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1.
Sci Total Environ ; 756: 143889, 2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-33302062

RESUMO

Whale-watching is a global tourism industry whose annual revenue exceeds two billion dollars. Australia is a key player in this industry, especially on the east and west coast where humpback whales migrate each year between their breeding and feeding grounds. However, the global whale-watching industry faces uncertainty from changing whale migration patterns, with whales progressively 'arriving' at the traditional whale-watching areas earlier than in previous years/decades. If the whale-watching industry cannot evolve with these changing dynamics then the arrival of the whales might be missed resulting in a potential loss of revenue. This social-ecological issue has suddenly been exacerbated by the disruption to tourism caused by the global pandemic COVID-19. In this study, we use a systems modelling framework, which combines qualitative and quantitative processes, to evaluate the social-ecological system behaviour of the whale-watching industry. We apply this systems approach to the Gold Coast, one of Australia's premier tourist destinations and home to a vibrant whale-watching industry. The outcome of this systems assessment is that the efficacy of the whale-watching industry is affected through determinants of both supply (ability to respond to changes in whale behaviour) and demand (attractiveness of whale-watching). Furthermore, the recovery time of all tourism after COVID-19 will take years if not decades.


Assuntos
Mudança Climática , Animais , Austrália , Gana , Humanos , Incerteza
2.
Environ Pollut ; 269: 116229, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33321310

RESUMO

In the present study, the daily dose in terms of particle surface area received by citizens living in different low- and middle-income countries, characterized by different lifestyles, habits, and climates, was evaluated. The level of exposure to submicron particles and the dose received by the populations of Accra (Ghana), Cairo (Egypt), Florianopolis (Brazil), and Nur-Sultan (Kazakhstan) were analyzed. A direct exposure assessment approach was adopted to measure the submicron particle concentration levels of volunteers at a personal scale during their daily activities. Non-smoking adult volunteers performing non-industrial jobs were considered. Exposure data were combined with time-activity pattern data (characteristic of each population) and the inhalation rates to estimate the daily dose in terms of particle surface area. The received dose of the populations under investigation varied from 450 mm2 (Florianopolis, Brazil) to 1300 mm2 (Cairo, Egypt). This work highlights the different contributions of the microenvironments to the daily dose with respect to high-income western populations. It was evident that the contribution of the Cooking & Eating microenvironment to the total exposure (which was previously proven to be one of the main exposure routes for western populations) was only 8%-14% for low- and middle-income populations. In contrast, significant contributions were estimated for Outdoor day and Transport microenvironments (up to 20% for Cairo, Egypt) and the Sleeping & Resting microenvironment (up to 28% for Accra, Ghana), highlighting the effects of different site-specific lifestyles (e.g. time-activity patterns), habits, socioeconomic conditions, climates, and outdoor air quality.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Brasil , Países em Desenvolvimento , Egito , Monitoramento Ambiental , Gana , Humanos , Cazaquistão , Tamanho da Partícula , Material Particulado/análise
3.
Chemosphere ; 263: 128156, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33297135

RESUMO

In this study, polybrominated and mixed halogenated dibenzo-p-dioxins and furans (PBDD/Fs and PXDD/Fs), and dioxin-like polychlorinated biphenyls (dlPCBs) were quantified in 24 human milk samples of first-time lactating mothers from Greater Accra region in Ghana. The aims of the study were to determine the concentrations and toxic equivalent concentrations of PBDD/F, PXDD/F and dlPCBs in human milk, and to estimate an infant's daily intake. The samples were analysed for 12 dioxin-like PCBs, 7 congeners of 2,3,7,8-polybrominated dibenzo-p-dioxins and furans (PBDD/Fs), and 7 congeners of 2,3,7,8-mixed halogenated dioxins and furans (PXDD/Fs, where X = Br/Cl). The mean concentrations in human milk ranged from 0.15 to 212.9 pg/g lipid for dlPCB congeners (mean TEQ: 1.67 pg WHO2005-TEQ/g lipid). Lesser concentrations for 2,3,7,8-PXDD/Fs (and PBDD/Fs congeners) ranged between <0.01-1.67 pg/g lipid, with a total mean tentative TEQ of 0.56 pg WHO2005-TEQ/g lipid. For an infant of average weight 7 kg, consuming an estimated volume of 600 mL human milk, the estimated average daily intake of dlPCBs in 21 human milk samples was 4.95 pg TEQ/kg bw/day; contributions from dlPCBs, PXDD/Fs and PBDD/Fs resulted in an average estimated daily intake of 6.56 pg TEQ/kg bw/day. The results obtained in this study, although lower than infant dietary intake estimates in human milk from industrialized countries, exceeded the recommended safety standards of 1 pg TEQ/kg bw/day and 1-4 pg TEQ/kg bw/day from the Agency for Toxic Substances and Disease Registry (ATSDR) and the World Health Organization (WHO), respectively.


Assuntos
Dioxinas , Furanos , Bifenilos Policlorados , Animais , Dibenzofuranos Policlorados , Exposição Dietética , Dioxinas/análise , Feminino , Gana , Humanos , Lactente , Lactação , Mães , Bifenilos Policlorados/análise
4.
Sci Total Environ ; 755(Pt 1): 142501, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33038841

RESUMO

Little evidence exists about the association between fuel type use and risk of respiratory symptoms among infants; we aimed to evaluate this hypothesis through a cohort study in the Northern Region of Ghana. The study was carried out from April 2018 to May 2019. We recruited 28 weeks old pregnant women at selected hospitals and prospectively followed them at birth in the hospital ward to register their newborns and at homes when the baby had attained 3 to 7 months to collect data on respiratory symptoms of infants. A logistic regression model was used to investigate the odds of respiratory symptoms in infants. Exactly 1270 infants completed the study; the average age of women was 27.1 years and standard deviation of 5.1. The study found that infants of mothers who cooked with charcoal and those with firewood had increased odds of having cough with cold 4.10 (95% CI, 2.21-7.61) and 3.95 (95% CI, 2.06-7.58), increased odds of congestion, phlegm with cold by 3.89 (95% CI, 1.73-8.79) and 3.45 (95% CI, 1.44-8.26), increased odds of wheezing 4-14 days or nights by 1.68 (95% CI, 0.72-3.91) and 3.37 (95% CI, 1.41-8.04) and increased odds of seeking medical treatments in a health facility for chest illness by 3.97 (95% CI, 1.31-12.02) and 6.67 (95% CI, 2.14-20.77) in comparison with liquid petroleum gas respectively. Some significant predictors of respiratory infections were maternal malaria, hospitalisations of an infant after birth, residence, cooking location, composite breastfeeding, sharing of a bedroom with infant and air-conditioner or fan in the living room. Our findings indicate increased odds of infant respiratory symptoms in households using solid fuel in Ghana. Although our observational design precludes ascribing any causal relationships, our results are consistent with other studies suggesting clean fuel use during pregnancy and infancy may benefit this vulnerable age group.


Assuntos
Aleitamento Materno , Culinária , Adulto , Estudos de Coortes , Feminino , Gana/epidemiologia , Humanos , Lactente , Recém-Nascido , Mães , Gravidez
5.
Environ Sci Pollut Res Int ; 28(2): 1812-1822, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32857308

RESUMO

Traditional medicine (TM) also known as folk medicine consists of medical knowledge systems that were developed over generations in various countries before the era of modern medicine. Over the last few years, there has been a shift in universal trend from modern medicine to TM because it is believed that these medicines are non-toxic to humans, have little to no side-effects, are readily available and affordable. The purpose of this study was to investigate the essential and non-essential elemental concentrations of ayurvedic medicines (AM), Ghanaian traditional medicines (GTM) and Chinese traditional medicines (CTM). The results indicate that the mean elemental concentrations in TM varied greatly. The mean concentrations of copper and mercury in AM, GTM and CTM ranged from 4 to 45 mg/kg and 0.01 to 2 mg/kg, respectively. Multivariate statistical analyses applied to recognise inter-element associations indicated that at 0.05 significant level, there was a positive correlation between elements suggesting they may have originated from the same source. The study concludes by highlighting the need for monitoring of the elemental concentrations in commonly consumed traditional medicines regularly to detect contamination in these medicines since the occurrence of metals in these medicines above or below legally permissible limits can be harmful to consumers.


Assuntos
Medicina Ayurvédica , Medicina Tradicional , China , Gana , Humanos , Índia
6.
Environ Sci Pollut Res Int ; 28(2): 2119-2131, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32870430

RESUMO

This paper investigates the existence of the Environmental Kuznets Curve for carbon dioxide emissions in Ghana. The causal relationship between economic growth and carbon dioxide emissions being examined and the short-run and long-run parameters of the estimated vector autoregressive models are found to be unstable. This necessitated the use of a time-varying approach and the rolling window Granger causality test to investigate the causal relationship between economic growth and carbon dioxide emissions. We find that GDP has a positive effect on carbon dioxide emissions in the sample periods where GDP Granger causes carbon dioxide emissions. Significant feedbacks from the environment to the economy are observed, with carbon dioxide emissions having a positive effect on GDP in most of the subsample periods. The empirical results show that the Environmental Kuznets Curve for carbon dioxide emissions for Ghana is upward sloping, contrary to the standard Environmental Kuznets Curve theory which postulates an inverted "U"-shaped relationship between economic growth and environmental degradation. The implication of the result is that carbon dioxide emissions increase with increases in GDP. The study recommends that existing policies designed to ensure environmental sustainability and hence control carbon dioxide emissions need to be strengthened and enforced to ensure that the rapid urbanization and industrialization of the Ghanaian economy does not come at a cost to the quality of the environment.


Assuntos
Dióxido de Carbono , Desenvolvimento Econômico , Dióxido de Carbono/análise , Gana , Desenvolvimento Industrial , Urbanização
7.
J Med Imaging Radiat Sci ; 51(4): 604-609, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33342483

RESUMO

BACKGROUND: Radiological examinations have a significant role in the diagnosis and management of Coronavirus disease 2019 (COVID-19), the disease caused by the novel coronavirus SARS-CoV-2. Many COVID-19 patients show typical Chest Computed Tomography (CT Scan) features which can aid in the diagnoses and triaging of such patients. This is especially so in resource-limited settings where access to molecular diagnostic techniques such as Reverse Transcription Polymerase Chain Reaction (RT-PCR) is not optimal. We report chest CT findings in 28 patients diagnosed with COVID-19 in Ghana. OBJECTIVE: To document common chest CT scan findings amongst patients with COVID-19 infection in Ghana. METHOD: Chest CT scans of twenty-eight COVID-19 patients (n = 28) were retrieved and reviewed independently by two experienced radiologists and their findings documented. Two 64 and one 32 slice spiral CT scanners were used at three centres. RESULTS: Chest CT Images from 16 males (57.1.7%) and 12 females (42.9%) patients aged between 36 and 65 years with mean age of 55.9 years (SD-8.4years) were evaluated. Of these, 21 (75.0%) of them were COVID-19 patients who were undiagnosed at the time of imaging while 7 (25.0%) were known confirmed COVID-19 patients. On the chest CT scans (n = 28), 17 (66.7%) patients showed predominantly ground glass opacities while 12 (42.9%) had evidence of consolidation predominantly. In 26 (92.9%) of the patients, the opacities were bilateral and peripheral in distribution. None of these patients had pleural effusion. CONCLUSION: COVID-19 patients tend to manifest typical imaging features on chest CT scan. The most common chest imaging finding was bilateral, peripheral and predominantly basal ground glass opacities. Importantly, these findings were frequently obtained before PCR diagnosis. Chest CT scan can help in the diagnosis and triaging of suspected or confirmed COVID-19 patients in jurisdictions with limited PCR diagnostic capacity and can improve early isolation, contact tracing and treatment thus helping to reduce community spread, morbidity and mortality.


Assuntos
/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica/métodos
8.
BMC Infect Dis ; 20(1): 957, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33317454

RESUMO

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.


Assuntos
Doenças Assintomáticas/epidemiologia , Coinfecção/epidemiologia , Citocinas/sangue , Vírus da Hepatite B/genética , Hepatite B/epidemiologia , Malária Falciparum/epidemiologia , Plasmodium falciparum/genética , Comportamento Sedentário , Adolescente , Adulto , Coinfecção/parasitologia , Coinfecção/virologia , Estudos Transversais , Feminino , Gana/epidemiologia , Hepatite B/sangue , Hepatite B/virologia , Humanos , Malária Falciparum/sangue , Malária Falciparum/parasitologia , Masculino , Pessoa de Meia-Idade , Autorrelato , Adulto Jovem
9.
PLoS One ; 15(12): e0243711, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33301533

RESUMO

BACKGROUND: Global cases of COVID-19 continue to rise, causing havoc to several economies. So far, Ghana has recorded 48,643 confirmed cases with 320 associated deaths. Although summaries of data are usually provided by the Ministry of Health, detailed epidemiological profile of cases are limited. This study sought to describe the socio-demographic features, pattern of COVID-19 spread and the viral load dynamics among subjects residing in northern, middle and part of the southern belt of Ghana. METHODS: This was a cross-sectional retrospective study that reviewed records of samples collected from February to July, 2020. Respiratory specimens such as sputum, deep-cough saliva and nasopharyngeal swabs were collected from suspected COVID-19 subjects in 12 regions of Ghana for laboratory analysis and confirmation by real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS: A total of 72,434 samples were collected during the review period, with majority of the sampled individuals being females (37,464; 51.9%). The prevalence of SARS-CoV-2 identified in the study population was 13.2% [95%CI: 12.9, 13.4). Males were mostly infected (4,897; 51.5%) compared to females. Individuals between the ages 21-30 years recorded the highest number of infections (3,144, 33.4%). Symptomatic subjects had higher viral loads (1479.7 copies/µl; IQR = 40.6-178919) than asymptomatic subjects (49.9; IQR = 5.5-3641.6). There was significant association between gender or age and infection with SARS-CoV-2 (p<0.05). Among all the suspected clinical presentations, anosmia was the strongest predictor of SARS-CoV-2 infection (Adj. OR (95%CI): 24.39 (20.18, 29.49). We observed an average reproductive number of 1.36 with a minimum of 1.28 and maximum of 1.43. The virus trajectory shows a gradual reduction of the virus reproductive number. CONCLUSION: This study has described the epidemiological profile of COVID-19 cases in northern, middle and part of the southern belt of Ghana, with males and younger individuals at greater risk of contracting the disease. Health professionals should be conscious of individuals presenting with anosmia since this was seen as the strongest predictor of virus infection.


Assuntos
/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
10.
PLoS One ; 15(11): e0242170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33186395

RESUMO

OBJECTIVE: To evaluate the cost-effectiveness of a program intended to reduce intrapartum and neonatal mortality in Accra, Ghana. DESIGN: Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. METHODS: A program integrating leadership development, clinical skills and quality improvement training was piloted at the Greater Accra Regional Hospital from 2013 to 2016. The number of intrapartum and neonatal deaths prevented were estimated using the hospital's 2012 stillbirth and neonatal mortality rates as a steady-state assumption. The cost-effectiveness of the intervention was calculated as cost per disability-adjusted life year (DALY) averted. In order to test the assumptions included in this analysis, it was subjected to probabilistic and one-way sensitivity analyses. MAIN OUTCOME MEASURES: Incremental cost-effectiveness ratio (ICER), which measures the cost per disability-adjusted life-year averted by the intervention compared to status quo. RESULTS: From 2012 to 2016, there were 45,495 births at the Greater Accra Regional Hospital, of whom 5,734 were admitted to the newborn intensive care unit. The budget for the systems strengthening program was US $1,716,976. Based on program estimates, 307 (±82) neonatal deaths and 84 (±35) stillbirths were prevented, amounting to 12,342 DALYs averted. The systems strengthening intervention was found to be highly cost effective with an ICER of US $139 (±$44), an amount significantly lower than the established threshold of cost-effectiveness of the per capita gross domestic product, which averaged US $1,649 between 2012-2016. The results were found to be sensitive to the following parameters: DALYs averted, number of neonatal deaths, and number of stillbirths. CONCLUSION: An integrated approach to system strengthening in referral hospitals has the potential to reduce neonatal and intrapartum mortality in low resource settings and is likely to be cost-effective. Sustained change can be achieved by building organizational capacity through leadership and clinical training.


Assuntos
Análise Custo-Benefício , Mortalidade Infantil/tendências , Melhoria de Qualidade/economia , Gana , Implementação de Plano de Saúde/economia , Humanos , Lactente , Anos de Vida Ajustados por Qualidade de Vida , Centros de Atenção Terciária/economia , Centros de Atenção Terciária/normas , Centros de Atenção Terciária/estatística & dados numéricos
11.
PLoS Genet ; 16(11): e1009121, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33166278

RESUMO

In many species, sexual differentiation is a vital prelude to reproduction, and disruption of this process can have severe fitness effects, including sterility. It is thus interesting that genetic systems governing sexual differentiation vary among-and even within-species. To understand these systems more, we investigated a rare example of a frog with three sex chromosomes: the Western clawed frog, Xenopus tropicalis. We demonstrate that natural populations from the western and eastern edges of Ghana have a young Y chromosome, and that a male-determining factor on this Y chromosome is in a very similar genomic location as a previously known female-determining factor on the W chromosome. Nucleotide polymorphism of expressed transcripts suggests genetic degeneration on the W chromosome, emergence of a new Y chromosome from an ancestral Z chromosome, and natural co-mingling of the W, Z, and Y chromosomes in the same population. Compared to the rest of the genome, a small sex-associated portion of the sex chromosomes has a 50-fold enrichment of transcripts with male-biased expression during early gonadal differentiation. Additionally, X. tropicalis has sex-differences in the rates and genomic locations of recombination events during gametogenesis that are similar to at least two other Xenopus species, which suggests that sex differences in recombination are genus-wide. These findings are consistent with theoretical expectations associated with recombination suppression on sex chromosomes, demonstrate that several characteristics of old and established sex chromosomes (e.g., nucleotide divergence, sex biased expression) can arise well before sex chromosomes become cytogenetically distinguished, and show how these characteristics can have lingering consequences that are carried forward through sex chromosome turnovers.


Assuntos
Cromossomos Sexuais/genética , Processos de Determinação Sexual/genética , Diferenciação Sexual/genética , Xenopus/genética , Animais , Feminino , Aptidão Genética , Gana , Masculino , Recombinação Genética
12.
PLoS One ; 15(11): e0242086, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180860

RESUMO

The triple burden of malnutrition is an incessant issue in low- and middle-income countries, and fish has the potential to mitigate this burden. In Ghana fish is a central part of the diet, but data on nutrients and contaminants in processed indigenous fish species, that are often eaten whole, are missing. Samples of smoked, dried or salted Engraulis encrasicolus (European anchovy), Brachydeuterus auritus (bigeye grunt), Sardinella aurita (round sardinella), Selene dorsalis (African moonfish), Sierrathrissa leonensis (West African (WA) pygmy herring) and Tilapia spp. (tilapia) were collected from five different regions in Ghana. Samples were analyzed for nutrients (crude protein, fat, fatty acids, several vitamins, minerals, and trace elements), microbiological quality (microbial loads of total colony counts, E. coli, coliforms, and Salmonella), and contaminants (PAH4 and heavy metals). Except for tilapia, the processed small fish species had the potential to significantly contribute to the nutrient intakes of vitamins, minerals, and essential fatty acids. High levels of iron, mercury and lead were detected in certain fish samples, which calls for further research and identification of anthropogenic sources along the value chains. The total cell counts in all samples were acceptable; Salmonella was not detected in any sample and E. coli only in one sample. However, high numbers of coliform bacteria were found. PAH4 in smoked samples reached high concentrations up to 1,300 µg/kg, but in contrast salted tilapia samples had a range of PAH4 concentration of 1 µg/kg to 24 µg/kg. This endpoint oriented study provides data for the nutritional value of small processed fish as food in Ghana and also provides information about potential food safety hazards. Future research is needed to determine potential sources of contamination along the value chains in different regions, identify critical points, and develop applicable mitigation strategies to improve the quality and safety of processed small fish in Ghana.


Assuntos
Produtos Pesqueiros/análise , Contaminação de Alimentos/análise , Metais Pesados/análise , Nutrientes/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Animais , Bactérias/classificação , Bactérias/isolamento & purificação , Produtos Pesqueiros/classificação , Microbiologia de Alimentos , Gana , Ferro/análise , Chumbo/análise , Mercúrio/análise
13.
PLoS One ; 15(11): e0241488, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166370

RESUMO

INTRODUCTION: The capacity of women to decide on their healthcare plays a key role in their health. In this study, we examined the association between women's healthcare decision-making capacity and their healthcare seeking behaviour for childhood illnesses in Ghana. MATERIALS AND METHODS: We used data from the 2014 Ghana Demographic and Health Survey. A total sample of 2,900 women with children less than 5 years was used for the analysis. Data were processed and analysed using STATA version 14.0. Chi-square test of independence and binary logistic regression were carried out to generate the results. Statistical significance was pegged at 95% confidence intervals (CIs). We relied on the 'Strengthening the Reporting of Observational Studies in Epidemiology' (STROBE) statement in writing the manuscript. RESULTS: Out of the 2,900 women, approximately 25.7% could take healthcare decisions alone and 89.7% sought healthcare for childhood illnesses. Women who decided alone on personal healthcare had 30% reduced odds of seeking healthcare for childhood illnesses compared to those who did not decide alone [AOR = 0.70, CI = 0.51-0.97]. With age, women aged 45-49 had 69% reduced odds of seeking healthcare for childhood illnesses compared to those aged 25-29 [AOR = 0.31, CI = 0.14-0.70]. Women from the Northern and Upper West regions had 72% [AOR: 0.28, CI: 0.11-0.70] and 77% [AOR: 0.23, CI: 0.09-0.58] reduced odds of seeking healthcare for childhood illnesses respectively, compared to those from the Western region. CONCLUSION: Ghanaian women with autonomy in healthcare decision-making, those who were older and those from the Northern and Upper West regions were less likely to seek healthcare for childhood illness. To reduce childhood mortalities and morbidities in Ghana, we recommend educating women such as those who take healthcare decisions alone, older women and women from deprived regions like the Northern and Upper West regions on the need to seek healthcare for childhood illnesses.


Assuntos
Tomada de Decisões , Demografia , Inquéritos Epidemiológicos , Aceitação pelo Paciente de Cuidados de Saúde , Mulheres , Adolescente , Adulto , Criança , Feminino , Gana , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Análise Multivariada , Adulto Jovem
14.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33181874

RESUMO

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.


Assuntos
Infecções por Coronavirus , Emoções , Características da Família , Família , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , Criança , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Medo , Feminino , Gana/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Esperança , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Ocupações , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Estigma Social , Adulto Jovem
15.
J Prim Care Community Health ; 11: 2150132720969483, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33213266

RESUMO

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.


Assuntos
Infecções por Coronavirus/etiologia , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/etiologia , Medição de Risco , Adulto , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Gravidez , Medição de Risco/métodos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
16.
PLoS One ; 15(11): e0241983, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33156874

RESUMO

In this article, we compared the content validity of two instruments used in measuring pediatric pain knowledge and attitudes. This was considered necessary due to the universal differences in culture, semantics and healthcare resources in different parts of the globe. Thirteen (13) pediatric experts in Ghana assessed the content validity of two instruments: the 42-item Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS) and the 41-item Pediatric Healthcare Providers' Knowledge and Attitudes Survey Regarding Pain (PHPKASRP). The relevance and clarity of each item on these instruments were rated on a four-point likert scaled options from 1 (not relevant/ not clear) to 4 (very relevant/ very clear). The item-level content validity index (I-CVI) was calculated by dividing the number of experts who rated an item with 3 or 4 by the total number of experts. The average scale-level content validity index (S-CVI/Ave) was also estimated by summing up the I-CVIs of all items and dividing them by the total number of items. The I-CVIs on the PNKAS ranged from 0.62 to 1.00 for the relevance component and 0.69 to 1.00 for the clarity component. The I-CVIs on the PHPKASRP ranged from 0.62 to 1.00 for both the relevance and clarity components. The S-CVI/Ave were 0.87 and 0.89 for the relevance and clarity aspects on the PNKAS respectively. The S-CVI/Ave for the PHPKASRP instrument were 0.86 and 0.89 for the relevance and clarity aspects correspondingly. At the end of the validation process, 5 items were revised on both instruments whilst 37 and 36 items were maintained on the PNKAS and PHPKASRP instruments respectively. The PNKAS and PHPKASRP have an acceptable level of content validity in the Ghanaian context and recommended for educational and research purposes. Other forms of validity and reliability of these instruments should also be examined in future studies.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Medição da Dor/psicologia , Dor/fisiopatologia , Dor/psicologia , Adulto , Criança , Feminino , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários
18.
Afr Health Sci ; 20(2): 487-596, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163015

RESUMO

Background: It is estimated that almost half of all people living with HIV have some form of neurocognitive impairment, but few studies have looked at the risk of neurocognitive impairment and its associated factors in Ghana, due in part to limited resources for such testing. Objectives: To examine neurocognitive performance in a group of Ghanaians living with HIV and possible factors that contribute to their performance. Methods: One hundred and four patients were assessed using a selection of brief non-invasive neuropsychological assessments as well as the International HIV Dementia Scale. Psycho-behavioural factors (alcohol use, depression, and medication adherence) as well as demographic characteristics and functional daily activities were assessed to determine their association with neurocognitive performance, using linear regression and receiver operating characteristic analyses. Result: About 48% of the participants met the criteria for risk of neurocognitive impairment. Age, education, and symptoms of depression were found to be significantly associated with the risk of impairment. Conclusion: Some people living with HIV showed risk of neurocognitive impairment, which was significantly associated with education, age and depressive symptoms. It is therefore important to consider routine neurocognitive screening in HIV management to recognize any risks for early interventions.


Assuntos
Complexo AIDS Demência/epidemiologia , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Transtornos Cognitivos/epidemiologia , Depressão/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Complexo AIDS Demência/psicologia , Adulto , Fatores Etários , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Transtornos Cognitivos/etiologia , Estudos Transversais , Depressão/etiologia , Escolaridade , Feminino , Gana/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Testes Neuropsicológicos/estatística & dados numéricos , Prevalência , Desempenho Psicomotor , Índice de Gravidade de Doença , Fatores Socioeconômicos
19.
BMC Infect Dis ; 20(1): 890, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33238903

RESUMO

BACKGROUND: There is limited data to guide the prevention and management of surgical site infections (SSI) in low- and middle-income countries. We prospectively studied aetiological agents associated with SSI and their corresponding antibiotic susceptibility patterns in a tertiary hospital in Ghana. METHODS: As part of a cohort study carried out at the surgical department of the Korle Bu Teaching Hospital (KBTH) from July 2017 to April 2019, wound swabs were collected from patients diagnosed with SSI. Isolates cultured from the wound swabs were identified by MALDI TOF and susceptibility testing was conducted according to EUCAST 2020 guidelines. Clinical data were monitored prospectively. RESULTS: Of 4577 patients, 438 developed an SSI and 352 microbial isolates were cultured. Isolates were predominantly Gram negative (286, 81%), a pattern seen for all kinds of surgery and all wound classes. The most common species included Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Acinetobacter baumannii. The majority of organisms were multi-drug resistant including 86% of E. coli, 52% of A. baumannii and 86% of K. pneumoniae; and 65% (17/26) of the cefotaxime-resistant K. pneumoniae were extended spectrum ß-lactamase producing. One of 139 E. coli, 15 of 49 P. aeruginosa, and 6 of 23 A. baumannii were meropenem resistant, but no clonal pattern was found. There was a 1% (5/428) prevalence of methicillin-resistant S. aureus. CONCLUSIONS: The predominance of Gram-negative organisms and the high level of multi-drug resistance indicate a need to re-evaluate antibiotic prophylaxis and treatment protocols in surgical practice in low- and middle-income countries.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecção da Ferida Cirúrgica/tratamento farmacológico , Adulto , Antibioticoprofilaxia , Feminino , Gana/epidemiologia , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Hospitais de Ensino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Infecção da Ferida Cirúrgica/epidemiologia
20.
BMC Med Educ ; 20(1): 465, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33239001

RESUMO

BACKGROUND: Ghana is challenged with shortage of critical human resources for health particularly nurses and midwives in rural hard-to-reach communities. This shortage potentially hinders efforts towards attaining universal access to basic healthcare. More importantly, poor quality of pre-service training for health trainees has the potential to worsen this predicament. There is therefore the need to leverage emerging digital innovations like e-learning to complement existing efforts. This study was conducted several months before the outbreak of COVID-19 to investigate the preparedness, acceptability and feasibility e-learning innovation for nursing and midwifery trainees. METHODS: The study is a cross-sectional descriptive survey involving nursing and midwifery students (n = 233) in one of Ghana's public universities, located in the Volta region of Ghana. Simple random sampling technique was used to collect responses from eligible respondents using a structured questionnaire. Descriptive statistical analysis was done using STATA software (version 12.0). RESULTS: It was found that nearly 100% of respondents owned smartphones that were used mostly for learning purposes including sharing of academic information. Over 70% of respondents particularly used social media, social networking applications and internet searches for learning purposes. Health trainees were however constrained by low bandwidth and lack of seamless internet connectivity within their learning environments to maximize the full benefits of these e-learning opportunities. CONCLUSION: Respondents were predominantly prepared for an e-learning pilot project. These feability findings suggest e-learning is a huge potential that can be used to augment existing approaches for pre-service training of health trainees in Ghana, when implementation threats are sufficiently addressed. Compelling findings of this study are therefore timely to inform evidence-based policy decisions on innovative digitial solutions for pre-service training of health workforce even as the world adapts to the "new normal" situation induced by COVID-19.


Assuntos
Instrução por Computador/estatística & dados numéricos , Bacharelado em Enfermagem/métodos , Tocologia/educação , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Estudos Transversais , Estudos de Viabilidade , Feminino , Gana , Humanos , Projetos Piloto , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Adulto Jovem
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