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1.
Pan Afr Med J ; 38: 50, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33854679

RESUMEN

Introduction: breast cancer is the commonest malignant disease in Ghanaian women and accounts for 17% of cancer-related deaths in the country. It has been classified into molecular subtypes depending on the presence or absence of hormone receptors and the human epidermal growth factor receptor 2. Computed tomography is often the preferred modality for monitoring metastatic disease due to its ability to determine the extent of local and metastatic disease. Methods: this was a retrospective study conducted at Sweden Ghana Medical Centre (SGMC). Hospital records and chest and abdominal computed tomography (CT) scan images of breast cancer patients who had been managed at SGMC between June 2016 and August 2019 were used to document age, gender, histological group, type of surgical intervention done, molecular subtypes of the disease and imaging findings. Microsoft Excel 2016 and SPSS version 20.0 were used to summarise the data obtained into tables, charts and to test for significant associations. Results: the most common site of breast cancer metastasis was lymph nodes. The three commonest sites of distant metastases were the lung seen in 44 patients (55.3%), bone in 37 patients (44.6%) and liver in 33 patients (39.8%). Chi square test for association between the molecular subtypes of the breast cancer and proportion of patients that showed a particular type of metastases revealed that, the differences noted for lung, pleural and cardiac metastases were statistically significant, that for bone and liver were not. Conclusion: breast cancer commonly metastasised to lymph nodes, lung, bone, liver, pleura and heart in descending order. The commonest CT patterns for metastases were multiple nodules for lung, effusion for pleura and heart and osteolytic lesions for bone.


Asunto(s)
Neoplasias de la Mama Masculina/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Neoplasias de la Mama Masculina/patología , Femenino , Ghana , Humanos , Metástasis Linfática/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/diagnóstico por imagen , Estudios Retrospectivos
2.
Environ Monit Assess ; 193(5): 264, 2021 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-33847837

RESUMEN

Populations in peri-urban communities of Sub-Saharan Africa frequently depend on shallow aquifers and on-site sanitation facilities concurrently. Routinely, domestic wells end up too close to toilet facilities, risking groundwater contamination. For coastal communities, saltwater intrusion adds to the risk of groundwater contamination. This study assessed both risks in five peri-urban communities of Cape Coast, Ghana. Groundwater samples collected from 40 domestic wells were analyzed for physicochemical and microbial constituents. Multivariate statistics including hierarchical cluster analysis (HCA) and principal component analysis (PCA) were used to classify and link contaminants to potential sources. Results indicate high enteric bacteria contamination in 98% of the samples, as well as high enrichment in physicochemical constituents, tied largely to impacts of on-site sanitation facilities. We found that wells located within 25 m of septic tanks/toilet facilities contained higher contaminant loads than those without such facilities within 25 m of their locations. Similarly, for wells located close to point sources, the closer the water table is below the land surface (within 2 m), the higher the contaminant loads. Lastly, using molar ratios of Cl-/HCO3- and Na+/Cl- with R-mode HCA, the study isolated a few wells, located within 2 km of the coastline, that are experiencing effects of saltwater intrusion. Overall, this study provides useful information for aiding groundwater quality mitigation policy, and the baseline data for aiding future investigations in the study area. It also has broader policy implications for other peri-urban settings throughout Ghana and the entire Sub-Saharan Africa.


Asunto(s)
Agua Subterránea , Contaminantes Químicos del Agua , Monitoreo del Ambiente , Ghana , Saneamiento , Contaminantes Químicos del Agua/análisis , Abastecimiento de Agua
3.
Artículo en Inglés | MEDLINE | ID: mdl-33801505

RESUMEN

(1) Background: Sub-Saharan African migrants residing in high-income countries are more affected by cardiovascular diseases (CVDs) and associated risk factors than host populations for unclear reasons. The aim was to explore the associations of religion and religious affiliations with CVD risk among Ghanaian non-migrants and migrants in Europe. (2) Methods: The 10-year CVD risk was estimated using pooled cohort equations for 3004 participants from the cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) study. Logistic regression analyses were conducted to assess associations between religion and elevated CVD risk (score ≥ 7.5) with adjustment for covariates. (3) Results: Religious men in Europe had a lower 10-year CVD risk compared with non-religious men (adjusted OR 0.51; 95% confidence interval 0.30-0.85), specifically men affiliated with Seventh-Day Adventism (0.24; 0.11-0.53) followed by other affiliations (0.32; 0.11-0.94) and Roman Catholicism (0.42; 0.21-0.86). The opposite was found in Ghana, with religious women having higher odds for elevated 10-year CVD risk (1.53; 1.02-2.30) compared with their non-religious counterparts, specifically women affiliated with Reformed Christianity (1.73; 1.03-2.90) and other denominations (2.81; 1.20-6.54). Associations were not significant for men in Ghana and women in Europe. Adjustments for social support, stress, and health behaviors did not meaningfully alter the associations. (4) Conclusions: Christian religious Ghanaian men living in Europe seem to have lower CVD risk compared with their non-religious counterparts, while Christian religious women in Ghana appear to have increased CVD risk. Further unravelling the contributing factors and the differences between sex and environmental settings is needed.


Asunto(s)
Enfermedades Cardiovasculares , Migrantes , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Ghana/epidemiología , Humanos , Masculino , Prevalencia , Religión
4.
Artículo en Inglés | MEDLINE | ID: mdl-33806590

RESUMEN

Menstrual hygiene management and health is increasingly gaining policy importance in a bid to promote dignity, gender equality and reproductive health. Effective and adequate menstrual hygiene management requires women and girls to have access to their menstrual health materials and products of choice, but also extends into having private, clean and safe spaces for using these materials. The paper provides empirical evidence of the inequality in menstrual hygiene management in Kinshasa (DRC), Ethiopia, Ghana, Kenya, Rajasthan (India), Indonesia, Nigeria and Uganda using concentration indices and decomposition methods. There is consistent evidence of wealth-related inequality in the conditions of menstrual hygiene management spaces as well as access to sanitary pads across all countries. Wealth, education, the rural-urban divide and infrastructural limitations of the household are major contributors to these inequalities. While wealth is identified as one of the key drivers of unequal access to menstrual hygiene management, other socio-economic, environmental and household factors require urgent policy attention. This specifically includes the lack of safe MHM spaces which threaten the health and dignity of women and girls.


Asunto(s)
Higiene , Pobreza , República Democrática del Congo , Países en Desarrollo , Etiopía , Femenino , Ghana , Conocimientos, Actitudes y Práctica en Salud , Humanos , India , Indonesia , Kenia , Menstruación , Nigeria , Uganda
5.
Artículo en Inglés | MEDLINE | ID: mdl-33810537

RESUMEN

BACKGROUND: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. METHODS: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. RESULTS: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria KAP. Although the market traders had an overall moderate knowledge (54.0% of the day traders and 56.5% of the night traders), misconceptions about malaria (especially that it could be caused by exposure to the sun) still existed among the traders. Moreover, the majority of the traders who demonstrated high knowledge (43.98%, n = 250) did not always take laboratory tests to confirm their suspicion, indicating poor attitude. Furthermore, the market traders' choice of drug for malaria treatment (p = 0.001) and preferred malaria treatment type (orthodox or herbal) (p = 0.005) were significantly associated with their knowledge level. CONCLUSIONS: Despite the observation that no significant difference in KAP exists between day and night market traders, appropriate health education programs and interventions still need to be directed at misconceptions, poor attitudes, and poor practices revealed by this study. This will ultimately help in the prevention and control of malaria in Ghana, and globally.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Malaria , Estudios Transversales , Ghana/epidemiología , Humanos , Malaria/epidemiología , Encuestas y Cuestionarios
6.
J Water Health ; 19(2): 203-215, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33901018

RESUMEN

The rationale for this study was to assess the physicochemical and bacteriological qualities of the Vea irrigation water and resultant effects on the quality of fresh vegetables produced in the area and associated implications for consumers' health. A total of 45 water samples were collected from the reservoir and canals. Also, 16 vegetable samples comprising four samples each of tomatoes, carrots, spring onions, and cabbages were collected from four farms with installed irrigation systems fed by the Vea Dam. The irrigation water samples were analyzed for total coliform (TC) and fecal coliform (FC), Escherichia coli, pH, and turbidity, while the samples of vegetables were analyzed for TC and FC, and E. coli. The results showed that except for pH, the bacterial loads and turbidity of the sampled vegetables and irrigation water were above the standards of the WHO and the International Commission on Microbiological Specifications for Food. Comparatively, the samples of cabbage recorded the highest levels of microbial contamination. The study suggests that the water should be treated before being used for irrigation; consumers should ensure that vegetables are properly washed and cooked/treated before consumption; and periodic monitoring and assessment should be done to ensure that the adverse effects of these activities are forestalled.


Asunto(s)
Verduras , Calidad del Agua , Riego Agrícola , Escherichia coli , Contaminación de Alimentos , Jardinería , Ghana , Microbiología del Agua
7.
Pan Afr Med J ; 38: 107, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33912277

RESUMEN

The COVID-19 pandemic had caused significant morbidity and mortality, with over a million deaths recorded to date. Mortality recorded among severe-critically ill patients admitted to intensive care units (ICU) has been significantly high, especially in most COVID-19 epicenters. Reports on the unique clinical characteristics and outcomes from the ICU admissions are on-going with isolated studies in Africa. This study was a retrospective single-centre study involving all polymerase chain reaction (PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients admitted to the medical intensive care unit (MICU) of the department of medicine and therapeutics, Korle-Bu Teaching Hospital, over the period of 13th April - 28th June 2020. Twenty-two (22) patients in total fulfilled the inclusion criteria and are included in this report. Patients' socio-demographic characteristics, clinical and laboratory parameters outcomes as well as treatment modalities employed were extracted from their respective medical records and analyzed using STATA version 14. Dyspnoea, fever and cough were most common associated symptoms. The mean duration of admission at the ICU was 4.1 ± 3.0 days with five deaths (22.7%). About 91% (20/22) had at least one comorbidity with hypertension as the most prevalent. The median oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) level was significantly higher in persons with only COVID-19 pneumonia compared to those with complicated respiratory failure (p<0.001). Six (27.3%) out of the 22 patients had non-invasive ventilation, with only 1/22 (4.5%) receiving mechanical ventilation. Although non-significant, the mean duration of ICU stay was relatively shorter in patients who received therapeutic doses of anticoagulation (p=0.32). Duration of treatment with methylprednisolone was significantly associated with patient outcomes (p=0.04) and serum ferritin levels had a tendency to negatively affect outcome (p=0.06). Clearly there are still no specific targeted medications for COVID-19 treatment, except for empirically symptoms-guided treatments and management of mild to critically ill patients. Early use of systemic corticosteroids for severe to critically ill patients in the ICU using S/F ratio and CRP levels may improve outcomes.


Asunto(s)
/terapia , Enfermedad Crítica/terapia , Unidades de Cuidados Intensivos , Insuficiencia Respiratoria/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , /fisiopatología , Cuidados Críticos/métodos , Enfermedad Crítica/mortalidad , Femenino , Ghana , Humanos , Masculino , Persona de Mediana Edad , Respiración Artificial/estadística & datos numéricos , Insuficiencia Respiratoria/virología , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
8.
BMC Infect Dis ; 21(1): 331, 2021 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-33832460

RESUMEN

BACKGROUND: Previous studies have reported that presence and severity of Buruli ulcer (BU) may reflect the underlying immunosuppression in HIV infected individuals by causing increased incidence of multiple, larger and ulcerated lesions. We report cases of BU-HIV coinfection and the accompanying programmatic challenges encountered in central Ghana. METHODS: Patients with PCR confirmed BU in central Ghana who were HIV positive were identified and their BU01 forms were retrieved and reviewed in further detail. A combined 16S rRNA reverse transcriptase / IS2404 qPCR assay was used to assess the Mycobacterium ulcerans load. The characteristics of coinfected patients (BU+HIV+) were compared with a group of matched controls. RESULTS: The prevalence of HIV in this BU cohort was 2.4% (compared to national HIV prevalence of 1.7%). Eight of 9 BU+HIV+ patients had a single lesion and ulcers were the most common lesion type. The lesions presented were predominantly category II (5/9) followed by category I lesions. The median (IQR) time to healing was 14 (8-28) weeks in the BU+HIV+ compared to 28 (12-33) weeks in the control BU+HIV- group (p = 0.360). Only one BU+HIV+ developed a paradoxical reaction at week 16 but the lesion healed completely at week 20. The median bacterial load (16SrRNA) of BU+HIV+ patients was 750 copies /ml (95% CI 0-398,000) versus 500 copies/ml (95% CI 0-126,855,500) in BU+HIV- group. Similarly, the median count using the IS2404 assay was 500 copies/ml (95% CI 0-500) for BU+HIV+ patients versus 500 copies/ml (95% CI 500-31,000) for BU+HIV- patients. BU+HIV- patients mounted a significantly higher interferon-γ response compared to the BU+HIV+ co-infected patients with respective median (range) responses of [1687(81.11-4399) pg/ml] versus [137.5(4.436-1406) pg/ml, p = 0.03]. There were challenges with the integration of HIV and BU care in this cohort. CONCLUSION: The prevalence of HIV in the BU+ infected population was not significantly increased when compared to the prevalence of HIV in the general population. There was no clear relationship between BU lesion severity and HIV viral load or CD4 counts. Efforts should be made to encourage the integration of care of patients with BU-HIV coinfection.


Asunto(s)
Úlcera de Buruli/epidemiología , Úlcera de Buruli/etiología , Infecciones por VIH/epidemiología , Adolescente , Adulto , Carga Bacteriana , Úlcera de Buruli/tratamiento farmacológico , Úlcera de Buruli/virología , Recuento de Linfocito CD4 , Coinfección/epidemiología , Coinfección/microbiología , Coinfección/virología , Femenino , Ghana/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/microbiología , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium ulcerans/genética , Prevalencia , ARN Ribosómico 16S , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Carga Viral , Cicatrización de Heridas , Adulto Joven
9.
Sci Total Environ ; 771: 144911, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33736178

RESUMEN

Heat exposure studies over the last decade have shown little attention in assessing and reporting the psychometric properties of the various scales used to measure impacts of occupational heat stress on workers. A descriptive cross-sectional survey including 320 small- and large-scale mining workers was employed to assess the construct validity of the social impacts of occupational heat stress scale (SIOHSS) in the Western Region of Ghana in 2017. A confirmatory factor analysis (CFA) and invariance analysis were carried out using AMOS version 25 and statistical product and service solutions (SPSS) version 26 to examine the model fit and establish consistency correspondingly across multiple groups (gender, age, working hours, type of mining and workplace setting). Empirically, our results depicted that effects on health and safety, behavioural, productivity and social well-being were each found to be reliable, with Cronbach's α of 0.722, 0.807, 0.852 and 0.900 respectively. Though there were issues of insufficient discriminant validity as some average variance extract (AVE) were smaller than the corresponding maximum shared variance (MSV), the CFA showed good model fit indices (CFI = 0.856, GFI = 0.890, TLI = 0.863, SRMR = 0.08, RMSEA = 0.08). Also, the model was variant for all constrained aspects of the structural model indicating a requirement for an adaptation of the instrument across groups. The good to moderate internal consistency and construct validity of the SIOHSS is adequate evidence for the confidence required for its reliability and accuracy in measuring the social impacts of occupational heat stress on workers.


Asunto(s)
Respuesta al Choque Térmico , Cambio Social , Estudios Transversales , Análisis Factorial , Ghana , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
10.
BMC Infect Dis ; 21(1): 303, 2021 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-33765944

RESUMEN

BACKGROUND: Proper detection of disease-causing organisms is very critical in controlling the course of outbreaks and avoiding large-scale epidemics. Nonetheless, availability of resources to address these gaps have been difficult due to limited funding. This report sought to highlight the importance of in-country partners and non-governmental organizations in improving detection of microbiological organisms in Ghanaian Public Health Laboratories (PHLs). METHODS/CONTEXT: This study was conducted between June, 2018 to August, 2019. U. S CDC engaged the Centre for Health Systems Strengthening (CfHSS) through the Association of Public Health Laboratories to design and implement strategies for strengthening three PHLs in Ghana. An assessment of the three PHLs was done using the WHO/CDS/CSR/ISR/2001.2 assessment tool. Based on findings from the assessments, partner organizations (CfHSS/APHL/CDC) serviced and procured microbiological equipment, laboratory reagents and logistics. CfHSS provided in-house mentoring and consultants to assist with capacity building in detection of epidemic-prone infectious pathogens by performing microbiological cultures and antimicrobial susceptibility tests. RESULTS: A total of 3902 samples were tested: blood (1107), urine (1742), stool (249) and cerebrospinal fluid (CSF) (804). All-inclusive, 593 pathogenic bacteria were isolated from blood cultures (70; 11.8%); urine cultures (356; 60%); stool cultures (19; 3.2%) and from CSF samples (148; 25%). The most predominant pathogens isolated from blood, urine and stool were Staphylococcus aureus (22/70; 31%), Escherichia coli (153/356; 43%) and Vibrio parahaemolyticus (5/19; 26.3%), respectively. In CSF samples, Streptococcus pneumoniae was the most frequent pathogen detected (80/148; 54.1%). New bacterial species such as Pastuerella pneumotropica, Klebsiella oxytoca, Vibrio parahaemolyticus, and Halfnia alvei were also identified with the aid of Analytical Profile Index (API) kits that were introduced as part of this implementation. Streptococcus pneumoniae and Neisseria meningitidis detections in CSF were highest during the hot dry season. Antimicrobial susceptibility test revealed high rate of S. aureus, K. pneumoniae and E. coli resistance to gentamicin (35-55%). In urine, E. coli was highly resistant to ciprofloxacin (39.2%) and ampicillin (34%). CONCLUSION: Detection of epidemic-prone pathogens can be greatly improved if laboratory capacity is strengthened. In-country partner organizations are encouraged to support this move to ensure accurate diagnosis of diseases and correct antimicrobial testing.


Asunto(s)
Bacterias/aislamiento & purificación , Infecciones Bacterianas/diagnóstico , Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Infecciones Bacterianas/microbiología , Sangre/microbiología , Líquido Cefalorraquídeo/microbiología , Farmacorresistencia Bacteriana/efectos de los fármacos , Heces/microbiología , Ghana , Humanos , Laboratorios , Pruebas de Sensibilidad Microbiana , Organizaciones , Estudios Retrospectivos , Estaciones del Año , Orina/microbiología
11.
Environ Monit Assess ; 193(4): 233, 2021 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-33772652

RESUMEN

Deltas are geographically and socio-ecologically distinct systems, with a unique climate and contextually high vulnerabilities to climate dynamics. Hence, they require specific climate change adaptation and policy responses, informed by delta-scale analysis. However, available climate knowledge on deltas is based mainly on broad-scale analysis that masks information unique to deltas. This applies to the Volta Delta system of Ghana. This study presents annual and intra-annual climate variability and trend analysis carried out across the Volta Delta, using the coefficient of variation (CV), anomaly, Mann-Kendall and Pettit statistics. There were time and space differences in climate change and variability. Statistically significant (P < 0.05) positive trends were observed for the major wet season and the mean annual rainfall for Ada and highly significant (P < 0.01) positive trends for Akatsi. These contrasted with the observations in Adidome, which experienced a statistically highly significant (P < 0.01) decreasing trend in rainfall. There were significant (P< 0.05) increases in annual minimum, maximum, and mean temperatures over time in both coastal and inland delta stations. The annual rate of change of mean temperature ranged from 0.03 to 0.05. Ada, the more coastal location, has experienced a narrow range of temperature change, most probably due to the buffering capacity of the ocean. Point changes were observed in the climate data series in four (4) localities. We recommend that adaption and policy actions should include, the provision of small-scale irrigation, encouraging adoption of drought-resistant crop varieties and crop diversification, and also be made responsive to the existing spatiotemporal climate variability and change within the Volta Delta.


Asunto(s)
Monitoreo del Ambiente , Lluvia , Cambio Climático , Ghana , Temperatura
12.
Environ Monit Assess ; 193(4): 180, 2021 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-33694002

RESUMEN

Studies on the influence of CN on Hg methylation rates in aquatic systems draining gold mining (artisanal and small-scale) communities in Africa are rare. The study assessed the influence of CN on Hg methylation in aquatic sediments of two major river systems draining artisanal and small-scale gold mining (ASGM) communities of the Prestea-Huni Valley district, Southwestern Ghana. The miners extract gold (Au) through exclusive amalgam [Hg-Au] formation or cyanidation of Au-rich Hg-contaminated tailings, or a combination of both techniques. Hg water solubility and probable mercuric compounds in sediments of Hg-contaminated CN-loaded (River Aprepre) and Hg-contaminated non-CN (River Ankobra) aquatic systems within the district were investigated. THg was determined by CV-AAS after HF/HNO3/HCl digestion. MeHg in sediments were extracted with H2SO4/KBr/CuSO4-CH2Cl2; followed by aqueous-phase propylation, preconcentration-on-Tenax, and GC-CV-AFS. River Aprepre showed 4.58-14.83 ngMeHg/g as Hg (1.4-3.7% THg as MeHg), with 241-415 ngTHg/g, and 0.05-0.21 mgCN/kg. For River Ankobra, MeHg ranged 0.24-1.21 ngMeHg/g (0.08-0.35% THg as MeHg) with 162-490 ngTHg/g dw and CN < 0.001 mg/kg. There was positive correlation (r2 = 0.5974; p < 0.01) between MeHg and CN in River Aprepre. The water-soluble fraction of Hg in sediment from both rivers was < 1% of THg. Hg in sediments from River Aprepre were generally more soluble than that from River Ankobra, indicating that Hg in sediments from River Aprepre were potentially more bioavailable for methylation. Accordingly, the presence of CN in Hg-dominated river sediments potentially influences and enhances the solubility and mobility of Hg, resulting in increased Hg methylation rates.


Asunto(s)
Mercurio , Compuestos de Metilmercurio , Contaminantes Químicos del Agua , Cianuros , Monitoreo del Ambiente , Sedimentos Geológicos , Ghana , Mercurio/análisis , Metilación , Ríos , Contaminantes Químicos del Agua/análisis
13.
Reprod Health ; 18(1): 52, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33648528

RESUMEN

INTRODUCTION: The practice of female genital mutilation (FGM/C) in traditional African societies is grounded in traditions of patriarchy that subjugate women. It is widely assumed that approaches to eradicating the practice must therefore focus on women's empowerment and changing gender roles. METHODS: This paper presents findings from a qualitative study of the FGM/C beliefs and opinions of men and women in Kassena-Nankana District of northern Ghana. Data are analyzed from 22 focus group panels of young women, young men, reproductive age women, and male social leaders. RESULTS: The social systemic influences on FGM/C decision-making are complex. Men represent exogenous sources of social influence on FGM/C decisions through their gender roles in the patriarchal system. As such, their FGM/C decision influence is more prominent for uncircumcised brides at the time of marriage than for FGM/C decisions concerning unmarried adolescents. Women in extended family compounds are relatively prominent as immediate sources of influence on FGM/C decision-making for both brides and adolescents. Circumcised women are the main source of social support for the practice, which they exercise through peer pressure in concert with co-wives. Junior wives entering a polygynous marriage or a large extended family are particularly vulnerable to this pressure. Men are less influential and more open to suggestions of eliminating the practice of FGM/C than women. CONCLUSION: Findings attest to the need for social research on ways to involve men in the promotion of FGM/C abandonment, building on their apparent openness to social change. Investigation is also needed on ways to marshal women's social networks for offsetting their extended family familial roles in sustaining FGM/C practices.


Asunto(s)
Circuncisión Femenina , Toma de Decisiones , Genitales Femeninos/lesiones , Adolescente , Adulto , Circuncisión Femenina/efectos adversos , Circuncisión Femenina/psicología , Circuncisión Femenina/estadística & datos numéricos , Cultura , Femenino , Grupos Focales , Genitales Femeninos/patología , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Matrimonio/psicología , Matrimonio/estadística & datos numéricos , Investigación Cualitativa , Religión , Determinantes Sociales de la Salud , Factores Socioeconómicos
14.
Arch Virol ; 166(5): 1385-1393, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33723631

RESUMEN

Following the detection of the first imported case of COVID-19 in the northern sector of Ghana, we molecularly characterized and phylogenetically analysed sequences, including three complete genome sequences, of severe acute respiratory syndrome coronavirus 2 obtained from nine patients in Ghana. We performed high-throughput sequencing on nine samples that were found to have a high concentration of viral RNA. We also assessed the potential impact that long-distance transport of samples to testing centres may have on sequencing results. Here, two samples that were similar in terms of viral RNA concentration but were transported from sites that are over 400 km apart were analyzed. All sequences were compared to previous sequences from Ghana and representative sequences from regions where our patients had previously travelled. Three complete genome sequences and another nearly complete genome sequence with 95.6% coverage were obtained. Sequences with coverage in excess of 80% were found to belong to three lineages, namely A, B.1 and B.2. Our sequences clustered in two different clades, with the majority falling within a clade composed of sequences from sub-Saharan Africa. Less RNA fragmentation was seen in sample KATH23, which was collected 9 km from the testing site, than in sample TTH6, which was collected and transported over a distance of 400 km to the testing site. The clustering of several sequences from sub-Saharan Africa suggests regional circulation of the viruses in the subregion. Importantly, there may be a need to decentralize testing sites and build more capacity across Africa to boost the sequencing output of the subregion.


Asunto(s)
/transmisión , Secuenciación Completa del Genoma/métodos , Femenino , Genoma Viral , Ghana , Humanos , Masculino , Nasofaringe/virología , Orofaringe/virología , Filogenia , Análisis de Secuencia de ARN
16.
Artículo en Inglés | MEDLINE | ID: mdl-33669889

RESUMEN

Informal recycling of electrical and electronic waste (e-waste) has myriad environmental and occupational health consequences, though information about the chronic musculoskeletal health effects on workers is limited. The aim of this study was to examine the prevalence and intensity of self-reported musculoskeletal disorder (MSD) symptoms among e-waste workers at Agbogbloshie in Ghana-the largest informal e-waste dumpsite in West Africa-relative to workers not engaged in e-waste recycling. A standardized musculoskeletal discomfort questionnaire was administered to 176 e-waste workers (73 collectors, 82 dismantlers, and 21 burners) and 41 workers in a reference group. The number of body parts with musculoskeletal discomfort were 1.62 and 1.39 times higher for collectors and dismantlers than burners, respectively. A 1-week discomfort prevalence was highest for collectors (91.8%) followed by dismantlers (89%), burners (81%), and the reference group (70.7%). The discomfort prevalence for e-waste workers was highest in the lower back (65.9%), shoulders (37.5%), and knees (37.5%). Whole-body pain scores (mean ± SE) were higher for collectors (83.7 ± 10.6) than dismantlers (45.5 ± 7.6), burners (34.0 ± 9.1), and the reference group (26.4 ± 5.9). Differences in prevalence, location, and intensity of MSD symptoms by the e-waste job category suggest specific work-related morbidity. Symptom prevalence and intensity call attention to the high risk for MSDs and work disability among informal e-waste workers, particularly collectors and dismantlers.


Asunto(s)
Residuos Electrónicos , Enfermedades Musculoesqueléticas , Exposición Profesional , Ghana/epidemiología , Humanos , Enfermedades Musculoesqueléticas/epidemiología , Exposición Profesional/análisis , Reciclaje
17.
Depress Anxiety ; 38(4): 439-446, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33687122

RESUMEN

BACKGROUND: To examine the association between self-reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). METHODS: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self-reported past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. RESULTS: In total, 34,129 individuals aged ≥50 years [mean (SD) age, 62.4 (16.0) years; 52.1% females] were included in the analysis. Overall, the prevalence of moderate and severe food insecurity was 6.7% and 5.1%, respectively, while the prevalence of depression was 6.0%. Meta-analyses based on countrywise estimates showed that overall, moderate food insecurity (vs. no food insecurity) is associated with a nonsignificant 1.69 (95% confidence interval [CI] = 0.82-3.48) times higher odds for depression, while severe food insecurity is significantly associated with 2.43 (95% CI = 1.65-3.57) times higher odds for depression. CONCLUSIONS: In this large representative sample of older adults from six LMICs, those with severe food insecurity were over two times more likely to suffer from depression (compared with no food insecurity). Utilizing lay health counselors and psychological interventions may be effective mechanisms to reduce depression among food-insecure populations. Interventions to address food insecurity (e.g., supplemental nutrition programs) may reduce depression at the population level but future longitudinal studies are warranted.


Asunto(s)
Depresión , Países en Desarrollo , Anciano , China , Estudios Transversales , Depresión/epidemiología , Femenino , Ghana/epidemiología , Humanos , India , Masculino , México , Persona de Mediana Edad , Prevalencia , Federación de Rusia , Sudáfrica
18.
Artículo en Inglés | MEDLINE | ID: mdl-33671553

RESUMEN

Although the conceptual underpinnings of needs-based health workforce planning have developed over the last two decades, lingering gaps in empirical models and lack of open access tools have partly constrained its uptake in health workforce planning processes in countries. This paper presents an advanced empirical framework for the need-based approach to health workforce planning with an open-access simulation tool in Microsoft® Excel to facilitate real-life health workforce planning in countries. Two fundamental mathematical models are used to quantify the supply of, and need for, health professionals, respectively. The supply-side model is based on a stock-and-flow process, and the need-side model extents a previously published analytical frameworks using the population health needs-based approach. We integrate the supply and need analyses by comparing them to establish the gaps in both absolute and relative terms, and then explore their cost implications for health workforce policy and strategy. To illustrate its use, the model was used to simulate a real-life example using midwives and obstetricians/gynaecologists in the context of maternal and new-born care in Ghana. Sensitivity analysis showed that if a constant level of health was assumed (as in previous works), the need for health professionals could have been underestimated in the long-term. Towards universal health coverage, the findings reveal a need to adopt the need-based approach for HWF planning and to adjust HWF supply in line with population health needs.


Asunto(s)
Planificación en Salud , Fuerza Laboral en Salud , Femenino , Ghana , Personal de Salud , Humanos , Embarazo , Recursos Humanos
19.
BMJ Open ; 11(3): e043887, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33692181

RESUMEN

INTRODUCTION: Very little is known about possible clinical sequelae that may persist after resolution of acute COVID-19. A recent longitudinal cohort from Italy including 143 patients followed up after hospitalisation with COVID-19 reported that 87% had at least one ongoing symptom at 60-day follow-up. Early indications suggest that patients with COVID-19 may need even more psychological support than typical intensive care unit patients. The assessment of risk factors for longer term consequences requires a longitudinal study linked to data on pre-existing conditions and care received during the acute phase of illness. The primary aim of this study is to characterise physical and psychosocial sequelae in patients post-COVID-19 hospital discharge. METHODS AND ANALYSIS: This is an international open-access prospective, observational multisite study. This protocol is linked with the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) and the WHO's Clinical Characterisation Protocol, which includes patients with suspected or confirmed COVID-19 during hospitalisation. This protocol will follow-up a subset of patients with confirmed COVID-19 using standardised surveys to measure longer term physical and psychosocial sequelae. The data will be linked with the acute phase data. Statistical analyses will be undertaken to characterise groups most likely to be affected by sequelae of COVID-19. The open-access follow-up survey can be used as a data collection tool by other follow-up studies, to facilitate data harmonisation and to identify subsets of patients for further in-depth follow-up. The outcomes of this study will inform strategies to prevent long-term consequences; inform clinical management, interventional studies, rehabilitation and public health management to reduce overall morbidity; and improve long-term outcomes of COVID-19. ETHICS AND DISSEMINATION: The protocol and survey are open access to enable low-resourced sites to join the study to facilitate global standardised, longitudinal data collection. Ethical approval has been given by sites in Colombia, Ghana, Italy, Norway, Russia, the UK and South Africa. New sites are welcome to join this collaborative study at any time. Sites interested in adopting the protocol as it is or in an adapted version are responsible for ensuring that local sponsorship and ethical approvals in place as appropriate. The tools are available on the ISARIC website (www.isaric.org). PROTOCOL REGISTRATION NUMBER: osf.io/c5rw3/ PROTOCOL VERSION: 3 August 2020 EUROQOL ID: 37035.


Asunto(s)
/diagnóstico , /psicología , Colombia , Ghana , Humanos , Italia , Estudios Longitudinales , Noruega , Estudios Prospectivos , Factores de Riesgo , Federación de Rusia , Sudáfrica , Reino Unido
20.
PLoS One ; 16(3): e0248282, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33690699

RESUMEN

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.


Asunto(s)
/psicología , Adhesión a Directriz/tendencias , Personal de Salud/psicología , Adulto , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Estudios Transversales , Femenino , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Conocimiento , Masculino , Pandemias/prevención & control , Equipo de Protección Personal/tendencias , Encuestas y Cuestionarios , Virosis/transmisión
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