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1.
PLoS One ; 17(9): e0274049, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36067188

RESUMO

BACKGROUND: Corona Virus Disease of 2019 (COVID-19) emerged in 2019 and caused widespread disruption to many facets of life, including healthcare. Healthcare workers, particularly nurses, became the front-line fighters against the pandemic, making it imperative to comply with recommended safety protocols. However, many nurses were infected by the virus in the Tamale Metropolis, raising concerns regarding their level of adherence to the safety protocols. This study assessed the predictors of knowledge and adherence to COVID-19 safety protocols among nurses at selected health facilities in the Tamale Metropolis of northern Ghana. METHODS: A facility based cross-sectional study design was adopted and 339 nurses from six (6) public health facilities in the Tamale Metropolis were recruited for the study using questionnaires. The questionnaires were transformed into Google Forms for respondents to answer online via WhatsApp or email. The data were exported from the Google spreadsheet into SPSS and analyzed using descriptive and inferential statistics. RESULTS: Of the 339 participants, 60.2% were classified as having adequate knowledge while only 9.1% demonstrated high adherence to COVID-19 safety protocols. Knowledge of COVID-19 was predicted by source of information, and marital status, whereas health facility types predicted level of adherence. The odds of having adequate knowledge were higher among unmarried nurses (AOR = 1.94; 95% CI: 1.16-3.25; p = 0.012) and nurses using social media (AOR = 1.80; 95%CI 1.02-3.18; p = 0.042) compared to their counterparts. Meanwhile, primary health care nurses (AOR = 0.24; 95% CI = 0.12-0.50; p<0.001) and secondary health care nurses (AOR = 0.52; 95% CI = 0.31-0.88; P = 0.016) had reduced odds of exhibiting higher adherence compared to nurses from tertiary-level facility. CONCLUSION: In this study, we found that knowledge was high but adherence to COVID-19 safety protocols was low. We suggest that facility managers should enforce compliance of their staff to the safety protocols to prevent spread of the virus within healthcare settings.


Assuntos
COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Gana/epidemiologia , Instalações de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Inquéritos e Questionários
2.
Pan Afr Med J ; 42: 126, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36060847

RESUMO

Introduction: fisherfolk play a major role in emerging economies such as Ghana. While many fishing communities are noted to be underdeveloped, fisherfolk are considered to neglect their oral hygiene, while being prone to certain conditions due to peculiar risks. The purpose of this study was to determine the periodontal health status of adults in a selected fishing community in Ghana. Methods: a descriptive cross-sectional study was carried out to assess the periodontal status of adults in Jamestown, a peri-urban area in Ghana. Data acquisition was by means of a structured questionnaire and periodontal examination. Information obtained consisted of demographic data (age, sex, education and occupation category) oral hygiene practices (type of teeth cleaning materials, methods of tooth cleansing, frequency of dental visits and reasons for the visit) and periodontal clinical parameters (plaque index, and community periodontal index of treatment needs). Results: a total of 276 participants were included in the study, with ages ranging from 21 to 70 years. The participants were made up of 138 fisherfolk and 138 non-fisherfolk. Males had worse scores for periodontal disease compared to females. Plaque score did not vary among age groups, but changed significantly between educational level and occupational categories. CPITN varied significantly between educational levels, age categories and occupational categories. Conclusion: the study found inhabitants of the fishing community of Jamestown to have a generally unsatisfactory periodontal status, but worse for the fisherfolk in the community.


Assuntos
Caça , Higiene Bucal , Adulto , Idoso , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
3.
BMC Public Health ; 22(1): 1676, 2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064368

RESUMO

BACKGROUND: The current COVID-19 pandemic affects the entire world population and has serious health, economic and social consequences. Assessing the prevalence of COVID-19 through population-based serological surveys is essential to monitor the progression of the epidemic, especially in African countries where the extent of SARS-CoV-2 spread remains unclear. METHODS: A two-stage cluster population-based SARS-CoV-2 seroprevalence survey was conducted in Bobo-Dioulasso and in Ouagadougou, Burkina Faso, Fianarantsoa, Madagascar and Kumasi, Ghana between February and June 2021. IgG seropositivity was determined in 2,163 households with a specificity improved SARS-CoV-2 Enzyme-linked Immunosorbent Assay. Population seroprevalence was evaluated using a Bayesian logistic regression model that accounted for test performance and age, sex and neighbourhood of the participants. RESULTS: Seroprevalence adjusted for test performance and population characteristics were 55.7% [95% Credible Interval (CrI) 49·0; 62·8] in Bobo-Dioulasso, 37·4% [95% CrI 31·3; 43·5] in Ouagadougou, 41·5% [95% CrI 36·5; 47·2] in Fianarantsoa, and 41·2% [95% CrI 34·5; 49·0] in Kumasi. Within the study population, less than 6% of participants performed a test for acute SARS-CoV-2 infection since the onset of the pandemic. CONCLUSIONS: High exposure to SARS-CoV-2 was found in the surveyed regions albeit below the herd immunity threshold and with a low rate of previous testing for acute infections. Despite the high seroprevalence in our study population, the duration of protection from naturally acquired immunity remains unclear and new virus variants continue to emerge. This highlights the importance of vaccine deployment and continued preventive measures to protect the population at risk.


Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , Teorema de Bayes , Burkina Faso/epidemiologia , COVID-19/epidemiologia , Gana/epidemiologia , Humanos , Madagáscar/epidemiologia , Pandemias , Estudos Soroepidemiológicos
4.
PLoS One ; 17(9): e0272597, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36048844

RESUMO

INTRODUCTION: Attrition of the Nursing Workforce from low-and middle-income countries to high-resourced settings is a reality that has escalated in the current Coronavirus pandemic due to varied reasons. With increased job stress resulting from the pandemic, the Quality of Work-Life of the Nursing Workforce is affected, with its effect on poor quality care to the client. This study sought to assess the perception of the Nursing Workforce about the Quality of Work-Life, and the factors that predict turnover intention among nurses in the Kumasi Metropolis, Ghana. METHODS: A cross-sectional, descriptive design involving multiple centres was used. The participants were made up of 348 Registered Nurses working in primary, secondary, and tertiary healthcare in five (5) hospitals in the Kumasi Metropolis. Data collection was done using questionnaires adapted from the Work-Related Quality of Life Scale and the Turnover Intention Scale and analyzed using frequencies, mean, standard deviation, Pearson's Product Moment Correlation, and Multiple Regression. RESULTS: The Registered Nurses perceived Quality of Work-Life as low; with close to half of them having a turnover intention. All the domains of Quality of Work-Life of the Nursing Workforce significantly correlated with Turnover intentions. Regression analysis showed that the number of years in a healthcare setting, general well-being, job control and satisfaction, and working condition of the Registered Nurse significantly predicted their turnover intentions at the p-value of 0.05. CONCLUSION: The findings of the study have provided an understanding of the Quality of Work-Life, and factors that contribute to increased turnover intentions among the Nursing Workforce amid the COVID-19 pandemic. Healthcare systems must enrol in requisite programmes that provide psychological and social support through counselling to promote the Quality of Work-Life of nurses.


Assuntos
COVID-19 , Recursos Humanos de Enfermagem no Hospital , COVID-19/epidemiologia , Estudos Transversais , Gana/epidemiologia , Humanos , Intenção , Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/psicologia , Pandemias , Reorganização de Recursos Humanos , Qualidade de Vida , Inquéritos e Questionários , Recursos Humanos
5.
PLoS One ; 17(9): e0271892, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36094929

RESUMO

BACKGROUND: Challenges exist in the diagnosis and management of autoimmune rheumatic diseases in low and middle income countries due to factors, such as poverty and under-resourced healthcare infrastructure. Furthermore, other contributory factors such as societal, cultural and religious practices influence health seeking behaviour which has a bearing on access and delivery of healthcare. OBJECTIVES: To examine the health seeking behaviour and referral patterns of Ghanaian patients with autoimmune rheumatic diseases and assess the associated factors that influence these. METHOD: A cross-sectional study using an explanatory sequential mixed method design was carried out in a Rheumatology clinic at a national referral centre. 110 participants were purposively recruited for the quantitative phase. The qualitative phase comprised 10 participants for in-depth interviews and 10 participants for a focus group discussion. Analysis using descriptive statistics, t-tests and logistic regression models were performed. Transcripts generated from the interviews and focused group discussion were analysed using thematic analysis. RESULTS: Median duration from onset of symptoms until seeking help was 1 week (IQR = 12); from seeking help until obtaining a final diagnosis was 12 months (IQR = 33). Multiple factors determined the choice of first facility visited, X2 (12, N = 107) = 32.29, p = .001. Only twenty-one participants (19.6%) had knowledge of their disease prior to diagnosis. Education predicted prior knowledge [OR = 2.6 (95% CI = .66-10.12), p < .021]. Unemployed participants had increased odds of seeking help after a month compared to those who were employed [Odds ratio = 2.60 (95% CI = 1.14-5.90), p = .02]. Knowledge of autoimmune rheumatic diseases was low with multiple causative factors such as biomedical, environmental and spiritual causes determining where patients accessed care. Forty (36.4%) participants utilised complementary and alternative treatment options. CONCLUSION: We observed that knowledge about autoimmune rheumatic diseases among Ghanaian patients was low. Patients sought help from numerous medical facilities, traditional healers and prayer camps often contributing to a delay in diagnosis for most patients. This was influenced by individual perceptions, cultural beliefs and socioeconomic status. Active awareness and educational programmes for the public and healthcare workers are required, as well as strategic planning to integrate the biomedical and traditional care services to enable earlier presentation, accurate diagnosis and better clinical outcomes for the patients.


Assuntos
Encaminhamento e Consulta , Doenças Reumáticas , Instituições de Assistência Ambulatorial , Estudos Transversais , Gana/epidemiologia , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Doenças Reumáticas/diagnóstico , Doenças Reumáticas/epidemiologia , Doenças Reumáticas/terapia
6.
PLoS One ; 17(9): e0273969, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36094915

RESUMO

INTRODUCTION: The rapid spread of COVID-19 has been a global public health problem and it is yet to be put under control. Active COVID-19 is associated with unrestrained secretion of pro-inflammatory cytokines and imbalances in haematological profile including anaemia, leukocytosis and thrombocytopaenia. However, the haematological profile and immune status following recovery from COVID-19 has not been recognized. We evaluated the immunohaematological profile among COVID-19 patients with active infection, recovered cases and unexposed healthy individuals in the Ashanti region of Ghana. METHODOLOGY: A total of 95 adult participants, consisting of 35 positive, 30 recovered and 30 unexposed COVID-19 negative individuals confirmed by RT-PCR were recruited for the study. All the patients had the complete blood count performed using the haematological analyzer Sysmex XN-1500. Their plasma cytokine levels of interleukin (IL)-1ß, IL-6, IL-10, IL-17, tumour necrosis factor-alpha (TNF-α) and interferon gamma (IFN-γ) were analysed using ELISA. Statistical analyses were performed on R statistical software. RESULT: The Patients with COVID-19 active infection had significantly higher levels of IL10 (181±6.14 pg/mL vs 155.00±14.32 pg/mL vs 158.80±11.70 pg/mL, p = 0.038), WBC count (5.5±0.4 x109 /L vs 4.5±0.6 x109 /L vs 3.8±0.5, p < 0.0001) and percentage basophil (1.8±0.1% vs 0.8±0.3% vs 0.7±0.2%, p = 0.0040) but significantly lower levels of IFN-γ (110.10±9.52 pg/mL vs 142.80±5.46 pg/mL vs 140.80±6.39 pg/mL, p = 0.021), haematocrit (24.1±3.7% vs 38.3± 3.0% vs 38.5±2.2%, p < 0.0001), haemoglobin concentration (9.4±0.1g/dl vs 12.5± 5.0g/dl vs 12.7±0.8, p < 0.0001) and MPV (9.8±0.2fL vs 11.1±0.5fL vs 11.6±0.3fL, p < 0.0001) compared to recovered and unexposed controls respectively. There were significant association between IL-1ß & neutrophils (r = 0.42, p<0.05), IL-10 & WBC (r = 0.39, p<0.05), IL-10 & Basophils (r = -0.51, p<0.01), IL-17 & Neutrophil (r = 0.39, p<0.05) in the active COVID-19 cases. CONCLUSION: COVID-19 active infection is associated with increased IL-10 and WBC with a concomitant decrease in IFN-γ and haemoglobin concentration. However, recovery from the disease is associated with immune recovery with appareantly normal haematological profile.


Assuntos
COVID-19 , Interleucina-10 , Adulto , Citocinas , Gana/epidemiologia , Hemoglobinas , Humanos , Interferon gama , Interleucina-17
7.
PLoS One ; 17(9): e0274544, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099308

RESUMO

Liver-related diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), are significant causes of mortality globally. Specific causes and predictors of liver-related mortality in low resource settings require assessment to help inform clinical decision making and develop strategies for improved survival. The objectives of this study were to determine the proportion of liver-related deaths associated with liver cirrhosis, HCC, and their known risk factors, and secondly to determine predictors of in-hospital mortality among cirrhosis and HCC patients in Ghana. We first performed a cross-sectional review of death register entries from 11 referral hospitals in Ghana to determine the proportion of liver-related deaths and the proportion of risk factors associated with these deaths. Secondly, we conducted a retrospective cohort review of 172 in-patient liver cirrhosis and HCC cases admitted to a tertiary referral centre and determined predictors of in-hospital mortality using binary logistic regression and Kaplan-Meier survival analysis. In total, 8.8% of deaths in Ghanaian adults were due to liver-related causes. The proportion of liver-related deaths attributed to HBV infection was 48.8% (95% CI: 45.95-51.76), HCV infection was 7.0% (95% CI: 5.58-8.45), HBV-HCV co-infection 0.5% (95% CI: 0.1-0.9) and alcohol was 10.0% (95% CI: 8.30-11.67). Of 172 cases of HCC and liver cirrhosis, the in-patient mortality rate was 54.1%. Predictors of in-patient mortality in cirrhotic patients were increasing WBC (OR = 1.14 95% CI: 1.00-1.30) and the revised model for end-stage liver disease with sodium (MELD-Na) score (OR = 1.24 95% CI: 1.01-1.54). For HCC patients, female sex (OR = 3.74 95% CI: 1.09-12.81) and hepatic encephalopathy (grade 1) were associated with higher mortality (OR = 5.66 95% CI: 1.10-29.2). In conclusion, HBV is linked to a high proportion of HCC-related deaths in Ghana, with high in-hospital mortality rates that require targeted policies to improve survival.


Assuntos
Carcinoma Hepatocelular , Doença Hepática Terminal , Hepatite C , Neoplasias Hepáticas , Adulto , Estudos Transversais , Doença Hepática Terminal/complicações , Feminino , Gana/epidemiologia , Hepatite C/complicações , Hospitais , Humanos , Cirrose Hepática/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
8.
Artigo em Inglês | MEDLINE | ID: mdl-36078645

RESUMO

Nasopharyngeal carriage of aerobic Gram-negative bacilli (GNB) may precede the development of invasive respiratory infections. We assessed the prevalence of nasopharyngeal carriage of aerobic GNB and their antimicrobial resistance patterns among healthy under-five children attending seven selected day-care centres in the Accra metropolis of the Greater Accra region of Ghana from September to December 2016. This cross-sectional study analysed a total of 410 frozen nasopharyngeal samples for GNB and antimicrobial drug resistance. The GNB prevalence was 13.9% (95% CI: 10.8-17.6%). The most common GNB were Escherichia coli (26.3%), Klebsiella pneumoniae (24.6%), and Enterobacter cloacae (17.5%). Resistance was most frequent for cefuroxime (73.7%), ampicillin (64.9%), and amoxicillin/clavulanic acid (59.6%). The organisms were least resistant to gentamicin (7.0%), amikacin (8.8%), and meropenem (8.8%). Multidrug resistance (MDR, being resistant to ≥3 classes of antibiotics) was observed in 66.7% (95% CI: 53.3-77.8%). Extended-spectrum beta-lactamase (ESBL)-producing bacteria constituted 17.5% (95% CI: 9.5-29.9%), AmpC-producing bacteria constituted 42.1% (95% CI: 29.8-55.5%), and carbapenemase-producing bacteria constituted 10.5% (95% CI: 4.7-21.8%) of isolates. The high levels of MDR are of great concern. These findings are useful in informing the choice of antibiotics in empiric treatment of GNB infections and call for improved infection control in day-care centres to prevent further transmission.


Assuntos
Infecções por Bactérias Gram-Negativas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias Aeróbias , Criança , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Escherichia coli , Gana/epidemiologia , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Nasofaringe , beta-Lactamases
9.
BMC Health Serv Res ; 22(1): 1163, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104695

RESUMO

BACKGROUND: Burnout syndrome is a psycho-social disorder which develops in an individual exposed to chronic stress on the job. Health workers in sub-Saharan Africa (SSA) are at increased risk of burnout due to job-related challenges. Burnout does not only affect the job performance of employees, but could result in dysregulation of multiple physiological systems (allostatic load) in victims and predispose them to non-communicable diseases (NCDs). This study examined the association between burnout and allostatic load among health workers engaged in human resourced-constrained hospitals in Accra, Ghana. METHOD: This study was a hospital-based cross-sectional study involving 1264 health workers (clinicians and non-clinicians) from three public hospitals in Accra, Ghana who were recruited using a proportionate stratified random sampling technique. The participants completed a questionnaire which collected general and burnout information. In addition, each participant's anthropometric; biochemical and hemodynamic indices were measured. The allostatic load in the participants was determined using eleven (11) biomarkers from the neuro-endocrine, cardiovascular, metabolic and anthropometric measures. The relationship between burnout and allostatic overload (high allostatic load) was determined at the bivariate and multivariable levels. The data analysis was done with the aid of Stata 15.0 at a 95% confidence level. RESULTS: The prevalence of burnout was 20.57%, higher in non-clinicians than clinicians (26.74% vs 15.64, p <  0.001). Also, non-clinical participants had higher levels of emotional exhaustion and depersonalization than the clinical participants. Over a quarter (26.27%) of the participants had allostatic overload manifesting as high allostatic load. Furthermore, for a one unit increase in overall burnout, the odds of experiencing allostatic overload was increased by 17.59 times (AOR = 17.59, 95% CI: 11.7-26.4) as compared to those without burnout and similar findings were found for the individual components of burnout syndrome with high allostatic load. CONCLUSION: Burnout among health workers is associated with multi-system physiological dysregulation manifesting as high allostatic load; a major risk factor for NCDs. It is recommended that measures aimed at reducing burnout and allostatic overload such as structured psychological counseling and healthy lifestyle patterns are recommended for health workers engaged in stressful work settings to reduce their risk of NCDs.


Assuntos
Alostase , Esgotamento Profissional , Alostase/fisiologia , Esgotamento Profissional/psicologia , Estudos Transversais , Gana/epidemiologia , Hospitais , Humanos
10.
PLoS One ; 17(8): e0269718, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36001627

RESUMO

BACKGROUND: Malnutrition is a major public health problem because of the devastating consequences it has on children, their families, and society at large. Our study, therefore, sought to determine the prevalence of undernutrition and overweight/obesity and its associated factors among children aged 6-12 in the South Tongu District, Ghana. METHODS: A school-based cross-sectional study was conducted among 423 school children aged 6-12 years in the South Tongu District of Ghana. A multistage sampling method was employed to recruit the school children for the study. A semi-structured questionnaire was used to collect data from the respondents. We used a dual-purpose (height and weight) measuring scale to obtain the anthropometric data. The World Health Organization's AnthroPlus software was used to generate the z-scores for determining the nutritional status. Percentages were used to present the results of the prevalence of undernutrition and overweight/obesity among school children. Bivariate and multivariable binary logistic regression were used to examine the factors associated with undernutrition and overweight/obesity among school children. The results were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), with their 95% confidence interval (CI). Statistical significance was set at p<0.05. Stata 16.0 was used to perform the analyses. RESULTS: The overall prevalence of undernutrition and overweight/obesity were 21.5% (CI = 17.7, 25.7) and 24.8% (CI = 20.8, 29.2), respectively. Specifically, the prevalence of stunting, thinness, underweight, overweight, and obesity were 10.4%, 12.1%, 3.8%, 11.1%, and 13.7%, respectively. School children whose household used water from non-portable sources were more likely to be undernourished [AOR = 2.03, 95% CI = 1.13, 3.63]. The odds of overweight/obesity was higher among school children whose mothers had attained formal education [AOR = 2.10, 95% CI = 1.09, 4.06], those who consumed beverages between meals per day [AOR = 1.87, CI = 1.08, 3.24], and those who had adequate dietary diversity score [AOR = 1.65, 95% CI = 1.02, 2.67]. School children aged 10-12 were less likely to be overweight/obese [AOR = 0.58, 95% CI = 0.35, 0.94] compared to those aged 6-9. CONCLUSION: The study showed a relatively high prevalence of undernutrition and overweight/obesity among school children in the South Tongu District. The identified risk factor(s) for undernutrition was the usage of water from non-potable sources whilst those of overweight/obesity were age (10-12 years), maternal formal education, beverage consumption between meals per day, and adequate dietary diversity. The findings reaffirm that malnutrition is still prevalent among school children. Hence, there is a need for the Ministry of Health, Ghana Education Service, and other Non-Governmental Organizations to pay critical attention to these factors to achieve the Sustainable Development Goal 2, target 2.2. Nutritional behavioural change education should be carried out among parents and school children. School health service activities should be intensified with a special focus on nutritional screening.


Assuntos
Desnutrição , Obesidade Pediátrica , Criança , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Prevalência , Magreza/epidemiologia , Água
11.
Malar J ; 21(1): 240, 2022 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-35987638

RESUMO

BACKGROUND: Malaria infection during pregnancy can cause significant morbidity and mortality to a pregnant woman, her fetus and newborn. In areas of high endemic transmission, gravidity is an important risk factor for infection, but there is a complex relationship with other exposure-related factors, and use of protective measures. This study investigated the association between gravidity and placental malaria (PM), among pregnant women aged 14-49 in Kintampo, a high transmission area of Ghana. METHODS: Between 2008 and 2011, as part of a study investigating the association between PM and malaria in infancy, pregnant women attending antenatal care (ANC) clinics in the study area were enrolled and followed up until delivery. The outcome of PM was assessed at delivery by placental histopathology. Multivariable logistic regression analyses were used to investigate the association between gravidity and PM, identify other key risk factors, and control for potential confounders. Pre-specified effect modifiers including area of residence, socio-economic score (SES), ITN use and IPTp-SP use were explored. RESULTS: The prevalence of PM was 65.9% in primigravidae, and 26.5% in multigravidae. After adjusting for age, SES and relationship status, primigravidae were shown to have over three times the odds of PM compared to multigravidae, defined as women with 2 or more previous pregnancies [adjusted OR = 3.36 (95% CI 2.39-4.71), N = 1808, P < 0.001]. The association appeared stronger in rural areas [OR for PG vs. MG was 3.79 (95% CI 3.61-5.51) in rural areas; 2.09 (95% CI 1.17-3.71) in urban areas; P for interaction = 0.07], and among women with lower socio-economic scores [OR for PG vs. MG was 4.73 (95% CI 3.08-7.25) amongst women with lower SES; OR = 2.14 (95% CI 1.38-3.35) among women with higher SES; P for interaction = 0.008]. There was also evidence of lower risk among primigravidae with better use of the current preventive measures IPTp and LLIN. CONCLUSIONS: The burden of PM is most heavily focused on primigravidae of low SES living in rural areas of high transmission. Programmes should prioritize primigravidae and young women of child-bearing age for interventions such as LLIN distribution, educational initiatives and treatment to reduce the burden of malaria in first pregnancy.


Assuntos
Antimaláricos , Malária , Complicações Parasitárias na Gravidez , Antimaláricos/uso terapêutico , Feminino , Gana/epidemiologia , Número de Gestações , Humanos , Recém-Nascido , Malária/prevenção & controle , Placenta , Gravidez , Complicações Parasitárias na Gravidez/prevenção & controle , Gestantes , Pirimetamina , Fatores de Risco , Sulfadoxina
12.
Sci Rep ; 12(1): 14218, 2022 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-35987958

RESUMO

Childhood malnutrition is a significant public health problem confronting countries across the globe. Although there is evidence of a downward trend in undernutrition globally, sub-Saharan Africa did not experience significant improvement in the past decades. This study investigated the basic determinants of linear growth among children living in poor households. We analysed a nationally representative sample of children aged 0-59 months (N = 24,264). The study countries were Ghana, Kenya, the Democratic Republic of Congo (DRC), Nigeria, and Mozambique. The child's height-for-age Z-scores (HAZ), categorised into HAZ > - 2 standard deviations (SD) (not stunted) and HAZ < - 2 SD (stunted) was the outcome variable of interest. We used logistic regression as our analytical strategy. In DRC, Ghana, Kenya and Nigeria, maternal years of schooling was associated with positive linear growth among children living in poor households. In Ghana and DRC, four antenatal visits had a positive effect on better linear growth, while in Nigeria, healthy maternal body mass index (kg/m2) had a positive effect on child's linear growth. The putative socio-demographic determinants investigated in our study can promote the linear growth of children living in poor households. Interventions aimed at fostering linear growth among children living in poverty should focus on enhancing these factors.


Assuntos
Características da Família , Desnutrição , Criança , Estudos Transversais , Feminino , Gana/epidemiologia , Inquéritos Epidemiológicos , Humanos , Lactente , Gravidez
13.
Sci Rep ; 12(1): 14282, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35995932

RESUMO

The evidence of rising numbers of multidrug-resistant organisms requires the implementation of effective stewardship programs. However, this should be informed by evidence-based knowledge of local antimicrobial resistance patterns. The current study aims to establish the prevalence of common pathogenic microbes including their antimicrobial susceptibility patterns and distribution in the Cape Coast Metropolis. This was a retrospective study where microbial culture and antimicrobial susceptibility records for 331 patients were reviewed from January to December 2019, at a private health centre. All data were analysed using Excel (Microsoft Office, USA), SPSS and GraphPad Prism 8 software programs. Among the samples tested, 125 (37.76%) were positive for microbes with high vaginal swab (HVS) samples recording the highest number of pathogens (44%), followed by urine (40%) and both pleural and semen samples having the least (0.3% each). Again, gram-negative isolates were more prevalent than the gram-positive isolates. The prevalence of antimicrobial resistance was very significant with isolates resistant to more than one antibiotic (P < 0.05). Escherichia coli showed the highest level of resistance, followed by Citrobacter spp. These were followed by Klebsiella spp., Staphylococcus spp., Coliforms, Pseudomonas spp., Commensals and Candida spp. The high resistance pattern suggests an inevitable catastrophe requiring continuous monitoring and implementation of effective antibiotic stewardship.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Antibacterianos/farmacologia , Escherichia coli , Feminino , Gana/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Prevalência , Estudos Retrospectivos
14.
PLoS One ; 17(8): e0272488, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35984853

RESUMO

BACKGROUND: Socio-demographic factors influence the magnitude of anemia in endemic areas. The purpose of this study is to establish the magnitude of anemia and to determine anemia preventive practices carried out by mothers with children under five years of age in the Kadjebi District of the Volta region of Ghana. METHODS: This purposive sampling study involved women of reproductive age with children less than five years of age from Saint Mary Theresa Hospital and nurses practicing in the pediatric ward of the hospital. A questionnaire and interview guide were administered respectively, and the data collected were analyzed using the Statistical Package for Social Sciences version 21. RESULTS: A total of 150 participants were studied; among which analysis of anemia was carried out on 129 women whose children had their hemoglobin levels checked and recorded in the laboratory. Hemoglobin levels recorded for these children showed that 85.3% were anemic, even though 93.8% of the mothers had been given iron supplements during their pregnancy. Furthermore, anemia prevention practices comprised whether the child had been given any anti-malaria prophylaxis (98.4% denied), if the child had been dewormed in the last three months (89.9% denied), whether the child was given iron supplements in the last three months (59.7% denied), if the child had been given vitamin supplements in the last three months (24.0% denied). CONCLUSION: Most of the children in the study were anemic. Mothers practiced exclusive breastfeeding, iron, and vitamin supplementation, and ensured that children slept under insecticide-treated mosquito nets as a means of preventing malaria.


Assuntos
Anemia , Anemia/epidemiologia , Anemia/prevenção & controle , Criança , Pré-Escolar , Feminino , Gana/epidemiologia , Hemoglobinas , Humanos , Lactente , Ferro , Mães , Gravidez , Vitaminas
15.
BMC Cancer ; 22(1): 893, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-35971095

RESUMO

INTRODUCTION: Globally breast cancer is the leading cause of cancer with an estimated 2.3 million new cases and 685,000 deaths in 2020. Late presentation is the hallmark of breast cancer in Ghana for which ignorance and fear are the major reasons fuelled largely by myths and misconceptions. Breast cancer awareness and education needs to start early to bring about a change in knowledge, attitude and practices. However, Breast cancer awareness activities in Ghana have usually targeted adult women. This study assessed the impact of breast cancer education among adolescent high school girls in Ghana. METHODOLOGY: A pre- post-test quasi experimental study was conducted at two senior high schools. A self-administered pre-educational questionnaire was followed by an educational intervention consisting of a drama, PowerPoint lecture, question and answer session and distribution of breast cancer information leaflets. After 3 months the same questionnaire was administered as a post-education test to assess the impact of the educational intervention. The total score for each domain was categorised into adequate knowledge > 50% and inadequate knowledge < 50%. RESULTS: The number of participants in the pre-test and post-test were 1043 and 1274; the median ages [IQR] were 16.0 [15.0-17.0] for both the pre and post-test students. General knowledge on breast cancer at pre-education (29.1%) improved to 72.5% (p < 0.001). Knowledge on signs and symptoms improved from 33.1 to 55% (p < 0.001); knowledge on risk factors improved from 55.3 to 79.2% (p < 0.001), and knowledge on breast self-examination and screening improved from 9.8 to 22.2% (p < 0.001). The overall performance of the students improved from 17.2 to 59.4% (p < 0.001). CONCLUSION: There is inadequate knowledge about breast cancer and self-examination among senior high school girls in Ghana. Our breast cancer educational intervention was effective in improving general knowledge of breast cancer, risk factors, signs and symptoms and breast self-examination. The overall knowledge base improved from 17.2 to 59.4% 3 months post intervention, accompanied by an increase in the reported practice of breast self-examination and a greater belief that breast cancer is curable. This study has demonstrated the need for a school breast cancer educational program and that breast cancer education in high schools is effective.


Assuntos
Neoplasias da Mama , Adolescente , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Autoexame de Mama , Feminino , Gana/epidemiologia , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Instituições Acadêmicas , Inquéritos e Questionários
16.
PLoS One ; 17(8): e0272274, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35939441

RESUMO

BACKGROUND: Obesity is rising in sub-Saharan Africa and globally, and is a highly significant public health problem that needs urgent attention. To reduce the obesity prevalence levels and associated challenges, public health interventions highlight healthy eating and increased physical activity, which are key elements for weight management. AIM: This study explored perceived factors that hinder or facilitate weight management in an urban poor context in Accra, Ghana. METHODS: A cross-sectional qualitative data was obtained from eight focus group discussions (FGDs) conducted among community members. The FGDs were audio recorded, transcribed, and analysed using thematic analysis. RESULTS: The findings indicate that weight management is mainly inhibited by the perception that healthy foods are expensive and not satisfying, laziness, lack of time to engage in physical activity, and social representation of being fat or slim. On the contrary, personal decision to manage weight and social support facilitated engagement in weight management. CONCLUSION: The findings indicate that weight management is influenced by individual, community, and structural factors. These findings have programmatic implications in terms of health education strategies and messaging.


Assuntos
Obesidade , Populações Vulneráveis , Estudos Transversais , Grupos Focais , Gana/epidemiologia , Humanos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Pesquisa Qualitativa
17.
PLoS One ; 17(8): e0270235, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35917367

RESUMO

BACKGROUND: Buruli ulcer is a tissue necrosis infection caused by an environmental mycobacterium called Mycobacterium ulcerans (MU). The disease is most prevalent in rural areas with the highest rates in West and Central African countries. The bacterium produces a toxin called mycolactone which can lead to the destruction of the skin, resulting in incapacitating deformities with an enormous economic and social burden on patients and their caregivers. Even though there is an effective antibiotic treatment for BU, the control and management rely on early case detection and rapid diagnosis to avert morbidities. The diagnosis of Mycobacterium ulcerans relies on smear microscopy, culture histopathology, and PCR. Unfortunately, all the current laboratory diagnostics have various limitations and are not available in endemic communities. Consequently, there is a need for a rapid diagnostic tool for use at the community health centre level to enable diagnosis and confirmation of suspected cases for early treatment. The present study corroborated the diagnostic performance and utility of fluorescent-thin layer chromatography (f-TLC) for the diagnosis of Buruli ulcer. METHODOLOGY/PRINCIPAL FINDINGS: The f-TLC method was evaluated for the diagnosis of Buruli ulcer in larger clinical samples than previously reported in an earlier preliminary study Wadagni et al. (2015). A total of 449 patients suspected of BU were included in the final data analysis out of which 122 (27.2%) were positive by f-TLC and 128 (28.5%) by PCR. Using a composite reference method generated from the two diagnostic methods, 85 (18.9%) patients were found to be truly infected with M. ulcerans, 284 (63.3%) were uninfected, while 80 (17.8%) were misidentified as infected or noninfected by the two methods. The data obtained was used to determine the discriminatory accuracy of the f-TLC against the gold standard IS2404 PCR through the analysis of its sensitivity, specificity, positive (+LR), and negative (-LR) likelihood ratio. The positive (PPV) and negative (NPV) predictive values, area under the receiver operating characteristic curve Azevedo et al. (2014), and diagnostic odds ratio were used to assess the predictive accuracy of the f-TLC method. The sensitivity of f-TLC was 66.4% (85/128), specificity was 88.5% (284/321), while the diagnostic accuracy was 82.2% (369/449). The AUC stood at 0.774 while the PPV, NPV, +LR, and-LR were 69.7% (85/122), 86.9% (284/327), 5.76, and 0.38, respectively. The use of the rule-of-thumb interpretation of diagnostic tests suggests that the method is good for use as a diagnostic tool. CONCLUSIONS/SIGNIFICANCE: Larger clinical samples than previously reported had been used to evaluate the f-TLC method for the diagnosis of Buruli ulcer. A sensitivity of 66.4%, a specificity of 88.5%, and diagnostic accuracy of 82.2% were obtained. The method is good for diagnosis and will help in making early clinical decisions about the patients as well as patient management and facilitating treatment decisions. However, it requires a slight modification to address the challenge of background interference and lack of automatic readout to become an excellent diagnostic tool.


Assuntos
Úlcera de Buruli , Mycobacterium ulcerans , Úlcera de Buruli/diagnóstico , Úlcera de Buruli/epidemiologia , Cromatografia em Camada Delgada/métodos , Gana/epidemiologia , Humanos , Reação em Cadeia da Polimerase
18.
PLoS Negl Trop Dis ; 16(8): e0010129, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35926012

RESUMO

BACKGROUND: Lymphatic filariasis (LF) causes chronic morbidity, which usually manifests as lymphedema or hydrocele. Mass drug administration (MDA) began in Kassena Nankana East Municipal (KNEM) and Nabdam, two hotspot districts in the Upper East Region in Ghana, in 2000 and 2005, respectively. This cross-sectional study evaluated the impact of 15 years of MDA on the control of LF as determined by circulating filarial antigen (CFA) and microfilariae assessment in the KNEM and the Nabdam districts. METHODOLOGY/PRINCIPAL FINDINGS: A total of 7,453 participants from eight sub-districts in the two hotspot districts (KNEM: N = 4604; Nabdam: N = 2849) were recruited into the study. The overall CFA prevalence as determined by the FTS was 19.6% and 12.8% in the KNEM and Nabdam districts, respectively. Manyoro, a sub-district on the border with Burkina Faso, recorded the highest CFA prevalence of 26% in the KNEM. Assessment of microfilariae and Og4C3 antigen was done from 1009 (KNEM: N = 799 (79.2%); Nabdam: N = 210 (20.8%)) randomly selected FTS-positive (N = 885) and FTS-negative (N = 124) individuals. The Og4C3 antigen was found in 22.6%/23.0% of the selected individuals (KNEM/Nabdam), whereas the night blood revealed microfilariae in only 0.7%/0.5%. CONCLUSIONS/SIGNIFICANCE: Using the WHO endorsed FTS, CFA prevalence exceeded the long-standing <2% threshold-which may need revision and validation. Surprisingly, the Og4C3 ELISA showed positive results in only about one-fifth of the FTS positive samples. However, even this result would not have met the <2% CFA criteria for LF elimination. In contrast, projections from the microfilariae results revealed a halt in LF transmission. The global elimination target was due in 2020 but has been extended to 2030 since this could not be met. Focused MDA intervention intensification on seasonal migrants and non-compliers, and implementation of alternative treatment strategies may suffice for the elimination of the disease.


Assuntos
Filariose Linfática , Animais , Antígenos de Helmintos , Estudos Transversais , Filariose Linfática/tratamento farmacológico , Filariose Linfática/epidemiologia , Filariose Linfática/prevenção & controle , Gana/epidemiologia , Humanos , Masculino , Administração Massiva de Medicamentos/métodos , Microfilárias , Prevalência , Wuchereria bancrofti
19.
PLoS One ; 17(8): e0271489, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35939419

RESUMO

Intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is used to prevent malaria and associated unfavorable maternal and foetal outcomes in pregnancy in moderate to high malaria transmission areas. Effectiveness of IPTp-SP is, however, threatened by mutations in the Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes which confer resistance to pyrimethamine and sulfadoxine, respectively. This study determined the prevalence of molecular markers of SP resistance among pregnant women in a high malaria transmission area in the forest-savannah area of Ghana. Genomic DNA was extracted from 286 P. falciparum-positive dried blood spots obtained from pregnant women aged ≥18 years (255 at first Antenatal Care (ANC) clinic visit and 31 at delivery from 2017 to 2019) using Chelex 100. Mutations in Pfdhfr and Pfdhps genes were detected using molecular inversion probes and next generation sequencing. In the Pfdhfr gene, single nucleotide polymorphisms (SNPs) were detected in 83.1% (157/189), 92.0% (173/188) and 91.0% (171/188) at codons 51, 59, and 108 respectively in samples collected at first ANC visit, while SNPs were detected in 96.6 (28/29), 96.6% (28/29) and 96.8% (30/31) in isolates collected at delivery. The Pfdhfr triple mutant N51I, C59R and S108N (IRN) was carried by 80.5% (128/159) and 96.5% (28/29) of the typed isolates collected at ANC visit and at delivery respectively. In the Pfdhps gene, SNPs were detected in 0.6% (1/174), 76.2% (138/181), 33.2% (60/181), 1.2% (2/174), 0% (0/183), and 16.6% (27/173) at codons 431, 436, 437, 540, 581 and 613 respectively in samples collected at ANC, and 0% (0/25), 72% (18/25), 40% (10/25), 3.6% (1/25), 0% (0/29) and 7.4% (2/27) in samples collected at delivery. Quadruple mutant Pfdhfr N51I, C59R, and S108N + Pfdhps A437G (IRN-GK) was present in 25.8% (33/128) and 34.8% (8/23) of isolates at ANC and at delivery respectively. Quintuple mutant alleles Pfdhfr N51I, C59R, and S108N + Pfdhps A437G and K540E (IRN-GE) were detected in 0.8% (1/128) and 4.4% (1/23) of samples collected at ANC and at delivery respectively. No mutations were identified at Pfdhfr codons 16 or 164 or Pfdhps 581. There is a high prevalence of Pfdhfr triple mutant P. falciparum infections among pregnant women in the study area. However, prevalence of the combined Pfdhfr/Pfdhps quadruple and quintuple mutants IRN-GK and IRN-GE respectively prior to commencement of IPTp-SP were low, and no Pfdhps A581G mutant was detected, indicating that SP is still likely to be efficacious for IPTp-SP in the forest-savannah area in the middle belt of Ghana.


Assuntos
Antimaláricos , Malária Falciparum , Adolescente , Adulto , Antimaláricos/farmacologia , Antimaláricos/uso terapêutico , Combinação de Medicamentos , Resistência a Medicamentos/genética , Feminino , Florestas , Gana/epidemiologia , Humanos , Malária Falciparum/tratamento farmacológico , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Plasmodium falciparum , Polimorfismo de Nucleotídeo Único , Gravidez , Gestantes , Prevalência , Pirimetamina/farmacologia , Pirimetamina/uso terapêutico , Sulfadoxina/farmacologia , Sulfadoxina/uso terapêutico , Tetra-Hidrofolato Desidrogenase/genética
20.
BMC Pregnancy Childbirth ; 22(1): 672, 2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-36045351

RESUMO

BACKGROUND: Geographic barriers to healthcare are associated with adverse maternal health outcomes. Modelling travel times using georeferenced data is becoming common in quantifying physical access. Multiple Demographic and Health Surveys ask women about distance-related problems accessing healthcare, but responses have not been evaluated against modelled travel times. This cross-sectional study aims to compare reported and modelled distance by socio-demographic characteristics and evaluate their relationship with skilled birth attendance. Also, we assess the socio-demographic factors associated with self-reported distance problems in accessing healthcare. METHODS: Distance problems and socio-demographic characteristics reported by 2210 women via the 2017 Ghana Maternal Health Survey were included in analysis. Geospatial methods were used to model travel time to the nearest health facility using roads, rivers, land cover, travel speeds, cluster locations and health facility locations. Logistic regressions were used to predict skilled birth attendance and self-reported distance problems. RESULTS: Women reporting distance challenges accessing healthcare had significantly longer travel times to the nearest health facility. Poverty significantly increased the odds of reporting challenges with distance. In contrast, living in urban areas and being registered with health insurance reduced the odds of reporting distance challenges. Women with a skilled attendant at birth, four or more skilled antenatal appointments and timely skilled postnatal care had shorter travel times to the nearest health facility. Generally, less educated, poor, rural women registered with health insurance had longer travel times to their nearest health facility. After adjusting for socio-demographic characteristics, the following factors increased the odds of skilled birth attendance: wealth, health insurance, higher education, living in urban areas, and completing four or more antenatal care appointments. CONCLUSION: Studies relying on modelled travel times to nearest facility should recognise the differential impact of geographic access to healthcare on poor rural women. Physical access to maternal health care should be scaled up in rural areas and utilisation increased by improving livelihoods.


Assuntos
Serviços de Saúde Materna , Estudos Transversais , Parto Obstétrico , Feminino , Gana/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Recém-Nascido , Gravidez , Cuidado Pré-Natal
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