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1.
BMC Infect Dis ; 21(1): 661, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34233627

RESUMO

BACKGROUND: Pneumococcal vaccine immunizations may be responsible for alterations in serotype epidemiology within a region. This study investigated the pneumococcal carriage prevalence and the impact of the 13-valent pneumococcal conjugate vaccine (PCV-13) on circulating serotypes among healthy children in Northern Ghana. METHODS: This was a cross sectional study conducted in the Kassena-Nankana districts of Northern Ghana from November to December during the dry season of 2018. Nasopharyngeal swabs collected from 193 participants were cultured per standard microbiological protocols and pneumococcal isolates were serotyped using the latex agglutination technique and the capsular Quellung reaction test. We examined for any association between the demographic characteristics of study participants and pneumococcal carriage using chi-square test and logistic regression. RESULTS: Of the 193 participants that were enrolled the mean age was 8.6 years and 54.4% were females. The carriage rate among the participants was 32.6% (63/193), and twenty different serotypes were identified. These included both vaccine serotypes (VT), 35% (7/20) and non-vaccine serotypes (NVT), 65% (13/20). The predominant serotypes (34 and 11A), both of which were NVT, accounted for a prevalence of 12.8%. PCV-13 covered only 35% of serotypes identified whiles 40% of serotypes are covered by PPV 23. CONCLUSION: Post-vaccination carriage of S. pneumoniae is high and is dominated by non-vaccine serotypes. There is therefore a need for the conduct of invasive pneumococcal disease surveillance (IPD) to find out if the high non-vaccine serotype carriage translates to disease. And in addition, a review of the currently used PCV-13 vaccine in the country would be considered relevant.


Assuntos
Portador Sadio/epidemiologia , Nasofaringe/microbiologia , Infecções Pneumocócicas/diagnóstico , Vacinas Pneumocócicas/administração & dosagem , Streptococcus pneumoniae/isolamento & purificação , Portador Sadio/microbiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Lactente , Testes de Fixação do Látex , Masculino , Infecções Pneumocócicas/epidemiologia , Vacinas Pneumocócicas/imunologia , Prevalência , Sorogrupo , Streptococcus pneumoniae/imunologia , Vacinação
2.
Artigo em Inglês | MEDLINE | ID: mdl-34199996

RESUMO

The Greater Accra Region is the smallest of the 16 administrative regions in Ghana. It is highly populated and characterized by tropical climatic conditions. Although efforts towards malaria control in Ghana have had positive impacts, malaria remains in the top five diseases reported at healthcare facilities within the Greater Accra Region. To further accelerate progress, analysis of regionally generated data is needed to inform control and management measures at this level. This study aimed to examine the climatic drivers of malaria transmission in the Greater Accra Region and identify inter-district variation in malaria burden. Monthly malaria cases for the Greater Accra Region were obtained from the Ghanaian District Health Information and Management System. Malaria cases were decomposed using seasonal-trend decomposition, based on locally weighted regression to analyze seasonality. A negative binomial regression model with a conditional autoregressive prior structure was used to quantify associations between climatic variables and malaria risk and spatial dependence. Posterior parameters were estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling. A total of 1,105,370 malaria cases were recorded in the region from 2015 to 2019. The overall malaria incidence for the region was approximately 47 per 1000 population. Malaria transmission was highly seasonal with an irregular inter-annual pattern. Monthly malaria case incidence was found to decrease by 2.3% (95% credible interval: 0.7-4.2%) for each 1 °C increase in monthly minimum temperature. Only five districts located in the south-central part of the region had a malaria incidence rate lower than the regional average at >95% probability level. The distribution of malaria cases was heterogeneous, seasonal, and significantly associated with climatic variables. Targeted malaria control and prevention in high-risk districts at the appropriate time points could result in a significant reduction in malaria transmission in the Greater Accra Region.


Assuntos
Malária , Teorema de Bayes , Gana/epidemiologia , Humanos , Incidência , Malária/epidemiologia , Análise Espaço-Temporal
3.
Artigo em Inglês | MEDLINE | ID: mdl-34281040

RESUMO

BACKGROUND: Emerging research suggests that the novel coronavirus disease (COVID-19) pandemic and associated public health restrictions have caused psychological distress in many contexts. In order for public health authorities and policy makers to effectively address the psychological distress associated with the pandemic, it is important to determine the prevalence and correlates of mental disorders, including depression. OBJECTIVES: We aimed to determine the prevalence, and demographic, social, clinical and other COVID-19 related correlates of major depressive disorder symptoms among the general population in Ghana during the COVID-19 pandemic. METHOD: The study was a cross-sectional survey using online data collection methods. The survey assessed demographic, social and clinical variables as well as COVID-19 related variables. Major depressive disorder symptoms were assessed using the Patient Health Questionnaire-9. The survey link was distributed primarily through WhatsApp-based platforms. Data were analyzed using descriptive and inferential statistics. RESULTS: The overall prevalence of likely MDD symptoms among the sample population was 12.3%. Variables such as employment, loss of jobs during the pandemic and rate of exposure to COVID-related news were independently and significantly associated with the likelihood that respondents had likely MDD. Variables such as gender, relationship, housing status and having a family member or friend who was sick from COVID-19 were not independently significantly associated with the likelihood that respondents had likely MDD, when all other factors in the model were controlled. CONCLUSION: This study has identified the prevalence and correlates of depression symptoms in Ghana during the COVID-19 pandemic. There is the urgent need for mental health policy makers and the government of Ghana to have policies in place to alleviate the potential threat to the mental health of the population.


Assuntos
COVID-19 , Transtorno Depressivo Maior , Adulto , Ansiedade , Estudos Transversais , Depressão , Transtorno Depressivo Maior/epidemiologia , Gana/epidemiologia , Humanos , Pandemias , Prevalência , SARS-CoV-2
4.
Pan Afr Med J ; 38: 277, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34122704

RESUMO

Introduction: eosinophilia is seen in children infected with parasitic organisms. This study aimed at evaluating eosinophilia in children infected with Plasmodium falciparum, Schistosoma haematobium and intestinal helminths in the Volta Region of Ghana. Methods: five hundred and fifty primary school children were selected for this study from 5 primary schools in 2 districts and a municipal area of the Volta Region of Ghana. Blood, stool and urine samples were obtained and screened for P. falciparum, intestinal helminths and S. haematobium respectively. Socio-demographic information were obtained using a standardized questionnaire administration. Pearson chi square analysis was used to evaluate the association between eosinophilia and parasitic infections, and multivariate logistics regression analysis was used to identify factors independently associated with increased risk of eosinophilia. Results: a total of 145(26.36%) children had eosinophilia of which 107(73.79%) were infected with P. falciparum infection, (p=0.016); 18(12.41%) with S. haematobium infection, (p=0.016); and 3(2.07%) children were infected with intestinal helminth, (p=0.36). Children infected with P. falciparum had 2 times increased risk of eosinophilia (AOR=2.01, 95% CI, [1.29-3.2], p=0.02); while children from Davanu primary school had 4 times increased risk of eosinophilia (AOR=4.3, 95% [2.41-10.10], p<0.001). Conclusion: there was significantly high prevalence of eosinophilia among children infected with P. falciparum infection. A longitudinal study is needed to further understand the immune response of these children to parasitic infections.


Assuntos
Eosinofilia/epidemiologia , Helmintíase/epidemiologia , Malária Falciparum/epidemiologia , Esquistossomose Urinária/epidemiologia , Adolescente , Animais , Criança , Eosinofilia/parasitologia , Feminino , Gana/epidemiologia , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Plasmodium falciparum/isolamento & purificação , Prevalência , Fatores de Risco , Instituições Acadêmicas , Inquéritos e Questionários
5.
BMC Health Serv Res ; 21(1): 584, 2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140000

RESUMO

BACKGROUND: Although the equitable distribution of diabetic retinopathy (DR) services across Ghana remains paramount, there is currently a poor understanding of nationwide DR treatment services. This study aims to conduct a situation analysis of DR treatment services in Ghana and provide evidence on the breadth, coverage, workload, and gaps in service delivery for DR treatment. METHODS: A cross-sectional study was designed to identify health facilities which treat DR in Ghana from June 2018 to August 2018. Data were obtained from the facilities using a semi-structured questionnaire which included questions identifying human resources involved in DR treatment, location of health facilities with laser, vitreoretinal surgery and Anti-vascular endothelial growth factor therapy (Anti-VEGF) for DR treatment, service utilisation and workload at these facilities, and the average price of DR treatment in these facilities. RESULTS: Fourteen facilities offer DR treatment in Ghana; four in the public sector, seven in the private sector and three in the Christian Health Association of Ghana (CHAG) centres. There was a huge disparity in the distribution of facilities offering DR services, the eye care cadre, workload, and DR treatment service (retinal laser, Anti-VEGF, and vitreoretinal surgery). The retinal laser treatment price was independent of all variables (facility type, settings, regions, and National Health Insurance Scheme coverage). However, settings (p = 0.028) and geographical regions (p = 0.010) were significantly associated with anti-VEGF treatment price per eye. CONCLUSION: Our results suggest a disproportionate distribution of DR services in Ghana. Hence, there should be a strategic development and implementation of an eye care plan to ensure the widespread provision of DR services to the disadvantaged population as we aim towards a disadvantaged population as we aim towards a universal health coverage.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Estudos Transversais , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/terapia , Gana/epidemiologia , Instalações de Saúde , Humanos , Cobertura Universal do Seguro de Saúde
6.
BMC Health Serv Res ; 21(1): 590, 2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34147100

RESUMO

BACKGROUND: There have been a major advance made in screening, early diagnosis, and prompt treatment of Diabetic Retinopathy among Person living with diabetes (PLWD). However, screening services remain a challenge in Low-Middle-Income-Countries where access to eye care professionals is inadequate. This study assesses the utilization of Eye Health Service prevalence (UEHS) among PLWD and associated factors and further quantifies its association with Non-Proliferative Diabetic Retinopathy (NPDR). METHODS: A cross-sectional study design with a random sample of 360 PLWD was conducted at Korle-Bu Teaching Hospital, a National Referral Centre in Ghana from May to July 2019. UEHS and DR were the study outcomes. We adopted Poisson and Probit regression analysis to assess factors associated with UEHS over the past year. We employed pairwise and phi correlation (fourfold correlational analysis) to assess the relationship between UEHS and DR (ordinal and binary respectively). Ordered Logistic and Poisson regression were applied to assess the association between the UEHS and DR. Stata 16.1 was used to perform the analyses and a p-value ≤ 0.05 was deemed significant. RESULTS: The prevalence of UEHS over the past year and DR was 21.7 %(95 %CI = 17.7-26.2) and 65.0 %(95 %CI = 59.9-69.8 respectively. The prevalence of severe NPDR with Clinically Significant Macular Edema (CSME) was 23.9 %(19.8-28.6). Type of diabetes, increasing age, educational level, mode of payment for healthcare services, marital status, years since diagnosis, and current blood glucose significantly influenced UEHS. There was a negative relationship between DR and UEHS (Pairwise and φ correlation were - 20 and - 15 respectively; p < 0.001). Non-UEHS among PLWD doubles the likelihood of experiencing severe NPDR with CSME compared with UEHS among PLWD [aOR(95 %CI) = 2.05(1.03-4.08)]. Meanwhile, the prevalence of DR among patients per non-UEHS was insignificantly higher [12 %; aPR(95 %CI) = 0.89-1.41)] compared with patients who utilized eye care health service. CONCLUSIONS: Most of the PLWD did not utilize the eye health service even once in a year and that was highly influenced by type of diabetes and increasing age. Type 2 diabetes patients and middle age decreased the likelihood of UEHS. There was a negative relationship between DR and UEHS among PLWD and this doubled the likelihood of experiencing severe NPDR with CSME. Structured health education and screening interventions are key to improving UEHS.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Edema Macular , Estudos Transversais , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/terapia , Gana/epidemiologia , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
7.
BMC Health Serv Res ; 21(1): 621, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34187464

RESUMO

BACKGROUND: Early essential newborn care is one of the important interventions developed by the World Health Organization to reduce morbidities and mortalities in neonates. This study investigated the role of the public and private sector health facilities on factors associated with early essential newborn care practices following institutional delivery in Ghana. METHODS: We used data from the 2017/2018 multiple indicator cluster survey for our analysis. A total of 2749 mothers aged 15-49 years were included in the study. Logistic regression analysis was used to assess the factors associated with early essential newborn care in both public and private health sectors. RESULTS: The prevalence of good early essential newborn care in the public sector health facilities was 26.4 % (95 % CI: 23.55, 29.30) whiles that of the private sector health facilities was 19.9 % (95 % CI: 13.55, 26.30). Mothers who had a Caesarean section in the public sector health facilities had 67 % lower odds of early essential newborn care compared to mothers who had a vaginal delivery [adjusted prevalence odds ratios (aPOR) = 0.33, 95 % CI: 0.20, 0.53]. Mothers without a health insurance in the public sector health facilities had 26 % lower odds of early essential newborn care compared to mothers with a health insurance (aPOR = 0.74, 95 % CI: 0.56, 0.97). However, these associations were not observed in the private sector health facilities. CONCLUSIONS: The findings suggest that the prevalence of good early essential newborn care in the public sector health facilities was higher than that reported in the private sector health facilities. Child health programs on early essential newborn care needs to be prioritized in the private healthcare sector. The Government of Ghana may also need to increase the coverage of the national health insurance scheme for women in reproductive age.


Assuntos
Cesárea , Setor Privado , Criança , Parto Obstétrico , Feminino , Gana/epidemiologia , Instalações de Saúde , Humanos , Recém-Nascido , Gravidez
8.
Artigo em Inglês | MEDLINE | ID: mdl-34072525

RESUMO

Pregnancy is associated with several physical and psychosocial challenges that influence women's health and wellbeing. However, prenatal mental health has received little attention. Therefore, this study examined the prevalence and correlates of prenatal depression, anxiety and current suicidal behaviors among pregnant women in the Volta Region of Ghana. Two hundred and fourteen (n = 214) pregnant women recruited from two hospitals responded to the hospital depression and anxiety scale (HADS), the insomnia severity index, and a set of psycho-behavioral, socioenvironmental and demographic characteristic questions. Chi-squared, bivariate and multivariate logistic regression were used for data analysis. Prevalence of prenatal depression, anxiety and current suicidal behaviors was 50.5%, 35.5% and 3.3%, respectively. After controlling for other variables, average monthly income, insomnia, non-nutritious food consumption (pica), and body image satisfaction were significantly associated with depression. Marital status, insomnia, lifetime suicidal behavior and partner support were significantly associated with anxiety. Current partner abuse was the only factor significantly associated with current suicidal behavior. The high prevalence rates of anxiety and depression among pregnant women and intimate partner violence remain important maternal health issues in the region. Therefore, brief mental health screening and counseling services should be integrated into prenatal healthcare services.


Assuntos
Violência por Parceiro Íntimo , Ideação Suicida , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Gana/epidemiologia , Humanos , Gravidez , Prevalência
9.
BMC Public Health ; 21(1): 1120, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34116657

RESUMO

BACKGROUND: While the burden and mortality from chronic non-communicable diseases (CNCDs) have reached epidemic proportions in sub-Saharan Africa (SSA), decision-makers and individuals still consider CNCDs to be infrequent and, therefore, do not pay the needed attention to their management. We, therefore, explored the practices and challenges associated with the management of CNCDs by patients and health professionals. METHODS: This was a qualitative study among 82 CNCD patients and 30 health professionals. Face-to-face in-depth interviews were used in collecting data from the participants. Data collected were analysed using thematic analysis. RESULTS: Experiences of health professionals regarding CNCD management practices involved general assessments such as education of patients, and specific practices based on type and stage of CNCDs presented. Patients' experiences mainly centred on self-management practices which comprised self-restrictions, exercise, and the use of anthropometric equipment to monitor health status at home. Inadequate logistics, work-related stress due to heavy workload, poor utility supply, and financial incapability of patients to afford the cost of managing their conditions were challenges that militated against the effective management of CNCDs. CONCLUSIONS: A myriad of challenges inhibits the effective management of CNCDs. To accelerate progress towards meeting the Sustainable Development Goal 3 on reducing premature mortality from CNCDs, the Ghana Health Service and management of the respective hospitals should ensure improved utility supply, adequate staff motivation, and regular in-service training. A chronic care management policy should also be implemented in addition to the review of the country's National Health Insurance Scheme (NHIS) by the Ministry of Health and the National Health Insurance Authority to cover the management of all CNCDs.


Assuntos
Doenças não Transmissíveis , Gana/epidemiologia , Serviços de Saúde , Humanos , Programas Nacionais de Saúde , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/terapia , Pesquisa Qualitativa
10.
PLoS One ; 16(6): e0253446, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138946

RESUMO

BACKGROUND: COVID-19 is a novel respiratory disease associated with severe morbidity and high mortality in the elderly population and people with comorbidities. Studies have suggested that pregnant women are more susceptible to COVID-19 compared to non-pregnant women. However, it's unclear whether pregnant women in Ghana are knowledgeable about COVID-19 and practice preventive measures against it. This study sought to assess the knowledge and preventive practices towards COVID-19 among pregnant women seeking antenatal services in Northern Ghana. METHODS: A cross-sectional study was conducted using a structured questionnaire in the Nabdam district in Ghana. A total of 527 pregnant women were randomly sampled from health facilities offering antenatal care services in the district. Multivariable logistic regression analysis was used to assess the association between the predictors and outcome variables. RESULTS: The prevalence of adequate knowledge and good COVID-19 preventive practices were 85.6%, (95% CI: 82.57, 88.59) and 46.6%, (95% CI: 42.41, 50.95) respectively. Having at least a primary education, residing in an urban area, and receiving COVID-19 education at a health facility were positively associated with adequate knowledge on COVID-19. Factors positively associated with good COVID-19 preventive practices were older age, having at least a primary education, pregnant women with a chronic disease, and living in an urban area. Multiparity was negatively associated with good COVID-19 preventive practices. CONCLUSION: Although majority of women had adequate knowledge of COVID-19, less than half of them were engaged in good COVID-19 preventive practices. Education of pregnant women on COVID-19 preventive practices should be intensified at health facilities while improving upon the water, sanitation and hygiene need particularly in rural communities.


Assuntos
COVID-19/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Gestantes , Cuidado Pré-Natal/estatística & dados numéricos , Medicina Preventiva/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Estudos Transversais , Escolaridade , Feminino , Gana/epidemiologia , Humanos , Modelos Logísticos , Análise Multivariada , Pandemias/prevenção & controle , Gravidez , Cuidado Pré-Natal/métodos , Medicina Preventiva/métodos , População Rural/estatística & dados numéricos , SARS-CoV-2/fisiologia , Inquéritos e Questionários , Adulto Jovem
11.
PLoS One ; 16(6): e0253800, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34181679

RESUMO

BACKGROUND: The COVID-19 pandemic and control measures adopted by countries globally can lead to stress and anxiety. Investigating the coping strategies to this unprecedented crisis is essential to guide mental health intervention and public health policy. This study examined how people are coping with the COVID-19 crisis in Ghana and identify factors influencing it. METHODS: This study was part of a multinational online cross-sectional survey on Personal and Family Coping with COVID-19 in the Global South. The study population included adults, ≥18 years and residents in Ghana. Respondents were recruited through different platforms, including social media and phone calls. The questionnaire was composed of different psychometrically validated instruments with coping as the outcome variable measured on the ordinal scale with 3 levels, namely, Not well or worse, Neutral, and Well or better. An ordinal logistic regression model using proportional odds assumption was then applied. RESULTS: A total of 811 responses were included in the analysis with 45.2% describing their coping level as well/better, 42.4% as neither worse nor better and 12.4% as worse/not well. Many respondents (46.9%) were between 25-34 years, 50.1% were males while 79.2% lived in urban Ghana. Having pre-existing conditions increased the chances of not coping well (aOR = 1.86, 95%CI: 1.15-3.01). Not being concerned about supporting the family financially (aOR = 1.67, 95%CI: 1.06-2.68) or having the feeling that life is better during the pandemic (aOR = 2.37, 95%CI: 1.26-4.62) increased chances of coping well. Praying (aOR: 0.62, 95%CI: 0.43-0.90) or sleeping (aOR: 0.55, 95%CI: 0.34-0.89) more during the pandemic than before reduces coping. CONCLUSION: In Ghana, during the COVID-19 pandemic, financial security and optimism about the disease increase one's chances of coping well while having pre-existing medical conditions, praying and sleeping more during the pandemic than before reduces one's chances of coping well. These findings should be considered in planning mental health and public health intervention/policy.


Assuntos
Adaptação Psicológica , COVID-19/epidemiologia , COVID-19/psicologia , Quarentena/psicologia , Adolescente , Adulto , Idoso , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
12.
BMC Health Serv Res ; 21(1): 545, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078379

RESUMO

BACKGROUND: Bypassing primary health care (PHC) facilities for maternal health care is an increasing phenomenon. In Ghana, however, there is a dearth of systematic evidence on bypassing PHC facilities for maternal healthcare. This study investigated the prevalence of bypassing PHC facilities for maternal healthcare, and the socio-economic factors and financial costs associated with bypassing PHC facilities within two municipalities in Northwestern Ghana. METHODS: A quantitative cross-sectional design was implemented between December 2019 and March 2020. Multistage stratified sampling was used to select 385 mothers receiving postnatal care in health facilities for a survey. Using STATA 12 software, bivariate analysis with chi-square test and binary logistic regression models were run to determine the socio-economic and demographic factors associated with bypassing PHC facilities. The two-sample independent group t-test was used to estimate the mean differences in healthcare costs of those who bypassed their PHC facilities and those who did not. RESULTS: The results revealed the prevalence of bypassing PHC facilities as 19.35 % for antenatal care, 33.33 % for delivery, and 38.44 % for postnatal care. The municipality of residence, ethnicity, tertiary education, pregnancy complications, means of transport, nature of the residential location, days after childbirth, age, and income were statistically significantly (p < 0.05) associated with bypassing PHC facilities for various maternal care services. Compared to the non-bypassers, the bypassers incurred a statistically significantly (P < 0.001) higher mean extra financial cost of GH₵112.09 (US$19.73) for delivery, GH₵44.61 (US$7.85) for postnatal care and ₵43.34 (US$7.65) for antenatal care. This average extra expenditure was incurred on transportation, feeding, accommodation, medicine, and other non-receipted expenses. CONCLUSIONS: The study found evidence of bypassing PHC facilities for maternal healthcare. Addressing this phenomenon of bypassing and its associated cost, will require effective policy reforms aimed at strengthening the service delivery capacities of PHC facilities. We recommend that the Ministry of Health and Ghana Health Service should embark on stakeholder engagement and sensitization campaigns on the financial consequences of bypassing PHC facilities for maternal health care. Future research, outside healthcare facility settings, is also required to understand the specific supply-side factors influencing bypassing of PHC facilities for maternal healthcare within the study area.


Assuntos
Serviços de Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Gravidez , Atenção Primária à Saúde , Fatores Socioeconômicos
13.
BMC Res Notes ; 14(1): 217, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059138

RESUMO

OBJECTIVES: To explore the mechanisms of collaboration between the stakeholders, including National Tuberculosis Control Program (NTP) and the Non-Communicable Disease Control and Prevention Program (NCDCP) at the national, regional, and local (health facility) levels of the health care system in Ghana. This is one of the objectives in a study on the "Barriers and Facilitators to the Implementation of the Collaborative Framework for the Care and Control of Tuberculosis and Diabetes in Ghana" RESULTS: The data analysis revealed 4 key themes. These were (1) Increased support for communicable diseases (CDs) compared to stagnant support for non-communicable diseases (NCDs), (2) Donor support, (3) Poor collaboration between NTP and NCDCP, and (4) Low Tuberculosis-Diabetes Mellitus (TB-DM) case detection.


Assuntos
Doenças Transmissíveis , Diabetes Mellitus , Tuberculose , Comorbidade , Diabetes Mellitus/epidemiologia , Gana/epidemiologia , Humanos , Tuberculose/epidemiologia , Tuberculose/prevenção & controle
14.
Pediatr Surg Int ; 37(8): 1069-1078, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34059928

RESUMO

PURPOSE: To describe the epidemiology and referral patterns of gastroschisis patients in northern Ghana. METHODS: A hospital-based retrospective review was undertaken at Tamale Teaching Hospital (TTH) Neonatal Intensive Care Unit (NICU) between 2014 and 2019. Data from gastroschisis patients were compared to patients with other surgical diagnoses. Descriptive and inferential statistics were performed with SAS. Referral flow maps were made with ArcGIS. RESULTS: From a total of 360 neonates admitted with surgical conditions, 12 (3%) were diagnosed with gastroschisis. Around 91% (n = 10) of gastroschisis patients were referred from other hospitals, traveling 4 h, on average. Referral patterns showed gastroschisis patients were admitted from three regions, whereas patients with other surgical diagnoses were admitted from eight regions. Only 6% (12/201) of expected gastroschisis cases were reported during the 6-year period in all regions. All gastroschisis deaths occurred within the first week of life. CONCLUSIONS: Improving access to surgical care and reducing neonatal mortality related to gastroschisis in northern Ghana is critical. This study provides a baseline to inform future gastroschisis interventions at TTH. Priority areas may include special management of low birth weight newborns, better referral systems, empowerment of community health workers, and increasing access to timely, affordable, and safe neonatal transport.


Assuntos
Gastrosquise/mortalidade , Acesso aos Serviços de Saúde/normas , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Encaminhamento e Consulta/normas , Estudos de Casos e Controles , Feminino , Gastrosquise/cirurgia , Gana/epidemiologia , Mortalidade Hospitalar , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Estudos Retrospectivos
15.
Pan Afr Med J ; 38: 244, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104292

RESUMO

Introduction: acute respiratory tract infections (ARIs) are responsible for significant proportions of illnesses and deaths annually. Most of ARIs are of viral etiology, with human coronaviruses (HCoVs) playing a key role. This study was conducted prior to the outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to provide evidence about the sero-epidemiology of HCoVs in rural areas of Ghana. Methods: this was a cross-sectional study conducted as part of a large epidemiological study investigating the occurrence of respiratory viruses in 3 rural areas of Ghana; Buoyem, Kwamang and Forikrom. Serum samples were collected and tested for the presence of IgG-antibodies to three HCoVs; HCoV-229E, HCoV-OC43 and HCoV-NL63 using immunofluorescence assay. Results: of 201 subjects enrolled into the study, 97 (48.3%) were positive for all three viruses. The most prevalent virus was HCoV-229E (23%; 95% CI: 17.2 - 29.3), followed by HCoV-OC43 (17%; 95% CI: 12.4 - 23.4), then HCoV-NL63 (8%, 95% CI: 4.6 - 12.6). Subjects in Kwamang had the highest sero-prevalence for HCoV-NL63 (68.8%). human coronaviruses-229E (41.3%) and HCoV-OC43 (45.7%) were much higher in Forikrom compared to the other study areas. There was however no statistical difference between place of origin and HCoVs positivity. Although blood group O+ and B+ were most common among the recruited subjects, there was no significant association (p = 0.163) between blood group and HCoV infection. Conclusion: this study reports a 48.3% sero-prevalence of HCoVs (OC43, NL63 and 229E) among rural communities in Ghana. The findings provide useful baseline data that could inform further sero-epidemiological studies on SARS-CoV-2 in Africa.


Assuntos
Coronavirus Humano 229E/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Coronavirus Humano NL63/isolamento & purificação , Coronavirus Humano OC43/isolamento & purificação , Adulto , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Adulto Jovem
16.
PLoS One ; 16(6): e0252507, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34061896

RESUMO

We recently developed 'cellular' reagents-lyophilized bacteria overexpressing proteins of interest-that can replace commercial pure enzymes in typical diagnostic and molecular biology reactions. To make cellular reagent technology widely accessible and amenable to local production with minimal instrumentation, we now report a significantly simplified method for preparing cellular reagents that requires only a common bacterial incubator to grow and subsequently dry enzyme-expressing bacteria at 37°C with the aid of inexpensive chemical desiccants. We demonstrate application of such dried cellular reagents in common molecular and synthetic biology processes, such as PCR, qPCR, reverse transcription, isothermal amplification, and Golden Gate DNA assembly, in building easy-to-use testing kits, and in rapid reagent production for meeting extraordinary diagnostic demands such as those being faced in the ongoing SARS-CoV-2 pandemic. Furthermore, we demonstrate feasibility of local production by successfully implementing this minimized procedure and preparing cellular reagents in several countries, including the United Kingdom, Cameroon, and Ghana. Our results demonstrate possibilities for readily scalable local and distributed reagent production, and further instantiate the opportunities available via synthetic biology in general.


Assuntos
Teste para COVID-19/normas , COVID-19/diagnóstico , COVID-19/epidemiologia , Testes Diagnósticos de Rotina/normas , Indicadores e Reagentes/normas , Reação em Cadeia da Polimerase em Tempo Real/normas , SARS-CoV-2/genética , COVID-19/virologia , Teste para COVID-19/métodos , Camarões/epidemiologia , Escherichia coli/genética , Escherichia coli/metabolismo , Expressão Gênica , Geobacillus stearothermophilus/genética , Geobacillus stearothermophilus/metabolismo , Gana/epidemiologia , Humanos , Indicadores e Reagentes/química , Indicadores e Reagentes/metabolismo , Indicadores e Reagentes/provisão & distribuição , Técnicas de Diagnóstico Molecular , Plasmídeos/química , Plasmídeos/metabolismo , Reação em Cadeia da Polimerase em Tempo Real/métodos , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/genética , Biologia Sintética/métodos , Transformação Bacteriana , Reino Unido/epidemiologia
17.
Afr J Reprod Health ; 25(1): 56-66, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077111

RESUMO

Maternal death is a major global health issue with the highest impact in low-income countries. Despite some modest decline in the maternal mortality rates in Ghana since the 1990's, this has been below expectation. The aim of this study was to describe the trends and contributory factors to maternal mortality at the Korle Bu Teaching Hospital (KBTH), Accra, Ghana. We performed a retrospective chart review of all maternal deaths at KBTH from 2015 to 2019. Data were analyzed using SPSS version 23. A p-value of <0.05 was considered statistically significant. Over the period, there were 45,676 live births, 276 maternal deaths and a maternal mortality ratio of 604/100,000 live births (95% CI: 590/100,000 - 739/100,000). The leading causes of maternal death were hypertensive disorders (37.3%), hemorrhage (20.6%), Sickle cell disease (8.3%), sepsis (8.3%), and pulmonary embolism (8.0%). Significant factors associated with maternal mortalities at the KBTH were: women with no formal education [AOR 3.23 (CI: 1.73- 7.61)], women who had less than four antenatal visits [AOR 1.93(CI: 1.23-3.03)], and emergency cesarean section [AOR 3.87(CI: 2.51-5.98)]. Hypertensive disorders remain the commonest cause of the high maternal mortality at KBTH. Formal education and improvement in antenatal visits may help prevent these deaths.


Assuntos
Hospitais de Ensino/estatística & dados numéricos , Morte Materna/estatística & dados numéricos , Mortalidade Materna , Complicações na Gravidez/mortalidade , Adolescente , Adulto , Causas de Morte , Feminino , Gana/epidemiologia , Humanos , Hipertensão Induzida pela Gravidez/mortalidade , Morte Materna/etnologia , Paridade , Gravidez , Estudos Retrospectivos , Adulto Jovem
18.
Afr J Reprod Health ; 25(1): 129-137, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077119

RESUMO

Miscarriage is a common adverse pregnancy outcome in childbearing and an increasing global reproductive health problem. This study explored 1) the national prevalence of the first trimester (≤12 weeks) miscarriage among women (15-49 years) in Ghana, and 2) the influence of first-trimester antenatal care (ANC) visits on miscarriage risk. A cross-sectional study using the Demographic Health Survey (DHS- 2017) on maternal health in Ghana was conducted. We used a nationally representative subsample of (7,846) women with no or early ANC visit of the initial sample (25,062). Women with late ANC visit (≥12 weeks) and those who were never pregnant or had not given birth at the time of the survey were excluded from this analysis. We performed multivariable Poisson regression to estimate miscarriage risk (RR), its associated risk factors, and national prevalence. The national first-trimester miscarriage prevalence was 19.1%. Increasing maternal age and urban residence were significantly associated with the risk of first- trimester miscarriage (p <0.001) while early ANC visits lower the risk of miscarriage by 43% (p=0.0246). We found that first trimester ANC visit decreases miscarriage risk in Ghana and highlights the important role of early ANC visits in reducing miscarriages.


Assuntos
Aborto Espontâneo/epidemiologia , Acesso aos Serviços de Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Aborto Espontâneo/prevenção & controle , Adolescente , Adulto , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Idade Materna , Gravidez , Primeiro Trimestre da Gravidez , Características de Residência , População Rural , População Urbana , Adulto Jovem
19.
Biomed Res Int ; 2021: 2873859, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33996995

RESUMO

The diagnosis and management of COVID-19 are much dependent on the adherence to standardized protocols. Healthcare workers play a crucial role in the case management of COVID-19 in many institutions. Globally, the disease burden is increasing, and the mortality has reached over 2 041 426 compared with 323 000 in May 2020. In West Africa, the pandemic has shown a slow but steady rise in many countries. Existing protocols and their utilization are best assessed after the occurrence of the index case. General aim. The study assessed the health worker's response to COVID-19 protocols at three designated areas of the in-hospital management care triaging, holding area, and treatment centers. Method. A qualitative design was used to assess the response of healthcare workers with regards to early case detection, infection prevention, risk communication to clients and compliance to protocols. The study conducted observational visits and purposively selected healthcare workers comprising of clinicians, nurses, emergency medical technicians, and laboratory technicians who perform routine duties at the triaging, holding, and treatment centers. A total of 41 observations were made over two weeks. Results. Participants comprised 23 males and 18 females. At all observed units, the case definition was being used to screen attendants presenting, and appropriate categorization of patients was ensured. The use of temperature in screening for COVID-19 at the units was generally adhered to. Only 50% of participants used the prescribed PPEs. The physical distancing between healthcare workers and client and between clients and caregivers were not enforced; however, hand hygiene was practiced. Disinfection of working surfaces and equipment with 0.5% chlorine or 70% alcohol-based rubs were used most of the time. It was observed however that no psychological counselling was given to suspected cases or their relatives. Conclusion. Healthcare workers showed discordant response to different parts of the protocols for COVID-19 especially appropriate distancing. There was an enhanced awareness among healthcare workers and improvement in infection prevention protocols. The study also observed that as the risk of infection increased from triaging to holding area and to treatment centers, the response of healthcare workers to COVID-19 protocols also improved. Risk communication is an essential part of the COVID-19 management strategy. At the treatment centers, healthcare workers adhered to this protocol, whereas it was a major gap at the triaging and holding areas.


Assuntos
COVID-19/psicologia , Fidelidade a Diretrizes/estatística & dados numéricos , Pessoal de Saúde/psicologia , Adulto , COVID-19/terapia , Administração de Caso/tendências , Feminino , Gana/epidemiologia , Higiene das Mãos , Pessoal de Saúde/estatística & dados numéricos , Hospitais Militares , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Pandemias , Equipamento de Proteção Individual , SARS-CoV-2/isolamento & purificação
20.
J Environ Public Health ; 2021: 5543977, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34012470

RESUMO

Discrete count time series data with an excessive number of zeros have warranted the development of zero-inflated time series models to incorporate the inflation of zeros and the overdispersion that comes with it. In this paper, we investigated the characteristics of the trend of daily count of COVID-19 deaths in Ghana using zero-inflated models. We envisaged that the trend of COVID-19 deaths per day in Ghana portrays a general increase from the onset of the pandemic in the country to about day 160 after which there is a general decrease onward. We fitted a zero-inflated Poisson autoregressive model and zero-inflated negative binomial autoregressive model to the data in the partial-likelihood framework. The zero-inflated negative binomial autoregressive model outperformed the zero-inflated Poisson autoregressive model. On the other hand, the dynamic zero-inflated Poisson autoregressive model performed better than the dynamic negative binomial autoregressive model. The predicted new death based on the zero-inflated negative binomial autoregressive model indicated that Ghana's COVID-19 death per day will rise sharply few days after 30th November 2020 and drastically fall just as in the observed data.


Assuntos
COVID-19/mortalidade , Análise de Séries Temporais Interrompida/métodos , Modelos Estatísticos , Distribuição Binomial , Gana/epidemiologia , Humanos , Mortalidade/tendências , Distribuição de Poisson , Reprodutibilidade dos Testes , SARS-CoV-2
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