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INTRODUCTION: Globally, 7 million people with HIV (PWH) aged over 50 years exist. 5 million of them live in sub-Saharan Africa, the epicenter of the HIV epidemic. In Ghana, every 1 in 6 PWH is aged over 50 years. However, access to geriatric health care is grossly limited in Ghana and the sub-Saharan Africa region. This has resulted in a lack of focus on geriatric syndromes, a multi-factorial clinical condition common in older PWH, that do not fit discrete disease categories. Consequently, this gap threatens the life expectancy for aging PWH, necessitating the need to promptly fill it. The KNUST Aging and HIV Outcomes (KAHO) study will help identify priorities and opportunities for developing an effective integrated model of HIV and geriatric healthcare in Ghana. METHODS AND ANALYSIS: The KAHO study will recruit 151 PWH aged 50 years and older at the Infectious Disease Unit (IDU) of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST). The study will be conducted over a 2-year period and participants will be seen at months 0, 6 and 12. Participants at each visit will be taken through assessments and questionnaires on geriatric health, cognition, social vulnerability, HIV-related conditions and they will provide biospecimens for laboratory testing. We will also conduct semi-structured qualitative interviews of PWH, healthcare providers, policy makers and study research assistants. Quantitative data will be analyzed using one sample proportion test and linear regression models appropriately. The Levesque's framework will be used as a guide to analyze qualitative data.
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Envelhecimento , Infecções por HIV , Humanos , Infecções por HIV/epidemiologia , Pessoa de Meia-Idade , Idoso , Gana/epidemiologia , Masculino , FemininoRESUMO
Background: Antibiograms provide effective support for empirical prescribing and antimicrobial stewardship programmes (ASPs). In low-resource settings, microbiology systems to develop antibiograms may be rudimentary or entirely lacking, which may place such facilities at a disadvantage. Notwithstanding this, facilities should use what they have to support ASPs to inform evidence-based antibiotic use. We report how an antibiogram was developed at a district hospital in Ghana to support its ASP. Methods: This was a retrospective analysis of antibiotic susceptibility testing (AST) results from the University Hospital, KNUST from January to December 2021. Data were exported from the hospital's laboratory information system to Microsoft Excel (Version 2013). IBM SPSS Statistics (Version 25) and Epi Info™ Version 7 were used for statistical analyses. Results: Overall, 1949 cultures were performed, 392 (20.1%) growing bacterial pathogens. Per the CLSI M39-A4 standard guidelines for antibiograms, only 360 of the bacterial isolates were used for the analyses. The majority of isolates were from urine (187; 51.9%). Among the Gram-negative bacteria, there was low susceptibility to amoxicillin/clavulanic acid (28%), cephalosporins (11%-35%) and meropenem (21%), but high susceptibility to amikacin (96%) and levofloxacin (81%). Low susceptibility of Gram-positive isolates to amoxicillin/clavulanic acid (34%), meropenem (34%) and penicillins (27%-35%) was also recorded, but high susceptibility to ciprofloxacin (80%), gentamicin (79%) and vancomycin (76%). Conclusion: High levels of bacterial resistance to cephalosporins and meropenem in the antibiogram were reported. This antibiogram highlighted the urgent need for pragmatic steps to curb antibiotic resistance through ASPs using strategies that positively improve clinicians' knowledge and prescribing practices.
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INTRODUCTION: Low research output is hindering efforts to improve health services in Sub-Saharan Africa (SSA). AfriWon Research Group of WONCA Africa has established an online collaborative research mentorship and training programme to boost research capacity among Family Physicians in SSA. This study aims to assess the effectiveness of the programme in achieving this goal. METHODOLOGY: A mixed-method descriptive cross-sectional study was used to interview the 54 members of the 2022 SOGER cohort. Structured questionnaires and key informant interviews of 12 members were used to collect data. Quantitative analysis was done using Epi Info version 7.2.5. Descriptive statistics were used to present data using frequencies and percentages. Qualitative analysis was then done by using Nvivo®. RESULTS: The 54 participants practised in 10 SSA countries and were mostly males 28 (51.9%) with a mean age of 41.56 ± 2.04 years. The majority of them 33 (61.1%) have had some form of research experience prior to joining SOGER. Members identified key benefits of the programme as fostering collaboration, mentorship and continuing education 46 (85.2%); and improvement of research skills 33 (61.1%). Barriers identified were poor collaboration and participation among members 37 (68.5%); irregular meeting schedules as a result of the different time zones 18 (33.3%); and poor internet facilities 19 (35.2%). CONCLUSION: The SOGER programme was rated as very effective in increasing the research capacity of young FPs and helping participants engage with other researchers and develop research skills. Identified areas of improvement were difficulty meeting set group targets, irregular meetings and conflicting work schedules.
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BACKGROUND: Sawmill workers are at increased risk of occupational injuries due to their exposure to workplace hazards. However, little is known about the burden of occupational injuries among them in Ghana. Understanding its prevalence and associated factors is necessary to design appropriate interventions to improve workers' health and safety. This study sought to determine the prevalence and factors associated with occupational injuries among small-scale sawmill workers at Sokoban Wood Village, Kumasi. METHODS: A cross-sectional study was conducted among 138 small-scale sawmill workers from December 2020 to January 2021. Data was collected on demographic and work-related characteristics including age, sex, personal protective equipment (PPE), workspace design, and lighting. The primary outcome was the prevalence of occupational injuries in the 12 months preceding the survey. Logistic regression method was used to assess for independent predictors of occupational injuries, and associations were deemed statistically significant at p < 0.05. RESULTS: Approximately 66.7% of the workers experienced occupational injuries within the 12 months preceding the study. Cuts (69.6%) were the most commonly reported injuries. Injuries were mainly caused by machine parts/sharp objects (47.8%) and being hit by logs/objects (46.8%). Only 40.7% of the workers reported always using PPE while legs (38.0%) and hands (37.0%) were the most common body parts injured. The worker's monthly income, poor workspace design and poor lighting had increased odds of occupational injuries while an increase in age was associated with a 5% decreased odds of occupational injuries. CONCLUSION: The prevalence of occupational injuries among the sawmill workers at the Sokoban Wood Village was high, and this calls for prioritization of health and safety at the workplace. Essential measures required include improvements in the safety of machine tools, workspace design and lighting.
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Traumatismos Ocupacionais , Humanos , Estudos Transversais , Gana/epidemiologia , Traumatismos Ocupacionais/epidemiologia , Prevalência , Madeira , Masculino , FemininoRESUMO
BACKGROUND: Workers are exposed to workplace hazards which increase their risk of occupational injury. Data on occupational injuries and associated factors are important for planning and informing national policy regarding workplace health and safety. This study sought to estimate the prevalence and factors associated with occupational injuries among workers in an industrial city in Ghana. METHODS: A community-based cross-sectional survey was conducted among 459 workers in the Tema industrial enclave in Ghana from 22nd December 2020 to 27th February 2021. Participants were recruited using a two-stage sampling technique. Eight communities were randomly selected from twenty-five communities in the first stage while households in each community were randomly selected in the second stage. Data on socio-demographic characteristics, occupational health and safety and occupational injuries were collected. Logistic regression was used to examine the relationship between occupational injuries and associated factors. RESULTS: The mean age of the workers was 33.9 (±6.8) years with a range of 21-53 while over 18.1% of them were working at the Port and Harbour. The prevalence of occupational injury among the workers in the preceding twelve months was 64.7%. The mechanism of injury was mainly the use of working tools (45.8%) and hot surfaces, substances or chemicals (14.1%). Being a casual staff (AOR: 2.26, 95%CI: 1.04-4.92), working at Port and Harbour (AOR: 3.77, 95%CI: 1.70-8.39), no health and safety training (AOR: 2.18, 95%CI: 1.08-4.39), dissatisfaction with health and safety measures (AOR: 4.31, 95%CI: 2.12-8.78) and tertiary education (AOR: 0.03, 95%CI: 0.01-0.10) were significantly associated with occupational injuries. CONCLUSION: The prevalence of occupational injuries in this study was high. Promoting machine tools' safety, health and safety training, and satisfaction with health and safety measures through rewarding workers who do not sustain injuries could be key to employees' health and safety.
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Traumatismos Ocupacionais , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Traumatismos Ocupacionais/epidemiologia , Prevalência , Gana/epidemiologia , Estudos Transversais , IndústriasRESUMO
BACKGROUND: The human immunodeficiency virus (HIV) has caused a lot of havoc since the early 1970s, affecting 37.6 million people worldwide. The 90-90-90 treatment policy was adopted in Ghana in 2015 with the overall aim to end new infections by 2030, and to improve the life expectancy of HIV seropositive individuals. With the scale-up of Highly Active Antiretroviral Therapy, the lifespan of People Living with HIV (PLWH) on antiretrovirals (ARVs) is expected to improve. In rural districts in Ghana, little is known about the survival probabilities of PLWH on ARVs. Hence, this study was conducted to estimate the survival trends of PLWH on ARVs. METHODS: A retrospective evaluation of data gathered across ARV centres within Tatale and Zabzugu districts in Ghana from 2016 to 2020 among PLWH on ARVs. A total of 261 participants were recruited for the study. The data was analyzed using STATA software version 16.0. Lifetable analysis and Kaplan-Meier graph were used to assess the survival probabilities. "Stptime" per 1000 person-years and the competing risk regression were used to evaluate mortality rates and risk. RESULTS: The cumulative survival probability was 0.8847 (95% CI: 0.8334-0.9209). The overall mortality rate was 51.89 (95% CI: 36.89-72.97) per 1000 person-years. WHO stage III and IV [AHR: 4.25 (95%CI: 1.6-9.71) p = 0.001] as well as age group (50+ years) [AHR: 5.02 (95% CI: 1.78-14.13) p = 0.002] were associated with mortality. CONCLUSION: Survival probabilities were high among the population of PLWH in Tatale and Zabzugu with declining mortality rates. Clinicians should provide critical attention and care to patients at HIV WHO stages III and IV and intensify HIV screening at all entry points since early diagnosis is associated with high survival probabilities.
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Antirretrovirais , Infecções por HIV , Humanos , Pessoa de Meia-Idade , Gana/epidemiologia , Estudos Retrospectivos , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologiaRESUMO
Objectives: Depression is one of the most widely reported mental health issues that affect adolescents globally. However, there is a dearth of data on its prevalence and associated factors among senior high school students in Ghana, since previous studies have focused more on adult populations. This can hinder policies needed to champion mental health and mental health care in senior high schools. Hence, this study sought to assess the prevalence of depression and associated factors among senior high school students in Ghana. Methods: An analytical cross-sectional study involving 289 students at the Manya Krobo Senior High School was conducted from December 2022 to February 2023. The students were selected using a two-stage random sampling method. A questionnaire was used to collect data on sociodemographics and individual characteristics. The primary outcome was depression, and this was assessed using the Patient Health Questionnaire-9. Summary statistics were presented as means, frequencies, and percentages. Multivariate logistic regression was used to identify factors associated with depression and odds ratios presented with 95% confidence intervals. Statistical significance was considered at p-value < 0.05. Results: The mean age of the students was 16.6 (±1.2) with a range of 14-20 years. Over a quarter (26.3%) of the students reported financial difficulties. The prevalence of depression among the students was 68.9%. The factors associated with depression in this study were female sex (adjusted odds ratio: 1.74, 95% confidence interval: 1.01-2.97), age (adjusted odds ratio: 1.41, 95% confidence interval: 1.10-1.81), history of chronic health condition (adjusted odds ratio: 3.74, 95% confidence interval: 1.36-10.25), and financial difficulties (adjusted odds ratio: 2.31, 95% confidence interval: 1.15-4.63). Conclusion: This study shows that depression is rife among students at the Manya Krobo Senior High School, Manya Krobo District, Ghana. These findings call for pragmatic interventions such as strengthening counseling units and professional mental health services to ameliorate the impact of depression on the lives of students.
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Objectives: Effective adherence to infection prevention and control practices is needed to reduce the rate of healthcare-acquired infections among healthcare workers. Policies to control healthcare-acquired infections among healthcare workers can be designed and implemented using information on adherence to infection prevention and control practices adherence and its determinants. This study, therefore, sought to assess the adherence to infection prevention and control practices among healthcare workers during the 2019 Coronavirus disease pandemic. Methods: A multicentre cross-sectional study was conducted among 323 randomly selected healthcare workers in four health facilities in the Suame Municipality, Ghana. Data on participants' socio-demographics, knowledge of infection prevention and control practices and adherence to infection prevention and control practices were collected using a pre-tested structured questionnaire. Multivariate logistic regression analysis was used to examine the effect of demographic characteristics and knowledge of infection prevention and control on adherence to infection prevention and control practices among study participants. Results: Over three-quarters (75.9%) of the study participants had adequate knowledge of infection prevention and control practices with a significant knowledge gap in the colour coding of bin liners for waste segregation (35.6%). The proportion of study participants who reported good adherence to infection prevention and control practices was 86.7%. Healthcare workers who were 33 years and above (Adjusted odds ratio (AOR): 0.27; 95% Confidence interval (CI): 0.08-0.92) and absence of an infection prevention and control committee at the facility AOR: 0.25; 95% CI: 0.08-0.73) had reduced odds of good adherence to infection prevention and control practices. Nursing staff (AOR: 9.49, 95% CI: 2.51-35.87) and having adequate knowledge of infection prevention and control practices (AOR: 2.66; 95% CI: 1.19-5.97) were associated with increased odds of good adherence to infection prevention and control practices. Conclusion: Adherence to infection prevention and control practices was high among this sample of Ghanaian healthcare workers. Interventions and strategies to improve adherence should include the setting up of infection prevention and control committees, education and strict observance of colour coding of bin liners for waste segregation and intensification of training of healthcare workers in infection prevention and control practices.
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BACKGROUND: Deaths due to cardiovascular diseases is on the rise, with hypertension as its most important risk factor. Effective management of hypertension, however, remains a challenge. Globally, only one in five adults with hypertension have it under control. The situation is worse in sub-Saharan Africa where hypertension prevalence is highest. Telepharmacy presents a great opportunity to enhance the way we address hypertension management. OBJECTIVES: This study sought to determine the effectiveness of pharmaceutical care interventions implemented through telepharmacy on medication adherence, practice of therapeutic lifestyles and overall blood pressure control among patients with hypertension. METHODS: This was a randomized control trial conducted among individuals with hypertension recruited from two Ghanaian hospitals from May 2022 to December 2022. Patients with confirmed diagnosis of hypertension were recruited and assigned into a control or intervention group. Both groups were followed for six months with the intervention group receiving telepharmacy services in addition to standard clinical care. Outcome measures included changes in blood pressure, medication adherence, lifestyle modifications, identification and resolution of pharmaceutical care issues. RESULTS: One hundred and eighteen (118) patients with hypertension were involved in the study. There was a statistically significant reduction in mean blood pressures for the intervention group after six months (Systolic-148.1 + 23.6, to 134.8 + 13.7, Diastolic- 85.8 + 9.8, to 79.5 + 8.7) (p < 0.05). The proportion of patients with adequately controlled blood pressure increased from 39.0% to 66.1%. There was also an increase in the mean adherence score (p < 0.05). The number of participants who adopted lifestyle modifications such as reducing salt consumption (89.5%) and exercising (77.2%) increased. The majority (87%) of all pharmaceutical care issues were identified and resolved over the six-month period. CONCLUSION: Telepharmacy service provided via phone calls was effective in improving the control of blood pressure. It also promoted the practice of therapeutic lifestyle modifications, medication adherence and identification of pharmaceutical care issues among patients with hypertension.
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Background: Antimicrobial stewardship (AMS) is imperative in addressing the menace of antimicrobial resistance (AMR) in health systems. Commonwealth Partnerships for Antimicrobial Stewardship uses a health partnership model to establish AMS in Commonwealth countries. The Hospital of Kwame Nkrumah University of Science and Technology in partnership with Ulster University, Northern Ireland, undertook an AMS project from November 2021 to May 2022. We report on implementation of the AMS, its impact on antibiotic use and infections management at the University Hospital; Kumasi, Ghana. Methods: The Global-Point Prevalence Survey (PPS) protocol was used to assess antibiotics use at the hospital at baseline, midpoint and end of the project. Feedback on each PPS was given to the hospital to inform practice, behavioural change and improve antibiotic use. Results: Antibiotic use reduced from 65% at baseline to 59.7% at the end of the project. The rate of healthcare-associated infections also reduced from 17.5% at baseline to 6.5%. Use of antibiotics from the WHO Access group was 40% at baseline but increased to 50% at the endpoint. Watch antibiotics reduced from 60% to 50% from baseline. Culture and susceptibility requests increased from baseline of 111 total requests to 330 requests in the intervention period to inform antimicrobial therapy. Conclusion: The model AMS instituted improved antibiotic use and quality of antimicrobial therapy within the study period. Continuous staff education and training in AMS, and use of standard tools for assessment and application of local data to inform infections management will ensure sustenance and improvement in the gains made.
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The novel coronavirus (COVID-19) pandemic has stretched the medical resources of both developed and developing countries. The global focus on COVID-19 may lead to the neglect of other infectious diseases such as malaria which is still endemic in many African countries. Some similarities in malaria and COVID-19 disease presentations may also lead to late diagnosis of either disease which could complicate the effects. Here, we present two cases of a 6-year-old child and a 17-year-old female who presented to a primary care facility in Ghana with a clinical and microscopy-confirmed diagnosis of severe malaria complicated by thrombocytopenia. As their symptoms worsened with associated respiratory complications, nasopharyngeal samples were taken for real-time polymerase chain reaction (RT-PCR) and tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinicians, policymakers, and public health practitioners should be alert to the variety of presenting symptoms of COVID-19 and its similarity to malaria to mitigate the risk of mortality from either disease.
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COVID-19 , Malária , Criança , Feminino , Humanos , Adolescente , COVID-19/complicações , COVID-19/diagnóstico , SARS-CoV-2 , Malária/complicações , Malária/diagnóstico , Saúde Pública , GanaRESUMO
BACKGROUND: Emergency Medical Technicians (EMTs) are the primary providers of prehospital emergency medical services. The operations of EMTs increase their risks of being exposed to occupational injuries. However, there is a paucity of data on the prevalence of occupational injuries among EMTs in sub-Saharan Africa. This study, therefore, sought to estimate the prevalence and determinants of occupational injuries among EMTs in the northern part of Ghana. METHODS: A cross-sectional study was conducted among 154 randomly recruited EMTs in the northern part of Ghana. A pre-tested structured questionnaire was used to collect data on participants' demographic characteristics, facility-related factors, personal protective equipment use, and occupational injuries. Binary and multivariate logistic regression analyses with a backward stepwise approach were used to examine the determinants of occupational injuries among EMTs. RESULTS: In the 12 months preceding data collection, the prevalence of occupational injuries among EMTs was 38.6%. Bruises (51.8%), and sprains/strains (14.3%) were the major types of injuries reported among the EMTs. The key determinants of occupational injury among EMTs were male sex (AOR: 3.39, 95%CI: 1.41-8.17), an absence of a health and safety committee at the workplace (AOR: 3.92, 95%CI: 1.63-9.43), absence of health and safety policy at the workplace (AOR: 2.76, 95%CI: 1.26-6.04) and dissatisfaction with health and safety measures at the workplace (AOR: 2.51, 95%CI: 1.10-5.71). CONCLUSION: In the twelve months before to the data collection for this study, the prevalence of occupational injuries among EMTs of the Ghana National Ambulance Service was high. The creation of health and safety committees, the creation of health and safety rules, and the strengthening of current health and safety procedures for EMTs are all possible ways to lessen this.
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Serviços Médicos de Emergência , Auxiliares de Emergência , Traumatismos Ocupacionais , Humanos , Masculino , Feminino , Traumatismos Ocupacionais/epidemiologia , Prevalência , Estudos Transversais , Gana/epidemiologiaRESUMO
BACKGROUND: The World Health Organization recommends parasitological confirmation of all suspected malaria cases by microscopy or rapid diagnostic tests (RDTs) before treatment. These conventional tools are widely used for point-of-care diagnosis in spite of their poor sensitivity at low parasite density. Previous studies in Ghana have compared microscopy and RDT using standard 18S rRNA PCR as reference with varying outcomes. However, how these conventional tools compare with ultrasensitive varATS qPCR has not been studied. This study, therefore, sought to investigate the clinical performance of microscopy and RDT assuming highly sensitive varATS qPCR as gold standard. METHODS: 1040 suspected malaria patients were recruited from two primary health care centers in the Ashanti Region of Ghana and tested for malaria by microscopy, RDT, and varATS qPCR. The sensitivity, specificity, and predictive values were assessed using varATS qPCR as gold standard. RESULTS: Parasite prevalence was 17.5%, 24.5%, and 42.1% by microscopy, RDT, and varATS qPCR respectively. Using varATS qPCR as the standard, RDT was more sensitive (55.7% vs 39.3%), equally specific (98.2% vs 98.3%), and reported higher positive (95.7% vs 94.5%) and negative predictive values (75.3% vs 69.0%) than microscopy. Consequently, RDT recorded better diagnostic agreement (kappa = 0.571) with varATS qPCR than microscopy (kappa = 0.409) for clinical detection of malaria. CONCLUSIONS: RDT outperformed microscopy for the diagnosis of Plasmodium falciparum malaria in the study. However, both tests missed over 40% of infections that were detected by varATS qPCR. Novel tools are needed to ensure prompt diagnosis of all clinical malaria cases.
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Malária Falciparum , Malária , Humanos , Microscopia , Reação em Cadeia da Polimerase , GanaRESUMO
Availability of effective antiretroviral therapy (ART) has improved patient survival and older adults (≥50 years old) constitute 10% of the world's HIV population. However, data on this population are lacking, especially in sub-Saharan Africa. To identify the profile of older adults with HIV infection receiving ART and factors associated with viral suppression. A retrospective cross-sectional study involving HIV patients ≥50 years, registered at a University Hospital in Kumasi, Ghana from January 2010 to July 2020. All study participants had been on ARTs for ≥12 months. Data were analysed using STATA® and multivariate logistic regression was done to determine the association between variables. We recruited 132 study participants with a mean age of 58.1 years (±6.8). Non-communicable diseases (NCD) comprised the commonest comorbidity (67.4%; n = 89) and hypertension was the most prevalent (47.2%). The mean duration of ART was 63.2 months (±32.0) and approximately 84.1% (n = 111) achieved viral suppression (≤50 copies/ml). After adjustment, factors independently associated with viral suppression were widow(ed) (aOR = 0.23; 95% CI = 0.07-0.72) and good ART adherence (aOR = 3.51; 95% CI = 1.03-11.99). Hypertension is prevalent among this cohort of HIV patients. Approximately 84% of elderly patients on ARTs achieve viral suppression, influenced by widowhood and good drug adherence.
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Fármacos Anti-HIV , Infecções por HIV , Hipertensão , Humanos , Idoso , Pessoa de Meia-Idade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Estudos Retrospectivos , Estudos Transversais , Gana/epidemiologia , Carga Viral , Adesão à Medicação , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hospitais , Fármacos Anti-HIV/uso terapêuticoRESUMO
AIM: This study determined the prevalence and key determinants of burnout among nurses and midwives in Kumasi, Ghana. DESIGN: Hospital-based cross-sectional study. METHOD: A questionnaire was used to obtain data from 391 nurses and midwives at a tertiary hospital in Kumasi, Ghana using simple random sampling. RESULTS: About 84.4% of the participants were females. The majority of the study participants experienced low burnout for all dimensions (58% in emotional exhaustion, 55.5% poor personal accomplishment and 38.3% depersonalization). Multiple regression analysis revealed that high emotional exhaustion was independently predicted by post-graduate education (ß = 6.42, p = .003), lack of support from management (ß = 2.07, p = .024), dislike for leadership style, (ß = 3.54, p < .001) and inadequate number of staff (ß = 2.93, p = .005). Age (ß = 0.35, p = .004), lack of support from management (ß = 1.60, p = .012), and inadequate number of staff (ß = 1.49, p = .034) independently predicted high depersonalisation. Female sex (ß = 4.36, p < .001) and years of practice (ß = -0.26, p < .001) independently predicted low personal accomplishment.
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Esgotamento Profissional , Tocologia , Enfermeiras e Enfermeiros , Humanos , Feminino , Gravidez , Masculino , Estudos Transversais , Centros de Atenção Terciária , Gana/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento PsicológicoRESUMO
Background: Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana. Methods: This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used. Results: The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention. Conclusion: Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.
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BACKGROUND: The declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana. METHODS: Swab samples collected from suspected COVID-19 patients were transported to the Zipline office by health workers. Information on the samples were sent to laboratory personnel located at KCCR through a WhatsApp platform to get them ready to receive the suspected COVID-19 samples while Zipline repackaged samples and transported them via drone. Time of take-off was reported as well as time of drop-off. RESULTS: A total of 2537 COVID-19 suspected samples were received via drone transport from 10 districts between April 2020 to June 2021 in 440 deliveries. Ejura-Sekyedumase District Health Directorate delivered the highest number of samples (765; 30%). The farthest district to use the drone was Pru East, located 270 km away from KCCR in Kumasi and 173 km to the Zipline office in Mampong. Here, significantly, it took on the average 39 minutes for drones to deliver samples compared to 117 minutes spent in transporting samples by road (p<0.001). CONCLUSION: The use of drones for sample transport during the COVID-19 pandemic significantly reduced the travel time taken for samples to be transported by road to the testing site. This has enhanced innovative measures to fight the pandemic using technology.
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COVID-19 , Dispositivos Aéreos não Tripulados , Humanos , Gana , PandemiasRESUMO
Real-world data on vaccine-elicited neutralising antibody responses for two-dose AZD1222 in African populations are limited. We assessed baseline SARS-CoV-2 seroprevalence and levels of protective neutralizing antibodies prior to vaccination rollout using binding antibodies analysis coupled with pseudotyped virus neutralisation assays in two cohorts from West Africa: Nigerian healthcare workers (n = 140) and a Ghanaian community cohort (n = 527) pre and post vaccination. We found 44 and 28% of pre-vaccination participants showed IgG anti-N positivity, increasing to 59 and 39% respectively with anti-receptor binding domain (RBD) IgG-specific antibodies. Previous IgG anti-N positivity significantly increased post two-dose neutralizing antibody titres in both populations. Serological evidence of breakthrough infection was observed in 8/49 (16%). Neutralising antibodies were observed to wane in both populations, especially in anti-N negative participants with an observed waning rate of 20% highlighting the need for a combination of additional markers to characterise previous infection. We conclude that AZD1222 is immunogenic in two independent West African cohorts with high background seroprevalence and incidence of breakthrough infection in 2021. Waning titres post second dose indicates the need for booster dosing after AZD1222 in the African setting despite hybrid immunity from previous infection.
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COVID-19 , Vacinas Virais , Anticorpos Neutralizantes , Anticorpos Antivirais , Formação de Anticorpos , COVID-19/epidemiologia , COVID-19/prevenção & controle , ChAdOx1 nCoV-19 , Gana , Humanos , Imunoglobulina G , SARS-CoV-2 , Estudos Soroepidemiológicos , VacinaçãoRESUMO
Since the global pandemic of the 2019 coronavirus disease (COVID-19), few studies have reported on the relevance of bacteria co-infection on outcome of COVID-19 patients. Little is known about the clinical presentation among pregnant women, mother-to-child transmission, and fetal outcomes. This report shows a 24-year-old nulliparous woman who was 32 weeks pregnant and was admitted to the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi Ghana with symptoms of fever (40.3°C), cough and breathlessness of two weeks duration. Her nasopharyngeal sample tested positive for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and blood culture isolated Burkholderia cepacia. She was given medications but went into pre-term labour and delivered a stillborn baby. This rare case of COVID-19 and Burkholderia cepacia co-infection emphasizes the need for a thorough assessment and appropriate treatment of patients presenting with fever and respiratory symptoms in order to mitigate poor outcome.
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Burkholderia cepacia , COVID-19 , Coinfecção , Complicações Infecciosas na Gravidez , Adulto , COVID-19/complicações , COVID-19/diagnóstico , Coinfecção/diagnóstico , Feminino , Morte Fetal , Febre/etiologia , Humanos , Transmissão Vertical de Doenças Infecciosas , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez , SARS-CoV-2 , Adulto JovemRESUMO
(1) Background: Rational use of medicines (RUM) and their assessment are important to ensure optimal use of resources and patient care in hospitals. These assessments are essential to identifying practice gaps for quality improvement. (2) Methods: Assessment of adherence to WHO/International Network for Rational Use of Drugs core prescribing indicators among outpatients in 2021 was conducted at the University Hospital of the Kwame Nkrumah University of Science and Technology in the Ashanti Region of Ghana. We reviewed electronic medical records (EMR) of 110,280 patient encounters in the year which resulted in 336,087 medicines prescribed. (3) Results: The average number of medicines prescribed per encounter was three, with generics being prescribed in 76% of prescriptions. Injections were prescribed in 7% of encounters while 90% of medicines were from Ghana's Essential Medicines List, 2017. (4) Conclusions: With the exception of patient encounters with injections, none of the prescribing indicators assessed in this study met WHO optimum levels, providing targets for quality improvement in RUM. Implementing prescribing guides and policies, regular audits and feedback as well as continuous professional development training may help to improve prescribing practices in the hospital.