Adolescent girls' and young mothers' knowledge and use of antenatal care in the Ahafo Region, Ghana: A cross-sectional study.

BACKGROUND:  Antenatal care (ANC) is crucial to reducing maternal and neonatal deaths, but few studies examined adolescent girls' and young women's ANC utilisation and knowledge in Ghana. AIM:  To assess adolescents' and young mothers' knowledge of ANC, utilisation and factors influencing its use in Ghana. SETTING:  Tano North Municipality, Ahafo Region. METHODS:  This community-based, cross-sectional study involved 440 adolescent and young mothers (between 10 and 24 years). A structured questionnaire was employed to collect data face-to-face. Descriptive and statistical analyses were performed, and p  0.05 was considered statistically significant. RESULTS:  Of the 440 respondents, most were aged 20-24 years (61.2%), married (30.0%), Christians (78.2%), completed junior high school (JHS) (47.8%) and traders (38.9%). Postnatal mothers were 71.6% (315), and all had utilised ANC services. Antenatal care knowledge was good among 75% (330) respondents, with no significant variation by age. Religion influenced knowledge, with Muslims having lower knowledge. Antenatal care utilisation was high ( 50%) among those aged 15-19 years, married, Christians, JHS graduates and traders. Age, marital status and employment type significantly influenced ANC utilisation. Individuals in the age group 15-19 years and married women demonstrated higher odds of utilising ANC services. Casual workers and unemployed respondents were found to have lower odds of utilising ANC services compared to traders. CONCLUSION:  Age, marital status, and employment type influenced ANC utilisation in the Ahafo Region. Adolescent mothers under 15 years had lower rates, requiring targeted interventions to improve pregnancy outcomes.Contribution: This study highlights the knowledge and factors influencing ANC use in Ahafo Region and adds to the existing research evidence on ANC.

Predictive signs and symptoms of bacterial meningitis isolates in Northern Ghana.

Cerebrospinal meningitis (CSM) is a public health burden in Ghana that causes up to 10% mortality in confirmed cases annually. About 20% of those who survive the infection suffer permanent sequelae. The study sought to understand the predictive signs and symptoms of bacterial meningitis implicated in its outcomes. Retrospective data from the Public Health Division, Ghana Health Service on bacterial meningitis from 2015 to 2019 was used for this study. A pre-tested data extraction form was used to collect patients' information from case-based forms kept at the Disease Control Unit from 2015 to 2019. Data were transcribed from the case-based forms into a pre-designed Microsoft Excel template. The data was cleaned and imported into SPSS version 26 for analysis. Between 2015 and 2019, a total of 2446 suspected bacterial meningitis cases were included in the study. Out of these, 842 (34.4%) were confirmed. Among the confirmed cases, males constituted majority with 55.3% of the cases. Children below 14 years of age were most affected (51.4%). The pathogens commonly responsible for bacterial meningitis were Neisseria meningitidis (43.7%) and Streptococcus pneumoniae (53.0%) with their respective strains Nm W135 (36.7%), Nm X (5.1%), Spn St. 1 (26.2%), and Spn St. 12F/12A/12B/44/4 (5.3%) accounting for more than 70.0% of the confirmed cases. The presence of neck stiffness (AOR = 1.244; C.I 1.026-1.508), convulsion (AOR = 1.338; C.I 1.083-1.652), altered consciousness (AOR = 1.516; C.I 1.225-1.876), and abdominal pains (AOR = 1.404; C.I 1.011-1.949) or any of these signs and symptoms poses a higher risk for testing positive for bacterial meningitis adjusting for age. Patients presenting one and/or more of these signs and symptoms (neck stiffness, convulsion, altered consciousness, and abdominal pain) have a higher risk of testing positive for bacterial meningitis after statistically adjusting for age.

Neonatal Jaundice Management: Knowledge, Attitude, and Practice Among Nurses and Midwives in the Northern Region, Ghana.

Background: Nurses and midwives play important role in managing neonatal jaundice and provide nursing health education to mothers on preventive and remedial measures to neonatal jaundice. However, the Knowledge, Attitudes, and Practices of nurses and midwives towards neonatal jaundice is not well understood in the Northern Region of Ghana. Aim of the study: The study assessed the knowledge, attitudes, and practices of nurses and midwives towards the management of neonatal jaundice. Design and Method: This is a hospital-based descriptive cross-sectional study, conducted between the periods of January 2021 to August 2021 in the Tamale Teaching Hospital, Northern Region, Ghana. Descriptive analysis such as mean, standard deviation, frequencies, and percentages were performed to give general description of the variables. Simple Pearson Chi-square test and logistic regression models were performed to test the level of associations between the outcome and independent variables and predictors for neonatal jaundice. A p-value of <.05 was considered statistically significant for the test of association. Results: Among the 202 nurses and midwives, the mean age was 30.6 ± 3.8 years and majority were females (71.3%). The overall good knowledge, attitudes, and practices score towards neonatal jaundice was 69.30%, 64.90%, and 62.90%, respectively. After adjusting for other variables, good knowledge (adjusted odds ratio [AOR] = 22.41(10.21-49.18) p < .001) and good attitude (AOR = 25(11.86-55.07) p < .001) were positively associated with practices towards neonatal jaundice. Conclusion/Interpretation: The participants demonstrated substantial knowledge, attitudes, and practices towards neonatal jaundice. However, there still exist some gaps in their knowledge, attitudes, and practices towards neonatal jaundice that need to be addressed to improve neonatal health outcomes in the study setting.

Geographic availability of and physical accessibility to tuberculosis diagnostic tests in Ghana: a cross-sectional survey.

BACKGROUND: In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. METHODS: We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. RESULTS: Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. CONCLUSION: This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.

Can maternal postpartum testosterone and estradiol retrospectively predict the offspring's sex at birth? A cross-sectional study in Ghana.

The selection of X- or Y-bearing spermatozoa during fertilization may depend on maternal circulating sex hormones. The zona pellucida of the developing oocyte is adapted to be selective for the Y-bearing spermatozoa when maternal circulating androgens are relatively high. This study sought to determine whether maternal postpartum testosterone and estradiol can retrospectively predict the offspring sex at birth. The study was cross-sectional from December 2020 to April 2021 at the Reproductive and Child Health unit in Tamale. The participants were part of a previous study and comprised 178 mother-offspring dyads (mother-daughter = 90, mother-son = 88). The mothers were between the ages of 18 and 35 years and had a median (interquartile range-IQR) postpartum interval of 111 (60-187) days. A single venous blood sample was drawn from the mothers between 8.00 am and 12.00 pm local time on each day to reduce diurnal variation. Postpartum serum estradiol, testosterone, and sex hormone-binding globulin were assayed using the ELISA technique. The serum total testosterone and the testosterone-to-estradiol ratio (TT: E2 ) were higher in mothers with sons while estradiol was higher in mothers with daughters (p < 0.050). The total testosterone and TT: E2 did not markedly differ by their area under the curve (AUC: 0.91 and 0.99, respectively) but both were higher than the AUC of estradiol (0.72). The Sensitivity was 97.7%, 97.7%, and 94.5% and specificity, 88.9%, 40.0%, and 95.5% at cutoff points of >1.659 nmol/L, ≤141.862 pmol/L, and > 31.5, respectively for total testosterone, estradiol, and TT: E2 . The maternal testosterone-to-estradiol ratio may be more predictive of offspring sex at birth than either testosterone or estradiol alone.

Preparedness of medical students to provide nutrition care following a nutrition education intervention.

BACKGROUND: Globally, 71% of deaths are due to non-communicable diseases (NCDs) of which 77% of these deaths occur in low-and-middle income countries. Nutrition is an important contributor to the occurrence, progression and management NCDs. Health care professionals' promotion of the adoption of healthy dietary habits among individuals has been shown to reduce the occurrence of NCDs. We assessed the effects of a nutrition education intervention on medical students' self-perceived preparedness to provide nutrition care. METHODS: We administered a pre, post and four-weeks follow-up questionnaire to second year medical students who participated in a nutrition education intervention that adapted varied teaching and learning activities. Outcomes were self-perceived preparedness, relevance of nutrition education and perceived need for further training in nutrition. Repeated measures and Friedman tests were used to assess differences in mean scores across pre, post and 4-weeks follow up assessment based on p < 0.5 at 95% confidence interval. RESULTS: The proportion of participants who felt prepared to provide nutrition care increased significantly (p = 0.001) from 38% (n = 35) at baseline to 65.2% (n = 60) immediately post-intervention and to 63.2% (n = 54) at 4-weeks follow-up. At baseline, 74.2% (n = 69) of the students perceived nutrition education to be relevant to their future career as medical doctors which increased to 85% (n = 78) immediately after the intervention (p = 0.026) and to 76% (n = 70) 4-weeks follow-up. The proportion of participants who reportedly said they will benefit from further training in nutrition increased from 63.8% (n = 58) at pre-intervention to 74.0% (n = 68) at post-intervention (p = 0.016). CONCLUSION: An innovative, multiple-strategy nutrition education intervention can improve medical students' self-perceived preparedness to provide nutrition care.

Knowledge, attitudes and practice towards yellow fever among nomadic populations: A cross-sectional study in yellow fever outbreak communities in Ghana.

Despite the government and global health initiatives toward yellow fever epidemic control in Ghana, the country continues to witness sporadic outbreaks of yellow fever mostly among the unvaccinated population and suspected migrates(nomadic) who enter the country. Little is known about nomadic knowledge, attitudes and practice regarding this communicable disease in Ghana. We conducted a community-based cross-sectional survey in 22 yellow fever outbreak communities to assess nomadic household heads' knowledge, attitudes and practices (KAP) regarding yellow fever after an outbreak in November 2021 outbreak. Our study results were analyzed using descriptive statistics, bivariate and multivariate logistics regression with dichotomous outcomes. Significant statistics were obtained from multivariate analysis. About 90% of the nomadic had poor knowledge of the signs and symptoms of yellow with only 16% knowing the vector that transmits yellow fever. The most common source of information on yellow fever was the health campaign. Over 80% of household heads surveyed had positive attitudes regarding yellow fever with about 84% worried about the disease outbreak in their community. In a multivariate logistic regression model, age group(AOR = 2.79; 95% CI: 1.31, 5.98, p = 0.008)., gender ideology(AOR = 2.27; 95% CI: 1.14-4.51, p = 0.019), occupation(AOR = 15.65; 95% CI: 7.02, 34.87, p<0.001), source of health information(AOR = 0.27; 95% CI: 0.07, 0.96, p = 0.043), duration of stay in the community(AOR = 1.11; 95% CI: 1.31, 5.98, p = 0.008) and nationality (AOR = 0.22; 95% CI:0.47, 0.47, p<0.001) were associated with positive attitudes towards yellow fever. Close to 74% have a positive practice, with 97.3% controlling mosquitoes in their household. Nationality (AOR = 3.85; 95% CI: 2.26, 6.56, p<0.001), duration of stay in the community (AOR = 1.06; 95% CI: 1.03, 1.10, p = 0.001), and age group(AOR = 040; 95% CI: 0.22, 0.73, p = 0.003) were associated with positive practices. Our findings show that yellow fever KAP was variable with clear knowledge gaps. Regular locally-tailored education and health promotion campaigns should be considered to improve knowledge and preventive practices against this infectious disease.

Influence of Sociodemographic Factors and Obstetric History on Choice of Place of Delivery: A Retrospective Study Among Post-Natal Women in Ghana.

Background and Objectives: Even though Ghana has recorded an appreciable level of facility delivery compared to other countries in sub-Saharan Africa, the country still has a lot of regional and community variations in facility delivery where professional maternal health care is guaranteed. This study assessed the main factors associated with facility delivery in the Sagnarigu Municipal Assembly of the Northern Region of Ghana. Methods: Using a simple random sampling method, a retrospective community-based cross-sectional study was conducted from July 12, 2021 to October 17, 2021, among 306 postnatal women within 15 to 49 years who had delivered within the last six months. We conducted descriptive analyses, and the Pearson chi-square test of association between the sociodemographic factors and obstetrics history with the outcome variable, choice of place of birth. Lastly, significant variables in the chi-square test were entered into adjusted multivariate logistics regression to determine their association with the place of delivery. Data analysis was performed using the Statistical Package for Social Sciences version-25, with statistical significance set at a p-value of 0.05. Results: The study reported a facility delivery rate of 82%, which is slightly higher than the national target (80%). We observed that age group [AOR 2.34 (1.07-5.14)], marital status [AOR 0.31 (0.12-0.81)], ethnicity [AOR 3.78 (1.18-12.13)], and couple's occupation [AOR 24.74 (2.51-243.91)] were the significant sociodemographic factors influencing facility delivery. The number of antenatal care (ANC) attendance [AOR 8.73 (3.41 - 22.2)] and previous pregnancy complications [AOR 2.4 (1.11 - 5.7)] were the significant obstetrics factors influencing facility delivery. Conclusion and Global Health Implications: We found that specific sociodemographic and obstetric factors significantly influence the choice of place of delivery in the study area. To address this, the study recommends targeted interventions that focus on providing support and resources for women from different age groups, marital statuses, ethnicities, and occupational backgrounds to access facility delivery services. Additionally, improving ANC attendance and effectively managing pregnancy complications were highlighted as important measures to encourage facility-based deliveries.

Nutrition Knowledge is Associated With the Consumption of Iron Rich Foods: A Survey Among Pregnant Women From a Rural District in Northern Ghana.

INTRODUCTION: Iron deficiency anaemia is an international public health concern and pregnant women are at an increased risk. We investigated the consumption of iron rich foods and associated factors among pregnant women in a rural district from Ghana. METHODS: Following a cross-sectional design, dietary intake of iron rich foods was obtained from 252 pregnant women using a 24-hour recall food check list. Nutrition knowledge, attitudes and socio-demographic characteristics were also assessed. FINDINGS: Participants had a mean (SD) knowledge score of 54.66 (22.74)%. About 73% of the participants had heard about iron-deficiency anaemia. Only 16.3% of the participants knew foods that help the body to absorb and use iron while 9.1% knew beverages that decrease iron absorption. About 71% of the participants ate fish and/or seafood while 67.1% of them ate green leafy vegetables. Only 4.4% of the participants ate organ meat, and 29% took flesh meat. Only 22.4% of the study participants usually drank coffee or tea while 78.2% ate vitamin C-rich foods. With regards to attitudes, 88.5% of the participants perceived anaemia to be a serious disease. Nutrition knowledge was significantly associated with the consumption of iron rich foods (ß = .02; 95% CI = 0.01-0.02). CONCLUSION: Nutrition knowledge may be an important determinant of the consumption of iron rich foods among pregnant women making it necessary for healthcare providers to continue to provide nutrition education to pregnant women during routine antenatal care.