International note: Analysis of risk and protective factors for risky sexual behaviours among school-aged adolescents.

This study examined the prevalence and associated factors of risky sexual behaviours among 1648 school-going adolescents using the 2012 Ghana Global School-based Student Health Survey. Our findings showed 33.5% of the participants had ever had sex 32.5% had multiple sexual partners and only 26.2% reported using condom during their last sexual intercourse. Being male, older age, anxiety, loneliness, suicidal ideation, being bullied, food insecurity (hunger), current alcohol and marijuana use were significant risk factors for being sexually experienced, multiple partners, but not condom use. Parental knowledge of activity was a significant protective factor against adolescents' sexual experience. These findings underscore the need to develop school-based interventions that would help reduce risky sexual behaviours among school-going adolescents.

Gender Differentials and Disease-Specific Cause of Infant Mortality: A Case Study in an Urban Hospital in Accra, Ghana.

Infant mortality is a major public health problem especially in developing countries. It is an indicator of quality of and accessibility to primary healthcare as well as the overall health status of a country. Understanding the risk factors for infant mortality is the first important step to reducing its incidence/prevalence. This study examined the prevalence and disease-specific causes of infant mortality in an urban hospital in Ghana and gender differences in the burden of infant mortality. Births and deaths data at the hospital were reviewed and analyzed. Results indicated infant mortality of 32/1000 live births and highlighted malaria, severe anemia, and neonatal sepsis as the leading causes of infant deaths. Gender differences in infant mortality was not statistically significant (X2; P-value=0.73). It is critical to strengthen existing malaria control programs for infants and develop targeted interventions to improve infant nutrition for high risk infants.

Influence of information, education and communication on prenatal and skilled delivery in the Tano North District, Ghana: A cross-sectional study.

Skilled birth attendance is considered an effective intervention to reduce maternal and early neonatal morbidity and mortality. Yet in Ghana, skilled birth attendance is said to be relatively low despite high antenatal attendance. In this study, we specifically assessed the influence of information, education and communication on prenatal and skilled delivery in the Tano North District of Ghana. A descriptive cross-sectional quantitative survey involving both closed and open-ended questionnaires were conducted among 393 women at three health facilities. The results showed skilled health personnel attended 94.1% of deliveries, which is higher than what has been reported in previous studies. Mothers with Senior High School Education were found to be 11.46 times more likely to be delivered by skilled birth attendant than those without formal education COR = 11.46, 95% (2.01-65.19) and this was statistically significant p = 0.006. There was also a significant association between information received by pregnant women and place of delivery (X2 = 20.85, P = 0.000 α = 0.05) in that the usefulness of information to mothers influenced their choice of health facility delivery. Marital status was also strongly correlated to being attended by skilled birth attendant (χ2 = 14.73, p = 0.005) as 0.4 times of mothers who were married were more likely to be attended by skilled birth attendants as compared to those that are single. COR = 0.005, 95% CI (0.00-0.36) and this was statistically significant p = 0.002. This study suggests the incorporation of IE&C into nursing training curriculum to orient students on the importance of IE&C so as to improve ANCs and skilled birth attendance further.

HIV Stigma and Status Disclosure in Three Municipalities in Ghana.

Background: HIV-related stigma and HIV status disclosure are important elements in the continuous fight against HIV as these impact the prevention efforts and antiretroviral treatment adherence among people living with HIV/AIDS (PLWHA) in many communities. Objectives: The objectives of the study were to examine the prevalence and experience of various types of HIV-related stigma and HIV status disclosure among PLWHA in Volta region. Methods: A cross-sectional design was used to collect quantitative data from 301 PLWHA. Descriptive statistics were used to analyze and present data on socio-demographic variables. Correlation analysis was done to determine factors associated with HIV stigma and status disclosure while a Mann-Whitney U test was used to determine differences in internalized HIV stigma. Findings: The mean age of the participants was 44.82 (SD: 12.22), 224 (74.4%) were female, and 90% attained at least primary education. A Pearson r analysis revealed that ethnicity (r[299] = 0.170, p = 0.003), religious affiliation (r[299] = -0.205, p = 0.001) and social support (r[299] = 0.142, p = 0.014) significantly predicted disclosure of HIV status. Fear of family rejection (62%) and shame (56%) were reasons for non-disclosure of HIV status. A Mann-Whitney's U-test revealed that females are more likely than males to internalize HIV stigma. Community-related HIV stigma in the form of gossip (56.1%), verbal harassment (30.9%), and physical harassment (8.6%) was reported. Conclusion: A high rate of HIV status disclosure was found with social support, ethnicity, and religious affiliation being the associated factors. Internalized HIV stigma is prevalent among PLWHA while community-related stigma impacts HIV status disclosure. Strengthening social support systems and implementing culturally appropriate educational interventions may help in reducing community-related HIV stigma.

Knowledge, risk of infection, and vaccination status of hepatitis B virus among rural high school students in Nanumba North and South Districts of Ghana.

BACKGROUND: Hepatitis B (HB) is a viral infection that affects the liver and can lead to life-threatening conditions including cirrhosis and liver cancer. Over a billion people are estimated to be infected globally with the hepatitis B virus, with over 240 million chronically infected. Sub-Saharan Africa including Ghana is an HBV endemic area and an estimated 5%- 10% of the population in the region is infected. Research on the knowledge and vaccination status of hepatitis B in rural communities in Ghana is lacking. OBJECTIVES: The objectives of this study proposed were to assess the HBV knowledge, risk of HBV infection, and vaccination status of high school students in two rural districts of the Northern region on Ghana. METHODS: A cross-sectional study of a random sample of 426 students from two senior high schools in the Nanumba North and South districts of the Northern region of Ghana on hepatitis B knowledge and vaccination status was conducted. Descriptive statistics were used to analyze and present data on demographic and knowledge variables. A Mann Whitney U test was used to compare the differences in HBV knowledge between male and female students and between students of the two high schools that were involved in the study. Pearson correlation coefficient was used to compute the association between HBV knowledge and age of students. Logistic regression was used to develop a model to predict variables that influenced vaccination against HB. RESULTS: The results of the study showed basic but not a good knowledge of HBV among the rural high school students, with a mean score of 11.8 (SD = 1.98) out of a maximum score of 16. Descriptive statistics also revealed that only 20% of 426 students ever tested for HBV and 96 (22.5%) were vaccinated against HBV. A Mann-Whitney U test results revealed no statistically significant difference in HBV knowledge between male and female students (p = 0.688, two-tailed) and between the two high schools (p = 0.24, two-tailed). A Pearson correlation showed no relationship between age and HBV knowledge (p = 0.486). Regression analysis showed that only taking the HBV test (p <0.05) and attending Bimbilla Senior High (p = 0.032) significantly predicted vaccination against HBV infection. CONCLUSION: The results of this study has re-echoed the high prevalence of HBV in Ghana. The poor state of knowledge and a high risk of HBV infection among young adults in rural communities have also been highlighted in the findings of this study. Vaccination against the HBV infection was found to be low and consistent with other findings. Finally, HBV screening is shown to be significantly associated with vaccination against the virus, hence the need for national screening and vaccination programs.

Availability, accessibility, and impact of social support on breast cancer treatment among breast cancer patients in Kumasi, Ghana: A qualitative study.

BACKGROUND: Breast cancer is one of the top types of cancer affecting women both in the developed and developing countries. Breast cancer is a chronic and debilitating condition for anybody diagnosed of it and as well as their family. Social support has been shown to offset or moderate the impact of stress caused by the illness and other related negative outcomes. OBJECTIVE: The objective of this study is to assess the availability, accessibility, and impact of social support on treatment for breast cancer patients at Komfo Anokye Teaching Hospital (KATH), Ashanti Region in Ghana. MATERIALS AND METHODS: A phenomenological study was employed. An in-depth interview guide was used to collect data on socio-demographic variables and social support availability and accessibility from 15 breast cancer patients. Thematic analysis was employed. RESULTS: Majority of the women who participated in the study were postmenopausal women with an average age of 55 years. The study also revealed that all the participants in this study received one kind of support or another including informational, financial, emotional, and tangible support and reported varying positive impacts on their lives as a result of the support received. For those who received support, the prognosis and general quality of life appeared promising and well-adjusted than those who reported not having received any form of support. CONCLUSION: Social support is critical for the survival and quality of life of chronic disease patients including breast cancer patients who were the focus of this study. The availability and/or accessibility of social support or otherwise significantly determines the prognosis and quality of life of breast cancer patients. Healthcare professionals and family members or significant others are major players in organizing social support for chronic disease patients.

Assessment of knowledge and practice of breast self-examination among reproductive age women in Akatsi South district of Volta region of Ghana.

BACKGROUND: Breast cancer is the primary cause of cancer death among women globally, responsible for about 425,000 deaths in 2010. This study assessed the awareness, knowledge and practices of breast self-examination as a method of prevention and early diagnosis of breast cancer among reproductive aged women in Akatsi South district in Volta region of Ghana. METHODS: This study was a cross-sectional study involving 385 women between the ages of 15-49 years. Data were collected with a structured questionnaire and variables included socio-demographic characteristics, breast cancer knowledge, breast self-examination knowledge and practice. Descriptive statistics were used to analyze and present the data and chi square test of significance was used to determine association between socio-demographic variable and practice of breast self-examination. RESULTS: The mean age of the women was 24.54±7.19. Only 3.1% of women had no formal education and 58.9% were single. Although 88.3% of the respondents were aware of breast cancer, 64.9% of the respondents had good or sufficient knowledge of breast cancer and only 94(37.6%) practice BSE. Over 50% of the respondents did not know how to perform BSE. There was a significant association between knowledge on breast cancer and practice of BSE (χ2 = 36.218 p = 0.000). The higher the age of a participant, the lower practice of breast self-examination and this was significant (χ2 = 11.324, p = 0.003). CONCLUSION: Breast self-examination is a key strategy to early detection of breast cancer and subsequently critical for effective treatment and cure of the disease. The findings in this study have shown significant low levels of awareness and practice of breast self-examination among women in Akatsi South district of the Volta region. This pattern may be similar to other rural communities across the region. The need to create awareness and to educate women, especially rural women, on importance of breast self-examination as preventive measure for breast cancer is paramount.

Perceptions of Factors Associated with Condom Use to Prevent HIV/AIDS among Persons with Physical Disability in an Urban Town of Cameroon: A Qualitative Study.

Persons with disabilities have been identified as one of the groups vulnerable to HIV, due to several challenges posed by their disabilities. They also suffer external stigma from their able bodied peers. However, they have largely been ignored as part of HIV prevention programs, largely due to the perceptions that they are not at risk, and information is not being accessible. About 5.4% of the Cameroon population lives with a disability. In Cameroon, no official statistics exist on perception of factors associated with condom use to prevent HIV among persons with disabilities, which creates a challenge for understanding the extent of the pandemic in this population. The objective of this study was therefore to investigate perceptions of factors associated with condom use among persons with physical disability in an urban town of Cameroon. The qualitative study from which this paper is based, used semi-structured in-depth interviews, conducted with a purposive sample of ten (5 male and 5 female) persons with physical disability, aged 18 years and above, in April 2015. The findings of this study as interpreted according to the components of the Health Belief Model, indicated that perceived susceptibility to HIV, perceived severity of HIV, perceived benefit of condom use, perceived barriers to condom use and perceived self-efficacy for condom use were the factors perceived by persons with physical disability, to be associated with condom use. It is therefore recommended that there should be educational programs in HIV/AIDS targeted specifically at persons with physical disability. These programs should pertinently promote the understanding and perceptions of persons with physical disability of the real threat of HIV/AIDS, and also equip them with condom negotiation skills and strategies to overcome barriers to condom use.