Prevalence and associated factors of occupational injuries in an industrial city in Ghana.

BACKGROUND: Workers are exposed to workplace hazards which increase their risk of occupational injury. Data on occupational injuries and associated factors are important for planning and informing national policy regarding workplace health and safety. This study sought to estimate the prevalence and factors associated with occupational injuries among workers in an industrial city in Ghana. METHODS: A community-based cross-sectional survey was conducted among 459 workers in the Tema industrial enclave in Ghana from 22nd December 2020 to 27th February 2021. Participants were recruited using a two-stage sampling technique. Eight communities were randomly selected from twenty-five communities in the first stage while households in each community were randomly selected in the second stage. Data on socio-demographic characteristics, occupational health and safety and occupational injuries were collected. Logistic regression was used to examine the relationship between occupational injuries and associated factors. RESULTS: The mean age of the workers was 33.9 (±6.8) years with a range of 21-53 while over 18.1% of them were working at the Port and Harbour. The prevalence of occupational injury among the workers in the preceding twelve months was 64.7%. The mechanism of injury was mainly the use of working tools (45.8%) and hot surfaces, substances or chemicals (14.1%). Being a casual staff (AOR: 2.26, 95%CI: 1.04-4.92), working at Port and Harbour (AOR: 3.77, 95%CI: 1.70-8.39), no health and safety training (AOR: 2.18, 95%CI: 1.08-4.39), dissatisfaction with health and safety measures (AOR: 4.31, 95%CI: 2.12-8.78) and tertiary education (AOR: 0.03, 95%CI: 0.01-0.10) were significantly associated with occupational injuries. CONCLUSION: The prevalence of occupational injuries in this study was high. Promoting machine tools' safety, health and safety training, and satisfaction with health and safety measures through rewarding workers who do not sustain injuries could be key to employees' health and safety.

Survival trends among people living with human immunodeficiency virus on antiretroviral treatment in two rural districts in Ghana.

BACKGROUND: The human immunodeficiency virus (HIV) has caused a lot of havoc since the early 1970s, affecting 37.6 million people worldwide. The 90-90-90 treatment policy was adopted in Ghana in 2015 with the overall aim to end new infections by 2030, and to improve the life expectancy of HIV seropositive individuals. With the scale-up of Highly Active Antiretroviral Therapy, the lifespan of People Living with HIV (PLWH) on antiretrovirals (ARVs) is expected to improve. In rural districts in Ghana, little is known about the survival probabilities of PLWH on ARVs. Hence, this study was conducted to estimate the survival trends of PLWH on ARVs. METHODS: A retrospective evaluation of data gathered across ARV centres within Tatale and Zabzugu districts in Ghana from 2016 to 2020 among PLWH on ARVs. A total of 261 participants were recruited for the study. The data was analyzed using STATA software version 16.0. Lifetable analysis and Kaplan-Meier graph were used to assess the survival probabilities. "Stptime" per 1000 person-years and the competing risk regression were used to evaluate mortality rates and risk. RESULTS: The cumulative survival probability was 0.8847 (95% CI: 0.8334-0.9209). The overall mortality rate was 51.89 (95% CI: 36.89-72.97) per 1000 person-years. WHO stage III and IV [AHR: 4.25 (95%CI: 1.6-9.71) p = 0.001] as well as age group (50+ years) [AHR: 5.02 (95% CI: 1.78-14.13) p = 0.002] were associated with mortality. CONCLUSION: Survival probabilities were high among the population of PLWH in Tatale and Zabzugu with declining mortality rates. Clinicians should provide critical attention and care to patients at HIV WHO stages III and IV and intensify HIV screening at all entry points since early diagnosis is associated with high survival probabilities.

Prevalence and correlates of depression among students in a senior high school in Ghana: A school-based cross-sectional study.

Objectives: Depression is one of the most widely reported mental health issues that affect adolescents globally. However, there is a dearth of data on its prevalence and associated factors among senior high school students in Ghana, since previous studies have focused more on adult populations. This can hinder policies needed to champion mental health and mental health care in senior high schools. Hence, this study sought to assess the prevalence of depression and associated factors among senior high school students in Ghana. Methods: An analytical cross-sectional study involving 289 students at the Manya Krobo Senior High School was conducted from December 2022 to February 2023. The students were selected using a two-stage random sampling method. A questionnaire was used to collect data on sociodemographics and individual characteristics. The primary outcome was depression, and this was assessed using the Patient Health Questionnaire-9. Summary statistics were presented as means, frequencies, and percentages. Multivariate logistic regression was used to identify factors associated with depression and odds ratios presented with 95% confidence intervals. Statistical significance was considered at p-value < 0.05. Results: The mean age of the students was 16.6 (±1.2) with a range of 14-20 years. Over a quarter (26.3%) of the students reported financial difficulties. The prevalence of depression among the students was 68.9%. The factors associated with depression in this study were female sex (adjusted odds ratio: 1.74, 95% confidence interval: 1.01-2.97), age (adjusted odds ratio: 1.41, 95% confidence interval: 1.10-1.81), history of chronic health condition (adjusted odds ratio: 3.74, 95% confidence interval: 1.36-10.25), and financial difficulties (adjusted odds ratio: 2.31, 95% confidence interval: 1.15-4.63). Conclusion: This study shows that depression is rife among students at the Manya Krobo Senior High School, Manya Krobo District, Ghana. These findings call for pragmatic interventions such as strengthening counseling units and professional mental health services to ameliorate the impact of depression on the lives of students.

Health and safety of health workers in the Suame Municipality of Ghana - Lessons learnt from the COVID-19 outbreak in infection prevention and control for future pandemics.

Objectives: Effective adherence to infection prevention and control practices is needed to reduce the rate of healthcare-acquired infections among healthcare workers. Policies to control healthcare-acquired infections among healthcare workers can be designed and implemented using information on adherence to infection prevention and control practices adherence and its determinants. This study, therefore, sought to assess the adherence to infection prevention and control practices among healthcare workers during the 2019 Coronavirus disease pandemic. Methods: A multicentre cross-sectional study was conducted among 323 randomly selected healthcare workers in four health facilities in the Suame Municipality, Ghana. Data on participants' socio-demographics, knowledge of infection prevention and control practices and adherence to infection prevention and control practices were collected using a pre-tested structured questionnaire. Multivariate logistic regression analysis was used to examine the effect of demographic characteristics and knowledge of infection prevention and control on adherence to infection prevention and control practices among study participants. Results: Over three-quarters (75.9%) of the study participants had adequate knowledge of infection prevention and control practices with a significant knowledge gap in the colour coding of bin liners for waste segregation (35.6%). The proportion of study participants who reported good adherence to infection prevention and control practices was 86.7%. Healthcare workers who were 33 years and above (Adjusted odds ratio (AOR): 0.27; 95% Confidence interval (CI): 0.08-0.92) and absence of an infection prevention and control committee at the facility AOR: 0.25; 95% CI: 0.08-0.73) had reduced odds of good adherence to infection prevention and control practices. Nursing staff (AOR: 9.49, 95% CI: 2.51-35.87) and having adequate knowledge of infection prevention and control practices (AOR: 2.66; 95% CI: 1.19-5.97) were associated with increased odds of good adherence to infection prevention and control practices. Conclusion: Adherence to infection prevention and control practices was high among this sample of Ghanaian healthcare workers. Interventions and strategies to improve adherence should include the setting up of infection prevention and control committees, education and strict observance of colour coding of bin liners for waste segregation and intensification of training of healthcare workers in infection prevention and control practices.

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.

Antiplasmodial Activity of ß-Ionone and the Effect of the Compound on Amelioration of Anaemia and Oxidative Organ Damage in Mice Infected with Plasmodium berghei.

INTRODUCTION: Owing to evolution of parasite strains that are resistant to existing antimalarial drugs, research for novel antimalarial medicines is progressing on numerous fronts. PURPOSE: Herein, we evaluated the in vivo anti-Plasmodium berghei activity of ß-ionone including its ameliorative potential towards P. berghei-associated anaemia and oxidative organ damage. METHODS: Mice were infected with chloroquine-sensitive strain of P. berghei and then treated with ß-ionone at doses of 10 and 20 mg/kg body weight (BW) for seven days. The parasitemia, packed cell volume and redox sensitive biomarkers in the liver, brain and spleen were estimated. RESULTS: Our result showed that ß-ionone, in a dose-dependent fashion, significantly (p < 0.05) repressed the multiplication of P. berghei. More so, the compound, at doses of 10 and 20 mg/kg BW, significantly (p < 0.05) mitigated anaemia and organ damage induced by P. berghei. CONCLUSION: Overall, the findings demonstrated that ß-ionone has antiplasmodial actions and plays a mitigative role against P. berghei-induced anaemia and oxidative organ damage.

Fetal outcomes and their correlates following caesarian section in a rural setting in Ghana.

BACKGROUND: Regular evaluation of caesarean section (CS) is required due to their rising trend and outcomes. Many women recently opt for elective CS, even in resource-constrained settings. Data evaluating the outcomes of CS is however sparse. Hence, this study sought to determine the rate of fetal mortalities and their determinants following CS in the Tatale District Hospital of the Northern Region, Ghana. METHODS: A retrospective cross-sectional study was employed to analyze the medical records of 275 women who underwent CS from 2019 to 2021. Data were collected from the hospital's record of CS cases from 2019 to 2021. Descriptive statistics were used to summarize the data and Pearson's chi-square/Fisher's exact test was used to examine the relationship between maternal and obstetric characteristics and fetal mortality. At a 95% confidence interval (95% CI), logistic regression was fitted to assess significant variables and reported the results using odds ratio. RESULTS: Of 1667 deliveries, 16.5% of the mothers gave birth by CS. A fetal mortality rate of 76.4 per 1000 total births was recorded following CS. Babies born with low Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores (0-3) at fifth-minute had an increased risk of fetal mortality (AOR = 523.19, 95%CI: 49.24-5559.37, p = <0.001). Having a history of previous CS, cephalopelvic disproportion and delayed labour were the major indications for CS. CONCLUSION: Overall, this study found a high rate of CS based on the World Health Organization's recommended CS rate. Interventions such as reducing the waiting time for surgery and early diagnosis of the need for CS, and ensuring the availability of modern equipment to resuscitate infants with low APGAR scores can significantly improve fetal outcomes following CS.

Therapeutic activity of eugenol towards mitigation of anaemia and oxidative organ damage caused by Plasmodium berghei.

The parasite responsible for causing malaria infection, Plasmodium, is known to exhibit resistance to a number of already available treatments. This has prompted the continue search for new antimalarial drugs ranging from medicinal plant parts to synthetic compounds. In lieu of this, the mitigative action of the bioactive compound, eugenol towards P. berghei-induced anaemia and oxidative organ damage was investigated following a demonstration of in vitro and in vivo antiplasmodial effects. Mice were infected with chloroquine-sensitive strain of P. berghei and thereafter treated with eugenol at doses of 10 and 20 mg/kg body weight (BW) for seven days. The packed cell volume and redox sensitive biomarkers in the liver, brain and spleen were measured. Our result demonstrated that eugenol significantly (p < 0.05) ameliorated the P. berghei-associated anaemia at a dose of 10 mg/kg BW. In addition, the compound, at a dose of 10 mg/kg BW, significantly (p < 0.05) alleviated the P. berghei-induced organ damage. This evidently confirmed that eugenol plays an ameliorative role towards P. berghei-related pathological alterations. Hence, the study opens up a new therapeutic use of eugenol against plasmodium parasite.

Effects of packing (load carrying) on body temperatures and their circadian rhythms in donkeys (Equus asinus) during the hot-dry season.

The study aimed to evaluate the effects of packing (load carrying) on rectal and body surface temperatures and their circadian rhythmicity in donkeys during the hot-dry season. Twenty pack donkeys of both sexes (15 males and 5 non-pregnant females), aged 2-3 years, with average weight of 93 ± 2.7 kg and divided into two groups randomly, served as experimental subjects. Group 1 donkeys (packing + trekking) were subjected to packing in addition to trekking, while group 2 (trekking only) did not carry any load. All the donkeys were trekked, covering a distance of 20 km. The procedure was repeated three times within the week, one day apart. During the experiment, dry-bulb temperature (DBT), relative humidity (RH) and temperature-humidity index (THI), wind speed and topsoil temperature were recorded; and rectal temperature (RT) and body surface temperature (BST) were measured before and immediately after packing. Starting from 16 h after the last packing, circadian rhythms of RT and BST were recorded at 3-h intervals for 27-h period. The RT and BST were measured by digital thermometer and non-contact infrared thermometer, respectively. The DBT and RH, especially after packing (35.83 ± 0.2 °C and 20.00 ± 0.0%, respectively), were outside the thermoneutral zone for donkeys. The RT value (38.63 ± 0.1 °C) in packing + trekking donkeys recorded immediately (15 min) after packing was higher (P < 0.05) than the value obtained in trekking only donkeys (37.27 ± 0.1 °C). The overall mean RT recorded during the continuous 27-h period of measurement, starting from 16 h after the last packing procedure was higher (P < 0.05) in packing + trekking donkeys (36.93 ± 0.2 °C) compared with trekking only donkeys (36.29 ± 0.3 °C). The BSTs recorded in both groups were higher (P < 0.05) immediately after packing when compared with pre-packing values, but insignificant 16-h post-packing. The RT and BST values were generally higher in the photophase and lower during the scotophase in both groups of donkeys during the continuous recordings. The eye temperature was the closest to the RT, followed by scapular temperature, while the coronary band temperature was the farthest. The mesor of RT in packing + trekking donkeys (37.06 ± 0.2 °C) was significantly higher than in donkeys that were trekked only (36.46 ± 0.1 °C). The amplitude of RT in trekking only donkeys (1.20 ± 0.1 °C) was wider (P < 0.05) than that obtained in packing + trekking donkeys (0.80 ± 0.1 °C). The acrophase and bathyphase occurred later in packing + trekking donkeys (18:10 ± 0.3 h and 6:10 ± 0.3 h, respectively), compared to the trekking only donkeys (16:50 ± 0.2 h and 4:50 ± 0.2 h, respectively). In conclusion, exposure to thermally stressful prevailing environmental conditions during packing increased the body temperature responses, especially in packing + trekking donkeys. Packing significantly influenced the circadian rhythms of body temperatures in working donkeys, as evidenced by differences in circadian rhythm parameters in packing + trekking group, compared with trekking only donkeys during the hot-dry season.

Biological functions and structural biology of Plasmodium falciparum autophagy-related proteins: The under-explored options for novel antimalarial drug design.

Malaria remains a threat to global public health and the available antimalarial drugs are undermined by side effects and parasite resistance, suggesting an emphasis on new potential targets. Among the novel targets, Plasmodium falciparum autophagy-related proteins (PfAtg) remain a priority. In this paper, we reviewed the existing knowledge on the functions and structural biology of PfAtg including the compounds with inhibitory activity toward P. falciparum Atg8-Atg3 protein-protein interaction (PfAtg8-PfAtg3 PPI). A total of five PfAtg (PfAtg5, PfAtg8, PfAtg12, PfAtg18, and Rab7) were observed to have autophagic and/or non-autophagic roles. Available data showed that PfAtg8 has conserved hydrophobic pockets, which allows it to interact with PfAtg3 to form PfAtg8-PfAtg3 PPI. Additionally, 2-bromo-N-(4-pyridin-2-yl-1,3-thiazol-2-yl) benzamide was identified as the most powerful inhibitor of PfAtg8-PfAtg3 PPI. Due to the dearth of knowledge in this field, we hope that the article would open an avenue to further research on the remaining PfAtg as possible drug candidates.

Effects of melatonin on hematologic and biochemical changes and the effects of circadian rhythm on hematologic changes in donkeys (Equus asinus) subjected to packing during the hot-dry season.

BACKGROUND: Melatonin is a hormone with antioxidant and anti-inflammatory properties and may alleviate the effects of stress on hematologic and biochemical analytes in working donkeys that pack (load-carry). OBJECTIVES: We aimed to evaluate the effects of melatonin administration on hematologic and biochemical responses in donkeys subjected to packing during the hot-dry season. We also examined its effects on circadian rhythms. METHODS: Ten male Nubian pack donkeys with (Packing + Melatonin; P + M) and without melatonin (Packing-Melatonin; P-M) administration were included. Blood samples were collected before, immediately after (15 min), and from 16 h to over 27-h postpacking at 3-h intervals for hematologic and total protein analyses. Serum from blood samples collected before and immediately after packing was analyzed for muscle enzyme activities and electrolyte concentrations. Student's t-test, one-way ANOVA, and online cosinor analysis were used for statistical analyses. RESULTS: Packed cell volumes (PCVs) of the P + M donkeys did not differ before and after packing. However, for the P-M donkeys, values before packing (30.20 ± 0.8%) were higher than those (26.87 ± 0.5%) after packing. The hematologic values recorded in the P + M donkeys were higher than those in the P-M donkeys, especially during the scotophase (P Ë‚ 0.05). The mesor PCV, hemoglobin (Hb), and red blood cell (RBC) values for the P + M donkeys were significantly (P Ë‚ 0.05) higher than those in the P-M donkeys. Lactate dehydrogenase (LDH) activity was not different before (289.40 ± 60.8 U/L) or after packing (323.20 ± 36.0 U/L) in P + M donkeys, but the activity was significantly (P Ë‚ 0.05) higher postpacking than prepacking in the P-M donkeys (294.20 ± 66.9 U/L and 513.40 ± 68.5 U/L, respectively). The relationships between the meteorologic parameters and PCV, Hb, and RBC concentrations in the P + M donkeys were significantly negative (P Ë‚ 0.05). CONCLUSIONS: Melatonin prevented a decrease in PCV and increase in LDH activity immediately after packing compared with non-treated donkeys. There was a marked effect during the scotophase on PCV, Hb, and RBC concentrations. The circadian parameters indicated a significant effect of melatonin on the rhythmicity of the PCV, Hb, and RBC concentration in the treated donkeys. Melatonin administration may reduce the risk of adverse effects of environmental stress and stress due to packing in donkeys during the hot-dry season.

Evaluating Khaya senegalensis for Dipeptidyl Peptidase-IV Inhibition Using in Vitro Analysis and Molecular Dynamic Simulation of Identified Bioactive Compounds.

The dipeptidyl peptidase-IV (DPP-IV) inhibitory activity of Khaya senegalensis extracts was evaluated. The DPP-IV from a rat kidney was purified to a purification fold of 2.3. Among extracts from K. senegalensis, the hexane extract had the best DPP-IV inhibitory activity, with IC50 value of 1.56±0.61 µg/mL and was fractionated to eleven fractions (A-K). Fraction I had the best DPP-IV inhibition via uncompetitive pattern. GC-MS analysis of fraction I showed that the major bioactive compounds were 3-amino-3-hydroxyimino-N-phenylpropanamide (1) and 11-(2-cyclopenten-1-yl)undecanoic acid (2), with good binding affinities toward DPP-IV, based on molecular docking,. They were then subjected to molecular dynamic simulation using WEBGRO and utilizing a GROMACS system for 100 ns. The 3-amino-3-hydroxyimino-N-phenylpropanamide-DPP-IV complex was more stable and compact than the other complex. K. senegalensis contains compounds like 1 that might be used for the design of new DPP-IV inhibitors.

The burden and predictors of late antenatal booking in a rural setting in Ghana.

AIM: The aim of the study was to determine the prevalence and key predictors of late booking among pregnant women accessing antenatal care services in a rural district of Ghana. DESIGN: Cross-sectional study. METHODS: Data on demographic characteristics, knowledge of accessing antenatal care services and booking gestation were collected from 163 randomly selected pregnant women accessing accessing antenatal care in rural Ghana from 1 March 2022 to 30 April 2022 using a structured questionnaire. The chi-square and logistic regression were used to explore associations between exposure and dependent variables. RESULTS: The prevalence of late accessing antenatal care booking among study participants was 44.8% (73/163). About 79.1% (129/163) of them had adequate knowledge of accessing antenatal care services. Maternal age of 35-49 years (AOR: 8.53, 95% CI: 2.41-30.12), participants whose partners had no formal education (AOR: 3.43, 95% CI: 1.03-11.39) and participants with adequate knowledge about accessing antenatal care services (AOR: 0.21, 95% CI: 0.07-0.62) were associated with late booking for accessing antenatal care services among study participants.

Melatonin modulates rectal and body surface temperatures and their circadian rhythmicity in donkeys (Equus asinus) subjected to packing during the hot-dry season.

The study aimed to evaluate the effects of melatonin administration on rectal and body surface temperature (RT and BST, respectively) responses and their circadian rhythmicity in donkeys subjected to packing (load carrying) during the hot-dry season. Twenty donkeys were divided into two equal groups randomly: Groups 1 (packing + melatonin) and 2 (packing - melatonin), subjected to packing and both covered 20 km. The RT, BST, and thermal environmental parameters were measured before and after packing. The procedure was carried out three times within the week, one day apart. This was followed 16-h after the last (third) packing procedure by 27-h recording period of all the parameters at 3-h intervals. The RT (37.77 ± 0.1℃) recorded in packing + melatonin donkeys was lower (P < 0.05) than in (packing - melatonin) (38.29 ± 0.1℃) post-packing, while the BSTs in packing + melatonin donkeys were lower than in (packing - melatonin) donkeys, especially the neck (33.07 ± 0.6℃ vs 35.4 ± 0.7℃, respectively) and coronary band (30.58 ± 0.5℃ vs 33.38 ± 0.7℃, respectively) temperatures. In both groups 16-h post-packing, overall mean RT and BST values were not different, except the coronary band temperature (26.61 ± 0.8℃) that was lower (P < 0.05) in packing + melatonin donkeys than (packing - melatonin) donkeys (28.78 ± 1.4℃). Melatonin-exerted biphasic effects on circadian rhythms of RT and BSTs by reducing body temperatures during the photophase and increasing the values during the scotophase in pack donkeys. In conclusion, melatonin may enhance packing output in donkeys during the hot-dry season.

Determinants of burnout among nurses and midwives at a tertiary hospital in Ghana: A cross-sectional study.

AIM: This study determined the prevalence and key determinants of burnout among nurses and midwives in Kumasi, Ghana. DESIGN: Hospital-based cross-sectional study. METHOD: A questionnaire was used to obtain data from 391 nurses and midwives at a tertiary hospital in Kumasi, Ghana using simple random sampling. RESULTS: About 84.4% of the participants were females. The majority of the study participants experienced low burnout for all dimensions (58% in emotional exhaustion, 55.5% poor personal accomplishment and 38.3% depersonalization). Multiple regression analysis revealed that high emotional exhaustion was independently predicted by post-graduate education (ß = 6.42, p = .003), lack of support from management (ß = 2.07, p = .024), dislike for leadership style, (ß = 3.54, p < .001) and inadequate number of staff (ß = 2.93, p = .005). Age (ß = 0.35, p = .004), lack of support from management (ß = 1.60, p = .012), and inadequate number of staff (ß = 1.49, p = .034) independently predicted high depersonalisation. Female sex (ß = 4.36, p < .001) and years of practice (ß = -0.26, p < .001) independently predicted low personal accomplishment.

Factors Influencing Turnover Intention among Nurses and Midwives in Ghana.

Background: Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana. Methods: This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used. Results: The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention. Conclusion: Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.

Penicillin V prophylaxis uptake among children living with sickle cell disease in a specialist sickle cell clinic in Ghana: A cross-sectional study.

Background and Aims: Penicillin V prophylaxis protects children living with sickle cell disease (SCD) from bacteria infections especially Streptococcus pneumonia. However, the uptake of penicillin V prophylaxis is difficult to assess and often poor among SCD patients. Therefore, this study sought to investigate oral penicillin V prophylaxis adherence among SCD children using urine assay and self-reported methods and the associated factors. Methods: The study employed an analytical cross-sectional design in the assessment of penicillin V prophylaxis adherence using both urine assay and self-reported methods. Multiple logistic regression analysis was used to determine the factors associated with penicillin V prophylaxis adherence. A p value < 0.05 was considered statistically significant. Results: Among the 421 SCD patients recruited, penicillin V prophylaxis adherence was observed to be 30.0% and 68.0% for the objective and subjective methods of assessment, respectively. For the objective method of assessment, being cared for by grandparents increased the odds of penicillin V adherence (adjusted odds ratio [aOR] = 3.68, confidence interval [CI] = 1.03-13.15). However, SCD patients within the ages of 10-14 years (aOR = 0.36, CI = 0.17-0.80), >14 years (aOR = 0.17, CI = 0.05-0.61), SCD patient cared for by married caregivers/parents (aOR = 0.32, CI = 0.14-0.72), SCD patient cared for by divorced caregivers/parents (aOR = 0.23, CI = 0.07-0.75), SCD patients taking homemade (herbal) preparations for the treatment of SCD (aOR = 0.42, CI = 0.21-0.83), and inappropriate intake of penicillin V prophylaxis (aOR = 0.27, CI = 0.11-0.67) reduced the odds of penicillin V adherence. For the subjective method of assessment, taking homemade preparation (herbal) for the treatment of SCD (aOR = 0.52, CI = 0.30-0.89) and inappropriate intake of penicillin V (aOR = 0.32, CI = 0.17-0.60) reduced the odds of penicillin V adherence. Conclusion: This study reports a relatively low adherence rate of penicillin V prophylaxis among children living with SCD. Educating and counseling both SCD patients and/or caregivers on the need to be adherent to penicillin V prophylaxis could prevent complications that may arise from nonadherence.

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.

Effect of fear appeal mobile phone messaging on health behaviors of caregivers with children under-five in Ghana.

Social and Behavior Change Communication is a vital strategy in the control of malaria. However, the effectiveness of fear appeal tactic as a preventive strategy remains uncertain. This study examined the influence of a fear appeal mobile phone-based intervention, guided by Witte's Extended Parallel Process model, on malaria prevention among caregivers with children under-five. We conducted a quasi-experimental study of a 12-month intervention using a sample of 324 caregivers from two rural districts, assigned to either an intervention or control group. The intervention group received fear appeal voice Short Message Service (SMS), once a week for twelve (12) months, while caregivers in the control group received none. The results showed that exposure to the messages was associated with an increased odds of positive attitude [adjusted Odds ratio (aOR) = 2.58; 95% CI 1.61-4.15] and behavioral changes (aOR = 2.03, 95% CI 1.29-3.19). The intervention group exhibited lower odds of defensive avoidance (aOR = 0.44, 95% CI 0.29-0.68) and message minimization (aOR = 0.51, 95% CI 0.33-0.78) compared with the control group. These findings highlight the importance of communicating health messages via mobile phones using fear appeal for improving the health behaviors of caregivers. This strategy, however, may not be useful for influencing the intention of caregivers to engage in positive health practices to protect their children from malaria.

Attrition of Nursing Professionals in Ghana: An Effect of Burnout on Intention to Quit.

Background: Burnout among nursing professionals at the workplace and how it influences their decision to quit the profession is crucial to the delivery of quality health service. The shortage of nursing professionals has serious consequences on the healthcare system. Aim: To examine the effect of burnout on intention to quit the profession among nursing professionals. Methods: A cross-sectional study among 375 randomly selected nursing professionals in active service at a tertiary healthcare setting in Kumasi, Ghana. The Maslach Burnout Inventory was used to determine burnout, and their intention to quit the profession was assessed by asking participants whether they ever thought about quitting the profession in the past 12 months. The effect of burnout on intention to quit was analyzed using logistic regression analysis. Results: The overall prevalence of burnout among participants was 2.1% (8/375) with 10.1% (38/375), 24.0% (90/375), and 56.3% (211/375) experiencing high emotional exhaustion, depersonalisation, and low personal accomplishment, respectively. Nearly half (49.3%, 185/375) of the participants had intention to quit the profession. Emotional exhaustion (adjusted odds tatio, AOR = 5.46; 95% CI = 2.25-13.20), depersonalisation (AOR = 1.77 95% CI = 1.07-2.95), and personal accomplishment (AOR = 2.27; 95% CI = 1.30-3.96) were associated with intention to quit the profession. Conclusion: Burnout has a negative effect causing intention to quit nursing profession. It is imperative to identify strategies such as occupational health surveillance that will aim at reducing the incidence of burnout at the workplace due to its consequences, one of them being the intention to quit.