Correlates of prevalent HIV infection among adolescents, young adults, and older adult female sex workers in Ghana: Analysis of data from the Ghana biobehavioral survey.

BACKGROUND: Human immunodeficiency virus infection remains a high burden among key populations such as female sex workers in the world. We aimed to provide distribution of prevalence and correlates of Human immunodeficiency virus infection among adolescent, young, and older adult FSWs in Ghana. METHODS: This data was obtained from the biobehavioral survey of female sex workers (2020) in Ghana based on a time location sampling approach for the selection of respondents. A sampling frame was developed taking into consideration list of venues, days, and time that sex workers operate across all the regions of Ghana. These lists were derived from a sampling universe which was obtained during a mapping exercise. All sex workers aged 16 years and above and eligible on the day of visit participated. Human immunodeficiency virus testing was done based on First Response and Oraquick. To obtain estimates for sex workers, sampling weights were calculated and applied to the dataset. Inferential analyses using Bayesian regression models were applied with interaction effects. RESULTS: A total of 5,990 participants completed both the biological and behavioral aspects of the study. The HIV prevalence among female sex workers in Ghana was 4.67% (CI: 4.05%, 5.40%). About 70% of the respondents who tested positive for Human immunodeficiency virus were among the older adults (= >25 years) group. Generally, there was a high prevalence variation across the 16 regions of Ghana, from 0.00% to 8.40%. Respondents' age was a significant contributor to the prevalence of HIV. Respondents who were forced into having sex had higher odds (38%) of being positive in the combined analysis. Respondents who had comprehensive knowledge of HIV had lower odds (39%) of testing positive. CONCLUSION: The findings suggest a low prevalence of HIV among sex workers in 2020 compared to the 2011 and 2015 biobehavioral survey results but higher than the general population. Specifically, older adults have a higher prevalence of HIV. There is generally low level of comprehensive knowledge among sex workers. Interventions geared towards increasing FSW knowledge on risky behavior should be vigorously pursued.

Exploring factors influencing acceptability of online capacity building platform for HIV and AIDS monitoring and evaluation in Ghana.

Introduction: Ghana's multi-sectoral approach towards the management of HIV and AIDS has resulted in many community-level activities and programs aimed at stopping HIV infections and reducing the impact of HIV and AIDS. This study seeks to investigate whether Monitoring & Evaluation (M&E) officers in Ghana will be willing to join in an electronic learning platform which is web-based as a means of building M&E capacity. Methods: 123 out of 130 participants were involved in the study. Continuous and categorical variables were analysed using means and proportions. Structural equation Modelling technique was used to determine the factors associated with acceptability/intention to use. Results: The results showed that Attitude toward usage had a positive significant influence on acceptability/intention to use (AITU). In addition, experience with online learning and Internet discussion also had a positive influence on perceived usefulness and perceived ease of use respectively. The overall model shows 71% of variation of M&E officers' attitude toward usage on acceptability/intention to use online M&E platform as observed by the covariates in the model. Conclusions: Attitude toward usage was observed to be the strongest determinant of the AITU online HIV/AIDS M&E platform for monitoring and evaluation activities.

Anaemia among women of reproductive age in selected sub-Saharan African countries: multivariate decomposition analyses of the demographic and health surveys data 2008-2018.

Objectives: The burden and highest regional prevalence of anaemia is reported in sub-Saharan Africa (SSA). The study evaluated changes in anaemia prevalence across the Demographic Health Surveys (DHS) periods in SSA and reported factors influencing observed changes in the trend. Method: The study was implemented by a two-stage cross-sectional stratified sampling approach. The study involved women of reproductive age (15-49 years) in sub-Saharan Africa countries (Ghana, Sierra Leone, Mali, and Benin) using two different periods of their demographic health surveys (DHS) data. The study adopted both descriptive and inferential statistical methods. The chi-square test was used to determine the existence of a statistically significant relationship between the outcome and predictor variables and test the observed changes in anaemia. Multivariable logistic regression analyses were conducted on each survey year and the pooled dataset for eligible study countries. Multivariate decomposition analysis was performed to explain how compositional changes and behavioural effects of women characteristics affected the changes in anaemia prevalence. The study reported frequencies, percentages and odds ratios along with their 95% confidence intervals (CI). Results: Ghana and Sierra Leone experienced 17.07% [95% CI: 14.76-19.37, p < 0.001] and 1% [95% CI: 1.0-2.9, p > 0.05] of anaemia decrease from period 1 to period 2, respectively, while Mali and Benin experienced 11% [95% CI: 9.14-12.90, p < 0.001] and 16.7% [95% CI: 14.99-18.5, p < 0.001] of increase in anaemia prevalence from period 1 to period 2, respectively. Behavioural effects explained the decrease in Ghana and the increase in Benin and Mali while endowments or compositional changes explained the decrease in Sierra Leone. Conclusion: Anaemia continues to pose a significant challenge in sub-Saharan Africa. Therefore, there is an imperative need to scale up the implementation of nutrition-related programmes and advocacies to ensure optimum changes in women nutrition-related behaviours.

Variations and Determinants of Anemia among Reproductive Age Women in Five Sub-Saharan Africa Countries.

BACKGROUND: The Ghana Demographic and Health Survey 2014 report indicates that anemia among women in their reproductive age in the country stood at 42 percent, making it a severe public health problem according to the World Health Organization (WHO) classification. WHO Global Observatory data indicates that some sub-Saharan African countries have been able to reduce the prevalence of anemia among women of reproductive age compared to Ghana in 2016. To inform policy decisions, data from the Demographic and Health Surveys 2014-2018 were analyzed to determine the disparities in the prevalence of anemia and related factors among women of reproductive age in Ghana, Ethiopia, Uganda, Tanzania, and Rwanda. METHODS: This research utilized data from the Demographic and Health Surveys 2014, 2016, 2014-2015, 2015-2016, and 2016 from Ghana, Ethiopia, Rwanda, Tanzania, and Uganda, respectively. Respondents were women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue hemoglobin meter. 45,299 women data were extracted from the five countries with 4,644, 14,923, 6,680, 13,064, and 5,988 from Ghana, Ethiopia, Rwanda, Tanzania, and Uganda, respectively. Association between anemia and selected predictive variables was assessed using Pearson's chi-square test statistic. Poisson regression with robust standard errors was used to estimate the prevalence rate ratios of developing anemia. The deviance goodness of fit test was employed to test the fit of the Poisson model to the data set. RESULTS: There was a statistically significant difference in prevalence of 1,962 (42.3%), 3,527 (23.6%), 1,284 (19.3%), 5,857 (44.8%), and 1,898 (31.7%) for Ghana, Ethiopia, Rwanda, Tanzania, and Uganda, respectively, χ 2 = 2,181.86 and p value < 0.001. Parity, pregnancy status, and contraceptives significantly increased the prevalence rate ratio of a woman developing anemia. Women in Ethiopia with a parity of six or more were 58% more likely to develop anemia than those with parity of zero. Tanzanian women who were pregnant had a 14% increased rate ratio of developing anemia. Factors that significantly decreased anemia in this study were wealth index, women's age, and women's highest level of education. Women who were in the higher education category in Ethiopia were 57% less likely to develop anemia. Ugandan women in the richest category of the wealth index were 28% less likely to develop anemia. Rwandan women in the middle category of the wealth index were 20% less likely to develop anemia. Women who were within the 45-49 age category in Ethiopia were 48% less likely to develop anemia. CONCLUSION: The individual country governments should encourage the implementation of increasing female enrollment in higher education. Women in their reproductive age should be encouraged to use modern contraceptives to reduce their anemia prevalence.

Comprehensive Knowledge of HIV and AIDS among Ghanaian Adults from 1998 to 2014: A Multilevel Logistic Regression Model Approach.

BACKGROUND: In order for stakeholders of HIV and AIDS to effectively plan HIV prevention programs, it is expedient to assess the level of individuals' knowledge on the most common preventive methods and misconceptions of the HIV virus. This study examines the trends and determinants of comprehensive knowledge (CK) of HIV and AIDS among Ghanaians from 1998-2014. METHOD: The data used for this study were drawn from the Ghana Demographic Health Surveys (GDHS), 1998-2014. A separate analysis was performed on each survey-year data and GDHS pooled dataset. Additionally, both the male and female datasets were combined. The samples used for the study were 6,389, 10706, 9484, and 13784 representing 1998, 2003, 2008, and 2014, respectively. The pooled dataset consisted of 40363 responses. The Pearson chi-square test and multilevel binary logistic regression analysis were carried out to assess the association between the study variables and CK of HIV and AIDS. RESULTS: CK of HIV and AIDS was found to be lower in women than men (29.24% vs. 37.7%) using the pooled dataset. The Greater Accra region recorded the highest percentage of CK of HIV and AIDS (44.18%), whereas the Northern region recorded the lowest (17.87%) among the 10 administrative regions in Ghana. Comprehensive knowledge of HIV and AIDS was also found to be less likely with an OR of 0.72 (95% CI; 0.65, 0.79, p < 0.001) among persons living in rural areas even after controlling for other study variables. There is also a decrease of CK of HIV and AIDS from 37.35% in 2008 to 32.5% in 2014. The lowest percentage (10.75%) of CK of HIV and AIDS among the four survey years was recorded in 1998. CONCLUSION: There are generally low levels of comprehensive knowledge among the Ghanaian adult population more especially among women. Those residing in rural areas have lower prevalence of CK of HIV and AIDS. To address some of these challenges, there is the need to intensify educational interventions more especially among women and people leaving in rural areas to reverse some of the knowledge gaps and correct the local misconceptions of HIV and AIDS.

Data reporting constraints for the lymphatic filariasis mass drug administration activities in two districts in Ghana: A qualitative study.

OBJECTIVES: Timely and accurate health data are important for objective decision making and policy formulation. However, little evidence exists to explain why poor quality routine health data persist. This study examined the constraints to data reporting for the lymphatic filariasis mass drug administration programme in two districts in Ghana. This qualitative study focused on timeliness and accuracy of mass drug administration reports submitted by community health volunteers. METHODS: The study is nested within a larger study focusing on the feasibility of mobile phone technology for the lymphatic filariasis programme. Using an exploratory study design, data were obtained through in-depth interviews (n = 7) with programme supervisors and focus group discussions (n = 4) with community health volunteers. Results were analysed using thematic content analysis. RESULTS: Reasons for delays in reporting were attributed to poor numeracy skills among community health volunteers, difficult physical access to communities, high supervisor workload, poor adherence reporting deadlines, difficulty in reaching communities within allocated time and untimely release of programme funds. Poor accuracy of data was mainly attributed to inadequate motivation for community health volunteers and difficulty calculating summaries. CONCLUSION: This study has shown that there are relevant issues that need to be addressed in order to improve the quality of lymphatic filariasis treatment coverage reports. Some of the factors identified are problems within the health system; others are specific to the community health volunteers and the lymphatic filariasis programme. Steps such as training on data reporting should be intensified for community health volunteers, allowances for community health volunteers should be re-evaluated and other non-monetary incentives should be provided for community health volunteers.