health facilities surveyed, 165 (96%) were offering HIV testing Services (HTS) during the survey period. More than 90% of the surveyed facilities reported to offer Anti-Retroviral Treatment (ART), patient counselling, TB screening and Prevention of Mother to Child Transmission (PMTCT) services. Viral load and Early Infant Diagnosis (EID) and laboratory testing services were reported at 10 (5.8%) and 23 (13.4%) respectively. HIV testing services (HTS), PMTCT, ART, patient counselling and opportunistic infections (OI) prophylaxis services were offered at all Tertiary and Regional hospitals surveyed. EID sample collection and testing services was reported at 2 out of 27 (7.4%) of the Health Centre and/or clinics in Ghana. The common adherence assessment methodology being implemented varied by facilities which included: asking patients if they took their drugs 154 (89.5%), pill counting 131 (76.2%), use of follow-up visit 79(45.9%) and use of CD4 counts, viral loads and clinical manifestation 76 (44.2%). Challenges encountered by facilities included shortage of test reagents and drugs 122 (71%), 111 (65%) respectively and patient compliance 101 (59%). CONCLUSION This study showed ART services to be available in most facilities. Methods used to assess patients adherence varied across facilities. Shortage of test reagents and drugs, EID sample collection and testing were major challenges. A standardised approach to assessing patient's adherence is recommended. Measures should be put in place to ensure availability of HIV commodities at all levels.
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Affiliation(s)
| | | | - Alfred Yawson
- National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | - Akosua N. Baddoo
- National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
| | - Jinkou Zhao
- The Global Fund to fight AIDS TB and Malaria, Geneva, Switzerland
| | - Nibretie Workneh
- The Global Fund to fight AIDS TB and Malaria, Geneva, Switzerland
| | - Ivy Okae
- National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
| | - Ekow Wiah
- National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
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Dwomoh D, Tambaa C, Ayisi Addo S, Wiah E, Abdulai M, Bosomprah S. Effect of antiretroviral therapy on all-cause mortality among people living with HIV/AIDS in Ghana using Mahalanobis distant metric matching within propensity score caliper analysis: A retrospective cohort study. PLoS One 2018; 13:e0203461. [PMID: 30192892 PMCID: PMC6128569 DOI: 10.1371/journal.pone.0203461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/24/2018] [Accepted: 08/21/2018] [Indexed: 11/18/2022] Open
Abstract
Several health interventions have been put in place to improve health outcomes of people living with HIV/AIDS (PLHIV) in Ghana. We evaluated the impact of Antiretroviral Therapy (ART) on all-cause mortality in Ghana using matching procedures. This was a retrospective cohort study of 12,881 HIV/AIDS patients initiated on ART at 40 sentinel sites and 199 treatment centers between 2013 and 2016 countrywide. Patients were included if they had date of ART initiation and if they had mortality outcome recorded. Mahalanobis distant metric matching within propensity score caliper and other matching procedures were used to evaluate the effectiveness of ART in reducing the risk of all-cause mortality among PLHIV in Ghana. We performed sensitivity analysis using different matching procedures including Kernel weighting adjustment and Mahalanobis distance metric matching with nearest neighbour to ascertain the robustness of our results in the presence of unmeasured covariates. The proportion of patients on ART was 60.3% (95% CI: 59.5-61.1). The total number of mortalities reported was only 734 representing 4.6% (95% CI: 4.2-4.9) of the studied population. The risk of all-cause mortality has reduced by 11.6 percentage point among HIV/AIDS patients who were on ART compared to those who were not on ART (95% CI: 9.6-13.4). ART was associated with a decreased risk of all-cause mortality. Effort being made by Government and non-Governmental organizations in support of ART treatment in Ghana should continue unabated to help reduce mortality rate and improve health outcomes among HIV/AIDS. To reduce bias to the barest minimum between treatment and intervention group when evaluating the effectiveness of health interventions, it is recommended to use matching procedures especially when the study design is not a randomized control trial.
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Affiliation(s)
- Duah Dwomoh
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | | | | | - Ekow Wiah
- National AIDS/STI Control Programme, Accra, Ghana
| | | | - Samuel Bosomprah
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
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Adjei EY, Malm KL, Mensah KN, Sackey SO, Ameme D, Kenu E, Abdulai M, Mills R, Afari E. Evaluation of cholera surveillance system in Osu Klottey District, Accra, Ghana (2011-2013). Pan Afr Med J 2018; 28:224. [PMID: 29629010 PMCID: PMC5881562 DOI: 10.11604/pamj.2017.28.224.10737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 09/15/2016] [Accepted: 08/16/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction Cholera is an acute illness characterized by profuse watery diarrhea. It is caused by vibrio cholera subgroup 01 and 0139. Rapid administration of fluid replacement therapy and supportive treatment can reduce mortality to around 1%. By the close of 2011, 10,628 cases and 100 deaths were reported in Ghana with a case fatality rate of 0.99. It is important to evaluate the cholera surveillance system in Ghana to determine if it is meeting its objective. Methods The study was conducted in Osu Klottey district in the Accra Metropolitan area in January 2014. We assessed the operations (attributes and performance) of the surveillance system for cholera using CDC guidelines (2001). Surveillance data records at the district level from 2011-2013 were extracted and analyzed for frequency using Microsoft excel. Stakeholders and key informants were interviewed using structured questionnaire. Records were also reviewed at some health facilities and at district levels. Results In 2011 and 2012, case fatality rates (1.3% and 0.65%) respectively. Males were mostly affected. The most affected age group was 20-29. In 2011, Predictive value positive was 69.2% and 50% in 2012.Cholera peaked in March 2011 and April 2012. The Government of Ghana funded the system. The system is sensitive, simple, stable, flexible, acceptable and representative. It was also useful and data quality was relatively good. Predictive Value Positive was also good. Conclusion The surveillance system is achieving its set out objectives. The system is sensitive, simple, stable, flexible, and acceptable. Predictive value positive was good.
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Affiliation(s)
- Eric Yirenkyi Adjei
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
| | | | - Kofi Nyarko Mensah
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
| | - Samuel Oko Sackey
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
| | - Donne Ameme
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
| | - Marijanatu Abdulai
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
| | | | - Edwin Afari
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana
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Noora CL, Afari EA, Nuoh RD, Adjei EY, Anthony GK, Abdulai M, Sackey SO, Kenu E, Nyarko KM. Pedestrians' adherence to road traffic regulations on the N1 Highway in Accra, Ghana. Pan Afr Med J 2017; 25:11. [PMID: 28149436 PMCID: PMC5257021 DOI: 10.11604/pamj.supp.2016.25.1.6184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 04/26/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction Pedestrian behavior and adherence to road traffic regulation is vital in the prevention and control of road traffic accidents (RTA) especially on highways in Ghana. We assessed pedestrians’ adherence to road crossing regulations on the George Walker Bush (N1) Highway in Accra. Methods We conducted a cross sectional study of pedestrians crossing the N1 highway from both sides of the road between 7:00 am and 11:00am. We observed all pedestrians using a checklist and interviewed 413 using a structured questionnaire. We collected data on basic demographics, and pedestrians’ knowledge on road crossing (exposures). Data was, cleaned and analyzed using Epi-info version 3.5.4. Pearson Chi-square was used to assess differences in proportions for categorical variables. Binary logistic regression was used to test for association between pedestrian choice of route and exposures. Results We observed (n = 1856) pedestrians crossing the road during the study period; 1155 (62.2%) males, 461 (24.8%) did not use the approved route(s). Majority 317(76.8%) were adults between the ages of 20-49, mostly males 265 (56.4%). Most people (92.7%) had at least basic education. AOR for sex (male) was 1.7(1.1-2.6), and regular use of Highway (always) was 0.4(0.2-0.8) at 95% CI. Conclusion One out of every 4pedestrians using the N1 Highway used an unapproved route. Majority of pedestrians who regularly cross the Highway at unapproved routes were males. We recommend vigorous public education and addition of more footbridges.
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Affiliation(s)
- Charles Lwanga Noora
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program; Ghana Health Service, Ghana
| | - Edwin Andrews Afari
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program
| | - Robert Domo Nuoh
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program; Ghana Health Service, Ghana
| | - Eric Yirenkyi Adjei
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program; Ghana Health Service, Ghana
| | - Gershon Kobla Anthony
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program
| | - Marijanatu Abdulai
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program; Ghana Health Service, Ghana
| | - Samuel Oko Sackey
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program
| | - Ernest Kenu
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana
| | - Kofi Mensah Nyarko
- School Of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; Ghana Field Epidemiology And Laboratory Training Program
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Nuoh RD, Nyarko KM, Nortey P, Sackey SO, Lwanga NC, Ameme DK, Nuolabong C, Abdulai M, Wurapa F, Afari E. Review of meningitis surveillance data, upper West Region, Ghana 2009-2013. Pan Afr Med J 2016; 25:9. [PMID: 28210377 PMCID: PMC5292117 DOI: 10.11604/pamj.supp.2016.25.1.6180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 01/23/2015] [Accepted: 05/10/2016] [Indexed: 12/01/2022] Open
Abstract
Introduction The Upper West region of Ghana is within the meningitis belt. Analysis of long term surveillance data is necessary for understanding changes in the disease occurrence. We analyzed five years of surveillance data to describe by person, place and time and to determine trends in meningitis. Methods Meningitis surveillance data from Ghana Health Service in the Upper West Region, from 2009 to 2013 were reviewed. Data was obtained from District-Health Information Management System and line list from the Disease Control Unit. Population figures (denominators) and rainfall data were also analyzed. Results Within the period 980 cases of meningitis were reported in the region, 507(52%) females and 473(48%) males. The mean age of cases was 20.1years and standard deviation 18.8 years with, 77.6 %( 761/980) cases occurring in persons aged under 30 years. Children under five years were 19.3% (190/980). Attack rates ranged from 6.1/100,000 population in the Daffiama-bussei-Issa-district to 47.5/100,000 in Jirapa. Overall case fatality rate of meningitis was 12.2% with 14deaths/100,000 population. Bacterial agents were isolated from 35% (245/702) of CSF. Majority were Streptococcus pneumonia 48.2 % ( 122/258), and N. meningitides Y/W 135 40.3% (102/258). Meningitis was found to be seasonal with peaks in the dry season. Conclusion Meningitis in the region is seasonal, and showed a decreasing trend. Jirapa, Lawra, Nadowli and Wa West districts had the highest burden. Control effort of the disease should focus on vaccination against streptococcus pneumonia and N. meningitis W135 especially within crowded settlements such as boarding schools.
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Affiliation(s)
- Robert Domo Nuoh
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service
| | - Kofi Mensah Nyarko
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service
| | - Priscilla Nortey
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra
| | - Samuel Oko Sackey
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra
| | - Noora Charles Lwanga
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service
| | - Donne Kofi Ameme
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra
| | - Culbert Nuolabong
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra
| | - Marijanatu Abdulai
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service
| | - Fredrick Wurapa
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra
| | - Edwin Afari
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra
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12
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Ameme DK, Abdulai M, Adjei EY, Afari EA, Nyarko KM, Asante D, Kye-Duodu G, Abbas M, Sackey S, Wurapa F. Foodborne disease outbreak in a resource-limited setting: a tale of missed opportunities and implications for response. Pan Afr Med J 2016; 23:69. [PMID: 27217893 PMCID: PMC4862777 DOI: 10.11604/pamj.2016.23.69.7660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 03/02/2016] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Foodborne diseases (FBD) have emerged as a major public health problem worldwide. Though the global burden of FBD is currently unknown, foodborne diarrhoeal diseases kill 1.9 million children globally every year. On 25th September 2014, health authorities in Eastern Region of Ghana were alerted of a suspected FBD outbreak involving patrons of a community food joint. We investigated to determine the magnitude, source and implement control and preventive measures. METHODS A retrospective cohort study was conducted. We reviewed medical records for data on demographics and clinical features. A suspected foodborne disease was any person in the affected community with abdominal pain, vomiting and or diarrhea between 25(th) and 30(th) September 2014 and had eaten from the food joint. We conducted active case search, descriptive data analysis and calculated food specific attack rate ratios (ARR) and their corresponding 95% confidence intervals. RESULTS Of 43 case-patients, 44.2% (19/43) were males; median age was 19 years (interquartile range: 17-24 years). Overall attack rate was 43.4% (43/99) with no fatality. Case counts rose sharply for four hours to a peak and fell to baseline levels after 12 hours. Compared to those who ate other food items, patrons who ate "waakye" and "shitor" were more likely to develop foodborne disease [ARR = 4.1 (95% CI = 1.09-15.63)]. Food samples and specimens from case-patients were unavailable for testing. Laboratory diagnostic capacity was also weak. CONCLUSION A point source FBD outbreak linked to probable contaminated "waakye" and or "shitor" occurred. Missed opportunities for definitive diagnosis highlighted the need for strengthening local response capacity.
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Affiliation(s)
- Donne Kofi Ameme
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
| | - Marijanatu Abdulai
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
| | - Eric Yirenkyi Adjei
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
| | - Edwin Andrews Afari
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
| | - Kofi Mensah Nyarko
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
| | - Dwamena Asante
- Upper West Akim District Health Directorate, Adeiso, Ghana
| | - Gideon Kye-Duodu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Mona Abbas
- Noguchi Memorial Institute for Medical Research, Legon, Accra, Ghana
| | - Samuel Sackey
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
| | - Fred Wurapa
- Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana
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