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1.
PLoS One ; 17(5): e0267658, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511930

RESUMO

The lived experiences of caregivers of older adults in Ghana are not well understood. The purpose of this study was to explore and discuss the lived experiences of these caregivers using the Ethics of Care as a theoretical lens and Interpretative phenomenological analysis as the methodological approach. Ten caregivers in receipt of social welfare services on behalf of older adults were recruited from the Social Welfare Unit at the Komfo Anokye Teaching Hospital (KATH) in southern Ghana. The analysis identified five interrelated themes: 1) committing the Self to caregiving; 2) caregiving impacting the Self; 3) motivating factors to caregiving; 4) caregiving burdens, and 5) thinking about personal affairs. Their experiences demonstrate that caregivers value the caregiving relationship, as posited by Ethics of Care, and tend to care for their health and well-being. Caregivers' expression of commitment to caring for older adults is mainly influenced by reciprocity, despite internal and external stressors, and desire to fulfil unmet personal needs. Ethics of care offers an understanding of the lived experiences of caregivers of older adults in Ghana. The findings draw attention to the state to develop specific programs to ensure the health, social and financial well-being of older adults' caregivers.


Assuntos
Cuidadores , Idoso , Gana , Humanos
2.
PLoS One ; 17(5): e0267179, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511936

RESUMO

INTRODUCTION: Despite widespread advocacy for exclusive breastfeeding, and the associated benefits of exclusive breastfeeding for both infants and mothers, there is low prevalence in both developed and developing countries. Additionally, although several studies have been conducted on exclusive breastfeeding, very few of such studies have linked birth weight and birth size to exclusive breastfeeding. This study seeks to examine the influence of birth weight and birth size on exclusive breastfeeding. METHODOLOGY: This study adopted a sequential explanatory mixed method approach using both quantitative and qualitative methods. The quantitative approach used cross-sectional data from the 2014 Ghana Demographic and Health Survey (GDHS) and the qualitative data from interviews with exclusive breastfeeding mothers from two health facilities in La Nkwantanang Municipal Assembly in Accra, Ghana. Logistic regression analysis was used to examine whether infants birth weight and mothers perceived birth size are associated with the practice of exclusive breastfeeding while the qualitative data provided further insights into the findings from the quantitative analysis. RESULTS: Majority (85%) of the infants in the study were of normal birth weight while 52% of the infants were perceived by their mothers to be of small birth size. The prevalence of exclusive breastfeeding was found to be 54.8%. The birth weight of infants and mothers' perceived birth size were found to be significant predictors of exclusive breastfeeding. Infants of normal birth weight (OR = 7.532; 95% CI: 2.171-26.132) and high birth weight (OR = 6.654; 95% CI: 1.477-29.978) were more likely to be exclusively breastfed compared to low-birth-weight infants. Similarly, infants perceived to be of normal birth size were more likely (OR = 1.908; 95% CI: 1.058-3.441) to be exclusively breastfed compared to infants perceived to be of small birth size. The findings from the qualitative analysis show that birth weight rather than birth size influence mothers' decision to practice exclusive breastfeeding. CONCLUSION: The findings of the study underscore the relevance of infant birth weight and perceived birth size in the practice of exclusive breastfeeding and highlights the need to incorporate both actual measurement of birth weight, and perception of infant's birth size into policies targeted at exclusive breastfeeding. There is the need for deliberate targeted efforts at women who deliver infants of low birth weight and women who perceive their children to be of small birth size to practice exclusive breastfeeding.


Assuntos
Aleitamento Materno , Mães , Peso ao Nascer , Criança , Estudos Transversais , Feminino , Gana , Humanos , Lactente , Gravidez
3.
Science ; 376(6593): 653-656, 2022 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-35511966

RESUMO

Anthropogenically elevated CO2 (eCO2) concentrations have been suggested to increase woody cover within tropical ecosystems through fertilization. The effect of eCO2 is built into Earth system models, although testing the relationship over long periods remains challenging. Here, we explore the relative importance of six drivers of vegetation change in western Africa over the past ~500,000 years (moisture availability, fire activity, mammalian herbivore density, temperature, temperature seasonality, CO2) by coupling past environmental change data from Lake Bosumtwi (Ghana) with global data. We found that moisture availability and fire activity were the most important factors in determining woody cover, whereas the effect of CO2 was small. Our findings suggest that the role of eCO2 effects on tropical vegetation in predictive models must be reconsidered.


Assuntos
Ecossistema , Incêndios , Dióxido de Carbono , Gana , Madeira
4.
BMC Pregnancy Childbirth ; 22(1): 391, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513775

RESUMO

BACKGROUND: Early antenatal care (ANC) is essential for improving maternal and child health outcomes. The primary aims of this study were to 1) estimate the association between partners' education attainment and early ANC, and 2) determine whether partners' level of education modified the relationship between mothers' education, mothers' age, planned pregnancy, employment status and early ANC. METHODS: Data were obtained from a cross-sectional study conducted from April to May 2021 among 519 mothers with a live birth in the past year in the Nabdam district in the Upper East Region in northern Ghana. Generalized estimating equations were used to assess whether partners' level of education modified the relationship between mothers' education, mothers' age, planned pregnancy, employment status and early ANC. Effect modification was assessed on the additive and multiplicative scales using adjusted prevalence ratios (aPR) and corresponding 95% confidence intervals. RESULTS: Mothers whose partners had secondary or higher education had a 26% higher prevalence of early ANC compared to mothers whose partners had less than a secondary level of education (aPR: 1.26, 95% CI: 1.05,1.51). There was evidence of effect modification by partners' education on the relationship between planned pregnancy and early ANC on both the additive (Relative excess risk due to interaction [RERI]: 0.61, 95% CI: 0.07,0.99), and multiplicative (ratio of PRs: 1.64, 95% CI: 1.01,2.70) scales. Among mothers whose partners had less than secondary education, mothers who had teenage pregnancy (i.e., aged 18-19 years old during pregnancy) were less likely to have early ANC compared to those who did not have teenage pregnancy (aPR: 0.71, 95% CI: 0.53,0.97). Among mothers whose partners had a secondary or higher education, early ANC was more prevalent among employed mothers compared to those who were unemployed (aPR: 1.27, 95% CI: 1.02,1.57). CONCLUSIONS: Our findings suggest that whilst mothers whose partners had a secondary or higher education were more likely to initiate early ANC, supporting such women to plan their pregnancies can further increase the coverage of early ANC.


Assuntos
Mães , Cuidado Pré-Natal , Adolescente , Adulto , Criança , Estudos Transversais , Escolaridade , Feminino , Gana , Humanos , Gravidez , Adulto Jovem
5.
BMC Public Health ; 22(1): 901, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513816

RESUMO

BACKGROUND: Adolescence, a transition period from childhood to adulthood forms the foundation of health in later life. The adolescence period which should have been characterised by good health is often marred with life-threatening and irreparable consequences of public health concern. Teen pregnancy is problematic because it could jeopardise adolescents' safe transition to adulthood which does not only affect adolescents, but also their families, babies and society. There is ample evidence about the determinants and effects of teen pregnancy, but it is fragmented and incomplete, especially in Sub-Sahara Africa. This study presents pregnant adolescents' voices to explain significant gaps in understanding their lived experiences and coping strategies. METHODS: This narrative inquiry, involved in-depth interviews with 16 pregnant adolescents, who were recruited from a peri-urban district in Southern Ghana using purposive and snowball techniques in health facilities and communities respectively. The audio recorded interviews were transcribed verbatim and analysed manually using content analysis. RESULTS: Many pregnant adolescents are silent victims of a hash socio-economic environment, in which they experience significant financial deprivation, parental neglect and sexual abuse. Also, negative experiences of some adolescent girls such as scolding, flogging by parents, stigmatisation and rejection by peers and neighbors result in grieve, stress and contemplation of abortion and or suicide. However, adolescents did not consider abortion as the best option with regard to their pregnancy. Rather, family members provided adolescents with critical support as they devise strategies such as avoiding people, depending on God and praying to cope with their pregnancy. CONCLUSION: Adolescent pregnancy occurred through consensual sex, transactional sex and sexual abuse. While parents provide support, pregnant adolescents self-isolate, depend on God and pray to cope with pregnancy and drop out of school. We recommend that the Ministries of Education and Health, and law enforcement agencies should engage community leaders and members, religious groups, non-governmental organisations and other key stakeholders to develop interventions aimed at supporting girls to complete at least Senior High School. While doing this, it is also important to provide support to victims of sexual abuse and punish perpetrators accordingly.


Assuntos
Aborto Induzido , Gravidez na Adolescência , Adaptação Psicológica , Adolescente , Adulto , Criança , Feminino , Gana , Humanos , Gravidez , Gestantes , Comportamento Sexual , Adulto Jovem
6.
BMC Public Health ; 22(1): 894, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513825

RESUMO

BACKGROUND: Significant rates of anxiety, depressive symptoms, and low quality of life (QoL) have been found among pregnant women in developed countries. These psychosocial disturbances have not been adequately assessed during pregnancy in many developing countries. METHODS: Women were recruited in their first trimester of pregnancy (< 13 weeks; n = 116) and followed through to their 2nd (n = 71) and 3rd (n = 71) trimesters. Questionnaires were used to collect data on anxiety symptoms (Beck Anxiety Inventory; BAI), depressive symptoms (Center for Epidemiological Studies-Depression Inventory; CES-D), and quality of life (RAND SF-36; QoL). Psychometric analyses were used to determine the reliability of the questionnaires in this context. The proportion of pregnant women with psychosocial disturbances at each trimester was determined. Repeated measures ANOVA were used to examine changes in psychosocial outcomes over time; and generalized estimating equation to determine if gestational age predicted the psychosocial outcomes whilst controlling for sociodemographic variables. RESULTS: Participants were aged 27.1 ± 5.2 years, on average. Psychometric analyses revealed a 4-factor solution for BAI (18 items), 1-factor solution for CES-D (13 items) and 4-factor solution for RAND SF-36 (26 items). The prevalence estimate of psychosocial disturbances was 34%, 10%, 2% (anxiety), 49%, 31%, 34% (depressive symptoms), and 46%, 37%, 59% (low QoL) for 1st, 2nd and 3rd trimesters, respectively. Gestational age and food insecurity were significant predictors of depressive symptoms, anxiety symptoms and QoL. CONCLUSIONS: In this population of Ghanaian women, the levels of depressive symptoms and low QoL observed across pregnancy should be recognized as major public health problems and efforts to address these should be put in place. Addressing food insecurity may be a major step to solve not only the physical needs of the pregnant woman but also the psychological needs.


Assuntos
Depressão , Qualidade de Vida , Ansiedade/epidemiologia , Depressão/psicologia , Feminino , Gana/epidemiologia , Humanos , Estudos Longitudinais , Gravidez , Reprodutibilidade dos Testes
7.
BMC Public Health ; 22(1): 899, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513863

RESUMO

BACKGROUND: Unintentional injuries among adolescents constitute a significant public health problem globally. Injured adolescents may face negative outcomes ranging from poor academic performance to short- and long-term physical and psychosocial health struggles, and even death. The aim of this study was to estimate the prevalence and describe the correlates and most frequent causes of injuries among school-going adolescents in three West African countries - Benin, Ghana, and Liberia. METHODS: We analysed self-reported data provided by 8,912 school-going adolescents who participated in the Global School-based Student Health Survey in Ghana (2012), Benin (2016), and Liberia (2017). Students responded to questions on sociodemographic factors, family involvement factors, mental health factors, school environment factors and injury behaviours. RESULTS: The overall 12-month prevalence estimate of serious injuries in adolescents was 40.9% (Benin = 27.3%; Ghana = 46.1%; Liberia = 49.2%). The most frequently reported injury type was a broken bone or dislocated joint (33% in Benin), cuts or stab wounds (31.7% in Ghana), and non-specified injuries (35.2% in Liberia). Prevalence of serious injuries was higher among males and increased with age. In the multivariable logistic regression analysis, interpersonal aggression outside the family context (bullying victimisation, engaging in physical fights, and having been physically attacked) emerged as key correlates of increased odds of serious injuries. CONCLUSION: The relatively higher prevalence estimates of serious injury reported in this study underscore the need for the included countries to develop interventions aimed at reducing and preventing physical injuries among adolescents.


Assuntos
Bullying , Instituições Acadêmicas , Adolescente , Feminino , Gana/epidemiologia , Humanos , Masculino , Prevalência , Autorrelato , Estudantes/psicologia
8.
Pan Afr Med J ; 41: 146, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35519170

RESUMO

Introduction: menstrual hygiene (MH) is important for all women, yet it is still a neglected issue in many parts of the world. In most traditional African contexts, including Ghana, menstruation is largely treated as a taboo and humiliating topic that is rarely discussed openly. The main aim of this study is to assess perceived factors influencing menstrual hygiene management among adolescent girls in Ghana´s Savannah Region, West Gonja Municipality. Methods: we conducted a descriptive exploratory qualitative study among adolescents who had reached menarche. Purposive sampling was used to conduct 24 interviews with 18 teenagers and 6 mothers. Data were analyzed using the thematic content analysis. Results: the majority (55.5%) of respondents were ≥15 years with maximum and minimum ages being 19 and 13 years respectively. The mean age was 15.7, with a standard deviation of 1.8. A higher proportion (38.9%) of respondents were in their final year (JHS 3). Before menarche, all adolescent girls had heard about menstruation, mostly from their mothers, then from instructors and friends. During menstruation, all of the girls in this study used absorbent products. The cost, comfort, heaviness of menstrual flow, and accessibility influenced the choice of absorbent material, with some respondents utilizing multiple absorbent materials. Some girls were forced to dry their reusable absorbent material in their room because of shyness. Girls thought that reusing absorbent materials after drying them in the sun would have killed germs and removed unpleasant odours. During menstruation, girls are barred from participating in social and religious activities. Conclusion: culture and religion have very dire consequences on effective menstrual hygiene management. There is therefore urgent need to dispel the growing myths and misconception on menstrual hygiene as well as providing support for adolescent girls for practicing good menstrual hygiene.


Assuntos
Higiene , Menstruação , Adolescente , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Produtos de Higiene Menstrual
9.
BMC Health Serv Res ; 22(1): 599, 2022 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-35509055

RESUMO

BACKGROUND: Expanding health insurance coverage is a priority under Sustainable Development Goal 3. To address the intersection between poverty and health and remove cost barriers, the government of Ghana established the National Health Insurance Scheme (NHIS). Government further linked NHIS with the Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer program by waiving premium fees for LEAP 1000 households. This linkage led to increased NHIS enrolment, however, large enrolment gaps remained. One potential reason for failure to enroll may relate to the poor quality of health services. METHODS: We examine whether LEAP 1000 impacts on NHIS enrolment were moderated by health facilities' service availability and readiness. RESULTS: We find that adults in areas with the highest service availability and readiness are 18 percentage points more likely to enroll in NHIS because of LEAP 1000, compared to program effects of only 9 percentage points in low service availability and readiness areas. Similar differences were seen for enrolment among children (20 v. 0 percentage points) and women of reproductive age (25 v. 10 percentage points). CONCLUSIONS: We find compelling evidence that supply-side factors relating to service readiness and availability boost positive impacts of a cash transfer program on NHIS enrolment. Our work suggests that demand-side interventions coupled with supply-side strengthening may facilitate greater population-level benefits down the line. In the quest for expanding financial protection towards accelerating the achievement of universal health coverage, policymakers in Ghana should prioritize the integration of efforts to simultaneously address demand- and supply-side factors. TRIAL REGISTRATION: This study is registered in the International Initiative for Impact Evaluation's (3ie) Registry for International Development Impact Evaluations ( RIDIE-STUDY-ID-55942496d53af ).


Assuntos
Acesso aos Serviços de Saúde , Seguro Saúde , Adulto , Criança , Feminino , Gana , Humanos , Programas Nacionais de Saúde , Cobertura Universal do Seguro de Saúde
10.
Inquiry ; 59: 469580221086919, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35510934

RESUMO

Anaemia during pregnancy is a major public health concern. Despite its wide scope and adverse effects including increased maternal and perinatal morbidity and mortality, and long-term adverse effects on the newborn, appropriate interventions using upstream approaches to public health have largely not been implemented. This study investigated the prevalence and associated factors of anaemia among pregnant women in four health facilities in the Kwabre East Municipality. A cross-sectional survey with a two-stage sampling technique was conducted on 220 pregnant women who attended antenatal care at the selected health facilities. Interview-based structured questionnaires were used. Bivariate and multivariate logistic regression were used to identify predictors. The prevalence of anaemia was 11.4%. Few women (25) were anaemic and morphologically, 14 (56%) had normocytic normochromic anaemia and 9 (36%) had microcytic hypochromic anaemia. Iron deficiency was reported in 19 (8.6%) pregnant women. Independent predictors of anaemia were iron sulphate intake (AOR [95% CI] = 3.16 [1.15, 7.37], ANC follow-up during pregnancy (AOR [95% CI] = 3.07 [1.59, 7.99], household size of ≥5 (AOR [95% CI] = 3.58 [1.75, 9.52], folic acid intake (AOR [95% CI] = 5.29 [2.65, 12.39] and the period in pregnancy AOR [95% CI] = ≥36 weeks 3.2 (1.3-4.5). Though anaemia prevalence has been low in urban areas as previously reported, collaborated healthcare measures that aim at eradicating the menace are encouraged. Maternal healthcare interventions including the administration of folic acid, regular iron sulphate intake and intensive education on early ANC are recommended.


Assuntos
Anemia , Gestantes , Anemia/epidemiologia , Estudos Transversais , Feminino , Ácido Fólico , Gana/epidemiologia , Humanos , Recém-Nascido , Ferro , Gravidez , Prevalência , Sulfatos
11.
Nat Commun ; 13(1): 2494, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35523782

RESUMO

The COVID-19 pandemic is one of the fastest evolving pandemics in recent history. As such, the SARS-CoV-2 viral evolution needs to be continuously tracked. This study sequenced 1123 SARS-CoV-2 genomes from patient isolates (121 from arriving travellers and 1002 from communities) to track the molecular evolution and spatio-temporal dynamics of the SARS-CoV-2 variants in Ghana. The data show that initial local transmission was dominated by B.1.1 lineage, but the second wave was overwhelmingly driven by the Alpha variant. Subsequently, an unheralded variant under monitoring, B.1.1.318, dominated transmission from April to June 2021 before being displaced by Delta variants, which were introduced into community transmission in May 2021. Mutational analysis indicated that variants that took hold in Ghana harboured transmission enhancing and immune escape spike substitutions. The observed rapid viral evolution demonstrates the potential for emergence of novel variants with greater mutational fitness as observed in other parts of the world.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , Genoma Viral/genética , Gana/epidemiologia , Humanos , Mutação , Pandemias , Filogenia , SARS-CoV-2/genética , Glicoproteína da Espícula de Coronavírus/genética
12.
BMJ Open ; 12(5): e054757, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534071

RESUMO

OBJECTIVE: The aim of this study was to evaluate the benefit-cost of E-claims. A benefit-cost analysis was used to evaluate the efficiency of E-claims from the perspective of the providers and the purchaser. DESIGN: A benefit-cost analysis approach was taken for this economic evaluation. Furthermore, we estimated the incremental benefit-cost ratio (IBCR) of the intervention under assessment. PARTICIPANTS: Purchasers and healthcare providers of the National Health Insurance Scheme (NHIS) of Ghana were the study population. RESULTS: The analysis was stratified according to providers and purchaser. Cost incurred in processing claims electronically and manually were estimated by assessing the resource use and their corresponding costs. Sensitivity analysis was conducted to assess the robustness of the results to variations in discount rate and proportions of claims processed under E-claims compared with paper claims. The combined sample of providers and purchaser made incremental gains from processing claims electronically. The IBCR was -19.75, 25.56 and 5.10 for all (sample) providers, purchaser and both providers and purchaser, respectively. When projected for the 330 facilities submitting claims to the NHIS claims processing centre (CPC) as at December 2014, the IBCR were -35.20, 25.56 and 90.06 for all providers, purchaser and both providers and purchaser. The results were sensitive to the discount rate used and proportions of E-claims compared with paper claims. CONCLUSION: Electronic processing of claims is more efficient compared with manual processing, hence provide an economic case for scaling it up to cover many more healthcare facilities and NHIS CPCs in the Ghana.


Assuntos
Instalações de Saúde , Programas Nacionais de Saúde , Análise Custo-Benefício , Eletrônica , Gana , Humanos , Seguro Saúde
13.
J Environ Public Health ; 2022: 8997449, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35535351

RESUMO

Pollution due to pesticide residues has been reported in the downstream of the Tano Basin in the rainy season and has been attributed to the anthropogenic activities upstream. However, data on the seasonal variations in pesticide residues in the upstream of Tano Basin are limited. Seasonal variations in 13 organochlorine pesticide residues, 8 organophosphorus pesticide residues, and 5 synthetic pesticide residues in water and sediment samples of River Tano upstream were assessed through extraction and Varian CP-3800 gas chromatography equipped with a CombiPAL Auto sampler set at ionization mode electron impact methods. Significantly higher pesticide residues were detected in water and sediment samples in the rainy season than the dry season. Permethrin (rainy: 0.007 ± 0.01 mg/kg; dry: 0.008 ± 0.02 mg/kg) and profenofos (rainy: 0.021 ± 0.02 mg/kg; dry: 0.026 ± 0.01 mg/kg) showed higher dry season concentrations in the sediment samples. Two isomers of lindane (δ-HCH = 0.059 ± 0.24 µg/L; γ-HCH = 0.002 ± 0.01 µg/L) were detected in the water in the rainy season, but 3 were detected in the sediment samples (δ-HCH = 0.004 ± 0.12 mg/kg; γ-HCH = 0.003 ± 0.01 mg/kg; aldrin = 0.001 ± 0.01 mg/kg) suggesting possible illegal use. The detected pesticide residual levels in both water and sediment samples were lower than the maximum residual levels in water and sediment. The Chemical Control and Management Centre of the Environmental Protection Agency should check possible faking and adulteration of banned organochlorine pesticides.


Assuntos
Resíduos de Praguicidas , Praguicidas , Poluentes Químicos da Água , Monitoramento Ambiental/métodos , Sedimentos Geológicos/química , Gana , Hexaclorocicloexano/análise , Compostos Organofosforados , Resíduos de Praguicidas/análise , Praguicidas/análise , Estações do Ano , Água/análise , Poluentes Químicos da Água/análise
14.
J Environ Public Health ; 2022: 4870731, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35528634

RESUMO

Background: Employers are required to supply personal protective equipment (PPE) to all employees in Ghana, and employees are required to wear the PPE provided. In Ghana, previous studies on health and safety in the construction industry that touched on PPE use did not explicitly demonstrate the reasons why many workers choose to use or not to use it, though they may be at risk of occupational hazards. The purpose of this study was to determine building construction artisans' level of access to PPE and the perceived barriers and motivating factors of adherence to its use. The contribution of this study lies in its examination of the perceived barriers and motivating factors underlying adherence and nonadherence to PPE use in the construction industry, particularly building construction, which is yet to be determined in Ghana. Method: Data was collected from 173 frontline building construction workers using a structured questionnaire. The data was analyzed using a two-way multivariate analysis of variance (MANOVA) and one-way analysis of variance (ANOVA) to examine the effects of demographic variables on the perceived barrier and motivating factors of adherence to PPE use. Results: The most common PPE that participants had access to was safety boots/shoes, with their main source being borrowing from colleagues. The majority of participants disagreed with the perceived barriers while agreeing with the motivating factors of adherence to PPE use. The results suggest statistically significant differences for years of working experience (Wilks = 0.77, F = 2.47; p ≤ 0.01) and form of employment (Wilks = 0.72, F = 3.25, p ≤ 0.01) for perceived barriers to adherence. For perceived motivating factors to adherence, significant differences were obtained for age group (Wilks = 0.84, F = 2.42, p ≤ 0.01), years of experience (Wilks = 0.85, F = 2.35, p ≤ 0.01), and form of employment (Wilks = 0.71, F = 5.22, p ≤ 0.01). Conclusion: Age groups, years of experience, and form of employment were the main factors mediating adherence and nonadherence to PPE use by the construction workers. This study recommends safety training for workers if good safety management and performance concerning PPE use are to be achieved.


Assuntos
Indústria da Construção , Equipamento de Proteção Individual , Emprego , Gana , Humanos , Inquéritos e Questionários
15.
J Hypertens ; 40(5): 897-907, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35506279

RESUMO

BACKGROUND: Socioeconomic status (SES) and ethnicity are both important determinants of hypertension prevalence and control rates but their separate contribution is unknown. We assessed the association of SES with hypertension prevalence, awareness, treatment and control, and whether this differs between ethnic groups. METHODS: We used baseline data from the Healthy Life in an Urban Setting (HELIUS) study, a multiethnic population-based cohort study, including 18 106 participants (84% of the total cohort) of Dutch (n = 4262), African Surinamese (n = 3732), Moroccan (n = 2902), Turkish (n = 2694), South-Asian Surinamese (n = 2664) and Ghanaian (n = 1947) descent with data on SES and hypertension status. RESULTS: Regardless of ethnicity, lower SES was associated with higher hypertension prevalence, especially in participants with no education compared with those with higher levels of education [OR 2.29 (2.05-2.56)]. There was an inverse association between SES and hypertension treatment with the strongest association for lower compared with higher educated participants [OR 1.63 (1.39-1.90)]. In addition, lower SES was associated with lower hypertension control with the strongest association for participants with the lowest compared with the highest occupational level [OR 0.76 (0.60-0.95)]. The association between educational level and treatment but not the other SES- or hypertension-indicators, was influenced by ethnicity, with lower educated Dutch and African Surinamese having higher ORs for hypertensive treatment [Dutch OR 1.98 (1.43-2.76); African Surinamese OR 1.44 (1.10-1.89)]. CONCLUSION: SES, in particular education, impacts hypertension treatment in the Netherlands, whereas the association of specific SES parameters with hypertension indicators differ across ethnic groups. Further exploration is needed on how sociocultural beliefs and behaviours may differentially affect blood pressure control across ethnic minority populations.


Assuntos
Hipertensão , Estudos de Coortes , Gana/epidemiologia , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Grupos Minoritários , Prevalência , Classe Social
16.
PLoS One ; 17(5): e0267797, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35499996

RESUMO

BACKGROUND: The African prostate cancer epidemiological trend has reported the late detection of the disease and resultant high mortality rate. Considering the economic position of the African continent, which often contributes to high mortality, it has become imperative to investigate cost-effective means of improving the timely detection of prostate cancer. This study, the third developmental phase of a robust Akan tool, aimed at conducting an external pilot survey to investigate the practicability of the tool in studying prostate cancer awareness in women. METHOD: The study was conducted in one of the biggest markets in Ghana employing a quantitative approach and recruiting 400 females from the age of 18 years. Post-ethical approval and study subjects' consent, the participants randomly responded to the Akan tool and the data was electronically entered in the presence of the participants. The data, entered in the Microsoft Excel spreadsheet, were analysed with the SPSS software (version 25). The results were presented as frequencies and percentages, with an assessment of the tool's reliability. RESULTS: A Cronbach's alpha reliability coefficient of 0.9030 was calculated. The majority (83.50%) of the participants belonged to the Akan tribe and were fluent in the Akan language. None of the knowledge items on the signs and symptoms, and risk factors of the disease had correct responses from more than 25.00% and 20.00% of the participants respectively whilst knowledge items on the causes of prostate cancer received varied responses. The participants were aware of the disease and had a positive perception. CONCLUSIONS: The pilot survey adequately tested the Akan tool and suggested various modifications to the tool and the study methodology. The tool exhibited acceptable reliability and could be applied to targeted populations to investigate the awareness of prostate cancer in women.


Assuntos
Neoplasias da Próstata , Adolescente , Gana/epidemiologia , Humanos , Masculino , Percepção , Projetos Piloto , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Reprodutibilidade dos Testes
17.
Afr J Prim Health Care Fam Med ; 14(1): e1-e7, 2022 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-35532111

RESUMO

BACKGROUND:  Alzheimer's disease and related dementias (ADRDs) pose a major public health challenge in older adults. In sub-Saharan Africa, the burden of ADRD is projected to escalate amidst ill-equipped healthcare workers (HCWs). AIM:  This study aimed to assess ADRD knowledge amongst Ghanaian HCWs and improve gaps identified through a workshop. SETTING:  Study was conducted among HCWs attending a workshop in Kumasi, Ghana. METHODS:  On 18 August 2021, a workshop on ADRD was organised in Kumasi, Ghana, which was attended by 49 HCWs comprising doctors, nurses, pharmacists, social workers and nutritionists. On arrival, they answered 30 pre-test questions using the Alzheimer's Disease Knowledge Scale (ADKS). A post-test using the same questionnaire was conducted after participants had been exposed to a 4-h in-person educational content on ADRD delivered by facilitators from family medicine, neurology, geriatrics, psychiatry and public health. RESULTS:  The mean age of participants was 34.6 (± 6.82), mean years of practice was 7.7 (± 5.6) and 38.8% (n = 19) were nurses. The mean score of participants' overall knowledge was 19.8 (± 4.3) at pre-test and 23.2 (± 4.0) at post-test. Participants' pre-test and post-test scores improved in all ADKS domains. Factors associated with participants' knowledge at baseline were profession, professional rank and the highest level of education attained. After adjusting for age and sex, participant's rank, being a specialist (adjusted ß = 14.44; 95% confidence interval [CI] = 7.03, 21.85; p  0.001) was an independent predictor of knowledge on Alzheimer's disease. CONCLUSION:  Existing knowledge gaps in ADRD could be improved via continuous medical education interventions of HCWs to prepare healthcare systems in Africa for the predicted ADRD epidemic.


Assuntos
Doença de Alzheimer , Idoso , Doença de Alzheimer/epidemiologia , Gana , Pessoal de Saúde , Mão de Obra em Saúde , Humanos , Inquéritos e Questionários
18.
Antimicrob Resist Infect Control ; 11(1): 53, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365210

RESUMO

BACKGROUND: Antibiotic consumption is increasing worldwide, particularly in low and middle-income countries (LMICs). Access to lifesaving antibiotics in LMICs is crucial while minimising inappropriate use. Studies assessing the economic impact of inappropriate antibiotic use in LMICs are lacking. We explored the economic impact of inappropriate antibiotic use using the example of upper respiratory tract infections (URIs) in Ghana, as part of the ABACUS (AntiBiotic ACcess and USe) project. METHODS: A top-down, retrospective economic impact analysis of inappropriate antibiotic use for URIs was conducted. Two inappropriate antibiotic use situations were considered: (1) URIs treated with antibiotics, against recommendations from clinical guidelines; and (2) URIs that should have been treated with antibiotics according to clinical guidelines, but were not. The analysis included data collected in Ghana during the ABACUS project (household surveys and exit-interviews among consumers buying antibiotics), scientific literature and stakeholder consultations. Included cost types related to health care seeking behaviour for URIs. Additionally, cost saving projections were computed based on potential effects of future interventions that improve antibiotic use. RESULTS: Health care costs related to inappropriate antibiotic use for URIs were estimated to be around 20 million (M) USD annually, including 18 M USD for situation 1 and 2 M USD for situation 2. Travel costs and lost income due to travel, together, were estimated to be around 44 M USD for situation 1 and 18 M USD for situation 2. Possible health care cost savings range from 2 to 12 M USD for situation 1 and from 0.2 to 1 M USD for situation 2. CONCLUSIONS: This study indicates that inappropriate antibiotic use leads to substantial economic costs in a LMIC setting that could have been prevented. We recommend investment in novel strategies to counter these unnecessary expenditures. As the projections indicate, this may result in considerable cost reductions. By tackling inappropriate use, progress can be made in combatting antibiotic resistance.


Assuntos
Antibacterianos , Infecções Respiratórias , Antibacterianos/uso terapêutico , Gana , Custos de Cuidados de Saúde , Humanos , Infecções Respiratórias/tratamento farmacológico , Estudos Retrospectivos
19.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2022 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-35365982

RESUMO

PURPOSE: Nurse managers' planning practices are essential to the practice of management in the unit, and the overall efficiency of the healthcare service delivery. This study aims to explore the planning practices of nurse managers in the Greater Accra Region, Ghana. DESIGN/METHODOLOGY/APPROACH: A descriptive phenomenological design was employed to explore nurse managers' planning practices. In total, 15 nurse managers and 47 nurses from 19 primary and secondary hospitals of the Ghana Health Service and two specialized hospitals in the Greater Accra Region, Ghana, were involved in the study. Data were collected using semi-structured interview guides and probes. FINDINGS: The findings suggested that plans were widely common to all the units of the hospitals and were considered satisfactory by nurse managers. However, most of these plans were not effectively utilized. Nurse managers had only fair knowledge about the planning process and were moderately involved and communicated ideas to colleagues in the process. Furthermore, nurse managers do not frequently share the vision neither do they even communicate expectations to achieve unit goals and objectives with subordinates. ORIGINALITY/VALUE: The research emphasizes the relevance of planning in healthcare management. It highlights the management practice of planning in the context of nurse managers and accentuates the values the healthcare system derives with effective planning practices.


Assuntos
Enfermeiras Administradoras , Gana , Humanos
20.
Front Cell Infect Microbiol ; 12: 832500, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372093

RESUMO

Background: Ulcerative colitis (UC) is a relapsing nontransmural inflammatory disease that is restricted to the colon and is characterized by flare-ups of bloody diarrhea. In this study, we aimed to investigate intestinal bacterial diversity in healthy controls and patients with UC with and without active disease, from Ghana and Denmark. Methods: The study included 18 UC patients (9 with active and 9 with inactive disease) and 18 healthy controls from Ghana. In addition 16 UC patients from Denmark (8 UC with active and 8 UC with inactive disease) and 19 healthy controls from Denmark. Microbiota diversity analysis relied on sequencing of ribosomal small subunit genes. Purified genomic DNA was submitted to PCR using a primer set targeting prokaryotes and eukaryotes. The purified DNA was sequenced on the Illumina MiSeq system in a 2 × 250 bp set up (Illumina, San Diego, CA, USA). Blinded analysis of the taxonomy table was performed using BioNumerics-7.5 (Applied Maths NV, Sint-Martens-Latem, Belgium). Results: When analyzing the taxonomy data for prokaryotes, cluster and principal component analysis shows Danish healthy controls clustered together, but separate from healthy controls from Ghana, which also clustered together. The Shannon diversity index (SDI) for prokaryotes shows significant differences between Danish healthy controls and patients in comparison with the corresponding groups from Ghana (p = 0.0056). Significant increased abundance of Escherichia coli was detected in healthy controls from Ghana in comparison with healthy controls from Denmark. The SDI of the prokaryotes ranges between 0 and 3.1 in the Ghana study groups, while in the Danish study groups it ranges between 1.4 and 3.2, the difference is however not significant (p = 0.138). Our data show a significant increased abundance of eukaryotes species in the healthy control group from Ghana and Denmark in comparison with patient groups from Ghana and Denmark. Conclusion: Overall, healthy controls and patients with UC from Denmark have increased diversity of prokaryotes. Healthy controls from Denmark and Ghana have increased abundance of eukaryotes in comparison with UC patient groups from Denmark and Ghana.


Assuntos
Colite Ulcerativa , Microbioma Gastrointestinal , Microbiota , Dinamarca/epidemiologia , Microbioma Gastrointestinal/genética , Gana , Humanos
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