Sero-Epidemiology of Toxocara Canis Infection in Children Attending Four Selected Health Facilities in the Central Region of Ghana.

OBJECTIVE: The study determined the seroprevalence of Toxocara canis infection among children attending four selected health facilities in the Central Region of Ghana. DESIGN: Cross-sectional study. METHOD: Sera from 566 children aged 1-15 years attending four selected health facilities in the Central Region of Ghana between July and September 2012 was used in a Toxocara excretory-secretory antigen-based ELISA to detect serum IgG. A short questionnaire was designed to obtain data on respondents as to age, gender, educational level, locality of residence, habits of washing of fruits, vegetable and hands before eating, keeping of pet (dogs or cats), and history of playing with soil and pets. Clinical information was also collected. Associations between sero-positivity and age group, gender, risk factors, educational level and other variables were determined by Chi square test. RESULTS: The overall sero-prevalence was 53.5% (n=566). Age, educational level and hospital visited were significantly associated with sero-positivity (p< 0.05). Children with history of playing with soil (χ(2)=9.03, p=0.003), pet-keeping (χ(2)=14.77, p=0.001) and not washing hands with soap before eating (χ(2)=5.82, p=0.016) were significantly associated with sero-positivity. CONCLUSION: The sero-prevalence of T. canis infection in children in the study was high. The children should be educated to desist from risk factors such as playing with soil and pets and be encouraged to ensure proper personal hygiene.

Client's satisfaction with delivery of animal health-care services in peri-urban Ghana.

I assessed the satisfaction in July-August 2005 of 889 livestock and poultry owners with animal health-care services delivery in peri-urban Ghana and determined factors associated with that satisfaction (and with being the owner of poultry versus of other livestock with or without poultry). Overall, 48% of the respondents were satisfied or very satisfied with service delivery, with only 8% in the very satisfied category. Of the 401 owners of poultry and 488 owners of other livestock, 52% and 45%, respectively, reported being satisfied or very satisfied with veterinary services delivery. I found significant differences between poultry and livestock owners in 11 of 15 indicators of quality of animal health-care services; significantly higher proportions of poultry owners gave positive assessments in nine of the indicators. All but one of the 15 indicators tested was significantly and positively associated with satisfaction among all owners, overall. The indicators are proposed as a checklist for Qualitative Rapid Appraisal of Veterinary Services.

Clients' perceptions of delivery of veterinary services in peri-urban Ghana.

A study was designed aimed at comparing the assessment of performance of animal health care delivery systems in peri-urban Ghana by livestock and poultry keepers in 4 locations. 889 respondents were interviewed using a questionnaire. A higher proportion of respondents in Location 1 met their needs for animal health by themselves, while in Location 3 these needs were met mainly by veterinarians. The mean distances to veterinary clinics, veterinary technicians or to purchase medicine were significantly higher in Location 1. Higher proportions in 3 locations perceived effectiveness of service delivery to be good. However, equity was poor in all 4 locations. Higher proportions in Locations 2, 3 and 4 said services were unaffordable. Client needs were perceived to have been met by higher proportions in Locations 3 and 4 but not in Locations 1 and 2. Staff attitude and technical competence were good in all 4 locations. The study concluded that the differences reported in the quality of service indicators in the 4 locations were not critical enough to recommend location-specific delivery systems.

Perceived quality of healthcare delivery in a rural district of ghana.

OBJECTIVE: The study aimed at finding out clients' perceptions of the quality of healthcare delivery at the district level in rural Ghana, using the Komenda-Edina-Eguafo-Abrem District as a case study. DESIGN: 803 patients were purposively selected and interviewed after visits to health facilities using a pretested questionnaire, while focus group discussions were held in 13 communities. The study was done between October 2003 and August 2004. RESULTS: The majority of respondents (70%) were females. The mean expected maximum waiting time for seeking medical help was 1 hr. About 98% said they were asked to explain their problem. However, lower proportions, 74%, 43% and 46% were physically examined, told what was wrong, or given advice about their illness, respectively. About 90% of the respondents were satisfied or very satisfied with the care given during their visit to the health facility. The participants perceived poor attitude of some health workers, long waiting times, high cost of services, inadequate staff, policy of payment for health services, frequent referrals to hospitals, and lack of ambulances at facilities as being detrimental to effective delivery of quality healthcare. CONCLUSIONS: The study found that generally the quality of healthcare delivery was perceived to be high for most of the indicators used. There were, however, some concerns that patients were not told the diagnosis or informed about the management of their illness. These need to be addressed. The level of satisfaction with quality of healthcare was high.

A comparison of the delivery of veterinary services to small-scale and medium to large-scale poultry keepers in peri-urban Ghana.

The study compared assessments of animal health care delivery to small-scale and medium to large-scale poultry keepers in peri-urban areas in four regions of Ghana. Four hundred and one keepers were interviewed using a questionnaire. Significantly higher proportions of the small-scale and medium to large-scale keepers met their needs by themselves. The mean distances or times used in getting veterinary services were similar for both groups. Significantly higher proportions of medium to large-scale keepers said drugs and vaccines were available and getting help was easy. Staff attitude and effectiveness were perceived as good by significantly higher proportions of small-scale keepers. Equity and efficiency were generally poor, while drug costs were considered expensive by medium to large-scale keepers. The study concluded that generally, there were no marked differences in the way in which the two groups perceived the quality of service delivery and the findings did not support claims that small-scale keepers receive inadequate services.

Client assessment of animal health care delivery in peri-urban Ghana.

The study used a questionnaire to assess the delivery of veterinary services as perceived by users in four peri-urban areas in Ghana. Eight hundred and eighty nine respondents were interviewed: 10.7% were cattle farmers, 27.4% were small ruminant farmers, 14.2% were pig farmers, 45.1% were poultry farmers and 2.6% reared various animals on a part-time basis. Most of the animal health needs were either met by the owners (50.4%) or by veterinarians (41.6%). Veterinarians were mainly consulted for advice on animal health, disease diagnosis and treatments. Most respondents (65.7%) had no difficulty in getting help from government services. Higher proportions of interviewees perceived effectiveness, efficiency, service quality, staff attitude and technical competence as 'good' or 'very good'. However, equity and accessibility were thought to be 'fair' to 'very poor', and the cost of drugs was considered expensive' or 'very expensive'. The study identified strengths and weaknesses in the delivery of animal health services in peri-urban Ghana and this information could be used as a basis to improve the overall quality of these services in the future.

Risk factors for lamb mortality in Sahelian sheep on a breeding station in Ghana.

A retrospective cohort study was designed to examine the effect of sex, season of birth, type and year of birth, and birth weight on lamb mortality. The method used involved analysis of breeding records for Sahelian sheep kept on a breeding station at Pong-Tamale in northern Ghana from 1994 to 2000. The pre-weaning and post-weaning mortalities were 10% (n = 505) and 19% (n = 453), respectively, while the overall mortality from birth up to 12 months of age was 28% (n = 505). Compared to the pre-weaning period, the post-weaning period recorded significantly higher proportions of deaths in male, single-born, lambs born in the rainy or dry seasons, and in lambs with low (<3 kg) or high (> or =3 kg) birth weight. The odds and risks of death for male lambs were about one and a half times those for females at post-weaning. Lambs born in the dry season had significantly higher mortality than those born in the rainy season. Lambs that died by the time of weaning were not significantly different in weight at birth from those that survived. The mean birth and weaning weights of single-born lambs were significantly higher than those for twins. The mean pre-weaning ADG was significantly higher in lambs born as singles compared to that for twins. The season of birth had influence on mean birth weight, with those born in the rainy season having significantly higher weights than those born in the dry season. The year of birth significantly affected birth weight, weaning weight, weight at 12 months and ADG at all stages of the lambs' life. The study concluded that the most significant risk factors for lamb mortality included sex of the lamb, season of birth and birth weight. The last two could be manipulated, to some extent, to reduce lamb mortality.

Promotion of private veterinary practice in Ghana: perceptions of veterinarians and veterinary technicians.

A study was designed to identify factors perceived by veterinarians and veterinary technicians as likely to promote private veterinary practice in Ghana. The participatory appraisal approach was used. The response rates were 88% (n = 90), 100% (n = 9) and 86% (n = 200) for government field veterinarians, private veterinarians and government veterinary technicians, respectively. Significant proportions of government field veterinarians (67%, n = 79), and veterinary technicians (64%, n = 167) were willing to go into private practice if the necessary push was given. Factors perceived as likely to motivate them to go into private practice included availability of capital to cover start-up costs; provision of a vehicle; prospect of higher income; availability of loans with low interest rates; availability of credit facilities from suppliers; stable macroeconomic environment with low interest and inflation rates; high pet, poultry and livestock populations at locations earmarked for private practice; leasing of vacant government premises for use as clinic and for accommodation; and enforcement of legislation on private practice, especially that against moonlighting by government veterinarians and technicians. These should be considered and used in the promotion of private veterinary practice in Ghana.

Perceptions of livestock owners of private veterinary practice in Ghana.

Using the participatory appraisal approach, a study was designed to assess the perceptions of livestock owners on private delivery of veterinary services in two districts in the major livestock-producing area in Ghana. A significant proportion (74%, n = 180) were willing to patronize locally established veterinary practices. However, the respondents emphasized that the fees charged had to be reasonable and affordable. Factors identified as likely to discourage the use of the private provider included the inability of the provider to speak the local language; non-availability of credit facilities for services rendered by the provider; unreliability of personnel; poor interpersonal skills; lack of technical know-how; inability of the provider to make house calls or farm visits; and poor personal and work ethics. These findings provide information for prospective private veterinarians on the expectations of their clients and could be used in the preparation of veterinarians for private practice.

Risk factors for kid mortality in West African Dwarf goats under an intensive management system in Ghana.

Breeding records from 1997 to 2000 for West African Dwarf goats kept under an intensive management system on the National Breeding Station at Kintampo in Ghana were analysed for the effect on mortality of sex, season and type of birth, and birth weight. The pre-weaning and post-weaning mortalities were 10% (n = 390) and 23.1% (n = 351), respectively, while the overall mortality from birth up to 12 months of age was 30.8% (n = 390). The post-weaning period recorded significantly higher proportions of deaths in males, females, single-born and twins, during the rainy and dry seasons, and for kids with low or high birth weight, compared to the pre-weaning period. There was significantly higher mortality in male kids than in female kids. The odds and risks of death for male kids were about twice those for females at post-weaning and up to 1 year of age. At pre-weaning and up to 1 year of age, a higher proportion of the dead were twins. Twins had approximately 2.5 the risk of death at pre-weaning, compared to singles. Also, kids born in the rainy season had significantly higher mortality than those born in the dry season. Kids that died by the time of weaning were significantly lighter in weight at birth than those that survived. Male kids had significantly higher mean weights at birth and at weaning, but not at 12 months of age. The significance of these findings is discussed.

Lamb and kid mortality in village flocks in the coastal savanna zone of Ghana.

A cohort study was designed to observe and follow up mortality in lambs and kids in 88 flocks of sheep and goats under the traditional production system in five villages within the coastal savanna zone of Ghana over a 2-year period. The overall mortality rates for kids and lambs were 30.8% and 33.5%, respectively. Significantly higher proportions of kids (80.2%) and lambs (75.6%) up to 3 months of age died compared to kids and lambs from 4 to 12 months of age. The differences in mortality rates, either between male and female kids and lambs or between single-born and multiple-birth kids and lambs, were not significant. The odds ratio (OR) and relative risks (RR) for lambs and kids, on the basis of sex and birth types, were not significant; neither were the values obtained for attributable risk, attributable fraction, population attributable risk and population attributable fraction. The overall mortality rate on the basis of species of animal was not significant. At the village level, significant differences in the proportions of mortality on the basis of sex were seen in two villages. At Akotokyir, more male lambs (54.2%) died compared to females (27.6%), while at Apewosika more female lambs (42.2%) died compared to males (16.7%). The only significant difference in mortality proportions on the basis of birth type at the village level was seen at Apewosika, where more single-born kids died (52.8%) compared to kids born with sibling(s) (28.4%). The significant ORs for mortalities were 3.10 for male lambs at Akotokyir, 3.35 for female lambs at Apewosika and 2.82 for single-born kids at Apewosika. The corresponding RRs were equally significant. On the basis of species, significantly more lambs died at Akotokyir (44.2%) and Kwesimprah (44.7%) compared to kids. The implications of these findings are discussed.

Assessment of veterinary needs of ruminant livestock owners in Ghana.

We assessed the needs of ruminant-livestock owners in three districts in Ghana for veterinary services, the acceptability of particular services or activities and the willingness of people to use services through public or private delivery systems. Purposive sampling was used in choosing 516, 100 and 100 ruminant-livestock owners in East Mamprusi, Savelugu-Nanton and Tamale districts, respectively, for the administration of a questionnaire. The response proportions were 87-99%. Focus-group discussions (FGDs) were done in Savelugu-Nanton and Tamale districts. Animal diseases, housing, and lack of knowledge on management practices were identified as the three most important problems in the districts. Generally, accessibility to veterinary services and drugs was not easy. Large proportions of respondents identified advice on health, bathing or spraying against ectoparasites, castration, deworming, treatment involving injectables, sale of medicines or drugs, treatment for skin diseases, vaccinations, and treatment of wounds as activities that they needed. Many used veterinary staff to meet their needs and were willing to use the services of private veterinary providers if private clinics were established in their localities.

Profile of veterinarians and veterinary practice in Ghana.

This paper presents a profile of veterinary practice and veterinarians in Ghana, as assessed through secondary data and a questionnaire. In all, 123 veterinarians responded, giving a response rate of 85%. (123/145). Analysis of the secondary data from 1986-95 revealed that Veterinary Livestock Units (VLU) per veterinarian ranged from 10000 to 16000 and VLU per technical support staff ranged from 2000 to 3000. However, the distribution of the staff within the country was poor, resulting in very high ratios for the Northern, Upper East, Upper West and Volta Regions and low ratios for Central, Ashanti and Eastern Regions. The bulk of the respondents (78%) had 15 or fewer years of experience. with the overall mean being 12 years. The most common animal species handled were small ruminants and the most common activities were prevention/treatment of worms, surgery and giving advice. Lack of transport ranked highest among the constraints to veterinary work. The perceived determinants of effective and efficient service delivery were the availability and efficiency of means of transport, adequacy of logistics, remuneration for staff in rural posts and farmer education in husbandry practices. The respondents perceived poor management techniques of farmers and lack of credit as major factors hindering livestock production in Ghana. The implications of these and other findings are discussed.

Comparison of methods for isolating Salmonella bacteria from faeces of naturally infected pigs.

A series of experiments was conducted using faecal samples collected from commercial swine farms to evaluate the effects of variation in methods used for the detection of Salmonella bacteria. The primary objective of the studies was to compare the protocols routinely used in two laboratories in the USA. The studies included five experiments comparing the enrichment protocols used routinely in the respective laboratories (Method 1: 10 g faeces--buffered peptone water (BPW) pre-enrichment--selective enrichment in Rappaport/Vassiliadis (RV) broth; Method 2: approximately 1g faeces--primary enrichments in tetrathionate and Hajna GN broths--secondary enrichment in RV broth). The effects of enrichment temperatures (37 vs 42 degrees C) using RV broth (two experiments) and delayed secondary enrichment (four experiments) were also evaluated. Direct comparison of Method 1 and Method 2 indicated comparable results. However, when compared using faecal samples of equal weight, the Method 2 enrichment protocol was more sensitive for detecting Salmonella bacteria than the Method 1 protocol. Enrichment in RV at 42 degrees C was superior to 37 degrees C, particularly for samples that were pre-enriched in BPW. Delayed secondary enrichment increased detection of Salmonella bacteria in swine faeces. These results highlight the imperfect sensitivity of culture methods, and the need for researchers to consider the sensitivity of bacteriological methods in the design and interpretation of the results of epidemiologic studies based on faecal culture.

Perceptions of veterinarians regarding privatization of veterinary services delivery in Ghana and Jamaica.

There are on-going reforms in the delivery of veterinary services in many developing countries, with privatization of certain veterinary activities as one of the approaches. In Jamaica, with the support of veterinarians, clinical aspects of veterinary services were privatized in 1992. In contrast, Ghanaian veterinarians are generally wary of the government's on-going privatization process. The objective of this study was to find out if perceptions of the veterinarians from these two countries on certain issues of privatization were sufficiently different to explain the willingness or reluctance to go into private practice. The response proportions for predominantly self-administered questionnaires were 83% (121/145) and 92% (35/38) for Ghana and Jamaica, respectively. There was a very good (92%) agreement in the perceptions of veterinarians in Ghana and Jamaica on a battery of 24 responses pertaining to privatization of veterinary services. Generally, the perceptions of the veterinarians in Ghana and Jamaica were similar even though the predominant delivery systems for animal health services were different. Therefore, reasons other than those examined in this study may explain the differences in willingness to go into private practice. The need to account for these other reasons is discussed.

Financing the delivery of animal health services in developing countries: a case study of Ghana.

Inadequate financing for the delivery of animal health services in many developing countries has been blamed for lack of efficiency and effectiveness of veterinary services. There are no reports of how the delivery of veterinary services in Ghana is financed. The aim of this paper is to provide information on the funding of veterinary services in Ghana to help in decision making on resource allocation. Various indicators and measures were used in assessing the adequacy of financing and resource allocation from 1990 to 1995. These measures were the veterinary budget as proportions of the national budget, GDP and AGDP; the proportions of the veterinary budget allocated to salaries; the ratios of salaries to non-staff expenditure and of non-staff expenditure to veterinary livestock units and technical staff; coefficient of efficacy; and R-ratio. These generally declined or worsened over the period, deviating from recommended norms where such norms exist. This confirmed the paucity of financing and resource allocation for the delivery of veterinary services. Revenue generation from cost recovery over the 1993-95 period was a potential source of funding, exceeding 100% of non-staff expenditure for 1993 and 1994. However, the revenue generated was not channelled back to veterinary services but went to the national coffers. This served as a disincentive. There is an urgent need to review how veterinary services are financed in Ghana, if the delivery of services is to improve in efficiency and effectiveness.

Perceived constraints to privatization of delivery of veterinary services in Ghana.

Ghana is on the verge of privatizing selected activities in the delivery of animal health services. However, various constraints are being encountered. The aim of this paper is to identify these constraints so as to help find and solutions to them. Questionnaires were administered to veterinarians in Ghana to elicit their responses on various issues concerning privatization. A significant proportion (61%) of government veterinarians, who formed 94% of the respondents, were unwilling to go into private practice. Among the reasons given were that private practice was too risky, that farmers were unwilling or unable to pay for services, that capital to start practices was lacking and that the societal value for animals was low. Also, low livestock densities in many areas and the absence of commercial livestock farming were perceived as deterrents to the sustainability of private practice. Furthermore, the poor macroeconomic environment of high inflation, high interest rates and unstable currency discouraged investment. If privatization of veterinary services is to succeed in Ghana, these perceptions have to be addressed and solutions found, since veterinarians are the targets of the privatization process.

Perceptions of veterinarians regarding privatization of veterinary services delivery in Ghana and Jamaica

There are on-going reforms in the delivery of veterinary services in many developing countries, with privatization of certain veterinary activities as one of the approaches. In Jamaica, with the support of veterinarians, clinical aspects of veterinary services were privatized in 1992. In contrast, Ghanian veterinarians are generally wary of the government's on-going privatization process. The objective of this study is to find out if perceptions of the veterinarians from these two countries on certain issues of privatization were sufficiently different to explain the willingness or reluctance to go into private practice. The response proportions for predominantly self-administered questionnaires were 83 percent (121/145) and 92 percent (35/38) for Ghana and Jamaica, respectively. There was a very good (92 percent) agreement in the perceptions of veterinarians in Ghana and Jamaica on a battery of 24 responses pertaining to privatization of veterinary services. Generally, the perceptions of the veterinarians in Ghana and Jamaica were similar even though the predominant delivery systems for animal health services were different. Therefore, reasons other than those examined in this study may explain the differences in willingness.(Au)

Financing the delivery of public-sector animal health services in Jamaica: pre- and post-privatization

Lack of adequate financing was a major reason for the privatization of veterinary services in Jamaica in 1992. The belief was that, with privatization, funding of animal health services delivery would improve, since staff numbers and clinical activities undertaken by the Veterinary Division were reduced. However, analyses of data revealed that, in most cases, privatization neither improved nor stemmed the declines, that had started before privatization, in the measures or indicators used. It was concluded that privatization of veterinary services did not result in any appreciable improvement in the financing of the delivery of public-sector animal health services in Jamaica in the short term (Au)