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1.
BMC Infect Dis ; 23(1): 723, 2023 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-37880663

RESUMEN

BACKGROUND: Antimicrobial resistance poses a public health threat for the treatment of community-acquired urinary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifing General Hospital in the Gambia. METHODS: A cross-sectional analytic study was conducted among patients with suspected urinary tract infections at Kanifing General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identification and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confidence level and a p -value < 0.05. RESULTS: A total of 422 patients were enrolled with 82.5% (348/422) being females. The prevalence of community acquired urinary tract infection was 12.8% (54/422). Escherichia coli was the most prevalent isolate (74.1%, 40/54), followed by Klebsiella spp (8.5%, 10/54). Antimicrobial resistance was highest for Ampicillin (87.0%, 47/54), Trimethoprim/Sulfamethoxazole (77.8%, 42/54) and Tetracycline (75.9%, 41/54). Uropathogens sensitivity was 77.8% (42/54) for Nitrofurantoin and 75.9% (41/54) for Ceftazidime. Being female (aOR 5.90 95% CI = 1.48-23.67), previous history of urinary tract infection (aOR 2.34, 95% CI = 1.06-5.14), use of unprescribed antibiotics (aOR 2.0, 95% CI = 1.05-3.62) and having no formal education (aOR 8.02, 95% CI = 1.04-62.0) were significant factors associated for having uropathogenic bacterial infection. CONCLUSION: E. coli was the most prevalent uropathogen isolated. Ciprofloxacin, Nitrofurantoin and Ceftazidime were the most sensitive antibiotics. Routine surveillance of susceptibility of uropathogenic bacteria would be helpful to update clinicians on the choice of antibiotics.


Asunto(s)
Infecciones Comunitarias Adquiridas , Infecciones Urinarias , Humanos , Femenino , Masculino , Nitrofurantoína , Escherichia coli , Hospitales Generales , Ceftazidima , Estudios Transversales , Gambia/epidemiología , Pruebas de Sensibilidad Microbiana , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiología , Bacterias , Infecciones Comunitarias Adquiridas/microbiología
2.
Parasitol Res ; 121(12): 3641-3651, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36264508

RESUMEN

By 2020, the World Health Organization and the Ghana Neglected Tropical Diseases programme intended to treat 75% and 100% of school-age children, respectively, during preventative chemotherapy (PCT), to control soil-transmitted helminths. The performance of PCT was assessed, and the factors associated with albendazole uptake in 2019 were determined. This study comprised secondary data (2019 PCT) and a community-based cross-sectional study conducted among 352 children aged from 7 to 14 years and enrolled with their caregivers. Logistic regression was used to determine the factors hindering or favouring the PCT uptake. According to surveillance data (2019 PCT), Krachi East Municipal reported coverage of 83% in schools and 40.9% for all children between 5 and 14 years. The cross-sectional data showed that the median child age was 11 years (IQR: 9-12). There was no gap in the estimates for coverage and uptake, which were both 90.9% (95%CI: 87.4-93.5%). Christians made up the majority of the caregivers (87.5%), and 48.0% had completed secondary or higher education. After controlling for potential confounders, caregiver religion (aOR = 0.07 95%CI: 0.01-0.36) and the perception of a child's PCT risk (aOR = 0.33 95%CI: 0.13-0.84) were the significant barriers of PCT uptake, whereas the child's age (aOR = 1.49 95%CI: 1.19-1.88) and the perception of a child's PCT's benefit (aOR = 10.26 95%CI: 2.57-40.95) were the significant facilitators among children 7-14 years old. Although the performance of PCT was high, the national treatment target was not attained. Intensive and focused health education is therefore needed to improve positive perceptions towards PCT for school-age children.


Asunto(s)
Helmintiasis , Helmintos , Niño , Animales , Humanos , Adolescente , Estudios Transversales , Suelo/parasitología , Ghana , Prevalencia , Helmintiasis/tratamiento farmacológico , Helmintiasis/prevención & control , Helmintiasis/epidemiología
3.
BMC Oral Health ; 22(1): 67, 2022 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-35279167

RESUMEN

BACKGROUND: Oral health surveys aid in estimating the oral health of a population and provide a projection for future oral health care needs. We report the procedures and rationale of a survey carried out to assess the oral health status and risk factors for oral disease among adults in the Greater Accra Region (GAR) of Ghana. The objective was to provide prevalence estimates on dental diseases, oral health behaviour and risk factors, and to establish baseline epidemiological data on the population's oral health for further research. METHODS: This was a population-based cross-sectional study of adults aged 25 years and above. A random, stratified two-stage sampling method was used to select participants from rural and urban communities in three types of districts (Metropolitan, Municipal, Ordinary). A semi- structured questionnaire was used to collect data on socio-demographic characteristics, oral health behaviours and risk factors for oral disease. Anthropometric data and a full-mouth clinical examination was carried out including: soft tissue assessment, tooth count, prosthodontic status, dental caries assessment and periodontal assessment. RESULTS: A total of 729 participants were included in the study with a mean age of 43.9 years (SD 14.6). Majority 425 (61.0%) were females. Though the metropolitan districts had more dental clinics and personnel, along with better health insurance coverage, they had a higher prevalence of missing teeth, retained roots, severe periodontitis and poorer oral health coverage. The findings also show some significant differences in disease prevalence, within the different localities and districts. CONCLUSIONS: Availability and access to oral health services is not the most important determinant of good oral health outcomes in this region. We recommend exploring socio-behavioral and cultural factors as well. This study provides district level data to inform policy and guide further research.


Asunto(s)
Caries Dental , Salud Bucal , Adulto , Estudios Transversales , Caries Dental/diagnóstico , Caries Dental/epidemiología , Encuestas de Salud Bucal , Femenino , Ghana/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia
4.
BMC Pregnancy Childbirth ; 21(1): 105, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33530957

RESUMEN

BACKGROUND: Malaria infection during pregnancy is of public health importance as it poses risk to the pregnant woman, her foetus and the newborn child. Intermittent preventive treatment during pregnancy using sulphadoxine-pyrimethamine is one way of reducing the effect of the disease on pregnancy outcomes. The study determined factors associated with uptake of sulphadoxine-pyrimethamine during pregnancy in the Cape Coast Metropolis of Ghana. METHODS: A health facility-based cross-sectional study involving pregnant women of ≥36 weeks gestation visiting antenatal clinics in three selected health facilities in the Cape Coast Metropolis was conducted. Participants were consecutively recruited using a structured questionnaire over a 6-week period from May to June, 2018. Descriptive statistics was used to summarize the data whilst Pearson's chi-square/Fisher exact test was performed to determine associations and logistic regression done to determine the strength of the associations. RESULTS: A total of 212 pregnant women participated in the study. Formal education, initiating ANC early, taking first dose of SP during second trimester, not experiencing side effects of SP, having knowledge about schedule for taking SP and making ≥4 ANC visits were factors associated with uptake of ≥3 doses of IPTp-SP. Logistic regression analysis revealed that, mothers who made ≥4 ANC visits were 53.77 times more likely to take ≥3 doses of SP compared with those who made < 4 ANC visits (p <  0.001). Those who initiated ANC during the first trimester were 3.60 times more likely to receive ≥5 doses compared with those who initiated ANC during the second or third trimester (p = 0.022). Making ≥8 ANC visits did not increase the chances of taking ≥5 doses of SP. CONCLUSION: Health promotion programmes targeting mothers with no formal education could increase their awareness about the importance of ANC services including uptake of IPTp-SP.


Asunto(s)
Antimaláricos/uso terapéutico , Malaria/prevención & control , Aceptación de la Atención de Salud/estadística & datos numéricos , Complicaciones Parasitarias del Embarazo/prevención & control , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Adolescente , Adulto , Estudios Transversales , Combinación de Medicamentos , Femenino , Ghana , Humanos , Embarazo , Atención Prenatal/estadística & datos numéricos , Adulto Joven
5.
Artículo en Inglés | MEDLINE | ID: mdl-31932374

RESUMEN

A key drawback to monitoring the emergence and spread of antimalarial drug resistance in sub-Saharan Africa is early detection and containment. Next-generation sequencing methods offer the resolution, sensitivity, and scale required to fill this gap by surveilling for molecular markers of drug resistance. We performed targeted sequencing using molecular inversion probes to interrogate five Plasmodium falciparum genes (pfcrt, pfmdr1, pfdhps, pfdhfr, and pfk13) implicated in chloroquine, sulfadoxine-pyrimethamine (SP), and artemisinin resistance in two sites in Ghana. A total of 803 dried blood spots from children aged between 6 months and 14 years presenting with uncomplicated P. falciparum malaria at the Begoro District Hospital in Begoro and the Ewim Polyclinic in Cape Coast, Ghana, from 2014 to 2017 were prepared on filter paper. Thirteen years after the removal of drug pressure, chloroquine-sensitive parasite strains with pfcrt K76 have increased nearly to fixation in Begoro, in the forest area (prevalence = 95%), but at a lower rate in Cape Coast, in the coastal region (prevalence = 71%, Z = -3.5, P < 0.001). In addition, pfmdr1 184F-bearing parasites are under strong selection. The pfdhfr/pfdhps quadruple genotype ( IRNG K), associated with SP resistance, is near saturation. Our study identified at a 2 to 10% prevalence pfdhps 581G, which is a sulfadoxine resistance marker that correlates with the failure of SP prophylaxis in pregnancy and which has not been observed in Ghana. The differences in the reexpansion of chloroquine-sensitive strains observed at the two study sites, the stronger SP resistance, and the high prevalence of pfmdr1 184F should be further monitored to inform malaria control strategies in Ghana.


Asunto(s)
Antimaláricos/uso terapéutico , Resistencia a Medicamentos/genética , Malaria Falciparum/tratamiento farmacológico , Plasmodium falciparum/efectos de los fármacos , Plasmodium falciparum/genética , Adolescente , Artemisininas/uso terapéutico , Niño , Preescolar , Cloroquina/uso terapéutico , Combinación de Medicamentos , Ghana , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Lactante , Proteínas Asociadas a Resistencia a Múltiples Medicamentos/genética , Pruebas de Sensibilidad Parasitaria , Plasmodium falciparum/aislamiento & purificación , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico
6.
BMC Infect Dis ; 19(1): 360, 2019 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-31035953

RESUMEN

BACKGROUND: Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The disease affects all ages and both sexes but more prevalent among the sexually active age group of 15-49 years. The purpose of the current study was to determine the prevalence and factors associated with syphilis infection among outpatients 15-49 years in the Asikuma Odoben Brakwa District of Ghana where high levels of infection were earlier reported among antenatal women. METHODS: A descriptive cross-sectional study was carried out in 13 randomly selected health facilities. Blood samples were collected and tested for syphilis infection and a questionnaire administered to determine factors associated with the disease. RESULTS: A total 277 patients aged 15-49 years participated in the study. The overall prevalence of syphilis infection was 3.2% (9/277), with 5.7% (6/105) and 1.7% (3/172) among males and females respectively. Significant factors associated with syphilis infection included sub-district of residence, (χ2 (4) = 31.20, p < 0.001) and history of coerced sexual intercourse (χ2 (1) =7.49, p = 0.006). CONCLUSIONS: The prevalence of syphilis infection was high among male patients who lived in rural areas. Having a history of coerced sexual intercourse was a strong predictor for syphilis infection. Access to sexually transmitted infection control interventions in rural communities including health education may help control the disease.


Asunto(s)
Enfermedades de Transmisión Sexual/diagnóstico , Sífilis/diagnóstico , Adolescente , Adulto , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pacientes Ambulatorios , Prevalencia , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/microbiología , Sífilis/epidemiología , Sífilis/microbiología , Treponema pallidum/aislamiento & purificación , Adulto Joven
7.
Malar J ; 16(1): 323, 2017 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-28797296

RESUMEN

BACKGROUND: Malaria in pregnancy poses a great risk to both mother and fetus. In Ghana, malaria accounts for 3.4% of deaths and 16.8% of all hospital admissions in pregnant women. In 2014, Ghana updated her policy on intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to reflect the updated policy of the WHO. This study determined the level of uptake of sulfadoxine pyrimethamine (SP) to serve as baseline for monitoring progress and also reviewed stock levels of SP, a key factor in the programme implementation. METHODS: A cross-sectional hospital-based study was carried out among nursing mothers who had delivered within 12 weeks and were seeking postnatal care at Osu Government Maternity Home in Accra. Antenatal record books of the mothers were reviewed and data collected on number of visits and receipt of IPTp-SP. Mothers were interviewed and data collected on their background characteristics and obstetric history. Data on SP stock levels for the past 6 months were also reviewed. Logistic regression analysis was carried out to determine antenatal indicators on uptake of IPTp-SP using Stata version 12. RESULTS: The proportion of uptake of three-five doses of SP were: IPT3 (87.5%), IPT4 (55.7%) and IPT5 (14.5%). The proportion of women who received the first dose of SP at 16 weeks of gestation was 21.3%. Women who made ≥4 visits were more likely to receive ≥3 doses of SP than those who made <4 visits (AOR = 4.57, 95% CI 1.15-18.16, p < 0.05). Women receiving the first dose of SP in the third trimester were less likely to receive ≥3 doses of SP than those who received the drug in the second trimester (AOR = 0.04, 95% CI 0.01-0.16, p < 0.05). Stock levels of SP were adequate to meet the demands by the pregnant women at the Maternity Home for the period under review. CONCLUSIONS: The uptake of ≥3 doses of SP was high in the study area. Frequent visits to the antenatal clinic and early uptake of the first dose of SP by pregnant women are necessary to achieve the new target of five or more doses of SP.


Asunto(s)
Antimaláricos/uso terapéutico , Malaria/prevención & control , Aceptación de la Atención de Salud/estadística & datos numéricos , Complicaciones Parasitarias del Embarazo/prevención & control , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Adolescente , Adulto , Estudios Transversales , Combinación de Medicamentos , Femenino , Ghana , Política de Salud , Humanos , Malaria/tratamiento farmacológico , Malaria/parasitología , Persona de Mediana Edad , Embarazo , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Complicaciones Parasitarias del Embarazo/parasitología , Adulto Joven
8.
BMC Infect Dis ; 16: 139, 2016 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-27013510

RESUMEN

BACKGROUND: There are over 250 foodborne diseases and are of growing public health concern worldwide. The distribution of these diseases varies from one locality to the other. Foodborne diseases come about as a result of ingestion of food contaminated with microorganisms or chemicals. The most common clinical presentation of foodborne disease takes the form of gastrointestinal symptoms; although other systems of the body can also be affected and represents a considerable burden of disability as well as mortality. The current study was carried out with the aim of describing the trends and patterns of foodborne diseases reported at the Ridge Hospital in Accra, Ghana to serve as the first step towards understanding the profile of foodborne diseases in Accra. The study could then serve as a guide in the establishment of a sentinel site or surveillance system for foodborne diseases. METHODS: A retrospective review of routine data kept on patients who visited the Ridge Hospital from January 2009 to December 2013 was conducted to describe the trends and patterns of foodborne diseases reported at the facility. All available health records were reviewed and data on foodborne diseases extracted and analysed by age group, sex, season and geographical location within the catchment area of the hospital. RESULTS: The review showed significant variation in the annual reported cases of foodborne diseases [2009 = 11.5% (118/1058); 2010 = 2.30% (22/956); 2011 = 17.45% (608/3485); 2012 = 7.98% (498/6315) and 2013 = 2.56% (345/13458)] p < 0.05. Significant seasonal variations were also observed [early dry season = 10.2% (322/3142); late dry season = 24.4% (909/3728); early wet season = 4.3% (107/2494); late wet season = 6.3% (256/4094). There were monthly variations also during the period (p < 0.001) except for the year 2010 (p = 0.428). The highest prevalence was reported during the late dry season (February-April). The most affected age group was those aged between 15 and 34 years who had significantly more infections in 2012 and 2013 than the other age groups (p < 0.001). Overall many more males than females reported of food borne diseases (p < 0.001). CONCLUSION: The commonly reported foodborne diseases at the Ridge Hospital were: typhoid fever, dysentery, cholera and viral hepatitis. These diseases were found to be very seasonal with peaks at the onset of the rainy season.


Asunto(s)
Enfermedades Transmitidas por los Alimentos/diagnóstico , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Cólera/diagnóstico , Cólera/epidemiología , Disentería/diagnóstico , Disentería/epidemiología , Femenino , Enfermedades Transmitidas por los Alimentos/epidemiología , Ghana/epidemiología , Hospitales , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Estaciones del Año , Factores Sexuales , Adulto Joven
9.
Malar J ; 14: 481, 2015 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-26625907

RESUMEN

BACKGROUND: The recently introduced SYBR Green1 (SG) assay for testing parasites susceptibility to anti-malarial drugs needs further improvement. This has been necessitated by various setbacks, the major one being the low fluorescence intensity associated with it use. This shortcoming diminishes the anticipated hope that this novel method was going to replace the more traditional ones, such as the isotopic and microscopy. In order to restore confidence in its use, series of experiments to determine conditions that give the best fluorescence intensity were conducted. METHODS: Conditions that yield the maximum fluorescent signal were ascertained by measuring the fluorescence after incubation of Plasmodium falciparum culture at different parasites concentration with lysis buffer containing SYBR Green (LBS) at different time period. In order to ascertain the effect of freeze-thaw on fluorescence intensity, P. falciparum culture was frozen for 1 h, thawed, incubated with LBS and the fluorescence measured. The optimized conditions determined in this study were then used to assess the susceptibility of clinical isolates of P. falciparum to artesunate, chloroquine and mefloquine. The concentration of anti-malarial drug inhibiting parasite growth by 50 % (IC50) for each drug was estimated using the online ICEstimator. The IC50 generated using the optimized SG method determined in this study was compared with that obtained using microscopic method and the previously reported standard SG method. RESULTS: Over all, the SG method was found to be easy to perform and sensitive. Freeze-thaw of parasite culture followed by incubation with lysis buffer containing the dye for 3 h was consistently observed to give the highest fluorescence signal. The IC50 values for chloroquine, mefloquine and artesunate determined were consistent and comparable with that determined with the previously reported standard SG method and the microscopic method. CONCLUSION: The authors conclude that freezing and thawing of parasite culture, followed by incubation with LBS in the dark for 3 h provided a significant improvement in fluorescence signal. The IC50 generated using the improved SG method is comparable with that from microscopy and the standard method.


Asunto(s)
Antimaláricos/farmacología , Resistencia a Medicamentos , Fluorometría/métodos , Compuestos Orgánicos/metabolismo , Pruebas de Sensibilidad Parasitaria/métodos , Plasmodium falciparum/efectos de los fármacos , Coloración y Etiquetado/métodos , Artemisininas/farmacología , Artesunato , Benzotiazoles , Niño , Preescolar , Cloroquina/farmacología , Diaminas , Humanos , Concentración 50 Inhibidora , Mefloquina/farmacología , Plasmodium falciparum/genética , Quinolinas
10.
PLoS One ; 19(4): e0298771, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38626000

RESUMEN

BACKGROUND: Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana. METHODS AND MATERIALS: An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. RESULTS: A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine. CONCLUSION: Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Femenino , Humanos , Adulto , Masculino , Infecciones de Transmisión Sanguínea , Ghana , Estudios Transversales , Personal de Salud , Virus de la Hepatitis B , Vacunación , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis B/tratamiento farmacológico , Encuestas y Cuestionarios
11.
Malar J ; 12: 63, 2013 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-23405912

RESUMEN

BACKGROUND: The relationship between entomological measures of malaria transmission intensity and mortality remains uncertain. This is partly because transmission is heterogeneous even within small geographical areas. Studying this relationship requires high resolution, spatially structured, longitudinal entomological data. Geostatistical models that have been used to analyse the spatio-temporal heterogeneity have not considered the uncertainty in both sporozoite rate (SR) and mosquito density data. This study analysed data from Kassena-Nankana districts in northern Ghana to obtain small area estimates of malaria transmission rates allowing for this uncertainty. METHODS: Independent Bayesian geostatistical models for sporozoite rate and mosquito density were fitted to produce explicit entomological inoculation rate (EIR) estimates for small areas and short time periods, controlling for environmental factors. RESULTS: Mosquitoes were trapped from 2,803 unique locations for three years using mainly CDC light traps. Anopheles gambiae constituted 52%, the rest were Anopheles funestus. Mean biting rates for An. funestus and An. gambiae were 32 and 33 respectively. Most bites occurred in September, the wettest month. The sporozoite rates were higher in the dry periods of the last two years compared with the wet period. The annual EIR varied from 1,132 to 157 infective bites. Monthly EIR varied between zero and 388 infective bites. Spatial correlation for SR was lower than that of mosquito densities. CONCLUSION: This study confirms the presence of spatio-temporal heterogeneity in malaria transmission within a small geographical area. Spatial variance was stronger than temporal especially in the SR. The estimated EIR will be used in mortality analysis for the area.


Asunto(s)
Anopheles/crecimiento & desarrollo , Anopheles/parasitología , Malaria/epidemiología , Malaria/transmisión , Animales , Anopheles/clasificación , Geografía , Ghana/epidemiología , Humanos , Malaria/mortalidad , Densidad de Población , Factores de Tiempo
12.
Ghana Med J ; 57(1): 19-27, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37576370

RESUMEN

Objectives: This study determined the prevalence of hypertension and its associated factors among patients attending the HIV clinic at the Korle-Bu Teaching Hospital (KBTH). Design: A hospital-based cross-sectional study was conducted at KBTH. The prevalence of hypertension was estimated among study participants, and socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling. Setting: Study participants were recruited from the HIV clinic at the KBTH. Participants: A total of 311 Persons Living with HIV were recruited as study participants. Interventions: Simple random sampling technique was used to recruit study participants. A questionnaire adapted from the WHO STEPwise approach to chronic disease risk-factor surveillance was used to collect study participants' data. Results: The prevalence of hypertension was 36.7%, and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2, total cholesterol level ≥5.17 mmol/L, exposure to anti-retroviral therapy (ART) and increasing duration of ART exposure. Conclusions: This study shows a high prevalence of hypertension among patients attending the HIV clinic at KBTH, associated with exposure to ART and increasing duration of this exposure. Blood pressure monitoring should move from routine to a more purposeful screening of patients for hypertension. Patients with the identified risk factors should be encouraged to have regular blood pressure measurements at home and not only when they visit the HIV clinic. Funding: Office of Research, Innovation and Development (ORID) of the University of Ghana. The funding agency was not involved in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.


Asunto(s)
Infecciones por VIH , Hipertensión , Humanos , Estudios Transversales , Hospitales de Enseñanza , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Factores de Riesgo , Hipertensión/epidemiología , Ghana/epidemiología , Prevalencia
13.
PLoS One ; 18(9): e0292034, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37756291

RESUMEN

BACKGROUND: A recent study detected cutaneous leishmaniasis (CL) in 31.9% of persons with skin ulcers in the Oti Region of Ghana, resulting in a need to investigate other potential causes of the unexplained skin ulcers. METHODOLOGY/PRINCIPAL FINDINGS: A community based cross-sectional study was conducted in the Oti region to investigate skin ulcers of undetermined aetiologies. To confirm a diagnosis of cutaneous leishmaniasis, Buruli ulcer, Haemophilus ducreyi ulcers, or yaws, DNA obtained from each patient skin ulcer sample was systematically subjected to polymerase chain reaction (PCR) for Leishmania spp., Mycobacterium ulcerans, Haemophilus ducreyi, and Treponema pallidum sub species pertenue. A total of 101 skin ulcer samples were obtained from 101 persons. Co-infection of more than one organism was observed in 68.3% of the samples. Forty (39.6%) participants had a positive result for Leishmania spp., 68 (67.3%) for Treponema pallidum sub. Sp. pertenue, and 74 (73.3%) for H. ducreyi. Twenty (19.8%) of the patient ulcers were simultaneously infected with Leishmania spp., Treponema pallidum sub. Sp. pertenue, and H. ducreyi. None of the patients' lesions yielded a positive result for Mycobacterium ulcerans. CONCLUSIONS/SIGNIFICANCE: This study detected single and mixed occurrence of the causative organisms of CL, yaws, and H. ducreyi cutaneous ulcers in CL endemic communities of the Oti Region in Ghana. These findings emphasize the importance of integrating multiple skin diseases on a common research platform and calls for the development of a comprehensive guideline for diagnosing and treating tropical ulcers in the study areas.


Asunto(s)
Haemophilus ducreyi , Leishmania , Leishmaniasis Cutánea , Mycobacterium ulcerans , Enfermedades Cutáneas Infecciosas , Úlcera Cutánea , Buba , Humanos , Úlcera/epidemiología , Buba/epidemiología , Ghana/epidemiología , Estudios Transversales , Úlcera Cutánea/epidemiología , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/epidemiología
14.
J Periodontol ; 93(5): 732-744, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34724216

RESUMEN

BACKGROUND: Periodontitis is a major public health problem affecting many adults, with considerable variation in its prevalence and severity worldwide. There is little data on its prevalence or associated risk factors in Ghana making development of evidence based preventive programs challenging. This study assessed the prevalence, severity, extent, and associated risk factors of periodontitis in an adult Ghanaian population. METHODS: A population based cross-sectional study involving adults aged ≥25 years in the Greater Accra Region (GAR) of Ghana. A random stratified two-stage sampling method was used to select participants from rural and urban communities. Data on sociodemographic and risk factors were collected using a semi-structured questionnaire. A full-mouth periodontal examination was performed to diagnose and describe the severity of periodontitis following the CDC-AAP case definition. RESULTS: A total of 729 participants were included in the study, with a mean age of 43.9 ± 14.6 years and 61% being female. Majority (84.8%) presented with gingivitis, 46.7% had periodontitis with 41.8% having both, and 13.9% had severe periodontitis. The mean clinical attachment loss (AL) was 1.36 ± 0.67 mm and 1.41 ± 0.57 mm for probing depth (PD). Factors associated with periodontitis included, increasing age, smoking, and alcohol use; being Muslim provided lower odds of disease. Older people, former smoking, being underweight and not having health insurance were associated with severe periodontitis. CONCLUSIONS: This study shows a high burden of periodontitis with comparatively more severe disease. Existing sociodemographic disparities in disease burden highlights the need of developing targeted population based preventive programs.


Asunto(s)
Periodontitis , Adulto , Anciano , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/epidemiología , Índice Periodontal , Periodontitis/epidemiología , Prevalencia , Factores de Riesgo
15.
Trop Med Int Health ; 16(9): 1112-9, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21689221

RESUMEN

OBJECTIVES: To compare (i) side effects associated with the simultaneous adminstration of praziquantel, albendazole and ivermectin with side affects associated with albendazole and ivermectin only and (ii) coverage by volunteers distributing three or two drugs. METHODS: Two-arm comparative study in northern Ghana integrated praziquantel distribution into an existing lymphatic filariasis and onchocerciasis control programme using Community Directed Distributors. The control arm continued to distribute only ivermectin and albendazole. Dosages of ivermectin and praziquantel were based on height. Treatment was directly observed, and all two/three drugs were co-administered. Adverse effects were recorded based on passive surveillance. Parasitological, anthropometric and haematological data were collected at baseline. RESULTS: Prevalence of Schistosoma haematobium infection among 1001 (boys: 47.9% girls: 52.1%) school-age children (6-15 years) [intervention: 30.0% (CI: 23.1-34.2); control: 23.0% (CI: 18.9-27.0)], mean haemoglobin, weight and age were similar among the intervention and control groups. While 1676 (99.1%) compounds in the control area were visited and 15,020 (96.58%) people were treated, only 1375 (88.5%) compounds in the intervention area were visited and 8454 (80.97%) people treated (P < 0.001). The numbers of adverse effects were similar (intervention: 50/6896; control: 130/15,020). The most reported adverse effects was headache (intervention: 14/50; control: 13/130), followed by body weakness, which was reported more from the intervention group (intervention: 13/50, 95% CI: 14.6-40.3; control: 6/130, 95% CI: 1.7-9.8]. Sixty-six per cent (6896/10,441) of the eligible population received praziquantel. CONCLUSIONS: Reported adverse events were mild and managed at the subdistrict level with no cases of hospitalization; intensive health education will, however, be required to improve coverage.


Asunto(s)
Filariasis Linfática/tratamiento farmacológico , Filaricidas/uso terapéutico , Oncocercosis/tratamiento farmacológico , Esquistosomiasis/tratamiento farmacológico , Adolescente , Albendazol/efectos adversos , Albendazol/uso terapéutico , Niño , Quimioterapia Combinada , Filariasis Linfática/epidemiología , Enfermedades Endémicas/prevención & control , Femenino , Filaricidas/efectos adversos , Ghana , Educación en Salud , Humanos , Ivermectina/efectos adversos , Ivermectina/uso terapéutico , Masculino , Oncocercosis/epidemiología , Praziquantel/administración & dosificación , Praziquantel/uso terapéutico , Población Rural , Esquistosomiasis/epidemiología
16.
J Infect Dis ; 202 Suppl: S231-8, 2010 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-20684709

RESUMEN

From October 2003 through September 2004, a total of 289 stool samples were collected from children <5 years of age who had severe diarrhea at admission to or when visiting the emergency department at the Navrongo War Memorial Hospital in rural Ghana during a study on rotavirus disease burden. Rotavirus antigen was detected in 115 stool samples (39.8%) tested for rotavirus. Four rotavirus-positive samples were found to bear G10P[6] specificity by reverse-transcription polymerase chain reaction, polymerase chain reaction-enzyme-linked immunosorbent assay, and oligonucleotide microarray hybridization. Two of these strains further exhibited serotype G10 specificity by neutralization and subgroup II specificity by enzyme immunoassay and possessed long electropheretic patterns by polyacrylamide gel electrophoresis. Their VP7 genes shared a much closer nucleotide identity with other African human G10 strains (>97%) than with human G10 strain from Asia or South America (<86%) or animal strains (<85%). The VP8* genes of the Ghanaian G10 strains exhibited >94% identity to that of human P[6] virus strains and belonged to the P[6] lineage 1a. The deduced VP7 amino acid sequence showed that the Ghanaian strains were more closely related to human G10 strains than to animal G10 strains. The possession of the typical human subgroup II specificity and the P[6] specificity (frequently found in Ghana and the rest of Africa) and the marked similarity in the VP7 antigenic sites suggest that these G10 strains may have evolved through genetic reassortment between bovine and human strains.


Asunto(s)
Diarrea/epidemiología , Diarrea/virología , Infecciones por Rotavirus/epidemiología , Infecciones por Rotavirus/virología , Rotavirus/aislamiento & purificación , Secuencia de Aminoácidos , Animales , Antígenos Virales/química , Antígenos Virales/genética , Proteínas de la Cápside/genética , Preescolar , Regulación Viral de la Expresión Génica , Ghana/epidemiología , Hospitalización , Humanos , Lactante , Datos de Secuencia Molecular , Filogenia , Proteínas de Unión al ARN/genética , Rotavirus/clasificación , Rotavirus/genética , Rotavirus/inmunología , Proteínas no Estructurales Virales/genética
17.
Drugs Real World Outcomes ; 8(3): 337-347, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33909271

RESUMEN

BACKGROUND: There is increasing public health concern regarding the addiction and dependence potential of tramadol. OBJECTIVE: This study sought to determine factors associated with tramadol abuse among commercial drivers and assistants in the Accra Metropolitan Area of Ghana. PATIENTS AND METHODS: The study employed a mixed-method quantitative and qualitative approach. It involved a cross-sectional survey and focus group discussions with commercial drivers and assistants at selected transport terminals in Accra. Data on abuse, reasons for abuse, sources of supply, and factors associated with abuse were collected from the respondents and analyzed using STATA and Nvivo, as appropriate. RESULTS: Of the 458 study participants, 114 (24.9%) indicated that they abused tramadol. The mean (± standard deviation) age of those who abused tramadol (25.14 ± 5.87 years) was significantly lower than that of nonabusers (28.23 ± 9.6 years), t(456) = -3.60; p = 0.001. The level of risk of dependence on tramadol among the abusers was high, as 49.1% (56/114) of abusers were estimated to have a composite risk score of ≥ 27. Various socioenvironmental factors, including tension or fighting among family members (adjusted odds ratio [AOR] 7.73; 95% confidence interval [CI] 3.33-17.98; p < 0.001), abuse of drugs by a family member (AOR 2.27; 95% CI 1.26-4.11; p = 0.007), and having a friend who abused drugs (AOR 2.17; 95% CI 1.22-3.89; p = 0.009) were associated with tramadol abuse. Reasons given for using tramadol included pain relief and sexual enhancement. CONCLUSION: The level of tramadol abuse and dependence was high. This calls for interventional programs, including health education, as dependency on tramadol has dire consequences on productivity.

18.
Arch Public Health ; 79(1): 177, 2021 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-34649606

RESUMEN

BACKGROUND: Ghana malaria control programme recommends the uptake of five doses of sulfadoxine pyrimethamine (SP) during pregnancy following the review of the World Health Organization recommendations in 2012. The uptake of higher doses of SP since the implementation of the new policy in 2016, has been low across the country. The current study determined factors that can be improved to increase uptake of SP for intermittent preventive treatment of malaria in pregnancy (IPTp-SP). METHODS: A cross-sectional analytical study was carried out among women who had just delivered in selected health facilities in the Sekondi-Takoradi Metropolis of Ghana. Participants were enrolled from the lying-in wards of the study facilities after delivery. Data including time of initiating antenatal care (ANC), number of visits, time of first dose of SP and number of doses were collected. ANC books were also reviewed. Logistic and ordered logistic regression analysis were done to determine respondent factors associated with uptake of IPTp-SP using Stata 15. RESULTS: Out of the 496 mothers who participated in the study, 370 (74.60%) initiated ANC during the first trimester, 123 (24.80%) during the second, with only three (0.60%) starting during the third trimester. Majority (463/496, 93.35%) made > 4 visits. Uptake of at least one dose of SP was 98.79% (490/496), ≥ 2 doses was 92.75 (460/496), ≥ 3 doses was 80.65% (400/496) and ≥ 4 doses was 40.32% (200/496). Uptake of IPTp 5 was very low (6.65%, 33/490). A unit increase of one ANC visit was associated with 20% higher odds of receiving 3-4 doses of SP with respect to receiving 1-2 doses (p <  0.001). The probability of receiving 5 or more doses of SP with respect to 1-2 doses was 26% higher with a unit increase of one ANC visit. CONCLUSION: Uptake of 3-4 doses and ≥ 5 doses of SP were associated with making more ANC visits. Encouraging and motivating expectant mothers to make more ANC visits can improve uptake of ≥5 doses of SP.

19.
Ital J Pediatr ; 47(1): 212, 2021 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-34711248

RESUMEN

BACKGROUND: Low birth weight (LBW) contributes significantly to infant and child mortality. Each year, about 20 1million deliveries are LBW with 96.5% occurring in developing countries. Whiles the incidence of LBW is reducing in other districts of Sierra Leone, it has been reported to be increasing in the Western Area Urban district. Determining the risk factors in a specific geographic area is important for identifying mothers at risk and thereby for planning and taking appropriate action. The current study sought to identify factors associated with LBW deliveries in the Western Area Urban district of Sierra Leone. METHODS: A hospital-based unmatched 1:2 case-control study was conducted among mothers who delivered live singleton babies from November, 2019 to February, 2020 in five referral health facilities. Mothers were conveniently sampled and sequentially enrolled into the study after delivery. Their antenatal care cards were reviewed and a pre-tested questionnaire administered to the mothers. Data analysis was done using Stata 15.0 and association between maternal socio-demographic, socio-economic, obstetric and lifestyle factors and LBW assessed using bivariable and multivariable logistic regression analyses. RESULTS: A total of 438 mothers (146 cases and 292 controls), mean age: 24.2 (±5.8) and 26.1 (±5.5) years for cases and controls respectively participated in the study. Multivariable analysis revealed that being unemployed (AoR = 2.52, 95% CI 1.16-5.49, p = 0.020), having anaemia during pregnancy (AoR = 3.88, 95% CI 1.90-7.90, p <  0.001), having less than 2 years inter-pregnancy interval (AoR = 2.53, 95% CI 1.11-5.73, p = 0.026), and smoking cigarettes during pregnancy (AoR = 4.36, 95% CI 1.94-9.80, p <  0.001) were significantly associated with having LBW babies. CONCLUSION: Factors associated with LBW identified were unemployment, anaemia during pregnancy, < 2 years inter-pregnancy interval and cigarette smoking during pregnancy. Health care providers should screen and sensitize mothers on the risk factors of LBW during antenatal sessions.


Asunto(s)
Recién Nacido de Bajo Peso , Adulto , Anemia/epidemiología , Intervalo entre Nacimientos , Estudios de Casos y Controles , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones del Embarazo/epidemiología , Sierra Leona/epidemiología , Fumar/epidemiología , Desempleo , Adulto Joven
20.
PLoS One ; 16(12): e0261192, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34914742

RESUMEN

BACKGROUND: The insecticide treated bed net (ITN) has been proven for malaria control. Evidence from systematic review also suggests benefits of ITN roll out in reducing the incidence of cutaneous leishmaniasis (CL) and other vector borne diseases. METHODS: Using a community-based cross-sectional study design, ITN use, factors associated with non-use of ITNs, and occurrence of sand flies were investigated in three communities with reported cases of CL in the Oti region of Ghana. RESULTS: A total of 587 households comprising 189 (32.2%), 200 (34.1%), and 198 (33.7%) households from Ashiabre, Keri, and Sibi Hilltop communities with de facto population of 3639 participated in this study. The proportion of households that owned at least one ITN was 97.1%. The number of households having at least one ITN for every two members was 386 (65.8%) and 3159 (86.8%) household population had access to ITN. The household population that slept in ITN the night before this survey was 2370 (65.1%). Lack of household access to ITN (AOR = 1.80; CI: 1.31, 2.47), having a family size of more than 10 members (AOR = 2.53; CI: 1.20, 4.24), having more than 10 rooms for sleeping in a household (AOR = 10.18; CI: 1.28, 81.00), having 2-4 screened windows (AOR = 1.49; CI: 1.00, 2.20), and having 8-10 screened windows (AOR = 3.57; CI: 1.25, 10.17) were significantly associated with increased odds of not sleeping in ITN the night before the survey. A total of 193 female sand flies were trapped from various locations within the study communities. CONCLUSIONS: Factors associated with ITN non-use such as lack of household access to ITN should be incorporated into future efforts to improve ITN use. Species of sand flies and their potential vectorial role in the study communities should also be investigated.


Asunto(s)
Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Leishmania/aislamiento & purificación , Leishmaniasis Cutánea/epidemiología , Malaria/complicaciones , Control de Mosquitos/métodos , Mosquitos Vectores/parasitología , Psychodidae/parasitología , Adulto , Anciano , Animales , Estudios Transversales , Composición Familiar , Femenino , Ghana/epidemiología , Humanos , Leishmaniasis Cutánea/parasitología , Malaria/parasitología , Masculino , Persona de Mediana Edad , Adulto Joven
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