Risk factors associated with COVID-19 morbidity and mortality at a national tertiary referral treatment centre in Ghana: a retrospective analysis

Introduction: there is a substantial variation in COVID-19 case fatality rates across different locations, which may be due to differences in population age structure, patient factors, or health system factors. The study evaluated the clinical features and risk of COVID-19 morbidity and mortality among confirmed cases at COVID-19 referral treatment centre. Methods: the study was a retrospective analysis of routine data of cases admitted and treated between March 2020 to March 2021 at Greater Accra Regional Hospital (Ridge Hospital). The data were analysed using descriptive statistics, simple and multiple logistic regression. Results: the overall mortality rate among this cohort of patients was 34.4%. Compared to survivors, non-survivors were older patients, non-insured, had a higher frequency of hypertension, diabetes, heart disease, and were more prone to suffer from a severe form of COVID-19 infection. Compared to survivors, non-survivors showed elevated levels of white blood cell count, platelets, higher heartbeat per minute and lower levels of haemoglobin, creatinine, and oxygen saturation. The independent risk factors for COVID-19 mortality in the national treatment centre were shorter stay of hospitalizations, having a heart disease, difficulty in breathing, increased in concentration of platelets, and creatinine. A 1% increase in oxygen saturation decreased a patient's likelihood of dying from COVID-19 by 29.0%. Conclusion: this study showed COVID-19 mortality was associated with a shorter stay in hospital, having heart disease, dyspnoea, elevated levels of platelets and creatinine, and decreased oxygen saturation. There is a need for awareness creation about these risk factors to clinicians and public health officials.

Seroprevalence of Taenia solium and Trichinella spiralis among Humans and Pigs in Ghana.

In this study, the seroprevalence of the intestinal worms Taenia solium and Trichinella spiralis in humans and pigs was assessed. A cross-sectional serological study design was performed. Blood samples were collected from 322 humans and 245 pigs used in the study. These were tested for markers of antibodies for Taenia solium and Trichinella spp. Demographic data such as sex, age, education, pig farming practices, and water source used were also obtained. An overall seroprevalence of 3.1% was recorded for Taenia solium in humans. There was also a statistical association between pig management system employed by pig farmers and seropositivity to Taenia solium (p = 0.005). Factors such as mode of waste disposal (p = 0.003) and water source used statistically correlated with Taenia solium seroprevalence among humans. For the pig samples, a Taenia solium seroprevalence of 24.9% was recorded. All the pig samples which tested positive for Taenia solium were reared on the free-ranged system. This study also recorded a seroprevalence of 0.31% for Trichinella spp. for humans and a seroprevalence of 4.5% for Trichinella spp. for pigs. Again, all the samples that showed serological evidence of Trichinella spp. among pigs came from those pigs which were raised on the free-ranged system. Proper pig management practice is a very important tool for controlling these intestinal parasites in both humans and animals. This study recommends public health education among the general public and good pig farming practices.

Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study.

Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.

Clinical characteristics, treatment regimen and duration of hospitalization among COVID-19 patients in Ghana: a retrospective cohort study.

INTRODUCTION: COVID-19 is a global pandemic seen in modern times. The clinical characteristics, treatment regimen and duration of hospitalization of COVID-19 patients remain unclear in Ghana. METHODS: we retrospectively reviewed the secondary data of 307 discharged COVID-19 patients to characterize their demographics, clinical symptoms, treatment regimen given and duration of hospitalization. RESULTS: the mean age and temperature of the patients were 37.9 years and 36.3°C, respectively. The majority (85.7%) of the cases reviewed were asymptomatic; for those presenting with symptoms, the main ones were cough (50%), fever (29.6%), headache (27.3%), and sore throat (22.7%). Comorbidities were present in 25.1% of the patients; the popularly reported comorbidities were hypertension (71.4%), asthma (7.8%) and diabetes (6.5%). The average duration of hospitalization was 13.8 days, and the duration of hospitalization for patients managed with azithromycin + chloroquine (AZ+CQ) was 10.4 days, followed closely by those managed with hydroxychloroquine (HCQ) only, 11.0 days. There was longer duration of hospitalization among patients who received AZ only compared to patients receiving AZ + CQ (3.24 ± 1.10 days, p=0.037; 95% CI 0.11, 6.37). Linear regression analysis showed that the duration of hospitalization for patients who received AZ only was 2.7 days, which was higher than that of patients who received AZ+CQ and HCQ only (95% CI 0.44, 4.93; p=0.019). CONCLUSION: in this cohort of COVID-19 patients, the common symptoms were cough, fever, headache, and sore throat. The use of AZ+CQ or HCQ only as a therapy for managing COVID-19 patients shortened the duration of hospitalization.

Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana.

BACKGROUND: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. OBJECTIVE: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. METHODS: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. RESULTS: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master's degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). CONCLUSION: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.

Consumer Preference and Quality of Sachet Water Sold and Consumed in the Sunyani Municipality of Ghana.

Good quality water is odourless, colourless, and free from faecal pollution, and a satisfactory safe supply must be made available to consumers. The study assessed consumer preference and quality of sachet water sold and consumed in the Sunyani Municipality of Ghana. A cross-sectional study design was used, and data were collected using a structured questionnaire from a sample size of 500 respondents. A total of twenty (20) samples of sachet water commonly sold and consumed in the Sunyani Municipality were also collected and analyzed for bacteriological and physicochemical parameters. Out of these 20 samples, 10 samples of sachet water were collected from the production site and the other 10 samples from the market site. Results showed that respondents' choice of sachet water was based on several indicators. While 70% (350/500) of consumers indicated that sachet water had taste, 58% (290/500) of them were not enthused when the water had colour. Using smell as an indicator, 71% of consumers have had an experience with sachet water smell being questionable. Water taste (p < 0.001), colour of water (p < 0.001), smell (p < 0.001), and increase in cost (p < 0.001) were found as determinants of consumer preference. Consumers who said the colour of water informed their decision when buying sachet water were seven times more likely to have a preference for a particular brand (OR 7.057, CI: 4.474-11.133). Those who checked for expiry dates when buying water (OR 4.871, CI: 3.110-7.628) and those who looked out for Food and Drugs Authority stamp (OR 4.433, CI: 2.806-7.003) were both four times more likely to have a preference for a particular brand. Water quality tests also indicated that 30% of all water samples collected from the production site were contaminated with total coliforms and 50% of sachet water samples collected from the markets were also contaminated with coliforms. The same brands of sachet water that contained total coliforms from the production site were the same brands that contained total coliforms selected from the market. From this study, only total coliforms other than Escherichia coli were detected in the water samples analyzed. It was observed that the evaluated physicochemical parameters of the water analyzed were within the accepted WHO limits. It is recommended that consumers be educated about the indicators to look out for when buying sachet water and, also, that regulatory bodies be empowered to ban the sale of unwholesome brands of sachet water on the market.