Reduction in diarrhea cases following implementation of COVID-19 hand hygiene interventions in Ghana: A causal impact analysis.

BACKGROUND: The human hand has constant contact with the environment, hence requires regular hand hygiene. Hand hygiene has gained recognition because of the COVID-19 pandemic and is a largely effective, affordable preventive measure against infectious diseases. This study used both national and sub-national analyses to evaluate the effect of COVID-19 handwashing guidelines on instances of diarrhea in Ghana. METHODS: Data on diarrhea cases spanning February 2018 and March 2022 were retrieved from the District Health Information Management System (DHIMS 2) using a data extraction guide. The data were summarized using descriptive statistics. The difference in diarrhea cases between the pre-COVID-19 and COVID-19 periods was measured using a two-sample t-test across Ghana's 16 administrative areas. Causal Impact package in R statistical software was employed to determine the impact of the introduction of COVID-19 hand hygiene protocols on diarrheal disease. RESULTS: A total of 5,645,533 diarrheal cases reported between February 2018 and March 2022 through the routine MIS (DHIMS2) were examined. Fifty-three percent of the cases occurred before the introduction of the hand hygiene protocol. Descriptive statistics indicated a statistically significant decrease in average diarrheal cases during the hand hygiene implementation era (13,463 cases reduction, p<0.001). Sub-national analyses revealed significant reductions in various regions: Greater Accra, Ashanti, Ahafo, Central, Eastern, Northern, Upper East, Upper West, and Volta (p<0.05). Causal impact analysis confirmed 11.0% nationwide reduction in diarrheal cases attributed to the COVID-19 hand hygiene protocols (p<0.001). CONCLUSION: This study underscores the effectiveness of COVID-19 hand hygiene protocols in reducing diarrheal morbidity in Ghana, with varying regional impacts. These findings advocate for the sustenance of investments and commitments made at the COVID hand hygiene protocols, particularly in this era where the pandemic appears controlled.

Intermittent Preventive Treatment of Malaria in Pregnancy with Sulphadoxine-Pyrimethamine and its Associated Factors in the Atwima Kwanwoma District, Ghana.

Background: Intermittent preventive treatment of malaria in pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) tablets is one of the recommended interventions to reduce the burden of malaria on both the pregnant woman and the unborn child. The aim of this study was to assess the prevalence of IPTp-SP uptake and its associated factors in the Atwima Kwanwoma District of Ashanti Region, Ghana. Methods: The study was cross sectional. A structured questionnaire was administered to 394 respondents, comprising pregnant women in their last two months of pregnancy and nursing mothers who delivered within three months prior to the study. Medical records of the respondents were also reviewed. Descriptive statistics such as simple proportions, and averages were computed. Chi-square test and multiple logistic regression analysis were performed to determine factors associated with IPTp-SP uptake. Results: The average age of the respondents was 28.2 (±5.9) years. Almost all of the respondents (98%) had received SP at the time of the study. Fifty percent received their first dose of SP between 16 and 19 weeks of gestation. The multiple logistic regression analysis showed a statistically significant association between IPTp-SP uptake and educational level, time of first ANC visit, number of ANC visits and receiving education on SP prior to the administration of the drug. Conclusion: Education on SP use should be intensified at all levels of the health system. Early initiation of ANC is also recommended for optimal uptake of IPTp-SP. More research is needed to understand factors affecting the uptake of SP during pregnancy in the country.