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1.
PLoS One ; 16(2): e0247038, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33571296

RESUMEN

BACKGROUND: Ghana confirmed the first two cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) infection on 12th March 2020. Following this, the government introduced routine and enhanced contact tracing to identify, quarantine, and test contacts for COVID-19. This study, therefore, intends to document the experiences of contact tracers, their supervisors, during COVID-19 containment in Ghana. METHODS: Purposive sampling was used to select twenty-seven (27) participants; sixteen contact tracers, six supervisors, and five contacts of COVID-19 cases for an in-depth interview using a topic guide. These interviews were conducted on a phone or face-to-face basis whilst maintaining physical distancing protocol. All these were recorded and transcribed verbatim. Then, QSR NVivo 12 was used to analyse the data thematically. RESULTS: Contact tracers were selected based on their professional background and surveillance experience with other infectious diseases. They were trained before the first confirmed cases of COVID-19 in the country and before deployment. Deployment of contact tracers was in pairs to monitor contacts daily through physical visits or over the phone. Their activities included educating contacts about the condition, filling the symptoms diary, and providing psychological support. Contacts for COVID-19 were identified through case investigation, and their monitoring is done once a day despite the twice-daily requirement. Wherever a case was confirmed, enhanced contact tracing within a 2km radius was done. Furthermore, it was reported that some contacts were not adhering to the self-quarantine. In addition to this, other challenges included; unstable provision of PPEs and remuneration, refusal of some contact to test, delays in receiving test results, and poor coordination of the whole process. CONCLUSIONS: The study concludes that contact tracing was generally perceived to be helpful in COVID-19 containment in Ghana. However, adhering to self-quarantine protocol had many challenges for both contact tracers and the contacts. Improving coordination and quick release of test results to contacts is necessary for COVID-19 containment. Lastly, the supply of Personal Protection Equipment and motivation needs to be addressed to help position the country well for effective contact tracing.


Asunto(s)
/epidemiología , Trazado de Contacto , Adulto , Trazado de Contacto/métodos , Femenino , Ghana/epidemiología , Humanos , Masculino , Investigación Cualitativa , Cuarentena , Adulto Joven
2.
Sci Rep ; 10(1): 22407, 2020 12 29.
Artículo en Inglés | MEDLINE | ID: mdl-33376254

RESUMEN

The novel coronavirus is predicted to have dire implications on global food systems including fisheries value chains due to restrictions imposed on human movements in many countries. In Ghana, food production, both agriculture and fisheries, is exempted from restrictions as an essential service. The enforcement of COVID-19 prevention protocols, particularly social distancing, has been widely reported in Ghana's agricultural markets whereas casual observations and media reports on fish landing sites suggest no such enforcements are in place. This study aimed to provide sound scientific evidence as a basis for informed policy direction and intervention for the artisanal fishing sector in these challenging times. We employed an unmanned aerial vehicle in assessing the risk of artisanal fishers to the pandemic using physical distancing as a proxy. From analysis of cumulative distribution function (G-function) of the nearest-neighbour distances, this study underscored crowding at all surveyed fish landing beaches, and identified potential "hotspots" for disease transmission. Aerial measurements taken at times of peak landing beach activity indicated that the highest proportion of people, representing 56%, 48%, 39% and 78% in Elmina, Winneba, Apam and Mumford respectively, were located at distances of less than one metre from their nearest neighbour. Risk of crowding was independent of the population at the landing beaches, suggesting that all categories of fish landing sites along the coast would require equal urgency and measured attention towards preventing and mitigating the spread of the disease.


Asunto(s)
/epidemiología , Explotaciones Pesqueras/estadística & datos numéricos , /transmisión , Aglomeración , Sistemas de Información Geográfica , Ghana/epidemiología , Humanos , Tecnología de Sensores Remotos , Riesgo
3.
PLoS Negl Trop Dis ; 14(12): e0008902, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33351803

RESUMEN

BACKGROUND: There is a dearth of data on scabies from Ghana. In September 2019, local health authorities in the East Mamprusi district of northern Ghana received reports of scabies from many parts of the district. Due to on-going reports of more cases, an assessment team visited the communities to assess the effect of the earlier individual treatment on the outbreak. The assessment team furthermore aimed to contribute to the data on scabies burden in Ghana and to demonstrate the use of the International Alliance for the Control of Scabies (IACS) diagnostic tool in a field survey in a resource limited setting. METHODOLOGY/PRINCIPAL FINDINGS: This was a cross sectional study. Demographic information and medical history was collected on all participants using a REDCap questionnaire. A standardised skin examination of exposed regions of the body was performed on all participants. Scabies was diagnosed based on the criteria of the International Alliance for the Control of Scabies (IACS). Participants were mostly female (61.5%) and had a median age of 18.8 years (IQR 13-25). Two hundred out of 283 (71%) of participants had scabies with most (47%) presenting with moderate disease. Impetigo was found in 22% of participants with scabies and 10.8% of those without scabies [RR 2.27 (95% CI 1.21-4.27)]. 119 participants who received scabies treatment in the past months still had clinical evidence of the disease. 97% of participants reported a recent scabies contact. Scabies was commoner in participants ≤16 years compared to those >16 years [RR 3.06 (95% CI 1.73-5.45)]. CONCLUSION/SIGNIFICANCE: The prevalence of scabies was extremely high. The lack of a systematic approach to scabies treatment led to recurrence and ongoing community spread. The IACS criteria was useful in this outbreak assessment in Ghana. Alternative strategies such as Mass drug administration may be required to contain outbreaks early in such settings.


Asunto(s)
Brotes de Enfermedades/veterinaria , Escabiosis/epidemiología , Adolescente , Adulto , Femenino , Ghana/epidemiología , Humanos , Masculino , Adulto Joven
4.
BMC Infect Dis ; 20(1): 957, 2020 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-33317454

RESUMEN

BACKGROUND: Chronic Sedentary lifestyles have been linked to increased odds of stress, elevated anxiety and diminished wellbeing, inducing cytokine production and predispose to hypertension and other cardiovascular diseases. In endemic areas, Plasmodium falciparum and hepatitis B virus (HBV) infections can trigger pro-inflammatory cytokine responses. However, the impact of these infections on cytokine response profiles in individuals engaged in chronic sedentary activities is unknown. This study was aimed at addressing these concerns using a predominantly sedentary population of traders in the Tamale metropolis of Ghana. METHOD: Four hundred respondents were categorized, based on their number of working years (< or ≥ 5 years) and number of working hours per day (< or ≥ 10 h), into sedentary (≥5 years + ≥ 10 h) and non-sedentary (≥ 5 years + < 10 h, < 5 years + ≥ 10 h and <  5 years + < 10 h) groups. The participants were tested for P. falciparum and HBV infections using polymerase chain reaction. Blood pressure and cytokines responses were measured. Associations and comparison analysis between variables were determined, and test statistics with p < 0.05 were considered statistically significant. RESULTS: Infection status included: un-infected (93.5%), P. falciparum mono-infected (1.0%), HBV mono-infected (3.0%) or P. falciparum /HBV co-infected (2.5%). Majority of the participants, 57.0% (n = 228) were involved in chronic sedentary life style. That notwithstanding, sedentary lifestyle was independent of the infection groups (χ2 = 7.08, p = 0.629). Hypertension was diagnosed in 53.8% of respondents and was independent of infection status (X 2 = 6.33, p = 0.097). Pro-inflammatory (TNF-α, IL-1ß, IL-6, IL-8 and IL-12) and anti-inflammatory (IL-10, IL-7 and IL-13) cytokine responses were similar among individuals with different sedentary working time and between hypertensive and non-hypertensive individuals (p > 0.05 for all comparisons). Among individuals with different infection status, pro-inflammatory (TNF-α; p = 0.290, IL-1ß; p = 0.442, IL-6; p = 0.686, IFN-γ; p = 0.801, IL-8; p = 0.546, IL-12; p = 0.154) and anti-inflammatory (IL-10; p = 0.201, IL-7; p = 0.190, IL-13; p = 0.763) cytokine responses were similar. CONCLUSION: Our data suggest that asymptomatic infections of P. falciparum and HBV together with a high prevalence of hypertension did not have any significant impact on cytokine response profiles among predominantly sedentary traders in the Tamale metropolis of Ghana.


Asunto(s)
Enfermedades Asintomáticas/epidemiología , Coinfección/epidemiología , Citocinas/sangre , Virus de la Hepatitis B/genética , Hepatitis B/epidemiología , Malaria Falciparum/epidemiología , Plasmodium falciparum/genética , Conducta Sedentaria , Adolescente , Adulto , Coinfección/parasitología , Coinfección/virología , Estudios Transversales , Femenino , Ghana/epidemiología , Hepatitis B/sangre , Hepatitis B/virología , Humanos , Malaria Falciparum/sangre , Malaria Falciparum/parasitología , Masculino , Persona de Mediana Edad , Autoinforme , Adulto Joven
5.
J Prim Care Community Health ; 11: 2150132720969483, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33213266

RESUMEN

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.


Asunto(s)
Infecciones por Coronavirus/etiología , Personal de Salud/estadística & datos numéricos , Neumonía Viral/etiología , Medición de Riesgo , Adulto , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/estadística & datos numéricos , Exposición Profesional/prevención & control , Exposición Profesional/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Embarazo , Medición de Riesgo/métodos , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
6.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33181874

RESUMEN

The 2019 corona virus disease (COVID-19) has wreaked havoc on countries, communities and households. Its effect on individuals and their families, although enormous, has not been adequately explored. We thus present a report on the illness experiences of three families in Ghana who had at least one member diagnosed with COVID-19. We interviewed them and recorded their commonest fears, such as death, stigmatisation and collapse of family business. Respondents had a fair idea about symptoms of COVID-19, mode of transmission and safety precautions. Family separation and loss of income were some of the adverse effects expressed. Majority of them were hopeful that family members with COVID-19 would recover and be reunited. The biopsychosocial impact of COVID-19 is tremendous and family physicians and other primary care workers have an essential role to play in addressing this.


Asunto(s)
Infecciones por Coronavirus , Emociones , Composición Familiar , Familia , Pandemias , Neumonía Viral , Adulto , Betacoronavirus , Niño , Coronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/virología , Miedo , Femenino , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Esperanza , Humanos , Renta , Masculino , Persona de Mediana Edad , Ocupaciones , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Neumonía Viral/virología , Estigma Social , Adulto Joven
7.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33054267

RESUMEN

The COVID-19 pandemic has affected nearly every country worldwide and all African countries. The issue of healthcare workers (HCWs) contracting the disease is a growing concern in Ghana, because of the risk of spreading infections amongst themselves and to vulnerable patients in their care. This article illustrates how 14 staff at the Korle Bu Polyclinic/Family Medicine Department were incidentally found to be Covid-19 positive with most of them being asymptomatic. This observation led to a modification of the personal protective equipment (PPE) used by clinical staff when attending to patients. Furthermore, this finding suggests that a different criteria or guideline may be needed for testing of HCWs during a pandemic where a significant proportion of infected people are asymptomatic. We conclude that in the primary care setting HCWs must be ready to see all the following cases safely: routine patients, asymptomatic COVID-19 patients and suspected COVID-19 patients.


Asunto(s)
Instituciones de Atención Ambulatoria , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Personal de Salud , Hallazgos Incidentales , Pandemias , Neumonía Viral , Atención Primaria de Salud , Adulto , Infecciones Asintomáticas , Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Ghana/epidemiología , Hospitales , Humanos , Incidencia , Control de Infecciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Equipo de Protección Personal , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Adulto Joven
8.
BMC Vet Res ; 16(1): 405, 2020 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-33109183

RESUMEN

BACKGROUND: Apart from the huge worldwide economic losses often occasioned by bovine coronavirus (BCoV) to the livestock industry, particularly with respect to cattle rearing, continuous surveillance of the virus in cattle and small ruminants is essential in monitoring variations in the virus that could enhance host switching. In this study, we collected rectal swabs from a total of 1,498 cattle, sheep and goats. BCoV detection was based on reverse transcriptase polymerase chain reaction. Sanger sequencing of the partial RNA-dependent RNA polymerase (RdRp) region for postive samples were done and nucleotide sequences were compared with homologous sequences from the GenBank. RESULTS: The study reports a BCoV prevalence of 0.3%, consisting of 4 positive cases; 3 goats and 1 cattle. Less than 10% of all the animals sampled showed clinical signs such as diarrhea and respiratory distress except for high temperature which occurred in > 1000 of the animals. However, none of the 4 BCoV positive animals manifested any clinical signs of the infection at the time of sample collection. Bayesian majority-rule cladogram comparing partial and full length BCoV RdRp genes obtained in the study to data from the GenBank revealed that the sequences obtained from this study formed one large monophyletic group with those from different species and countries. The goat sequences were similar to each other and clustered within the same clade. No major variations were thus observed between our isolates and those from elsewhere. CONCLUSIONS: Given that Ghana predominantly practices the extensive and semi-intensive systems of animal rearing, our study highlights the potential for spillover of BCoV to small ruminants in settings with mixed husbandry and limited separation between species.


Asunto(s)
Enfermedades de los Bovinos/virología , Infecciones por Coronavirus/veterinaria , Coronavirus Bovino/aislamiento & purificación , Enfermedades de las Cabras/virología , Enfermedades de las Ovejas/virología , Animales , Secuencia de Bases , Teorema de Bayes , Bovinos , Enfermedades de los Bovinos/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Coronavirus Bovino/genética , Diarrea/veterinaria , Ghana/epidemiología , Enfermedades de las Cabras/epidemiología , Cabras , Filogenia , Prevalencia , /veterinaria , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/veterinaria , Ovinos , Enfermedades de las Ovejas/epidemiología
9.
PLoS One ; 15(10): e0233817, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33119603

RESUMEN

BACKGROUND: One of the most common medical problems associated with pregnancy is hypertension. Hypertensive disorders of pregnancy (HDP), which has been attributable to abnormal placentation may have adverse effects on both mother and foetus if left unchecked. The objective of this study was to determine the prevalence of this condition and its effect on placental morphology as well as maternal and perinatal outcomes. MATERIALS AND METHODS: This was a prospective case-control study, conducted at Komfo Anokye Teaching Hospital (KATH), Ghana between February 2018 and July 2018. The progression of pregnancy in normotensive and hypertensive pregnant women, and the eventual perinatal outcomes were closely followed. Statistical analysis was performed using IMB-SPSS version 23. Associations were considered significant at p values of ≤ 0.05. RESULTS: From a total of 214 deliveries recorded during the period of study, 84 (39.25%) were hypertensives. Forty four (52%) of the hypertensives had preeclampsia, 28 (33.3%) had gestational hypertension, 6 (7.1%) had eclampsia, 4 (4.8%) had chronic hypertension, and 2 (2.4%) had preeclampsia superimposed on chronic hypertension. The frequency of placental haematoma, placental infarction, and placental calcification in the normotensives were significantly (p = 0.001) lower than that of the hypertensives. The mean placental weight (p = 0.01), placental volume (p = 0.001), placental diameter (p = 0.03), and placental thickness (p = 0.001) of the normotensives were significantly higher than those of the hypertensives. The number of normotensives in whom labour was induced, who had their babies delivered by caesarean section, and who were admitted after they had given birth were significantly (p = 0.001) lower than that of hypertensives who underwent similar procedures. No stillbirths were recorded in the normotensives compared with four in the hypertensives. The number of babies delivered to the normotensives who were admitted to the NICU was significantly (p = 0.001) lower than those delivered by hypertensives. CONCLUSION: There was a high prevalence of hypertensive disorders of pregnancy in the study site. Pregnant women who developed HDP are at a risk of developing placental abnormalities that adversely affected perinatal outcomes. These adverse effects can be curtailed by embarking on a vigorous health education drive.


Asunto(s)
Hematoma/epidemiología , Hipertensión Inducida en el Embarazo/epidemiología , Hipertensión/epidemiología , Enfermedades Placentarias/epidemiología , Complicaciones del Embarazo/epidemiología , Adulto , Estudios de Casos y Controles , Cesárea/estadística & datos numéricos , Femenino , Ghana/epidemiología , Hospitales de Enseñanza , Humanos , Hipertensión/complicaciones , Trabajo de Parto Inducido/estadística & datos numéricos , Edad Materna , Embarazo , Prevalencia , Estudios Prospectivos , Adulto Joven
10.
PLoS One ; 15(10): e0239754, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33002092

RESUMEN

BACKGROUND: Vaccination is proven to be one of the most cost-effective measures adopted to improve the health of children globally. Adhering to vaccines for children has the propensity to prevent about 1.5 million annual child deaths globally. This study sought to assess the trend and determinants of complete vaccination coverage among children aged 12-23 months in Ghana. MATERIALS AND METHODS: The study was based on data from four rounds of the Ghana Demographic and Health Survey (GDHS 1998, 2003, 2008, and 2014). Information on 5,119 children aged 12-23 months were extracted from the children's files. Both bivariate and multivariate analyses were conducted to assess the factors associated with complete vaccination and statistical significance was pegged at p<0.05. RESULTS: We found that complete vaccination coverage increased from 85.1% in 1998 to 95.2% in 2014. Children whose mothers were in rural areas [aOR = 0.45; CI = 0.33-0.60] had lower odds of getting complete vaccination, compared to those whose mothers were in urban areas. Also, children whose mothers had a secondary level of education [aOR = 1.87; CI = 1.39-2.50] had higher odds of receiving complete vaccination, compared to those whose mothers had no formal education. Children whose mothers were either Traditionalists [aOR = 0.60; CI = 0.42-0.84] or had no religion [aOR = 0.58, CI = 0.43-0.79] had lower odds of receiving complete vaccination, compared to children whose mothers were Christians. CONCLUSION: The study revealed that there has been an increase in the coverage of complete vaccination from 1998 to 2014 in Ghana. Mother's place of residence, education, and religious affiliation were significantly associated with full childhood vaccination. Although there was an increase in complete childhood vaccination, it is imperative to improve health education and expand maternal and child health services to rural areas and among women with no formal education to further increase complete vaccination coverage in Ghana.


Asunto(s)
Cobertura de Vacunación/estadística & datos numéricos , Adolescente , Adulto , Escolaridad , Ghana/epidemiología , Encuestas Epidemiológicas , Humanos , Lactante , Edad Materna , Persona de Mediana Edad , Religión y Medicina , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto Joven
11.
Afr J AIDS Res ; 19(3): 222-230, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32892711

RESUMEN

Sub-Saharan Africa is a region that is severely affected by the HIV and AIDS pandemic with females disproportionately affected. Having accurate and comprehensive knowledge about HIV and AIDS is a major strategy in the fight against the pandemic. This study sought to examine the individual and contextual predictors of comprehensive HIV and AIDS knowledge among young women in Ghana. The study used the females' file from the 2014 Ghana Demographic and Health Survey dataset. A total of 1 407 young women were used for the analysis. Both bivariate and multivariate analyses were done. The results showed that about 22% of the respondents had comprehensive HIV and AIDS knowledge. Young women with secondary and higher levels of education (AOR = 2.85, p < 0.01) and those from the Upper East Region (AOR = 7.15, p < 0.001) had higher odds of comprehensive HIV and AIDS knowledge. However, those cohabiting (AOR = 0.57, p < 0.01) and those who do not watch TV at all (AOR = 0.50, p < 0.01) had lower odds of comprehensive HIV and AIDS knowledge. Comprehensive HIV and AIDS knowledge is low among young women in Ghana and the predictors are both individual (marital status and education) and contextual (region, watching television and listening to radio). A concerted effort is needed to improve the HIV and AIDS knowledge of young people. Mass media campaigns aimed at improving comprehensive HIV and AIDS knowledge should appreciate the individual and contextual factors that influence the comprehensive HIV & AIDS knowledge of young women.


Asunto(s)
Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/psicología , Adolescente , Femenino , Ghana/epidemiología , Infecciones por VIH/psicología , Encuestas Epidemiológicas , Humanos , Análisis Multivariante , Adulto Joven
12.
PLoS One ; 15(9): e0238792, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32925931

RESUMEN

INTRODUCTION: Anaemia is prevalent among children in developing countries. The main objective of this study was to assess the association between health insurance membership and anaemia among Ghanaian children under-five years. METHODS: We obtained Ghana's Multiple Indicators Cluster Survey, 2011 dataset from the United Nations International Children's Emergency Fund. Data were analyzed with the aid of Stata/IC, version 15. RESULTS: The prevalence of anaemia among Ghanaian children under-five years was estimated to be 57%. Majority (73%) of the children were not insured. Health insurance membership was found to be a significant predictor of anaemia among children under-five years. CONCLUSION: Health insurance membership is a protective factor against anaemia among children under-five years. In the quest to eradicate anaemia among children, stakeholders would have to review the benefit package of the National Health Insurance Scheme coupled with prioritizing anaemia prevention interventions among more vulnerable children.


Asunto(s)
Anemia/epidemiología , Seguro de Salud/estadística & datos numéricos , Preescolar , Prestación de Atención de Salud , Femenino , Ghana/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Pacientes no Asegurados/estadística & datos numéricos , Prevalencia , Encuestas y Cuestionarios
13.
J Infect Dev Ctries ; 14(8): 838-843, 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-32903226

RESUMEN

The novel coronavirus, SARS-CoV-2, which causes COVID-19, is seen world-wide. In developing countries, adequate health facilities and staff numbers are a concern. Ghana recorded its first 2 cases of COVID-19 on 12 March 2020. On 30 March 2020, a partial lockdown for 14 days was imposed and later extended along with other measures. By the end of the initial lockdown, 19 April 2020, an estimated 86,000 people had been traced and 68,591 tests performed. Of the 68,591 tests, there were 1,042 (1.5%) positive cases, 9 deaths, and 99 recoveries, with Ghana ranked number one among African countries in administering tests per million people. Ghana's effective track and trace system, as well as lockdown and other measures, have helped limit mortality with only 85 recorded deaths by 23 June 2020. Scientists from three facilities of the University of Ghana have also successfully sequenced the genomes of COVID-19 from 15 confirmed cases, and the Food and Drugs Authority in Ghana have also helped address shortages by fast-tracking certification of hand sanitizers and local production of 3.6 million standardized personal protective equipment. There has also been the development of prototypes of locally-manufactured mechanical ventilators to meet local need at intensive care units. Most people have also resorted to changing diets and the use of supplements to boost their immune system. Although initial results are encouraging, further research is needed to understand the dynamics of COVID-19 in Ghana and provide additional guidance.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Infecciones por Coronavirus/prevención & control , Ghana/epidemiología , Recursos en Salud , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control
14.
PLoS One ; 15(9): e0238749, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32886699

RESUMEN

INTRODUCTION: False-negative malaria rapid diagnostic test (RDT) results amongst symptomatic malaria patients are detrimental as they could lead to ineffective malaria case management. This study determined the nationwide contribution of parasites with Pfhrp2 and Pfhrp 3 gene deletions to false negative malaria RDT results in Ghana. METHODS: This was a cross sectional study where whole blood (~2 ml) was collected from patients presenting with malaria symptoms at 100 health facilities in all the regions in Ghana from May to August 2018. An aliquot of the blood was used to prepare thin and thick blood smears, filter paper blood spots (DBS) and spot a PfHRP 2 RDT kit. The remaining blood was separated into plasma and blood cells and stored at -20°C. Plasmodium parasite density and species identity was estimated from the blood smears. Plasmodium falciparum specific 18S rRNA PCR, merozoite surface protein (msp 1) and glutamate rich protein (glurp) gene PCR were used to identify P. falciparum positive samples, which were subjected to Pfhrp 2/3 exon1-2 and exon2 genotyping. RESULTS: Of the 2,860 microscopically P. falciparum positive patients analyzed, 134 (4.69%) had false negative P. falciparum specific RDT results. Samples for PCR analysis was available for 127 of the false negative patients, and the analysis identified 116 (91.3%) as positive for P. falciparum. Only 58.1% (79/116) of the false negative RDT samples tested positive by msp 1 and glurp PCR. Genotyping of exon 1-2 and exon 2 of the Pfhrp 2 gene identified 12.9% (10/79) and 39.5% (31/79) of samples respectively to have deletions. Genotyping exon 1-2 and exon 2 of the Pfhrp 3 gene identified 15.2% (12/79) and 40.5% (32/79) of samples respectively to have deletions. Only 5% (4/79) of the false negative samples had deletions in both exon 1-2 and exon 2 of the Pfhrp 2 gene. Out of the 49 samples that tested positive for aldolase by luminex, 32.6% (16/49) and) had deletions in Pfhrp 2 exon 2 and 2% (1/49) had deletions in both exon 2 and exon 1-2 of the Pfhrp 2 gene. CONCLUSIONS: The low prevalence of false negative RDT test results provides assurance that PfHRP 2 based malaria RDT kits remain effective in diagnosing symptomatic malaria patients across all the Regions of Ghana. Although there was a low prevalence of parasites with deletions in exon 2 and exon 1-2 of the Pfhrp 2 gene the prevalence of parasites with deletions in Pfhrp 2 exon 2 was about a third of the false negative RDT results. The need to ensure rapid, accurate and reliable malaria diagnosis requires continuous surveillance of parasites with Pfhrp 2 gene deletions.


Asunto(s)
Antígenos de Protozoos/genética , Antígenos de Protozoos/metabolismo , Eliminación de Gen , Malaria Falciparum/diagnóstico , Plasmodium falciparum/genética , Proteínas Protozoarias/genética , Proteínas Protozoarias/metabolismo , Adulto , Antígenos de Protozoos/inmunología , Reacciones Falso Negativas , Femenino , Técnicas de Genotipaje , Ghana/epidemiología , Humanos , Malaria Falciparum/epidemiología , Masculino , Persona de Mediana Edad , Plasmodium falciparum/inmunología , Plasmodium falciparum/fisiología , Adulto Joven
15.
PLoS Negl Trop Dis ; 14(8): e0007009, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32804967

RESUMEN

Ghana has been implementing Mass Drug Administration (MDA) since the year 2001, and Lymphatic Filariasis transmission has been interrupted in 76 out of the 98 targeted districts. The remaining districts have a microfilaria prevalence above the 1% threshold needed for the interruption of transmission. This study assesses the level of lymphatic filariasis MDA coverage and explored factors affecting the quality of implementation of the MDA in the Bole and Central Gonja Districts of Northern Ghana. A concurrent mixed methods study design approach was used to provide both a quantitative and qualitative insight. A descriptive analysis was carried out, and the results are presented in tables and charts. The transcripts of the qualitative interviews were imported into Nvivo and framework methods of analysis were used. The results were summarized based on the themes and buttressed with narratives with key quotes presented within the texts. The overall MDA coverage in Central Gonja is 89.3% while that of Bole district is 82.9%. Refusal to ingest the drug and adverse drug reactions were higher in Bole district than the Central Gonja District. The persistent transmission of lymphatic filariasis in Bole District was characterized by poor community mobilization and sensitization, nonadherence to the directly observed treatment strategy, refusal to ingest the drug due to the fear of adverse drug reactions, inadequate knowledge and misconceptions about the disease. Reported mass drug administration coverage will not necessarily result into interruption of transmission of the disease without strict compliance to the directly observed treatment strategy, strong stakeholder engagement coupled with evidence-based context-specific multi-channel community education strategies with key educational messages on the cause of the disease and adverse drug reactions. While the clock for the elimination of lymphatic filariasis by the year 2020 and meeting of the Sustainable Development Goal 3 target 3.3 by 2030 is ticking, there is an urgent need for a concerted effort to improve the fidelity of the ongoing lymphatic filariasis MDA campaigns in the Bole District of Northern Ghana.


Asunto(s)
Filariasis Linfática/prevención & control , Filaricidas/uso terapéutico , Administración Masiva de Medicamentos/estadística & datos numéricos , Adulto , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/normas , Femenino , Filaricidas/administración & dosificación , Filaricidas/efectos adversos , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Administración Masiva de Medicamentos/efectos adversos , Administración Masiva de Medicamentos/métodos , Persona de Mediana Edad , Negativa del Paciente al Tratamiento/estadística & datos numéricos
16.
Artículo en Inglés | MEDLINE | ID: mdl-32784978

RESUMEN

This study investigated the impact of COVID-19 on the insurance industry by studying the case of Ghana from March to June 2020. With a parallel comparison to previous pandemics such as SARS-CoV, H1N1 and MERS, we developed outlines for simulating the impact of the pandemic on the insurance industry. The study used qualitative and quantitative interviews to estimate the impact of the pandemic. Presently, the trend is an economic recession with decreasing profits but increasing claims. Due to the cancellation of travels, events and other economic losses, the Ghanaian insurance industry witnessed a loss currently estimated at GH Ȼ112 million. Our comparison and forecast predicts a normalization of economic indicators from January 2021. In the meantime, while the pandemic persists, insurers should adapt to working from remote locations, train and equip staff to work under social distancing regulations, enhance cybersecurity protocols and simplify claims/premium processing using e-payment channels. It will require the collaboration of the Ghana Ministry of Health, Banking Sector, Police Department, Customs Excise and Preventive Service, other relevant Ministries and the international community to bring the pandemic to a stop.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Aseguradoras/estadística & datos numéricos , Neumonía Viral/epidemiología , Betacoronavirus , Recesión Económica , Ghana/epidemiología , Humanos , Subtipo H1N1 del Virus de la Influenza A , Aseguradoras/economía , Coronavirus del Síndrome Respiratorio de Oriente Medio , Pandemias
17.
PLoS One ; 15(8): e0237518, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32810136

RESUMEN

The study assessed the prevalence and determinants of non-fistulous urinary incontinence among gynaecologic care seekers as well as its interference with everyday life activities of affected women. A cross-sectional study involving 400 women was conducted in a tertiary facility in Ghana. Urinary incontinence was assessed using the International Consultation on Incontinence Questionnaire-short form (ICIQ-SF) which has not been validated locally. The questionnaire was administered mostly in the Asante Twi language with translation done at the time of the interview. The data was analysed for proportions and associations between selected variables. The prevalence of urinary incontinence was 12%, the common types being urgency (33.3%), stress (22.9%), and mixed (20.8%). Age ≥60 years compared to 18-39 years (OR 3.66 95%CI 1.48-9.00 P = 0.005), and a history of chronic cough (OR 3.80 95% CI 1.36-10.58 P = 0.01) were associated with urinary incontinence. Women with education beyond the basic level were 72% less likely to experience urinary incontinence (OR 0.28 95%CI 0.08-0.96 P = 0.04). Urinary incontinence interferes with everyday life activities of most affected women. Non-fistulous urinary incontinence is relatively common among gynaecologic care seekers yet very few women were referred with such a diagnosis. Advocacy measures aimed at urging affected women to report the condition and educating the general population on potential causes, prevention and treatment are needed.


Asunto(s)
Aceptación de la Atención de Salud , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/etiología , Actividades Cotidianas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Ghana/epidemiología , Ginecología/estadística & datos numéricos , Hospitales de Enseñanza , Humanos , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos , Calidad de Vida , Derivación y Consulta/estadística & datos numéricos , Factores de Riesgo , Encuestas y Cuestionarios , Incontinencia Urinaria/diagnóstico , Adulto Joven
18.
PLoS One ; 15(8): e0237710, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32822381

RESUMEN

BACKGROUND: Diabetes often coexists with other medical conditions and is a contributing cause of death in 88% of people who have it. The study aimed at evaluating medication adherence, self-care behaviours and diabetes knowledge among patients with type 2 diabetes mellitus in Ghana. METHODS: A total of 330 participants were recruited into the study from three public hospitals in the Tamale metropolis. A validated medication adherence questionnaire and the Summary of Diabetes Self-care Activities tool were used to assess medication adherence and self-care activities respectively. Logistic and linear regressions were used to determine factors positively associated with non-adherence to medication and self-care behaviours respectively. RESULTS: Of the 330 participants whose data were analysed, the mean (SD) age was 57.5 (11.8) years. The majority (84.5%) were adherent to anti-diabetes medication. Participant's age, educational level, and practice of self-care behaviours influenced adherence to anti-diabetes medication. Participants aged 70 years and above were 79% less likely to be non-adherent to medication as compared to those below 50 years [OR = 0.21 (95%CI: 0.06-0.74), p = 0.016]. Participants with senior high school education were 3.7 times more likely to be non-adherent to medication than those with tertiary education [OR = 3.68 (95%CI: 1.01-13.44), p = 0.049]. Participants with tertiary education had an increase in the level of practice of self-management by 1.14 (p = 0.041). A unit increase in knowledge score also increased the level of practice of self-management by 3.02 (p<0.001). CONCLUSION: The majority of participants were adherent to anti-diabetes medication. Non-adherence to medication was associated with younger age and low level of education. Interventions to improve adherence should target younger and newly diagnosed patients through aggressive counselling to address healthy self-management behaviours.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Cumplimiento de la Medicación , Anciano , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Persona de Mediana Edad , Autocuidado
19.
PLoS One ; 15(8): e0238077, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32822409

RESUMEN

BACKGROUND: Malaria in pregnancy remains a major public health problem in Africa and Ghana and has been associated with a variety of pregnancy-related adverse complications. The development of effective and timely health policies for the prevention and control of malaria and anemia in pregnancy; requires current and consistent data on the prevalence and risk factors. We report the prevalence and risk factors of malaria and anemia from three major hospitals across three regions in Ghana. METHODS: This multicenter cross-sectional study comprising a total of 628 pregnant women was conducted at the antenatal care units of the Achimota Hospital in the Greater Accra Region (n = 199), St. Michael's Hospital in the Ashanti Region (n = 221), and Effia Nkwanta Regional Hospital in the Western Region (n = 211). Questionnaires were administered to obtain socio-demographic, obstetrics and clinical data. Venous blood, stool and urine samples were collected for hematological profile and parasite identification using microscopy. Risk factors were evaluated using logistic regression models. RESULTS: The overall prevalence of P. falciparum malaria was 8.9%. Factors independently associated with malaria were self-reported mosquito exposure (moderate exposure: aOR = 3.11, 95% CI (1.12-8.61) and severe exposure: aOR = 10.46, 95% CI (3.86-28.34)) and non-use mosquito repellents (aOR = 3.29, 95% CI (1.70-6.39)). Multiparty (parity of 2: aOR = 0.19, 95% CI (0.05-0.70) and parity ≥3: aOR = 0.11, 95% CI (0.03-0.45)) and age (20-30 years old: aOR = 0.22, 95% CI (0.09-0.56)) reduced the odds of infection. The overall prevalence of anemia was 42.4%. The prevalence of mild, moderate and severe anemia were 35.7%, 6.1% and 0.6%, respectively. The use of water other than purified water (tap water: aOR = 3.05, 95% CI (2.06-4.51) and well water: aOR = 2.45, 95% CI (1.35-4.44)), increasing gestational age (second trimester: aOR = 2.05, 95% CI (1.41-2.97) and third trimester: aOR = 7.20, 95% CI (3.06-16.92)) and malaria (aOR = 2.40, 95% CI (1.27-4.53)) were independent risk factors for anemia. CONCLUSIONS: Although the prevalence of malaria is relatively low, that of anemia remains high. We recommend increasing efforts to make ITNs more available to strengthen malaria prevention. Public health education programs could help improve uptake and proper use of ITNs. To help reduce anemia in pregnancy, women should be empowered economically and interventions that reduce malnutrition should be encouraged. Women should be educated on early initiation of antenatal care to enhance surveillance, identification and treatment of anemia.


Asunto(s)
Anemia/diagnóstico , Malaria/diagnóstico , Adulto , Anemia/complicaciones , Anemia/epidemiología , Anemia/patología , Estudios Transversales , Femenino , Edad Gestacional , Ghana/epidemiología , Humanos , Modelos Logísticos , Malaria/complicaciones , Malaria/epidemiología , Control de Mosquitos/estadística & datos numéricos , Oportunidad Relativa , Embarazo , Mujeres Embarazadas , Atención Prenatal , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
20.
Glob Health Action ; 13(1): 1795963, 2020 12 31.
Artículo en Inglés | MEDLINE | ID: mdl-32762300

RESUMEN

Managing a deadly pandemic in low- and middle-income countries (LMIC) is challenging. The task becomes tougher when there is an outbreak of an equally deadly disease. This is the present situation of Ghana, a low-resource country, that is confronted with the coronavirus disease 2019 (COVID-19) pandemic and cerebrospinal meningitis (CSM) outbreak. Apart from the resource constraint at both governmental and individual levels, such a situation affects the overall wellbeing of ordinary citizens as well as healthcare professionals, particularly those in high-risk areas. Perhaps, more than ever, we have to ensure equitable distribution of scarce healthcare resources in our effort to manage this 'twin disaster' of COVID-19 and CSM. We evaluated Ghana's situation (outbreak response) and recommended measures to help us navigate this conundrum of a public health crisis.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Desastres/prevención & control , Brotes de Enfermedades/prevención & control , Meningitis/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Países en Desarrollo , Ghana/epidemiología , Asignación de Recursos para la Atención de Salud , Recursos en Salud/provisión & distribución , Humanos , Meningitis/epidemiología , Neumonía Viral/epidemiología
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