Awareness of and participation in mass drug administration programs used for onchocerciasis control in the Atwima Nwabiagya North District, Ghana.

BACKGROUND: Studies on Mass drug administration (MDA) in Ghana targeting various diseases, have mostly focused on factors that affect coverage and compliance to MDA with limited focus on evidence regarding awareness and community perception of the program. Therefore, this study sought to provide empirical evidence on the knowledge of onchocerciasis, and awareness of and participation in the MDA among community members. METHODS: A community-based cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District, Ghana. Data was collected from 2,008 respondents. Bivariate and multivariate logistic regression analyses were performed to measure the associations between socio-demographics, having heard of onchocerciasis and its prevention, and levels of awareness of the MDA program. RESULTS: A total of 1268 respondents (63.2%) were aware of the MDA program. The majority ofMost respondents (74.4%) were of the view that the information given about the program was not enough and 45.4% of the respondents had no idea about the relevance of the MDA program. Respondents who had ever heard about onchocerciasis prevention and persons who had previously participated in the MDA program were more likely to be aware of the MDA program during implementation (AOR = 2.32; 95% CI 1.79-3.01 and AOR = 9.31; 95% CI 7.06-12.26, respectively). CONCLUSIONS: We observed a significant association between being aware of MDA campaigns and knowledge of onchocerciasis and its preventive methods, and participation in previous MDA campaigns. We recommend intensification and improvement of prevention campaigns regarding the onchocerciasis MDA program as key to ensuring increased MDA program participation.

Hospitalizations among children with sickle cell disease enrolled in the Kumasi Sickle Cell Pan African Consortium (SPARCo) database: A cross sectional study.

Background and Aims: Sickle cell disease (SCD) is the commonest monogenic haemolytic disorder in Africa. Despite strides made in its management, a significant proportion of patients are hospitalized from the various complications of the disease. This study set out to describe the main causes and outcomes of hospitalizations among pediatric patients with SCD. Methods: A cross-sectional study was conducted at the Pediatric Emergency Unit of Komfo Anokye Teaching Hospital within a period of 12 months to recruit pediatric SCD patients. This study looked at causes of admission, length of hospital stay (LOS), and outcome of admission. Results: Of the 201 SCD patients recruited, 57.2% were males and majority were of SCD-SS phenotype 83.1%. The median age was 6 years. The three leading causes of hospitalization were Vaso-occlusive pain events (VOPE) (39.8%), acute chest syndrome (ACS) (25.9%), and infections (12.4%). Ten (5.0%) of the patients presented with a stroke. High admissions were observed in June (12.4%) and November (16.9%). The median (interquartile range [IQR]) LOS was 6 days (IQR: 4-10). Six (3.0%) of the patients died from complications of the disease during hospitalization. Conclusion: VOPE, ACS, infections, and acute anaemia from hyperhaemolysis were observed as the most common causes of admissions among SCD patients. A good outcome of discharge was seen in most of the patients that were hospitalized with a median length of stay of 6 days. This study also strengthens the importance of a good SCD database with patient follow-ups for better outcomes in SCD patients.

Training Traditional Bonesetters in Basic Principles of Fracture Treatment: A Proof of Concept in Ghana.

BACKGROUND: Our study assessed the effectiveness of a traditional bonesetter (TBS) educational program that was designed to increase knowledge, reduce complications, and promote the referral of patients to local hospitals by TBSs when necessary. METHODS: From April to December 2021, TBSs from the Northern Sector (the Northern, Savannah, and North East regions) and the Ashanti region of Ghana underwent a 4-day training course that had been designed to teach basic principles of fracture care with the use of local tools. We assessed the levels of knowledge of the TBSs both before and after training. The change in practice of the trained TBSs also was assessed at 6 months using a structured questionnaire and a checklist. RESULTS: In total, 157 TBSs were trained in 5 training sessions over a 9-month period. There was an improvement in knowledge in all of the modules of training, with an overall knowledge gain of 19.7% (from 67.2% to 86.9%). At 6 months of follow-up, the practices of TBSs that had most improved were record-keeping, hand hygiene, and patient rehabilitation. As a result of the referral system that was established by the training project, a total of 37 patients were referred to local hospitals in the 6 months following the training. CONCLUSIONS: Formal training for TBSs that was provided by a multidisciplinary team with use of a locally developed curriculum and tools was effective in improving the practice and outcomes of treatment by TBSs. There was marked knowledge retention by the trained TBSs at 6 months after training in fracture management. CLINICAL RELEVANCE: Education, training, and the establishment of referral pathways between TBSs and local hospitals could improve trauma care in Ghana.

Iron stores in steady-state sickle cell disease children accessing care at a sickle cell disease clinic in Kumasi, Ghana: A cross-sectional study.

Background and Aims: Children with sickle cell disease (SCD) have an increased risk of multiple hemotransfusions and this can predispose them to elevated iron stores. The objectives of the study were to determine the extent of elevated iron stores and the associated risk factors in a population of steady-state SCD children in Ghana. Methods: This cross-sectional study was conducted at the pediatric sickle cell clinic at the Komfo Anokye Teaching Hospital. Complete blood count and serum ferritin assay were performed for (n = 178) steady-state SCD children. Descriptive and multivariate logistic regression analysis were performed. Elevated iron stores were defined as serum ferritin levels >300 ng/ml. Statistical significance was considered at p < 0.05. Results: The mean (standard deviation) age of the participants was 9.61 (±4.34) years, and 51% of them were males. About 17% of SCD children had elevated iron stores and receiving at least three hemotransfusions during the last 12 months was strongly associated with elevated iron stores (p < 0.001). History of chronic hemotransfusion increased the odds of having elevated iron store (adjusted odds ratio [aOR] = 11.41; 95% confidence interval [CI] = 3.11-30.85; p < 0.001) but SCD patients on hydroxyurea treatment had reduced-odds of having elevated iron stores (aOR = 0.18; 95% CI = 0.06-0.602; p = 0.006). Moreover, red blood cell (Coef. = -0.84; 95% CI = -0.37, -1.32; p = 0.001), hemoglobin (Coef. = -0.83; 95% CI = -0.05, -1.61; p = 0.04), hematocrit (Coef. = -0.85; 95% CI = -0.08, -1.63; p = 0.03), mean cell volume (Coef. = 0.02; 95% CI = 0.01, 0.03; p = 0.001) and mean cell hemoglobin (Coef. = 0.04; 95% CI = 0.01, 0.07; p = 0.002) could significantly predict serum ferritin levels. Conclusion: The magnitude of elevated iron stores was high among children with SCD in steady-state. Red cell indices could provide invaluable information regarding the risk of elevated iron stores. SCD children who have a history of chronic hemotransfusion or had received at least three hemotransfusions in a year should be monitored for elevated iron stores.

Mass drug administration targeting Onchocerca volvulus in Owabi catchment area in Ashanti Region, Ghana: Determinants of drug coverage and drug uptake.

INTRODUCTION: Achieving high Mass Drug Administration (MDA) coverage and drug uptake are pivotal in the efforts to eradicate onchocerciasis. The present study investigated the extent and predictors of ivermectin MDA coverage and uptake from the individual and healthcare providers' perspectives. The extent of ivermectin distribution and uptake, and the predictors of distribution and uptake were investigated in endemic communities in the Ashanti Region of Ghana. METHODS: A cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District. A total of 2008 respondents were interviewed. Data was collected with REDCap mobile App which had an electronic version of the structured questionnaire. Descriptive data was presented in frequency tables, and bivariate and multivariate logistics regression analysis were performed to measure the associations between exposure variables and outcome variables which were received and uptake of MDA drugs. RESULTS: A total of 1284 (63.9%) respondents did not receive ivermectin during the 2019 MDA programme and more than half of them were not aware of the drug distribution (53.3%). The most common reasons for not ingesting the drug were fear of side effects (47.7%) and not trusting the drug distributors (20.0%). Respondents in the age group 48-57 years (AOR = 1.37; 95%CI: 1.01-2.67), Persons in the high wealth index (AOR = 1.40; 95%CI: 1.11-1.77), Being aware of the MDA programme (AOR = 6.67: 95%CI: 4.76-9.35), MDA being beneficial (AOR = 2.12; 95%CI: 1.54-2.92) participating in previous MDA (AOR = 5.44; 95%CI: 4.25-6.98) and having stayed in the communities for 10 years and above significantly increased the odds of receiving MDA drugs. Previous uptake of MDA drugs (AOR = 10.58; 95%CI: 5.78-19.38) and perception of the MDA drug as beneficial (AOR = 5.25; 95%CI: 2.55-10.82) increased the likelihood of ingesting drugs when received. CONCLUSION: The main health system challenge was limited awareness creation regarding MDA. This seems to affect the optimal utilization of the ivermectin MDA intervention. MDA programmes against onchocerciasis eradication should be designed taking into account specific contextual factors to improve implementation outcomes.

Treatment Outcomes and Associated Factors in Tuberculosis Patients at Atwima Nwabiagya District, Ashanti Region, Ghana: A Ten-Year Retrospective Study.

INTRODUCTION: Tuberculosis poses a great threat to public health around the globe and affects persons mostly in their productive age, notwithstanding; everyone is susceptible to tuberculosis (TB) infection. To assess the effectiveness and performance of the tuberculosis control program activities, the percentage of cases with treatment success outcome is key. To control tuberculosis, interrupting transmission through effective treatment cannot be overemphasized. The study was conducted to determine factors associated with TB treatment outcome, in the Atwima Nwabiagya District from 2007-2017. METHOD: A Retrospective review of routine/standard TB registers was carried out in five directly observed therapy short-course (DOTS) centres at the Atwima Nwabiagya District from January 2007 to December 2017. Demographic characteristics, clinical characteristics, and treatment outcomes were assessed. Bivariate and multivariate logistic regression was conducted to determine the predictors of successful treatment outcome. RESULTS: Of the 891 TB client's data that was assessed in the district, the treatment success rate was 68.46%. Patients, aged ≤ 20 years (adjusted odds ratio (aOR) = 4.74, 95%CI = 1.75 - 12.83) and 51-60 years (aOR = 1.94, 95%CI = 1.12 - 3.39), having a pretreatment weight of 35-45 kg (aOR = 2.54, 95%CI = 1.32 - 4.87), 46-55 kg (aOR = 2.75, 95%CI = 1.44 - 5.27) and 56-65 kg (aOR = 3.04, 95%CI = 1.50 - 6.14) were associated with treatment success. However, retreatment patients (aOR = 0.31, 95%CI = 0.11 - 0.84) resulted in unsuccessful treatment outcome. CONCLUSION: Successful treatment outcome among TB patients was about 20.00% and 30.00% lower compared to the national average treatment success rate and WHO target, respectively. Active monitoring, motivation, and counselling of retreatment patients and patients with advanced age are key to treatment success.

Self-Esteem Assessment among Adolescents Living with HIV and Seeking Healthcare at Komfo Anokye Teaching Hospital-Kumasi, Ghana.

BACKGROUND: This study assessed the predictors of self-esteem among Adolescents Living with HIV (ALHIV) in Ghana seeking healthcare at Komfo Anokye Teaching Hospital. METHODS: A cross-sectional study was employed in sampling 139 adolescents using a purposive sampling technique. Rosenberg's rating scale was used in assessing the self-esteem of the participants. RESULTS: A total of 139 adolescents made up of 78 (56.12%) females and 61 (43.88%) males were recruited. Low self-esteem was reported among 66 (47.00%) of the adolescents. Adolescents aged 17-19 years (aOR = 2.97, 95%CI = 1.34-6.56, p = 0.007) were significantly associated with low self-esteem. CONCLUSION: The occurrence of low self-esteem among ALHIV was high and more pronounced among those in age cohorts of 17 to 19 years. Social support interventions designed which includes psychosocial support, life skills training, and avenue for discussing sexual and reproductive health matters could improve self-esteem.