Experience of psychosocial rehabilitation; perspectives of depressed adolescents.

Given the multifaceted character of depression and its related symptoms, an adolescent living with it is at increased risk for a wide range of adverse events. This research aimed to understand and characterize the psychosocial rehabilitation experiences of depressed teenage participants in the Greater Accra Region of Ghana. A cross-sectional semi-structured interview design influenced by an interpretive phenomenological analysis (IPA) technique was adopted. We employed a nonprobability, purposeful sampling approach to recruit twenty-one adolescents (6 males, 15 females) diagnosed with depression from the community after one month of discharge from admission and undergoing psychosocial rehabilitation. Using separate interviews, we gathered and analyzed data using interpretive phenomenological analysis to produce themes and sub-themes. These were presented with the participants' direct quotations. We discovered that the perspectives of adolescents' psychosocial rehabilitation experience include hopelessness and suicide ideation, coping difficulties, undesirable attitudes from support networks, challenges related to school, and isolation. Participants suggested appropriate therapeutic environments, encouraging support systems, and the media's role in preventing and treating depression among young people as rehabilitation approaches that could assist adolescents to remain lucid for longer intervals. These results shed light on the tragic realities faced by depressed adolescents. There is an urgent need to put well-defined structures in place to aid their rehabilitation and develop coping strategies for a better life.

Molecular identification of cattle ticks in the Greater Accra Region of Ghana: a high occurrence of Rhipicephalus microplus.

Ticks are competent vectors of a wide range of pathogens. They are of veterinary and public health importance as they affect both animal and human health. Transhumance and the transboundary movements of cattle within the West African Sub-region have facilitated the spread of ticks which threatens the introduction of invasive species. Currently, Rhipicephalus microplus have been identified in the Upper East Region of Ghana which could mean a wider distribution of the species across the country due to livestock trade. This study focused on three sites in the Greater Accra Region, which serves as the gateway to receiving most of the cattle transported from the northern regions of Ghana. Ticks were sampled from August 2022 in the wet season to January 2023 in the dry season. Three tick genera were identified: Amblyomma (19.5%), Hyalomma (1.1%), and Rhipicephalus (79.3%) from the 1,489 feeding ticks collected from cattle. Furthermore, Rhipicephalus microplus, Hyalomma rufipes and Amblyomma variegatum were identified molecularly using primers that target the mitochondrial COI gene. There was a significant association between the tick species and seasons (p < 0.001). Finding R. microplus in this study indicates the extent of the spread of this invasive tick species in Ghana and highlights the need for efficient surveillance systems and control measures within the country.

SARS-CoV-2 Molecular Evolutionary Dynamics in the Greater Accra Region, Ghana.

To assess dynamics of SARS-CoV-2 in Greater Accra Region, Ghana, we analyzed SARS-CoV-2 genomic sequences from persons in the community and returning from international travel. The Accra Metropolitan District was a major origin of virus spread to other districts and should be a primary focus for interventions against future infectious disease outbreaks.

Availability of Safe Second-Trimester Abortion Services in Health Facilities in Accra, Ghana.

BACKGROUND: We examined providers, methods employed, cost, and other determinants of availability of second-trimester abortion services in health facilities in Accra, Ghana in 2019 to inform policy and program decisions. METHODS: A two-stage mixed quantitative and qualitative study designs were employed in the conduct of the study. The first stage was a short interaction of the mystery client with a clinical care provider to identify health facilities that provide second trimester induced abortion, the cost, and referral practices, where the facility did not have the service. The second stage was in-depth interviews of second-trimester abortion care providers and non-providers in various health facilities. For internal validity, it also explored the procedure cost, referral, and other practices at the health facilities included in the study, independent of what was captured in the mystery client survey. RESULTS: Second-trimester abortion services in Accra, Ghana are widely unavailable even in most facilities that provided abortion services. Referral policies and practices indicated by the service providers at various facility levels were inadequate. Criminalization of the procedure, social stigma, and fear of complications are the main factors that adversely influence the availability of second-trimester abortion in health facilities in Accra. CONCLUSION: Albeit increasing demand for second-trimester abortion in health facilities in Accra, services are not readily available due to the ambiguity of the law, its interpretation, and limited flow of accurate information on providers. Policies and programs that limit access to Second-trimester abortions in Ghana are amendable to ensure safe services.

Sexual and reproductive health education and its association with ever use of contraception: a cross-sectional study among women in urban slums, Accra.

BACKGROUND: Sexual and reproductive health education among girls and women has several reproductive health benefits, including improved contraceptive knowledge, contraception use at first intercourse, increased chance of contraceptive use in a lifetime, and effective usage of contraceptives. It is however not clear whether women/girls in urban slums who have had sexual and reproductive health education would likely utilize contraception. This study sets out to test the hypothesis that Accra slum women who have had sex education have higher chances of ever using contraception. METHODS: A cross-sectional survey was conducted among reproductive aged women in two slums (i.e. Agbogbloshie and Old Fadama) in Accra, Ghana. A sample size of 691, made up of respondents who provided responses to the question on ever used contraception, sex education as well as those with complete information on all the other variables of interest was considered in this study. Binary logistic regression models were fitted to examine association between sexual and reproductive health education and ever use of contraception. Crude odds ratios (cOR) and adjusted odds ratios (aOR) at p-value less than 0.05 were used to assess the strength of the association between the outcome and independent variables. RESULTS: More than half (56.73%) of the women have never received sexual and reproductive health education. Most of the respondents (77.28%) had ever used contraceptives. Women who had no form of sexual and reproductive health education had lower odds of ever using contraception (OR = 0.641, 95% CI 0.443, 0.928) and this persisted after controlling for the effect of demographic factors (AOR = 0.652, 95% CI 0.436, 0.975] compared to those who have ever received any form of sex education. Non-married women as well as women who were exposed to media (newspapers/radio/television) were also more likely to use contraceptives in slums in Accra, Ghana. CONCLUSION: The study revealed a relatively low prevalence of sex education among women in urban slums in Accra. However, sex education was found to increase the odds of ever use of contraception. These findings call for intensified sexual and reproductive health education among reproductive aged girls and women in urban slums in Accra using existing informal social networks and local media platforms.

Sexual and reproductive health education among girls and women has several reproductive health benefits, including improved contraceptive knowledge, contraception use at first intercourse, increased chance of contraceptive use in a lifetime, and effective usage of contraceptives. It is however not clear whether women/girls in urban slums who have had some form of sex education would likely utilize contraception more than those who have not. This study sets out to test the hypothesis that Accra slum women who have had sex education have higher chances of ever using contraception. A cross-sectional survey was conducted among reproductive aged women in two slums (i.e. Agbogbloshie and Old Fadama) in Accra, Ghana. A sample size of 691 girls/women aged 15­49 was considered. More than half (56.73%) of the women had never received some form of sex education. Most of the respondents (77.28%) had ever used contraceptives. Women who had no form of sex education had lower odds of ever using contraception and this persisted after controlling for the effect of demographic factors compared to those who have ever received any form of sex education. Non-married women as well as women who were exposed to media (newspapers/radio/television) were also more likely to use contraceptives in slums in Accra, Ghana. In sum, the study revealed that while prevalence of sex education was relatively low among urban slum women, sex education generally increased the chances of ever use of contraception. These findings call for more and targeted sexual and reproductive health education among reproductive aged girls and women in urban slums in Accra using existing informal social networks and local media platforms.

Dynamics of influenza A (avian influenza) virus in poultry in the Greater Accra region of Ghana amongst the production levels.

This research explores, through active surveillance, influenza A prevalence at different production levels in the Greater Accra region of Ghana, a study area with previous outbreak of highly pathogenic avian influenza H5N1 virus. The prevalence of influenza A was determined by rtRTPCR. This was achieved by screening 2040 samples comprising tracheal and cloacal swabs from chicken, ducks, pigeons, guinea fowls, and turkeys. Influenza A prevalence by production levels and species was computed at 95% confidence interval (CI) using the exact binomial interval. Structured questionnaires were also administered to 50 randomly selected poultry traders in the live bird markets. The overall influenza A prevalence was 7.7% (95% CI, 6.6, 8.9). Live bird market recorded 13.5% (n = 139, 95% CI, 11.5, 15.7), backyard poultry was 1.4% (95% CI, 0.6, 2.7), and commercial poultry 2.4% (95% CI, 1.2, 4.3). There was evidence of influenza A in all the poultry species sampled except for turkey. Subtyping of the M-gene has revealed the circulation of H9 in the three production levels. Live bird market has demonstrated high prevalence coupled with low level of biosecurity consciousness among the poultry operators. This is suggestive of live bird market serving as a potential basket for genetic reassortment with unpredictable future consequences.

Electronic waste control and management in Ghana: A critical assessment of the law, perceptions and practices.

The aim of the study was to assess the impact of Ghana's hazardous and e-waste control and management Act 917 of 2016 on current e-waste management practices and the level of awareness among key stakeholders (general public, repairers, wholesalers/retailers, recyclers and importers of electronic items) in the Greater Accra Region of Ghana. Both quantitative and qualitative data were collected and examined in this study. Results showed a low level (12%) of awareness among stakeholders on the e-waste legislation. Almost 13% of respondents had been educated on e-waste management. Community engagement and the mass media were the main sources of information on e-waste. Significant associations between background information of respondents and awareness level on 'Ghana's Act 917' were observed. Relative to general e-waste issues, only education and stakeholder showed significant associations with e-waste legislation and management. The main e-waste disposal methods adopted by respondents were disposal at dumpsites (22.7%), repair and reuse (21.1%) and reselling (20.1%). Almost 10% of respondents made changes to their e-waste disposal practices over the past 5 years. These changes were mainly due to the economic benefits derived from reselling e-waste (37.6%) and the perceived adverse impacts of e-waste on the environment (23.9%). Overall, there is the need to intensify awareness on 'Ghana's Act 917', especially issues regarding sustainable e-waste management practices.

Covid-19 and school closure: Examining the impact on private mid-range and low-fee private basic schools in Ghana.

The Covid-19 lockdown implemented globally to prevent the spread of the virus has led to the closure of schools. However, insight into the impact of the lockdown on private schools and the responses it has elicited is limited, especially across the African continent. This article examines the impact of the lockdown on private basic schools in Ghana and how they responded to the closure. Following "organizational ambidexterity" and qualitative interviews with nine proprietors of private schools in Ghana, the study found that the schools' closure had a negative impact on private basic schools in five crucial ways: disruption to teaching and learning, difficulty in retrieving unpaid teaching fees, inability to pay staff salaries and statutory payments, underutilization of existing assets, and the cost of storing unused stock. The article offers suggestions to the government to support private schools that are broadening educational access at thin profit margins.

Treatment outcomes among children treated for uncomplicated severe acute malnutrition: a retrospective study in Accra, Ghana.

OBJECTIVES: The objectives of the study were to describe outcomes of children with uncomplicated severe acute malnutrition (SAM) attending community-based management of acute malnutrition (CMAM) treatment centres in Accra Metropolitan Area (AMA) and explore factors associated with non-adherence to clinic visits and defaulting from the treatment programme. DESIGN: A retrospective cohort study analysing routinely collected data on children with uncomplicated SAM enrolled into CMAM in 2017 was conducted. SETTING: Study was conducted at seven sites comprising Princess Marie Louise Children's Hospital, three sub-metropolitan health facilities and three community centres, located in five sub-metropolitan areas in AMA. PARTICIPANTS: Children with uncomplicated SAM aged 6-59 months, enrolled from community-level facilities (pure uncomplicated SAM, PUSAM) or transferred after completing inpatient care (post-stabilisation uncomplicated SAM, PSSAM), participated in the study. RESULTS: Out of 174 cases studied (105 PUSAM, sixty-nine PSSAM), 56·3 % defaulted, 34·5 % recovered and 8·6 % were not cured by 16 weeks. No deaths were recorded. Mid-upper arm circumference (MUAC) increased by 2·2 (95 % CI 1·8, 2·5) mm/week with full compliance and 0·9 (95 % CI 0·6, 1·2) mm/week with more than two missed visits. In breast-feeding children, MUAC increased at a slower rate than in other children by 1·3 (95 % CI 1·0, 1·5) mm/week. Independent predictors of subsequent missed visits were diarrhoea and fever, while children with MUAC < 110 mm on enrolment were at increased risk of defaulting. CONCLUSION: A high default rate and a long time to recovery are challenges for CMAM in AMA. Efforts must be made to improve adherence to treatment to improve outcomes.

Face Mask Use Among Commercial Drivers During the COVID-19 Pandemic in Accra, Ghana.

The paper contributes to unravelling the perceptions of urban commercial drivers regarding their vulnerability to catching the SARS-CoV-2 virus while at work. It further examines how the perception of vulnerability influences personal use of face masks by drivers, as well as on their insistence on appropriate masking behaviour by other persons on-board public transport. Overcrowding and unsanitary conditions in informal public transport in Africa could facilitate the spread of the corona virus. However, the use of face masks, among other enhanced mitigation measures significantly contain and minimize the spread of the virus. Primary data, obtained through surveys at five major public transport terminals in Accra, was analysed and interpreted using the Health Belief Model as an explanatory framework. Results indicate that most drivers have a high vulnerability perception to Covid-19. It further emerged that older drivers, in particular, consistently wore face masks and insisted on other persons in their commercial vehicles to follow suit. Socio-demographic factors, and the need to ensure one's personal safety and those of loved ones were critical determinants of face mask use among surveyed drivers. The study thus recommends that public awareness campaigns should strategically focus attention on the younger generation of drivers (i.e. 18-39 years) who perceived themselves to be immune to the SARS-CoV-2 virus. Also, the collaborative efforts of state and non-state actors, like the transport operator unions, must be further strengthened if the gains made so far against Covid-19 is to be sustained.

Predictors of primary and secondary sexual abstinence among never-married youth in urban poor Accra, Ghana.

BACKGROUND: Sexual abstinence is a key component of the strategy to address unwanted pregnancies, sexually transmitted infections and HIV among youth in sub-Sahara Africa. But contextual pressures make abstaining from sex a formidable task for urban poor youth in the sub-region. Nevertheless, some youth in these settings still manage to resist the pressure to initiate sex early, while others choose abstinence after an initial sexual debut. Few studies in the sub-region have examined sexual abstinence among urban poor youth. We therefore examined the factors that predict primary and secondary sexual abstinence among youth in urban poor Accra. The findings highlight the protective factors associated with sexual intercourse and should help to address the needs of youth at risk of unprotected sex. METHODS: The study analysed pooled data from two rounds of the Urban Health and Poverty Survey. The surveys analysed were conducted in 2011 and 2013. The analysis was restricted to unmarried youth between age 20 and 24 years. The total sample comprised 235 female and male youth. We conducted multinomial logistic regression analysis to examine the predictors of primary and secondary abstinence relative to current sexual intercourse. RESULTS: The results showed that being female, sexual communication with only fathers, sexual communication with only friends and slum residence were negatively associated with primary sexual abstinence. Contrarily, being in school, attaching importance to religion, residing in a household that received social support and sexual communication with both parents were positively associated with primary abstinence. Regarding secondary abstinence, only the sexual communication variables had significant effects. Sexual communication with both parents positively predicted secondary abstinence while communication with fathers-only and friends-only had a negative effect. CONCLUSION: Sexual abstinence is predicted by factors which range from individual through household factors to the locality of residence. Despite the importance of all the predictors, the study found that sexual communication with both parents was the only factor that predicted a higher likelihood of both primary and secondary sexual abstinence. We therefore recommend sexual communication between parents and youth as a key strategy for promoting sexual abstinence among urban poor youth in Accra, Ghana.

Extent of inappropriate prescription of artemisinin and anti-malarial injections to febrile outpatients, a cross-sectional analytic survey in the Greater Accra region, Ghana.

BACKGROUND: Febrile children seen in malaria hypo-endemic settings, such as the Greater Accra region (GAR) of Ghana are more likely to be suffering from a non-malarial febrile illness compared to those seen in hyper-endemic settings. The need for prescribers to rely on malaria test results to guide treatment practices in the GAR is even greater. This study was designed to investigate the factors associated with inappropriate artemisinin-based combination therapy (ACT) prescription. METHODS: A survey was conducted in six health facilities in the region in 2015. Treatment practices for febrile outpatient department (OPD) patients were obtained from their records. Prescribers were interviewed and availability of malaria commodities were assessed. The primary outcome was the proportion of patients prescribed ACT inappropriately. Independent variables included patient age and access to care, prescriber factors (professional category, work experience, access to guidelines, exposure to training). Data were analysed using Stata at 95% CI (α-value of 0.05). Frequencies and means were used to describe the characteristics of patients and prescribers. To identify the predictors of inappropriate ACT prescription, regression analyses were performed accounting for clustering. RESULTS: Overall, 2519 febrile OPD records were analysed; 45.6% (n = 1149) were younger than 5 years. Only 40.0% of patients were tested. The proportion of patients who were prescribed ACT inappropriately was 76.4% (n = 791 of 1036). Of these 791 patients, 141 (17.8%) were prescribed anti-malarial injections. Patients seen in facilities with rapid diagnostic tests (RDT) in stock were less likely to be prescribed ACT inappropriately, (AOR: 0.04, 95% CI 0.01-0.14, p < 0.001) compared to those seen in facilities with RDT stock-outs. Prescribers who had been trained on malaria case management within the past year were 4 times more likely to prescribe ACT inappropriately compared to those who had not been trained (AOR: 4.1; 95% CI (1.5-11.6); p < 0.01). Patients seen by prescribers who had been supervised were 8 times more likely to be  prescribed ACT inappropriately. CONCLUSION: Inappropriate ACT prescription to OPD febrile cases was high. Training and supervision of health workers appears not to be yielding the desired outcomes. Further research is needed to understand this observation.

Investigating the virulence genes and antibiotic susceptibility patterns of Vibrio cholerae O1 in environmental and clinical isolates in Accra, Ghana.

BACKGROUND: Cholera has been endemic in Ghana since its detection in 1970. It has been shown that long-term survival of the bacteria may be attained in aquatic environments. Consequently, cholera outbreaks may be triggered predominantly in densely populated urban areas. We investigated clinical and environmental isolates of Vibrio cholerae O1 in Accra to determine their virulence genes, antibiotic susceptibility patterns and environmental factors maintaining their persistence in the environment. METHODS: Water samples from various sources were analyzed for the presence of V. cholerae O1 using culture methods. Forty clinical isolates from a previous cholera outbreak were included in the study for comparison. Antibiotic susceptibility patterns of the bacteria were determined by disc diffusion. Virulence genes were identified by analyzing genes for ctx, tcpA (tcpAEl Tor tcpACl), zot, ompW, rbfO1 and attRS using PCR. Physicochemical characteristics of water were investigated using standard methods. One-way ANOVA and student t - test were employed to analyze the relationship between physicochemical factors and the occurrence of V. cholerae O1. RESULTS: Eleven V. cholerae O1 strains were successfully isolated from streams, storage tanks and wells during the study period. All isolates were resistant to one or more of the eight antibiotics used. Multidrug resistance was observed in over 97% of the isolates. All isolates had genes for at least one virulence factor. Vibrio cholerae toxin gene was detected in 82.4% of the isolates. Approximately 81.8% of the isolates were positive for tcpAEl Tor gene, but also harbored the tcpAcl gene. Isolates were grouped into thirteen genotypes based on the genes analyzed. High temperature, salinity, total dissolved solids and conductivity was found to significantly correlate positively with isolation of V. cholerae O1. V. cholerae serotype Ogawa biotype El tor is the main biotype circulating in Ghana with the emergence of a hybrid strain. CONCLUSIONS: Multidrug resistant V. cholerae O1 with different genotypes and pathogenicity are present in water sources and co-exist with non O1/O139 in the study area.

Frequency of ABO/Rhesus (D) blood groupings and ethnic distribution in the Greater-Accra region of Ghana, towards effective blood bank inventory.

Knowledge on blood group phenotypes is of key importance in clinical practice. It used in blood transfusion practice to determine the direction of recruitment of voluntary donors as required for each population within a country, and for disease association and population genetics studies. This study aimed at reporting the frequency of ABO and Rhesus (Rh) groups in the population of the Greater-Accra region of Ghana and amongst their various ethnic groups. A retrospective study in 11 main hospitals within the region was done. Data collected provided information on the blood group status of persons (both blood donors and recipients) who visited the selected hospitals. Medical records used were within the years 2012-2017. A total of 42,317 (26,802 males and 15,515 females) data were retrieved and analysed. The frequencies of the blood groups O, A, B and AB were 50.0%, 24.3%, 20.7% and 5.0%, respectively. Rhesus-positive to negative ratio was 93.2%/6.2%. Frequencies of blood group O was highest (49.1%-53.6%) in all ethnic groups. The second most dominant blood group was B (24.2%-25.4%) in the Ga-Adamgbe, Akan and Ewe ethnic groups, whilst blood group A (25.0%-26.9%) was the second most dominant in the Northerners and non-Ghanaians. Blood group distribution amongst gender and different age groups showed no significant differences but followed the same pattern for the general population. The study provides data on the ethnic distribution and frequency of ABO and Rhesus blood groupings in the Greater-Accra region of Ghana. It also informs the need for blood banks in the region to increase the proportion of stockpiled Rhesus-positive blood groups especially for O, B and A that may be high in demand.

Sociodemographic correlates of depressive symptoms: a cross-sectional analytic study among healthy urban Ghanaian women.

BACKGROUND: Studies on healthy individuals that show minor signs of distress and depression-but that are not significant enough to be debilitating or to report to the hospital for treatment-are rare. Our primary objective was to measure the prevalence of depressive symptoms and sociodemographic correlates among healthy women 18 years and above in urban Accra, Ghana. METHOD: We used secondary data from the Women's Health Study of Accra, Wave 1 (WHSA-1), a large scale, analytic, cross-sectional study conducted in Accra, Ghana involving 3183 women. The presence or absence of depressive symptoms within the past 30 days was estimated from the average score on three common symptoms of depression: sleep, anxiety, and sadness. The explanatory variables were age-group, socioeconomic level, marital status, ethnicity, religion, education, employment, and parity. Frequencies and means were used to summarize categorical and continuous variables, respectively. Logistic regression analyses were employed to determine the predictors of depressive symptoms. RESULTS: The prevalence of depressive symptoms within the previous 30 days was 26.5% (95% CI: 25.0-28.1). Women 55 years and older were more likely than women between the ages of 18 and 24 to experience depressive symptoms (AOR 2.8, 95% CI: 2.0-4.0, p < 0.001), whilst women between the ages of 35 and 54 were 1.95 times more likely than women between the ages of 18 and 24 to experience depression (AOR 1.95, 95% CI: 1.40-2.70, p < 0.001). Self-employed women were less likely to report depressive symptoms compared to the unemployed (AOR 0.70, 95% CI: 0.56-0.87, p < 0.01). Akans were less likely to experience depressive symptoms compared to Ga women (AOR 0.75, 95% CI: 0.61-0.92, p < 0.01). Non-orthodox Christians were more likely to report depressive symptoms compared to Orthodox Christians (AOR 1.32, 95% CI: 1.09-1.60, p < 0.01). CONCLUSION: The prevalence of symptoms of depression among healthy urban Ghanaian women is high. Older women, those with low education, and unemployed women appear to be at higher risk for depression and therefore should be targeted for interventions. Groups at risk for depression-especially older adults or individuals under economic strain-should be targeted for mood assessment as part of routine medical care.

Do the urban poor want household taps? Community preferences and willingness to pay for household taps in Accra, Ghana.

In Sub-Saharan Africa, only 35% of the urban population has piped water on premises despite the economic (time savings) and public health benefits that household taps offer. In the urban informal settlements, even fewer people own household taps. However, while there is extensive literature on everyday urban water insecurity in the region, far less attention has focused on whether the urban poor are interested in private taps, and if so, what service attributes are important to them. We implemented a choice experiment in Nima, an urban settlement in Accra, Ghana, to investigate community preferences and willingness to pay (WTP) for household taps. We used a comprehensive set of system attributes including days of service, service hours, water pressure, water quality, connection fees, monthly payment, and management, an attribute very few WTP studies have explored. Results from the choice experiment show that residents are more sensitive to time (not day) of service delivery, quality of water, connection fees, and monthly water bills. Households had no preference between a 24-h supply and 12-h supply during the day. Households preferred Accra Metropolitan Assembly (AMA) to Ghana Water Company Limited (GWCL) as the service provider and were willing to pay more for a system managed by AMA, an indication of declining trust in GWCL. The findings provide valuable information that policymakers and water utilities can use to assess the feasibility and cost effectiveness of extending household taps to poor urban settlements.

Socioeconomic Status and Temporal Urban Environmental Change in Accra: a Comparative Analysis of Area-based Socioeconomic and Urban Environmental Quality Conditions Between Two Time Points.

The influence of area-based socioeconomic (SE) conditions on environmental quality conditions has recently been reported showing the precise spatial relationship between area-based SE conditions and neighborhood environmental quality in an urban area in a low-income setting. Nonetheless, there is still a lack of understanding of the nature of the relationship on a temporal scale. This study aimed to investigate the dynamic temporal relationship between area-based SE conditions and urban environmental quality conditions over a decadal period in Accra, Ghana. The results showed that there were differences in environmental quality across the SE quintiles in space (with regard to per capita waste generation (p < 0.012), waste collection/clearing (p < 0.01), and waste deposition (p < 0.001) and that the urban environmental quality conditions had changed dramatically over the decade for most of the environmental variables (p < 0.001). Despite the enormous urban development initiatives, some of the environmental quality indicators (e.g., proportion of households without flush toilet/Water Closet, connection to central sewer p < 0.001) appeared to have worsened in the high class quintile, suggesting that a high proportion of households were without acceptable sanitation facilities. The study concludes that urban development in low-income countries will need to follow strictly international best practice by observing standardized building codes and guidelines, if progress should be made in meeting the Millennium Development Goals targets.

Detection of Dengue Virus among Children with Suspected Malaria, Accra, Ghana.

We report new molecular evidence of locally acquired dengue virus infections in Ghana. We detected dengue viral RNA among children with suspected malaria by using a multipathogen real-time PCR. Subsequent sequence analysis revealed a close relationship with dengue virus serotype 2, which was implicated in a 2016 outbreak in Burkina Faso.

Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana.

BACKGROUND: In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. METHODS: This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. RESULTS: Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. CONCLUSIONS: The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.

Experiences of frontline nursing staff on workplace safety and occupational health hazards in two psychiatric hospitals in Ghana.

BACKGROUND: Psychiatric hospitals need safe working environments to promote productivity at the workplace. Even though occupational health and safety is not completely new to the corporate society, its scope is largely limited to the manufacturing/processing industries which are perceived to pose greater dangers to workers than the health sector. This paper sought to explore the experiences of frontline nursing personnel on the occupational health and safety conditions in two psychiatric hospitals in Ghana. METHODS: This is an exploratory cross-sectional study among 296 nurses and nurse-assistants in Accra (n = 164) and Pantang (n = 132) psychiatric hospitals using the proportional stratified random sampling technique. Multivariate Ordinary Least Squares (OLS) regression test was conducted to ascertain the determinants of staff exposure to occupational health hazards and the frequency of exposure to these occupational health hazards on daily basis. RESULTS: Knowledge levels on occupational health hazards was high in Accra and Pantang psychiatric hospitals (i.e. 92 and 81% respectively), but barely 44% of the 296 interviewed staff in the two hospitals said they reported their most recent exposure to an occupational health hazard to hospital management. It was found that staff who worked for more years on the ward had higher likelihood of exposure to occupational health hazards than those who worked for lesser years (p = 0.002). The category of occupational health hazards reported most were the physical health hazards. Psychosocial hazards were the least reported health hazards. Frequency of exposure to occupational health hazards on daily basis was positively associated with work schedules of staff particularly, staff on routine day schedule (Coef = 4.49, p = 0.011) and those who alternated between day and night schedules (Coef = 4.48, p = 0.010). CONCLUSION: Occupational health and safety conditions in the two hospitals were found to be generally poor. Even though majority of the staff knew about occupational health and safety, less than half of them reported exposure to workplace health hazards. Key stakeholders such as the Ministry of Health in collaboration with the Mental Health Authority should intensify efforts towards effective enforcement of existing policies on safety in healthcare institutions, particularly psychiatric hospitals where exposure to occupational health hazards is more prevalent.