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1.
Chemosphere ; 240: 124909, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31550590

RESUMO

Environmental pollution and human health issues due to unrestricted electronic waste (e-waste) recycling activities have been reported at a number of locations. Among different e-waste recycling techniques, open burning of e-waste releases diverse metal(loid)s into the environment, which has aroused concern worldwide. In human health risk assessments (HHRAs), oral ingestion of soil can be a major route of exposure to many immobile soil contaminants. In vitro assays are currently being developed and validated to avoid overestimation of pollutants absorbed by the human body when calculating total pollutant concentrations in HHRAs. In this study, Cu, As, Cd, Sb, and Pb bioaccessibility in polluted soils (n = 10) from e-waste open burning sites at Agbogbloshie in Accra, Ghana, was assessed using an in vitro assay, the physiologically based extraction test. A bioaccessibility-corrected HHRA was then conducted to estimate the potential health risks to local inhabitants. The in vitro results (%) varied greatly among the different metal(loid)s (Cu: 1.3-60, As: 1.3-40, Cd: 4.2-67, Sb: 0.7-85, Pb: 4.1-57), and also showed marked variance between the gastric phase and small intestinal phase. The particle sizes of soil samples and chemical forms of metal(loid)s also influenced bioaccessibility values. Using these bioaccessibility values, both the hazard index and carcinogenic risk were calculated. The hazard index was above the threshold value (>1) for 5/10 samples, indicating a potential health risk to local inhabitants.


Assuntos
Resíduo Eletrônico , Metaloides/análise , Medição de Risco , Poluentes do Solo/farmacocinética , Disponibilidade Biológica , Exposição Dietética/efeitos adversos , Exposição Dietética/análise , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Monitoramento Ambiental , Gana , Humanos , Concentração de Íons de Hidrogênio , Metaloides/farmacocinética , Metaloides/toxicidade , Metais/análise , Metais/farmacocinética , Metais/toxicidade , Tamanho da Partícula , Reciclagem , Solo/química , Poluentes do Solo/análise , Poluentes do Solo/toxicidade
2.
J Environ Manage ; 254: 109807, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31733472

RESUMO

This study explored willingness of households to adopt a greywater treatment and reuse system using the theory of planned behaviour in its original form and an extended model including personal norms. The study was conducted among 478 household heads in the central region of Ghana. The results indicate the original theory of planned behaviour (TPB) model explained about 54% of the variance in respondents' intentions to adopt this system and the extended model which includes personal norms explained 59% of the intentions. The extended model turned out to be the better model to predict willingness to adopt this household greywater and treatment system. The findings of this study shed more light on the role of personal norms in households' willingness to adopt a greywater treatment and reuse system and may inform interventions aimed at promoting such systems.


Assuntos
Países em Desenvolvimento , Teoria Psicológica , Características da Família , Gana , Intenção , Inquéritos e Questionários
3.
Pan Afr Med J ; 34: 44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762911

RESUMO

Introduction: Cervical cancer is a major cause of death amongst women around the world. In Ghana, it accounts for over 2,119 female deaths and about 3,151 new diagnoses of the disease. It is usually diagnosed at an advanced stage, making it difficult to treat. This study aims at assessing the knowledge on risk factors, prevention and treatment of cervical cancer among women in Kenyase Bosore, Ghana. Methods: This study was a cross-sectional descriptive study conducted among women in Bosore Kenyase, Ghana. A total of 200 women were selected for the studies using the convenience sampling technique. Structured questionnaires were used for data collection and statistical package for social sciences application was also used to analyse the data. Pearson chi-square test was used to find associations between knowledge and awareness level and socio-demographic characteristics of the participants. Results: Overall, 9.7% of the respondents had high knowledge on cervical cancer, 20.6% had moderate knowledge and 69.7% had low knowledge on cervical cancer. There was a significant association between educational background (p=0.000) and awareness level of the respondents. There was also a significant association between the occupation (p=0.003), educational background (p=0.000) and knowledge level of the respondents. Conclusion: The knowledge level of the respondents was very low. Specifically, the respondents had inadequate knowledge on risk factors, signs and symptoms, prevention and treatment of cervical cancer. The authors recommend the intensification of cervical cancer education in Kenyase Bosore, and Ghana as a whole.


Assuntos
Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias do Colo do Útero/etiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Gana , Humanos , Fatores de Risco , Inquéritos e Questionários , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/terapia , Adulto Jovem
4.
Environ Monit Assess ; 191(12): 716, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31686222

RESUMO

The data presented here are from the Offinso North District Farm Health Study (ONFAHS), a population-based cross-sectional study among vegetable farmers in Ghana. The paper addresses knowledge, pesticide handling practices, and protective measures related to pesticide use by self-reported symptoms for 310 adult farmers who completed a comprehensive questionnaire on pesticide management practices and health. In addition, an inventory was prepared using information supplied by pesticide sellers/dealers in this district. We report that cough and wheezing (but not breathlessness) are positively associated with stirring pesticide preparations with bare hands/drinking water while mixing/applying pesticides, and stirring pesticide preparations with bare hands/drinking water/smoking cigarettes while mixing/applying pesticides. There is a significant exposure-response association between the number of precautionary measures practiced while handling pesticides and cough and wheezing but not with breathlessness. We also found unsafe practices to be associated with sexual dysfunction, nervousness, and lack of concentration. The results also suggest a negative association between practice of any precautionary measure when mixing/applying pesticides and sexual dysfunction, nervousness, and lack of concentration. We found that in spite of the fact that farmers have adequate knowledge about the environment and health effects of pesticides, several unhygienic practices are in widespread use, indicating that knowledge is not necessarily always translated in action. Further action is necessary to promote the safe use of pesticides and to replace existing poor management practices among these and other farmers in Ghana.


Assuntos
Fazendeiros , Conhecimentos, Atitudes e Prática em Saúde , Exposição Ocupacional/análise , Praguicidas , Adulto , Agricultura , Tosse , Estudos Transversais , Gana , Humanos , Sons Respiratórios , Autorrelato
5.
Zootaxa ; 4609(3): zootaxa.4609.3.6, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31717096

RESUMO

The species of Diaclina Jacquelin du Val, 1861 (Tenebrioninae: Alphitobiini) from the Sub-Saharan Africa are revised. Following new species are proposed: Diaclina ashantica sp. nov. (Ghana), D. grandis sp. nov. (Congo), D. muehlei sp. nov. (Rwanda). Diaclina ovalis Gebien, 1921 is revalidated. Following new synonyms are introduced: Diaclina gracilis (Fåhraeus, 1870) = Diaclina depressa Ardoin, 1963 syn. nov., Diaclina elliptica Ardoin, 1969 syn. nov.; Diaclina ovalis Gebien, 1921 = Diaclina decellei Ardoin, 1969 syn. nov. Lectotypes are designated for Diaclina brevicollis Gebien, 1921, D. cameruna Gebien, 1921, D. minuta Gebien, 1921, and D. ovalis Gebien, 1921. Habitus photographs and figures of aedeagi of all examined species are provided, and an identification key for the African species is added.


Assuntos
Besouros , Distribuição Animal , Estruturas Animais , Animais , Congo , Gana , Tamanho do Órgão , Ruanda
6.
Pan Afr Med J ; 33: 236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692655

RESUMO

Introduction: Acute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors. Methods: An observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI. Results: Mean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively. Conclusion: The study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery.


Assuntos
Lesão Renal Aguda/fisiopatologia , Edema/epidemiologia , Febre/epidemiologia , Edema Pulmonar/epidemiologia , Lesão Renal Aguda/diagnóstico , Adulto , Edema/etiologia , Feminino , Febre/etiologia , Gana , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Edema Pulmonar/etiologia , Recuperação de Função Fisiológica , Sódio/sangue , Centros de Atenção Terciária , Adulto Jovem
7.
Pan Afr Med J ; 33: 218, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692718

RESUMO

Introduction: Hepatitis B is a major health concern in Ghana, where prevalence of the virus remains high and most chronic patients are infected during childhood or at birth. This study aimed to determine the prevalence and main factors associated with mother-to-child transmission of hepatitis B in the context of Ghana. Methods: In this cross-sectional pilot study, we tested infants born to hepatitis B positive mothers at a hospital in the Eastern Region of Ghana to determine the prevalence of mother-to-child transmission. A questionnaire was completed by hepatitis B positive mothers to investigate the association between factors surrounding the birth of the child and whether transmission had occurred. These factors were analyzed independently using Fisher's exact test. To investigate the relationship between mother's age at the time of delivery and viral transmission, a univariate logistic regression analysis was performed. Results: The prevalence of mother-to-child transmission was 5.9%, with 51 hepatitis B positive mothers included in the study and three infants testing positive. A majority of infants received the standard hepatitis B vaccination schedule (96.1%) while two-thirds received the birth dose. There was no significant association observed between the clinical interventions reported in the study and mother-to-child transmission. No significant association was observed between the age of the mother at the time of delivery and viral transmission (OR: 1.077, 95% CI: 0.828 - 1.403, p = 0.58). Viral marker testing during pregnancy was absent in the population and could not be reliably assessed. Conclusion: There was a low prevalence of HBV mother-to-child transmission observed despite a clear absence of viral marker and viral load testing. It is recommended that viral profile analysis is performed for hepatitis B positive pregnancies to identify high risk cases.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/virologia , Adulto , Estudos Transversais , Feminino , Gana , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Idade Materna , Projetos Piloto , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Carga Viral , Adulto Jovem
8.
Pan Afr Med J ; 33: 256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692849

RESUMO

A rare case series of traumatic right diaphragmatic rupture with hepatothorax in Ghana is reported. The first case involved a middle-aged man who sustained a penetrating chest injury following an unprovoked attack by a wild bull. The second case was a young woman who sustained a blunt chest injury after being knocked down by a moving vehicle whiles crossing the road. Both presented with ruptured right diaphgramatic rupture and had to undergo repair through thoracotomy after stabilization and the two had been well one year after surgery without any complications or sequelae.


Assuntos
Diafragma/lesões , Fígado/patologia , Ferimentos não Penetrantes/complicações , Ferimentos Penetrantes/complicações , Adulto , Diafragma/cirurgia , Feminino , Gana , Hérnia Diafragmática Traumática/etiologia , Hérnia Diafragmática Traumática/cirurgia , Humanos , Masculino , Ruptura , Traumatismos Torácicos/complicações , Traumatismos Torácicos/cirurgia , Toracotomia/métodos , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/cirurgia
9.
Pan Afr Med J ; 33: 325, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692871

RESUMO

Introduction: Anaemia in pregnancy remains a critical public health concern in many African settings; but its determinants are not clear. The purpose of this study was to assess anaemia at antenatal care initiation and associated factors among pregnant women in a local district of Ghana. Methods: A facility-based cross-sectional survey was conducted. A total of 378 pregnant women attending antenatal care at two health facilities were surveyed. Data on haemoglobin level, helminths and malaria infection status at first antenatal care registration were extracted from antenatal records booklets of each pregnant women. Questionnaires were then used to collect data on socio-demographic and dietary variables. Binary and multivariate logistic regression analyses were done to assess factors associated with anaemia. Results: The prevalence of anaemia was 56%, with mild anaemia being the highest form (31.0%). Anaemia prevalence was highest (73.2%) among respondents aged 15-19 years. Factors that significantly independently reduced the odds of anaemia in pregnancy after controlling for potential confounders were early (within first trimester) antenatal care initiation (AOR=5.01; 95% CI =1.41-17.76; p=0.013) and consumption of egg three or more times in a week (AOR=0.30; 95% CI=0.15-0.81; P=0.014). Conclusion: Health facility and community-based preconception and conception care interventions must not only aim to educate women and community members about the importance of early ANC initiation, balanced diet, protein and iron-rich foods sources that may reduce anaemia, but must also engage community leaders and men to address food taboos and cultural prohibitions that negatively affect pregnant woman.


Assuntos
Anemia/epidemiologia , Educação em Saúde/métodos , Complicações Hematológicas na Gravidez/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Gana , Humanos , Gravidez , Prevalência , Inquéritos e Questionários , Adulto Jovem
10.
Pan Afr Med J ; 33: 299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692876

RESUMO

Introduction: Persons with disabilities have the same sexual and reproductive health (SRH) needs as the abled people but they often face barriers to SRH information and services which are necessary for healthy and safe relationships, protection from HIV and other sexually transmitted infections (STIs). This study sought to access the SRH services among adolescents with disabilities in four Special Needs Schools in Ghana. Methods: The study adopted a cross-sectional study design with a quantitative approach to data collection between the months of January to March, 2018. A structured and pretested questionnaire was used to collect data from adolescents with disabilities from selected schools in Ghana. Both descriptive and inferential statistics were performed using chi-square test and multivariate logistic regression. Results: Majority of participants had hearing disability (52.1%). The average age at menarche among females was 13 years whiles the age at which puberty was attained among boys was 14 years. School teachers were the major source of information on SRH for the respondents (63.7%) followed by parents (12.2%). A majority (67.1%) of respondents had good knowledge of SRH. Factors which were significantly associated with knowledge level were age (p=0.026), religion (p=0.034), sources of information (p<0.001), guardians (p=0.049). Conclusion: The majority of participants had good knowledge of SRH, although their knowledge of contraceptive and access were poor. Only condoms were mostly known. There is the need for increased awareness on the availability of other contraceptives methods and the removal of barriers to contraceptive methods.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva , Saúde Sexual , Adolescente , Anticoncepção/métodos , Estudos Transversais , Feminino , Gana , Acesso aos Serviços de Saúde , Humanos , Masculino , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
11.
Pan Afr Med J ; 33: 320, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692933

RESUMO

Introduction: Occupational stress is a recognized health problem among nurses. Globally, its prevalence varies between 9.2% and 68.0%. It detracts from nurses' quality of life and efficiency of job performance. In Ghana, we do not know the important contributory factors to this problem. Our study sought to identify the important predictors of occupational stress among nurses. Methods: In January 2016, we conducted an institutional-based survey among nurses of Salaga Government Hospital. They completed a five-point Likert type questionnaire adopted from the British Psychological Working Conditions Survey, and the Nurse Stress Index. Across 30 predictor variables, a mean score of 4.00 to 5.00 represented high to extreme occupational stress. We performed bivariate and multivariate analyses to identify important predictors of occupational stress at 95% confidence level. Results: Of 167 nurses, 58.1% (97) were females. Respondents who experienced high to extreme stress levels had a 2.3 times odds of reporting sickness absence (CI: 1.03-5.14). Sources of occupational stress included: manual lifting of patients and pieces of equipment (OR: 16.23; CI: 6.28 - 41.92), the risks of acquiring infections (OR: 14.67; CI 5.90 - 36.46), receiving feedback only upon unsatisfactory performance (OR: 28.00; CI: 9.72 - 80.64), and inadequate opportunities for continuous professional development (OR: 63.50; CI: 19.99 - 201.75). Conclusion: The working conditions of nurses were stressful. The most significant predictors of occupational stress were poor supportive supervision by superiors, lack of adequate skills to perform routine tasks, uncertainty about their job role, and the lack of adequate opportunities for career advancements.


Assuntos
Competência Clínica , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Licença Médica/estatística & dados numéricos , Adulto , Mobilidade Ocupacional , Feminino , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
12.
Pan Afr Med J ; 33: 287, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692942

RESUMO

Catamenial pneumothorax is a rare condition that is often misdiagnosed. It is defined as spontaneous pneumothorax occurring within 72 hours before or after onset of menstruation. Etiology is unknown but could be linked to endometriosis. Pleural ablation via thoracoscopy and hormonal therapy are mainstay treatment options to avoid recurrence. We present a case of a young adult female who experienced gradual painless abdominal distention that resolved spontaneously after each menses twelve years post menarche. She was first seen at a peripheral facility where laparotomy undertaken was negative for suspected ectopic pregnancy. However, a bleeding omental mass was noticed and a biopsy taken. Histopathology reported it as an endometriotic tissue. The patient subsequently had recurrent cyclical chest pains and breathlessness leading to the diagnosis of catamenial pneumothorax. She had chemical pleurodesis done with sterile talc after chest tube drainage and has been well over two years now.


Assuntos
Endometriose/diagnóstico , Pleurodese/métodos , Pneumotórax/diagnóstico , Adulto , Dor no Peito/etiologia , Drenagem/métodos , Feminino , Gana , Humanos , Menstruação/fisiologia , Pneumotórax/terapia
13.
Zootaxa ; 4664(3): zootaxa.4664.3.3, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31716665

RESUMO

Two new species of Casinaria Holmgren, C. camura sp. nov. and C. scalaris sp. nov. and the first record of C. kriechbaumeri (Costa) are recorded from Mongolia. Venturia aquila sp. nov. is described from Ghana. The previously unknown female of V. crassicaput (Morley), an Afrotropical species, is described here for the first time. First records of Venturia anatolica Horstmann from Romania and V. canescens (Gravenhorst) from Mongolia are reported, and an identification key to the Western Palaearctic species of Venturia Schrottky is provided.


Assuntos
Ascomicetos , Himenópteros , Animais , Feminino , Gana , Mongólia , Romênia
14.
BMC Health Serv Res ; 19(1): 693, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615529

RESUMO

BACKGROUND: Hypertension, itself a cardiovascular condition, is a significant risk factor for other cardiovascular diseases. Hypertension is recognized as a major public health challenge in Ghana. Beginning in 2014, a collaborative team launched the community-based hypertension improvement program (ComHIP) in one health district in Ghana. The ComHIP project, a public-private partnership, tests a community-based model that engages the private sector and utilizes information and communication technology (ICT) to control hypertension. This paper, focuses on the various challenges associated with managing hypertension in Ghana, as reported by ComHIP stakeholders. METHODS: A total of 55 informants - comprising patients, health care professionals, licensed chemical sellers (LCS), national and sub-national policymakers - were purposively selected for interview and focus group discussions (FGDs). Interviews were audio-recorded and transcribed verbatim. Where applicable, transcriptions were translated directly from local language to English. The data were then analysed using two-step thematic analysis. The protocol was approved by the two ethics review committees based in Ghana and the third, based in the United Kingdom. All participants were interviewed after giving informed consent. RESULTS: Our data have implications for the on-going implementation of ComHIP, especially the importance of policy maker buy-in, and the benefits, as well as drawbacks, of the program to different stakeholders. While our data show that the ComHIP initiative is acceptable to patients and healthcare providers - increasing providers' knowledge on hypertension and patients' awareness of same- there were implementation challenges identified by both patients and providers. Policy level challenges relate to task-sharing bottlenecks, which precluded nurses from prescribing or dispensing antihypertensives, and LCS from stocking same. Medication adherence and the phenomenon of medical pluralism in Ghana were identified challenges. The perspectives from the national level stakeholders enable elucidation of whole of health system challenges to ComHIP and similarly designed programmes. CONCLUSIONS: This paper sheds important light on the patient/individual, and system level challenges to hypertension and related non-communicable disease prevention and treatment in Ghana. The data show that although the ComHIP initiative is acceptable to patients and healthcare providers, policy level task-sharing bottlenecks preclude optimal implementation of ComHIP.


Assuntos
Hipertensão/prevenção & controle , Doenças não Transmissíveis/prevenção & controle , Pessoal Administrativo , Adulto , Conscientização , Serviços de Saúde Comunitária/organização & administração , Feminino , Grupos Focais , Gana , Programas Governamentais , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Política de Saúde , Hospitais , Humanos , Masculino , Assistência Médica , Setor Privado , Saúde Pública , Setor Público , Parcerias Público-Privadas , Pesquisa Qualitativa , Fatores de Risco
15.
BMC Public Health ; 19(1): 1368, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651271

RESUMO

BACKGROUND: To determine the potential risk factors for injury, estimate the annual injury rate and examine the safety perceptions, and use of personal protective equipment among small-scale gold miners in Ghana. METHODS: A cross-sectional survey was carried out with 494 small-scale gold miners from four major mining districts in Ghana. A household-based approach was used to obtain a representative sample of miners. The study was conducted from June 2015 to August 2016. A systematic sampling technique was used to select households and recruit respondents to interview. Miners were asked about any mining related injury that they had sustained in the past year. A logistics regression model was employed to examine the association between risk factors and injury. Data were analyzed with STATA version 14.0. RESULTS: The annual incidence rate of mining-related injury was 289 per 1000 workers. Injuries were mainly caused by machinery/tools 66(46.1%), followed by slip/falls 46(32.2%). The major risk factor for injury was underground work (adjusted odds ratio for injury 3.19; 95% CI = 1.42-7.20) compared with surface work. Higher education levels were protective, with adjusted odds ratios of 0.48 (95% CI = 0.24-0.99) for middle school education and 0.38 (95% CI 0.17-0.83) for secondary school compared with no schooling. Only 15(3.0%) of miners reported to have had safety training in the past year and 105(21.3%) indicated that there were safety regulations at their work place. A moderate number of workers reported using work boots 178(36.0%) and hand gloves 134(27.1%), but less than 10% of workers used other personal protective equipment. CONCLUSION: The annual injury incidence rate among small-scale gold miners is high. Potential targets for improving safety include increasing safety training, increasing use of personal protective equipment, and better understanding potential changes that can be made in the machinery and tools used in small-scale mining, which were associated with almost half of all injuries.


Assuntos
Ouro , Mineradores/estatística & dados numéricos , Mineração , Traumatismos Ocupacionais/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
16.
BMC Infect Dis ; 19(1): 898, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660876

RESUMO

BACKGROUND: Salmonella infection poses significant public health threat globally, especially in resource-limited countries. Emergence and spread of antibiotic resistant strains to fluoroquinolones have led to treatment failures and increased mortality in Salmonella infection. However, there is dearth of information regarding mechanisms of resistance to fluoroquinolones in Ghana. This study therefore sought to identify chromosomal mutations and plasmid-mediated resistance as possible mechanisms of fluoroquinolone resistance from clinical isolates in Ghana. METHODS: This was a retrospective study of archived isolates biobanked at Kumasi Centre for Collaborative Research in Tropical Medicine, Ghana. Isolates were obtained from blood, stool and oropharynx samples at two hospitals, between May, 2016 and January, 2018. Salmonella identification was done using standard microbiological protocols and antibiotic susceptibility testing performed by Kirby-Bauer disc diffusion method. Isolates with intermediate susceptibility and/or resistance to nalidixic acid and/or ciprofloxacin were selected and examined for chromosomal mutations by Sanger sequencing and plasmid-mediated resistance by PCR. RESULTS: Of 133 biobanked isolates cultured, 68 (51.1%) and 16 (12%) were identified as Salmonella Typhi and non-typhoidal Salmonella (NTS), respectively. Sequence analysis of gyrA gene revealed the presence of 5 different nonsynonymous mutations, with the most frequent mutation (Ile203Ser) occurring in 12 out of 13 isolates tested. Gyrase B (gyrB) gene had 1 nonsynonymous mutation in 3 out of 13 isolates, substituting phenylalanine with leucine at codon 601 (Phe601Leu). No mutation was observed in parC and parE genes. Two NTS isolates were found to harbour qnrS plasmid-mediated resistant gene of molecular size 550 bp with high ciprofloxacin MIC of 0.5 µg/ml. CONCLUSION: This study reports for the first time in Ghana plasmid-mediated fluoroquinolone resistant gene qnrS in Salmonella clinical isolates. Nonsynonymous mutations of gyrA and gyrB genes likely to confer Salmonella reduced susceptibility to ciprofloxacin were also reported.


Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/genética , Fluoroquinolonas/efeitos adversos , Fluoroquinolonas/uso terapêutico , Genes Bacterianos/genética , Plasmídeos/metabolismo , Infecções por Salmonella/tratamento farmacológico , Salmonella enterica/genética , Adolescente , Pré-Escolar , Ciprofloxacino/efeitos adversos , Ciprofloxacino/uso terapêutico , DNA Girase/genética , DNA Topoisomerase IV/genética , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Feminino , Gana , Humanos , Masculino , Mutação , Estudos Retrospectivos , Salmonella enterica/isolamento & purificação , Adulto Jovem
17.
Int J Occup Environ Med ; 10(4): 159-173, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31586381

RESUMO

BACKGROUND: The palm oil industry is the largest contributor to global production of oils and fats. Indonesia and Malaysia are the largest producers of palm oil. More than a million workers are employed in this industry, yet there is a lack of information on their occupational health and safety. OBJECTIVE: To identify and summarize occupational hazards among oil palm plantation workers. METHODS: A search was carried out in June 2018 in PubMed, Web of Science, Scopus, and Ovid. Relevant publications were identified by a systematic search of four databases and relevant journals. Publications were included if they examined occupational hazards in oil palm plantation workers. RESULTS: 941 publications were identified; of these, 25 studies were found eligible to be included in the final review. Of the 25 studies examined, 19 were conducted in Malaysia, 2 in Costa Rica, and one each in Ghana, Indonesia, Myanmar, Papua New Guinea, and Cameroon. Oil palm plantation workers were found to be at risk of musculoskeletal conditions, injuries, psychosocial disorders, and infectious diseases such as malaria and leptospirosis. In addition, they have potential exposure to paraquat and other pesticides. CONCLUSION: In light of the potential of palm oil for use as a biofuel, this is an industry with strong growth potential. The workers are exposed to various occupational hazards. Further research and interventions are necessary to improve the working conditions of this already vast and growing workforce.


Assuntos
Indústria Alimentícia , Exposição Ocupacional , Saúde do Trabalhador , Óleo de Palmeira , Doenças dos Trabalhadores Agrícolas/epidemiologia , Camarões/epidemiologia , Comorbidade , Costa Rica/epidemiologia , Indústria Alimentícia/normas , Indústria Alimentícia/estatística & dados numéricos , Inocuidade dos Alimentos , Gana/epidemiologia , Humanos , Indonésia/epidemiologia , Malásia/epidemiologia , Mianmar/epidemiologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Óleo de Palmeira/efeitos adversos , Papua Nova Guiné/epidemiologia , Praguicidas/toxicidade , Óleos Vegetais/efeitos adversos
18.
Int J Gynaecol Obstet ; 147(2): 140-146, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31571230

RESUMO

OBJECTIVE: To explore the knowledge of Developmental Origins of Health and Disease (DOHaD) concepts among midwives and obstetricians and to identify barriers and facilitators for clinicians to engage women and their partners before or early in pregnancy on risk factors associated with DOHaD, and thus to embed the concept of DOHaD in routine clinical practice. METHODS: A qualitative study using semi-structured interviews will be conducted in Ghana, India, Pakistan, Brazil, the UK, and USA in collaboration with the International Confederation of Midwives and the International Federation of Obstetricians and Gynecologists. Participants will be contacted via email and telephone interviews will be conducted until data saturation followed by inductive thematic analysis. RESULTS: Findings from this exploratory study will provide new knowledge about the perspectives of midwives and obstetricians on DOHaD and their role in preventing the intergenerational passage of non-communicable disease (NCD) risk and improving preconception care. CONCLUSION: This study will help us understand the current use of DOHaD principles in international maternity care and how this can be improved. Bringing DOHaD to clinical practice will help healthcare practitioners adopt a long-term approach in the prevention of NCDs and childhood obesity and will help women to enter pregnancy in optimum health.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Tocologia/métodos , Obstetrícia/métodos , Cuidado Pré-Concepcional/métodos , Brasil , Feminino , Gana , Humanos , Índia , Tocologia/educação , Obstetrícia/educação , Paquistão , Gravidez , Pesquisa Qualitativa , Melhoria de Qualidade
19.
Pan Afr Med J ; 33: 123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565114

RESUMO

Introduction: The proportion of antenatal attendants in Ghana who had at least four antenatal visits increased from 78% in 2008 to 87% in 2014. However, it is not known whether these visits followed the recommended timing of focused antenatal clinic attendance in Ghana. We sought to assess the adherence to the clinic schedule and its determinants in the Accra Metropolis. Methods: A cross-sectional study was conducted. Face-to-face interviews were conducted with postpartum women. Multiple logistic regression was used in the analysis of determinants of adherence to the recommended timing of clinic attendance. A p-value of <0.05 was considered statistically significant. Results: Among 446 focused antenatal care clinic attendants, 378 (84.8%) had four or more visits. Among these, 101 (26.7%) adhered to the recommended clinic schedule. Women who adhered were more likely to have had education up to Junior High School [AOR=3.31, 95%CI (1.03-10.61)] or Senior High School [AOR=4.47, 95%CI (1.14-17.51)], or have history of abortion [(AOR=3.36, 95%CI (1.69-7.96)]. For every week increase in gestational age at booking at the antenatal clinic, respondents were 34% less likely to complete all four antenatal visits at the recommended times. [(AOR=0.66, 95% (0.60-0.73)]. Conclusion: Majority of women receiving focused antenatal care in the Accra Metropolis have four or more visits but only about a quarter of them adhered to the recommended clinic schedule. Having high school education, history of abortion and early initiation of antenatal care were predictors of adherence to clinic schedule. Women should be educated on early initiation of antenatal care to enhance adherence.


Assuntos
Idade Gestacional , Cooperação do Paciente/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Estudos Transversais , Escolaridade , Feminino , Gana , Humanos , Entrevistas como Assunto , Modelos Logísticos , Gravidez , Fatores de Tempo , Adulto Jovem
20.
Pan Afr Med J ; 33: 186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565146

RESUMO

Introduction: Acute gastroenteritis (AGE) is a leading cause of mortality in children in developing countries. Management of AGE consumes medical resources, including antibiotics and intra-venous fluids, but factors affecting resource utilization in the management of AGE are under-studied. We hope to identify clinical predictors of resource utilization in AGE. Methods: We performed a retrospective chart review of patients 1-60 months of age admitted to a tertiary hospital in Northern Ghana between January 2013 and December 2014 with an admitting diagnosis of AGE. We collected data on patient demographics, presenting symptoms, and subsequent management. Our primary outcome was prolonged hospital length of stay, defined as >4 days. Secondary outcomes included other measures of resource utilization, such as use of antibiotics, antimalarials and intravenous fluids. Demographic and clinical characteristics were compared between groups with Pearson chi square test for categorical variables and ANOVA for continuous variables. Multivariable logistic regression modeling for each outcome included all variables found to be significant in the bivariate analysis. Results: We reviewed charts for 473 patients admitted for AGE during this timeframe. 264 (56%) were male, median age was 12 months. 448 (95%) received antibiotics, 396 (84%) received antimalarials and 365 (77.2%) received intravenous fluids. 167 (35.3%) had prolonged LOS >4 days. Following multiple logistic regression analysis, clinical features associated with prolonged LOS included fever duration (OR 2.87, 95% CI 2.28-3.61 per 1-day increase), mild (OR 2.39, 95% CI 1.12-5.08) or moderate (OR 3.13, 95% CI 1.57-6.21) dehydration (compared to none) and symptom duration (OR 1.13, 95% CI 1.01-1.27 per 1-day increase). Conclusion: Dehydration and duration of symptoms prior to presentation predict prolonged hospital LOS in young children with AGE in Northern Ghana.


Assuntos
Desidratação/terapia , Gastroenterite/terapia , Hospitalização/estatística & dados numéricos , Doença Aguda , Antibacterianos/administração & dosagem , Antimaláricos/administração & dosagem , Pré-Escolar , Desidratação/epidemiologia , Feminino , Febre/epidemiologia , Hidratação/estatística & dados numéricos , Gana , Recursos em Saúde/estatística & dados numéricos , Humanos , Lactente , Tempo de Internação/estatística & dados numéricos , Modelos Logísticos , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária
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