Differences in physical and mental health symptoms among residents living near municipal solid waste sites: a cross sectional study in the Ashanti Region, Ghana

OBJECTIVE

Physical and mental health concerns and symptoms, including sleep problems, low mood, extreme tiredness, and appetite loss are prevalent among people living near waste sites. This research examines differences in health symptoms among residents living near municipal solid waste sites in the Ashanti Region, Ghana.

METHODS

The study used cross-sectional data from 827 residents living near three municipal waste sites, including Besease, Asokore, and Dompoase sites in the Ashanti Region, Ghana. Descriptive statistics, Pearson's chi-square, and binary logistic regressions were performed to examine the differences and associations between the variables.

RESULTS

Health symptoms, including sleep problems/insomnia, frequent extreme tiredness, low mood, loss of appetite, stress, anxiety, and depression, were reported by the majority of the participants. Residents near open dumpsites (Besease and Asokore) exhibit significantly higher likelihoods of experiencing various health symptoms such as extreme fatigue, depression, psychological disorders, thinking and concentration problems, low mood, loss of appetite, and anxiety compared to those near the engineered Oti landfill in Dompoase.

CONCLUSION

While emphasizing the importance of proper landfill design and management in Ghana, this study underscores the need for further longitudinal and clinical investigations. Clinically establishing the link between dumpsites and health symptoms is imperative for informed public health interventions and policy decisions aimed at mitigating the potential adverse health effects of landfills on residents' well-being.

Barriers to tuberculosis treatment adherence in high-burden tuberculosis settings in Ashanti region, Ghana: a qualitative study from patient's perspective

BACKGROUND

Despite having an effective community-based Directly Observed Therapy Short-course (DOTS) strategy for tuberculosis (TB) care, treatment adherence has been a major challenge in many developing countries including Ghana. Poor adherence results in discontinuity of treatment and leads to adverse treatment outcomes which pose an increased risk of drug resistance. This study explored barriers to TB treatment adherence and recommended potential patient-centered strategies to improve treatment adherence in two high-burden TB settings in the Ashanti region of Ghana.

METHODS

The study was conducted among TB patients who defaulted on treatment in the Obuasi Municipal and Obuasi East districts in the Ashanti region. A qualitative phenomenology approach was used to explore the barriers to TB treatment adherence. Purposive sampling was adopted to select study participants with different sociodemographic backgrounds and experiences with TB care. Eligible participants were selected by reviewing the medical records of patients from health facility TB registers (2019-2021). Sixty-one (61) TB patients met the eligibility criteria and were contacted via phone call. Out of the 61 patients, 20 were successfully reached and consented to participate. In-depth interviews were conducted with participants using a semi-structured interview guide. All interviews were audio recorded and transcribed verbatim. The transcripts were imported into Atlas.ti version 8.4 software and analyzed using thematic content analysis.

RESULTS

Food insecurity, cost of transportation to the treatment center, lack of family support, income insecurity, long distance to the treatment center, insufficient knowledge about TB, side effect of drugs, improvement in health after the intensive phase of the treatment regimen, and difficulty in accessing public transportation were the main co-occurring barriers to treatment adherence among the TB patients.

CONCLUSION

The main barriers to TB treatment adherence identified in this study reveal major implementation gaps in the TB programme including gaps related to social support, food security, income security, knowledge, and proximity to treatment centers. Hence, to improve treatment adherence there is a need for the government and the National Tuberculosis Programme (NTP) to collaborate with different sectors to provide comprehensive health education, social and financial support as well as food aid to TB patients.

Ophthalmic services utilisation and associated factors in the Ashanti region, Ghana

Objective

This survey determined the utilisation of eye care services and associated factors among adults in the Ashanti region of Ghana.

Design

A population-based cross-sectional descriptive study.

Method

Data for this study was collected from 1615 randomly selected individuals in the Ashanti region of Ghana, using a structured, pretested interviewer-guided questionnaire. Information regarding the accessibility and determinants of, and barriers to, eye care services was based on self-reports, using the WHO Eye Care Services Assessment Questionnaire. Inferential analyses were performed using the chi-square test for statistical significance, set at p=0.05.

Setting

Ashanti Region, Ghana.

Participants

One thousand six hundred and fifteen randomly selected adults.

Results

Public eye care facilities were used by 58.2% of the participants for their last eye exam. Of the participants, 47.0% had travelled less than five kilometres for their last eye exam. Waiting time and service cost were participants' most frequently cited challenges in seeking care. No need felt (40.1%), self-medication (37.7%) and cost (22.2%) were the most frequently mentioned barriers to seeking ophthalmic services.

Conclusion

The major challenges encountered in seeking eye care services were waiting time and cost of service. Major barriers to ophthalmic services utilisation were no need felt, self-medication and cost. Factors such as cost, lack of felt need and self-medication, which serve as barriers to utilising eye care services, should be addressed by stake-holders through eye health education and promotion.

Funding

None declared.

The practice of integrated healthcare and the experiences of people in Ghana's Ashanti region

Background

The Ghanaian government has implemented interventions that integrate traditional medicine (TM) into its national health system in response to the high prevalence of TM use. However, empirical evidence of the experiences of service users and the practice of integrated health in Ghana is scanty. Therefore, this study explored the experiences of people with TM integration into the formal health system in Ashanti region using an adapted TM integration framework.

Methods

A sequential explanatory mixed methods study design comprising survey administration and in-depth interviews for data collection was utilised to address the research objective. Framework analysis was used in analysing the qualitative data and for triangulation of results.

Results

Participants were aware of licensing and training of TM practitioners in a science-based university in Ghana. However, knowledge of the existence of TM units in selected hospitals in the region was minimal. Integration knowledge was largely influenced by sex, marital status, household size and residential status, where males and urban dwellers were more familiar with the process than females and rural dwellers. Low patronage of integrated health services in the region was attributable to weak cross referrals. However, service users who had engaged with the integrated system recounted a satisfactory outcome.

Conclusion

Service users’ unfamiliarity with the presence of integrated facilities in Ghana could be an impediment to the practice of integrated healthcare. Sensitisation of the public about the practice of an integrated system could refine the Ghanaian integrated system. Regular evaluation of patient satisfaction and outcome measures might also serve as an effective strategy for improving health services delivery since evaluation is becoming an important component of health service design and implementation. There is the need for future studies to focus on exploring the perceptions and experiences of health practitioners and hospital administrators regarding the practice of integrated health in Ghana.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07340-0.

Burden of hypertension in Ghana - Analysis of awareness and screening campaign in the Ashanti Region of Ghana

OBJECTIVES

Hypertension is a major risk factor for cardiovascular mortality globally and in Ghana. May Measurement Month (MMM) is a global awareness and screening campaign initiated by the International Society of Hypertension.

METHODS

Participants were recruited by opportunist sampling in the Ashanti region of Ghana. The blood pressures of participants were measured three times and the mean of the last two readings was used for the analysis. Simple and multiple logistic regression was used to determine the predictors of hypertension.

RESULTS

The MMM 2018 awareness and screening campaign enrolled 5054 participants with a mean age of 39.4 ± 14.7 years. There were 2553 (50.6%) males, 987 (20.1%) of respondents had never checked their blood pressure and 676 (13.9%) had a prior history of hypertension. The prevalence of hypertension was 37.4%. We found that 589(66.8%) of 822 respondents with high blood pressure did not have a history of hypertension. Respondents with a known history of hypertension on medication were 442 (65.9%) and 219(68.0%) of 322 respondents on medication had uncontrolled hypertension. The predictors of high blood pressure in a multiple logistic regression were increasing age (OR = 1.05 CI 1.05-1.06, p < 0.001), history of alcohol intake (OR = 1.33 CI 1.04 -1.70, p = 0.02), overweight (OR = 1.4 CI 1.14-1.76, p = 0.001) and obesity (OR = 1.32, CI 1.01-1.74, p = 0.047).

CONCLUSION

There is a high prevalence of hypertension in the Ashanti region in Ghana. Most participants with hypertension were not aware and the majority of those with hypertension on medications were uncontrolled. This calls for more education and screening of hypertension to decrease cardiovascular mortality.

Perceptions and Experiences of Orthodox Health Practitioners and Hospital Administrators towards Integrating Traditional Medicine into the Ghanaian Health System

The government of Ghana has been piloting traditional medicine (TM) integration in 17 health facilities across the country. However, the nature of current practice of integrated healthcare has not been thoroughly explored. This paper sought to explore the experiences and recommendations of orthodox health practitioners and hospital administrators in the Ashanti region regarding the practice of integrated healthcare in Ghana. The study adopted a qualitative, phenomenological approach involving 22 interviews. Purposive sampling technique was used in selecting study participants. Framework analysis was used to draw on the experiences of participants relating to TM integration. Participants were knowledgeable about the existence of integrated health facilities and stated that TM integration has created options in health services. However, participants deemed the integrated system ineffective and attributed the inefficiency to poor processing and certification of TM products, opposition of medical doctors to TM usage, absence of a protocol to guide the integration process, and inadequate publicity. Professional training of TM practitioners and inclusion of TM in medical school curriculum could improve collaboration between the health practitioners. Future research should focus on assessing the opinions and involvements of TM practitioners regarding the integration of traditional therapies into national health systems.

Determination of trace elements and their concentrations in clay balls: problem of geophagia practice in Ghana

Ten samples of 100 g weight were subsampled from 1400 g of the clay balls from which the contained trace element levels were determined by X-ray fluorescence technique. The results of trace elements in the clay balls were calibrated using certified reference materials "MAJMON" and "BH-1." The results showed elevated concentrations but with different concentration levels in the regions, particularly with arsenic, chromium, cobalt, Cs, Zr and La. These trace elements contained in the clay balls are known to be hazardous to human health. Thence the relatively high concentrations of these listed trace elements in clay balls in the three regions, namely Ashanti, Upper East and Volta, which are widely sold in markets in Ghana, could present negative health impact on consumers if consumed at 70 g per day or more and on regular basis. On the basis of these, the study concludes an investigation to establish breakeven range for trace element concentrations in the clay balls as it has been able to demonstrate the uneven and elevated values in them. The standardized safe ranges of trace elements will make the practice safer for the people that ingest clay balls in Ghana.