RESUMEN

BACKGROUND: Severe Plasmodium falciparum malarial anemia is still the principal cause of death in children in underdeveloped countries. An imbalance between proinflammatory and anti-inflammatory cytokines is associated with malaria progression. This study evaluated circulating levels of selected inflammatory cytokines among malaria-infected children in Ghana. METHODS: This case-control study was conducted at Tamale Teaching Hospital, Ghana. One hundred and twenty children with malaria and 60 controls, aged 12-144 months were selected from April to July, 2023 for the study. Malaria was diagnosed through microscopy, full blood count was measured using hematology analyzer, and cytokines were measured using enzyme-linked immunosorbent assay. RESULTS: Malaria-infected children had higher tumor necrosis factor alpha (TNF-α) (p < .001), interferon-gamma (IFN-É£) (p < .001), interleukin (IL)-1ß (p < .001), IL-6 (p < .001), granulocyte macrophage-colony stimulating factor (GM-CSF) (p < .001), and IL-10 (p < .001) levels than controls. Participants with high parasitemia had raised TNF-α (p < .001), IFN-É£ (p < .001), IL-1ß (p < .001), IL-6 (p < .001), GM-CSF (p < .001), and IL-10 (p < .001), but reduced IL-3 (p < .001) and TGF-ß (p < .001) than those with low parasitemia. Severe malarial anemic children had elevated TNF-α (p < .001), IFN-É£ (p < .001), IL-1ß (p < .001), IL-6 (p < .001), GM-CSF (p < .001), and IL-10 (p < .001), but lower IL-3 (p < .001) and TGF-ß (p < .001) than those with uncomplicated malaria. CONCLUSION: Parasite density was the principal predictor of the cytokine levels, as parasitemia positively associated with IL-10, GM-CSF, IL-6, IL-1ß, IFN-É£, and TNF-α, but negatively associated with IL-3 and TGF-ß. Malaria is associated with enhanced secretion of pro- and anti-inflammatory cytokines in Ghanaian children. Inflammatory cytokines may be involved in the development of severe malarial anemia in children. However, IL-3 and TGF-ß may offer protection against severe malarial anemia.

Asunto(s)

Anemia , Citocinas , Progresión de la Enfermedad , Malaria Falciparum , Humanos , Citocinas/sangre , Anemia/sangre , Anemia/inmunología , Anemia/parasitología , Masculino , Preescolar , Femenino , Estudios Prospectivos , Estudios de Casos y Controles , Lactante , Malaria Falciparum/sangre , Malaria Falciparum/inmunología , Malaria Falciparum/complicaciones , Malaria Falciparum/parasitología , Malaria Falciparum/epidemiología , Ghana/epidemiología , Niño , Parasitemia/sangre , Parasitemia/inmunología , Plasmodium falciparum/inmunología , Mediadores de Inflamación/sangre

RESUMEN

BACKGROUND: Malaria in pregnancy (MiP) is a condition that can be prevented by using intermittent preventive treatment using Sulfadoxine-pyrimethamine. However, despite all the effort to reduce the consequences of MiP for the woman, the unborn child, and the neonate, the knowledge of Intermittent Preventive Treatment of Malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) is low in most malaria-endemic countries, including Ghana. Thus, the need to examine knowledge, and attitude of service users of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine. METHODS: The study was a cross-sectional survey of two selected districts in the Volta Region of Ghana. The study participants were randomly selected from communities within Nkwanta North and North Tongu District. In all a total of 438 mothers who have delivered in the past 24 months were selected for the study. The women were interviewed using a structured questionnaire and the bivariate and multivariable logistic regression results presented in tables. RESULTS: The level of knowledge, and attitude were reported as 45.9% and 58.9% respectively. Knowledge of the service user is determined by the level of education of the women. The attitude of the service user is determined by making 4-7 visits during ANC, Gestational age at booking for ANC is 4-7 weeks, income level between 100 to 999, partner educational level above Middle/JHS/JSS, and age of a partner is above 40 years. CONCLUSION: The findings from the present studies highlighted important factor such as number of antenatal visits that affect both knowledge of services and attitude to use IPTp-SP. Therefore, a community-based health promotion programmes to help to increase knowledges and improved attitude on timely and regular antenatal attendance to promote the benefit of IPTp-SP should be encouraged.

Asunto(s)

Antimaláricos , Combinación de Medicamentos , Conocimientos, Actitudes y Práctica en Salud , Malaria , Complicaciones Parasitarias del Embarazo , Pirimetamina , Sulfadoxina , Humanos , Femenino , Ghana/epidemiología , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Embarazo , Adulto , Malaria/prevención & control , Malaria/tratamiento farmacológico , Malaria/epidemiología , Antimaláricos/uso terapéutico , Estudios Transversales , Complicaciones Parasitarias del Embarazo/prevención & control , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Adulto Joven , Adolescente , Encuestas y Cuestionarios

RESUMEN

BACKGROUND: In many places in the world, workers in the meat processing industry report high incidence of injuries. Details of such injuries are not well known for Ghana or much of Africa. METHODS: A cross-sectional survey involving 300 workers from three major meat processing facilities in the Kumasi metropolis of Ghana was carried out using a structured questionnaire from April to June 2023. The prevalence, types and outcome of injuries among workers were assessed. Test of association was established by Chi square analysis. RESULTS: Over the prior 6 months, the prevalence of injury was 83.0%. Among the various injury types, lacerations had the highest prevalence (46.0%) followed by musculoskeletal pain (16.7%) bone fractures (14.0%), swelling (13.0%), burns and scalds (7.3%), and dislocations/sprains/strains (6.7%). More than half (58.9%) of injuries sustained were moderately severe (2-7 days of lost work) and nearly half (42.0%) required immediate medical attention. Gender, employment status, wages, availability and use of safety equipment were significantly associated with injuries among abattoir workers. CONCLUSIONS: The incidence of injuries among abattoir workers in Kumasi, Ghana demonstrates a large public health burden requiring attention and improved enforcement through occupational safety interventions.

Asunto(s)

Mataderos , Traumatismos Ocupacionales , Humanos , Ghana/epidemiología , Masculino , Femenino , Mataderos/estadística & datos numéricos , Prevalencia , Estudios Transversales , Traumatismos Ocupacionales/epidemiología , Adulto , Persona de Mediana Edad , Adulto Joven , Laceraciones/epidemiología , Encuestas y Cuestionarios , Incidencia

RESUMEN

BACKGROUND: Ticks are vectors of pathogens that affect the health of animals and humans. With the constant trade of livestock across borders, there is the risk of new tick species invasion accompanied by the spread of infectious tick-borne pathogens. AIM: This study sought to determine the diversity of tick species within abattoirs and a slaughter slab as well as identify the pathogens carried by these ticks. METHODS: The ticks were collected from slaughtered cattle, identified and screened for pathogens using PCR and sequencing. RESULTS: A total of 371 ticks were collected from slaughtered cattle across the three sampling sites: Kumasi abattoir (288, 77.63%), Akwatia Line slaughter slab (52, 14.02%) and Suame abattoir (31, 8.35%). The predominant species was Amblyomma variegatum (85.44%) with Rhipicephalus sanguineus (s.l.) (0.27%) as the least occurring species. Total nucleic acid from the tick pools was screened for pathogens based on the nucleoprotein gene region in the S segment of the Crimean-Congo haemorrhagic fever virus (CCHFV) genome, the 295-bp fragment of the transposase gene of the Coxiella burnetii IS1111a element, the 560 bp segment of the ssrRNA gene of Babesia and Theileria, the 345 bp fragment of the Ehrlichia genus 16SrRNA gene and the rOmpA gene (OmpA) of Rickettsia. From the 52 tick pools screened, 40 (76.92%) were found positive for pathogen DNA. The pathogens identified were Rickettsia africae (69.23%), Rickettsia aeschlimannii (7.69%), C. burnetii (5.77%), uncultured Ehrlichia sp. (5.77%), Candidatus Midichloria mitochondrii (3.85%) and CCHFV (3.85%). A significant association was observed among A. variegatum, Hyalomma rufipes, Hyalomma truncatum and occurring tick-borne pathogens R. africae, R. aeschlimannii and uncultured Ehrlichia sp. (p < 0.001). CONCLUSION: The findings show the occurrence of zoonotic pathogens, suggesting an increased risk of infections among the abattoir workers. There is a need to adopt control measures within the abattoirs to prevent pathogen spread.

Asunto(s)

Mataderos , Animales , Mataderos/estadística & datos numéricos , Bovinos , Ghana/epidemiología , Enfermedades por Picaduras de Garrapatas/veterinaria , Enfermedades por Picaduras de Garrapatas/epidemiología , Enfermedades por Picaduras de Garrapatas/microbiología , Enfermedades por Picaduras de Garrapatas/parasitología , Ixodidae/microbiología , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/microbiología , Enfermedades de los Bovinos/parasitología , Rickettsia/aislamiento & purificación , Rickettsia/genética

RESUMEN

BACKGROUND: Malaria in pregnancy (MiP) is a preventable condition leading to maternal and neonatal morbidity and mortality. Invariably, with all the knowledge about the serious consequences of MiP for the woman, the unborn child, and the neonate, the uptake of Intermittent Preventive Treatment of Malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) is low in most malaria-endemic countries, including Ghana. This study sought to examine the uptake and service user predictors of the implementation of IPTp-SP after the policy upgrade in 2014. METHODS: This cross-sectional survey was carried out in two selected districts in the Volta Region. The study participants were randomly selected from communities within Nkwanta North and North Tongu District. A total of 438 mothers who have delivered in the past 24 months were selected for the study. The women were interviewed on their background, knowledge, and attitude toward the use of IPTp-SP using a structured questionnaire. Multiple logistic regression was done to determine the factors that influence the demand for IPTp-SP. The results were presented in the form of tables. RESULTS: The mean number of antenatal care (ANC) attendance was 5 (SD:2.6) visits per client, with 262 (59.82%) of them getting the 3+ doses of IPTp-SP. Also, a significant 44 (10.1%) of the mothers did not receive any dose of IPTp-SP. Respondents who attended antenatal clinics 4-7 times had 7 (CI:3.9-12.3) times higher uptake of 3+ doses of IPTp-SP as compared to others who attended less than 4 visits. Similarly, women who had 8 or more visits had a 16.1 (CI: 5.9-43.6) times higher chance of getting more than 2 doses of IPTp-SP compared with others who had fewer than 4 attendances. CONCLUSION: The uptake of 3+ doses of IPTp-SP is still lower than the global target of 80%. Thus, the need for innovative interventions aimed at improving antenatal attendance and early booking for IPTp-SP are recommended.

Asunto(s)

Antimaláricos , Combinación de Medicamentos , Malaria , Complicaciones Parasitarias del Embarazo , Pirimetamina , Sulfadoxina , Humanos , Femenino , Pirimetamina/uso terapéutico , Pirimetamina/administración & dosificación , Sulfadoxina/uso terapéutico , Sulfadoxina/administración & dosificación , Ghana/epidemiología , Embarazo , Adulto , Antimaláricos/uso terapéutico , Malaria/prevención & control , Malaria/tratamiento farmacológico , Malaria/epidemiología , Estudios Transversales , Complicaciones Parasitarias del Embarazo/prevención & control , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Adulto Joven , Adolescente , Atención Prenatal , Conocimientos, Actitudes y Práctica en Salud , Encuestas y Cuestionarios

RESUMEN

Objective: To describe the profile of Streptococcus pneumoniae, identify research gaps, and provide in-depth insights into various aspects related to the pathogen. Methods: Google Scholar, PubMed, and ScienceDirect were searched for all studies on the pneumococcus in Ghana that reported on specimen collected, population and sample size, carriage prevalence, incidence of pneumococcal diseases, age of the study population, types of test performed, serotypes identified, antimicrobial susceptibilities, or molecular analysis on the pneumococci for data extraction. Results: Overall, a total of 7954 results were obtained from the three-database search, and of this, 24 articles were selected after screening. A total of 924 isolates were accounted for by serotyping/serogrouping. The prevalence of pneumococcal carriage in Ghana ranges from 11.0% to 51.4% in the population depending on the age (≤ 24-80 years), sickle cell disease (SCD), human immunodeficiency virus (HIV) status, or health of the study population, and penicillin (Pen)-nonsusceptible isolates ranged from 17% to 63%. The prevalence of pneumococci found as the etiologic agent of diseases among Ghanaians ranges from 3.4% for otitis media to 77.7% for meningitis. Overall, the 13-valent pneumococcal conjugate vaccine (PCV) (PCV-13) carriage serotypes accounted for 28.4% of the reported pneumococcal isolates. PCV-13 invasive serotypes accounted for 22.4% of the reported isolates. The non-PCV-13 carriage serotypes accounted for most (43.9%) of the reported isolates. In the pre-PCV-13 era, the nontypeable (NT) (5.5%) and other nonvaccine types (NVTs) (6.4%) were reported as being predominant. The non-PCV-13 serotypes accounted for 4.4% of the reported isolates in invasive pneumococcal disease (IPD) cases. Multidrug resistance (MDR) ranged from 7.8% to 100%. Conclusion: Predicting the invasiveness of pneumococci using molecular typing is the way to go in the future as this will provide answers to the extent to which capsular switching is contributing to the pneumococcal disease burden in Ghana almost a decade after introducing PCV-13. Continuous monitoring of antibiotic resistance patterns at both phenotypic and genotypic levels, along with serotyping and molecular typing, should be a standard practice in the surveillance of pneumococcal disease burden in Ghana.

Asunto(s)

Infecciones Neumocócicas , Vacunas Neumococicas , Streptococcus pneumoniae , Humanos , Ghana/epidemiología , Streptococcus pneumoniae/patogenicidad , Streptococcus pneumoniae/aislamiento & purificación , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Prevalencia , Serogrupo , Adulto , Anciano , Persona de Mediana Edad , Anciano de 80 o más Años , Serotipificación , Femenino , Antibacterianos/farmacología , Antibacterianos/uso terapéutico

RESUMEN

INTRODUCTION: In Sub-Saharan Africa alone, about 40-65% of Hepatitis B Virus infections among HCWs were a result of percutaneous occupational exposures to contaminated blood and body fluids of patients. Occupational exposure to blood and body fluids among healthcare workers is on the rise in Ghana. However, the relationship between self-reported exposures to blood and body fluids suspected to be contaminated with the hepatitis B virus and actual serological evidence of exposure remains unknown. The aim of the study however was to assess the self-reported exposure to HBV as against the serological evidence of lifetime exposure to HBV and associated factors among Ghanaian HCWs. METHODS: The study was a cross-sectional analytical survey that involved 340 HCWs who were recruited using a simple random sampling procedure from six cadres of staff from five districts in Greater Accra. The participants were surveyed using a validated instrument and 5mls of venous blood was aseptically withdrawn for qualitative detection of Anti-HBc. SPSS version 23.0 was used to analyze the data to obtain proportions, odds ratios and their corresponding confidence intervals with the level of significance set at 0.05. RESULTS: The response rate was 94% with Nurses and Doctors in the majority with a mean age of 35.6 ± 7.2. Self-reported exposure to HBV was 63% whereas lifetime exposure to HBV (Anti-HBc) prevalence was 8.2% (95% CI = 5.0-11.0%). Females were 60% less likely to be exposed to HBV (aOR = 0.4; 95% CI = 0.1-0.9) than their male counterparts. HCWs without training in the prevention of blood-borne infections had almost three times higher odds of being exposed to HBV in their lifetime (aOR = 2.6; 95% CI = 1.0-6.4). CONCLUSIONS: The findings of this study suggest that self-reported exposure to HBV-contaminated biological materials was high with a corresponding high lifetime exposure to HBV. The female gender was protective of anti-HBc acquisition. Apart from direct interventions for preventing occupational exposures to HBV in the healthcare setting, periodic training of all categories of healthcare workers in infection prevention techniques could significantly reduce exposure to the Hepatitis B virus.

Asunto(s)

Personal de Salud , Hepatitis B , Exposición Profesional , Autoinforme , Humanos , Estudios Transversales , Ghana/epidemiología , Femenino , Masculino , Personal de Salud/estadística & datos numéricos , Adulto , Hepatitis B/epidemiología , Hepatitis B/transmisión , Exposición Profesional/estadística & datos numéricos , Persona de Mediana Edad , Líquidos Corporales/virología , Virus de la Hepatitis B/inmunología , Virus de la Hepatitis B/aislamiento & purificación , Adulto Joven , Anticuerpos contra la Hepatitis B/sangre

RESUMEN

BACKGROUND: Reactive case detection (RCD) aims to reduce malaria transmission stemming from asymptomatic carriers. Symptomatic individuals diagnosed with malaria at a health centre are followed to their households, where members of the index case and neighbouring households are tested and treated for malaria. An RCD programme was tested in the Ashanti region of Ghana in order to study diagnostic accuracy in the hospital and household settings, assess the prevalence of subclinical infections and possible clustering in index case households, and identify operational challenges for future RCD programmes. Currently, transmission in this region is high, but reactive interventions might become an option once transmission is reduced. METHODS: 264 febrile individuals were enrolled at the Mankranso Government Hospital and tested for malaria using rapid diagnostic tests (RDT). From the pool of RDT-positive febrile index cases, 14 successful RCD follow-ups were conducted, and 233 individuals were enrolled from the index case, neighbour, and control households. The sensitivity of diagnostic tools for clinical and subclinical cases was compared, including RDT, expert microscopy by World Health Organization-certified microscopists, field microscopy, and qPCR. RESULTS: Poor diagnosis and low receptivity to RCD-style follow-ups were major limitations to a successful and effective RCD programme. Field microscopy detected only 49% of clinical infections compared to RDT. 54% of individuals did not agree to a follow-up, and 66% of attempted follow-ups failed. The system effectiveness of RCD, calculated as the product of correctly diagnosed index cases, successful follow-ups, and proportion of asymptomatic infections detected by RDT, was very low at 4.0%. CONCLUSIONS: Due to low system effectiveness and the endemic nature of the disease setting in which asymptomatic prevalence is high and infections are not clustered around index case households, RCD is currently not a feasible option for malaria control in this region. The operational challenges identified through this study may help inform future reactive intervention programme designs once transmission is reduced.

Asunto(s)

Infecciones Asintomáticas , Pruebas Diagnósticas de Rutina , Malaria Falciparum , Ghana/epidemiología , Humanos , Malaria Falciparum/diagnóstico , Malaria Falciparum/epidemiología , Malaria Falciparum/prevención & control , Infecciones Asintomáticas/epidemiología , Femenino , Masculino , Preescolar , Niño , Adolescente , Pruebas Diagnósticas de Rutina/métodos , Pruebas Diagnósticas de Rutina/estadística & datos numéricos , Adulto , Adulto Joven , Lactante , Persona de Mediana Edad , Plasmodium falciparum/aislamiento & purificación , Prevalencia , Sensibilidad y Especificidad , Anciano

RESUMEN

Objectives: The radiographic assessment of the head is a crucial part of headache care. A computed tomography (CT) scan enables a more detailed analysis of the condition and more focused care. This study examined head CT scans to determine what kinds of anomalies were present in patients with headaches as their primary complaint. Methods: We evaluated 4 years' worth of CT scan data from head exams conducted at two diagnostic facilities in Ghana's western and central regions. We examined data on 477 patients with a headache as their primary complaint between January 2017 and December 2020. We employed chi-square and Fisher's exact tests (where applicable) to compare head CT diagnoses between age groups, gender, headache subtypes, and brain lesion subgroups. Results: There were 53.5% (n = 255) females and 46.5% (n = 222) males in the study. The average age of patients was 38.67 ± 17.23 years, with an annual rate of abnormal CT diagnoses ranging from 35.9% in 2017 to 45.4% in 2022. Abnormal head CT diagnoses are strongly correlated with age groups and patient gender (p = 0.011 and p = 0.009, respectively). Of the 202 patients, 15.3% and 24.3% were classified as intracranial lesions and extracranial lesions, respectively. Maxillary sinusitis affected nearly 60% of the patients, while tumors and hemorrhages affected 25.2% and 11.9%, respectively. Conclusions: A CT scan of the head is essential to detect abnormalities in nearly 50% of patients suffering from various degrees of headache. Sinusitis, brain tumors, and hemorrhage were common lesions detected. It is crucial to create local standard operating procedures to promote better utilization of this type of imaging service, particularly among patients who have been diagnosed with headaches.

Asunto(s)

Cefalea , Tomografía Computarizada por Rayos X , Humanos , Masculino , Femenino , Ghana/epidemiología , Adulto , Tomografía Computarizada por Rayos X/métodos , Cefalea/diagnóstico por imagen , Persona de Mediana Edad , Estudios Retrospectivos , Adolescente , Anciano , Adulto Joven , Niño , Cabeza/diagnóstico por imagen

RESUMEN

BACKGROUND: Intimate partner violence in pregnancy is a significant public health issue that has several detrimental effects. Pregnant women subjected to intimate partner violence (IPV) have a higher risk for adverse pregnancy outcomes. OBJECTIVE: The aim of the study was to determine the prevalence, patterns and factors associated with intimate partner violence among pregnant women attending a primary care antenatal clinic. METHODS: A quantitative cross-sectional study design was employed to study intimate partner violence among 269 pregnant women in Accra, Ghana between July and October 2021. Participants were selected by systematic sampling technique. The self-reported Composite Abuse Scale was used to assess and classify intimate partner violence. Socio-demographic, clinical (obstetric) and behavioural characteristics were obtained with a structured questionnaire. Associations were determined between independent and dependent variables using the chi-squared test, and logistic regression with adjusted odds ratio (AOR). The statistical significance level was set at a p-value ≤ 0.05. RESULTS: The prevalence of IPV was 11.2%. The prevalence of emotional/psychological abuse, harassment/controlling behaviour, physical abuse, sexual abuse and severe combined abuse were 12.3%, 13.0%, 8.2%, 3.3% and 8.9% respectively. Pregnant women who were employed had reduced odds of experiencing IPV [AOR = 0.16 (95%CI: 0.05-0.47), p = 0.001], however, the past experience of violence [AOR = 4.9 (95%CI: 1.06-22.96), p = 0.042], alcohol use by women [AOR = 7.8 (95%CI: 1.63-37.42), p = 0.01], and partners' alcohol consumption [AOR = 10.0 (95%CI: 3.22-31.26), p<0.001] were associated with increased odds of IPV. CONCLUSIONS: There is a high prevalence of IPV among pregnant women in this study from a resource-limited setting. The factors found to be associated with IPV in pregnancy were the employment status of women, alcohol consumption by women or their partners and a previous history of violence. Healthcare providers in primary care need to recognize IPV as a medical condition that can occur in pregnancy and be ready to assist and manage the victims when it is detected.

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Violencia de Pareja , Mujeres Embarazadas , Atención Primaria de Salud , Humanos , Femenino , Embarazo , Violencia de Pareja/estadística & datos numéricos , Violencia de Pareja/psicología , Adulto , Ghana/epidemiología , Estudios Transversales , Atención Primaria de Salud/estadística & datos numéricos , Prevalencia , Mujeres Embarazadas/psicología , Adulto Joven , Adolescente , Encuestas y Cuestionarios , Factores de Riesgo

RESUMEN

BACKGROUND: Mycoplasma genitalium (MG), a sexually transmitted infection (STI), has emerged as a common cause of non-gonococcal urethritis and cervicitis worldwide, with documented resistance to commonly used antibiotics including doxycycline and azithromycin. Data in Ghana regarding the prevalence of MG is limited. METHODS: This retrospective study investigated MG presence and macrolide resistance among patients who previously reported to selected clinics for STI symptoms between December 2012 and June 2020. Samples were screened for MG and mutations associated with azithromycin resistance were investigated using Nucleic Acid Amplification Testing (NAAT) including the Resistance Plus MG® kit from SpeeDx and the LightMix® kit for MG, combined with the Modular Mycoplasma Macrolide from TIB Molbiol. RESULTS: A total of 1,015 samples were screened, out of which MG infection rate by TIB Molbiol and SpeeDx were 3.1% and 3.4%, respectively. The mutation responsible for macrolide resistance was detected in one MG positive sample by both assays. Both diagnostic tests revealed no significant association between MG infection and socio-demographic characteristics, clinical symptoms, gonorrhea, and chlamydia infection status. There was no significant difference in the mycoplasma percentage positivity rate detected using SpeeDx (3.4%) and TIB Molbiol (3.1%). CONCLUSIONS: While not commonly tested as a cause of STI symptoms, MG is widespread in Ghana, exhibiting symptoms and prevalence comparable to those in other countries and linked to antimicrobial resistance. Future research using various molecular techniques is essential to monitor resistance trends and guide future antibiotic choices.

Asunto(s)

Antibacterianos , Farmacorresistencia Bacteriana , Macrólidos , Infecciones por Mycoplasma , Mycoplasma genitalium , Mycoplasma genitalium/efectos de los fármacos , Mycoplasma genitalium/genética , Mycoplasma genitalium/aislamiento & purificación , Humanos , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/microbiología , Ghana/epidemiología , Femenino , Masculino , Adulto , Estudios Retrospectivos , Prevalencia , Macrólidos/farmacología , Macrólidos/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana/genética , Adulto Joven , Adolescente , Persona de Mediana Edad , Salud Sexual , Azitromicina/farmacología , Azitromicina/uso terapéutico , Mutación , Pruebas de Sensibilidad Microbiana

RESUMEN

Background: Analysing data on adverse drug reactions (ADRs) in health facilities is an essential step to help develop effective strategies to reduce their incidence. The objective was to analyse spontaneous ADR reports sent to the Ghanaian Food and Drugs Authority (FDA) by two reporting health facilities over 5 years. Methods: Data from duplicate spontaneous ADR reports sent to the FDA (Ghana) from 2014 to 2018 were extracted. The relationship between independent variables such as age, sex, and source of drugs and ADR outcomes was assessed with either chi-square or a Cramer's V test for association where appropriate. Results: Type A reactions (65.2%) were the most prevalent of the ADRs, followed by Type B (34.1%), with the majority (80%) of patients affected recovering fully. The majority of Type A reactions (54.1%) occurred in the clinic, while the majority of Type B reactions (43.5%) occurred in the hospital. The skin and central nervous system (CNS) were the most affected (70.8%) organs. A higher incidence of CNS and skin-related ADRs was recorded in patients older than 30 (RR = 1.28 (1.07-1.53)). Also, females were more likely to experience a CNS-related ADR. The seriousness of the ADR was found to be significantly associated with the (1) type of prescriber, (2) whether the drug was prescribed, or (3) whether the drug regimen prescribed was appropriate. Even though, in 86% of cases, the offending drug was withdrawn within the first 5 days, it exceeded 20 days in about 6% of cases. The record of allergy status in a patient's folder and the source of the drug were significantly associated with the chance that the offending drug was withdrawn. However, recording ADRs did not influence whether the offending drug was stopped. Conclusion: Most of the ADRs experienced by patients could be avoided if the current systems are improved to prevent the rechallenge of offending drugs. Efforts to improve and update patient medication records and steps to ensure continuity of care are essential in preventing these adverse drug events.

Asunto(s)

Sistemas de Registro de Reacción Adversa a Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Humanos , Femenino , Masculino , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/prevención & control , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Adulto , Persona de Mediana Edad , Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Ghana/epidemiología , Adolescente , Niño , Adulto Joven , Anciano , Preescolar , Lactante , Incidencia

RESUMEN

BACKGROUND: Non-communicable diseases (NCDs) predispose households to exorbitant healthcare expenditures in health systems where there is no access to effective financial protection for healthcare. This study assessed the economic burden associated with the rising burden of type-2 diabetes (T2D) and hypertension comorbidity management, and its implications for healthcare seeking in urban Accra. METHODS: A convergent parallel mixed-methods study design was used. Quantitative sociodemographic and cost data were collected through survey from a random community-based sample of 120 adults aged 25 years and older and living with comorbid T2D and hypertension in Ga Mashie, Accra, Ghana in November and December 2022. The monthly economic cost of T2D and hypertension comorbidity care was estimated using a descriptive cost-of-illness analysis technique from the perspective of patients. Thirteen focus group discussions (FGDs) were conducted among community members with and without comorbid T2D and hypertension. The FGDs were analysed using deductive and inductive thematic approaches. Findings from the survey and qualitative study were integrated in the discussion. RESULTS: Out of a total of 120 respondents who self-reported comorbid T2D and hypertension, 23 (19.2%) provided complete healthcare cost data. The direct cost of managing T2D and hypertension comorbidity constituted almost 94% of the monthly economic cost of care, and the median direct cost of care was US$19.30 (IQR:10.55-118.88). Almost a quarter of the respondents pay for their healthcare through co-payment and insurance jointly, and 42.9% pay out-of-pocket (OOP). Patients with lower socioeconomic status incurred a higher direct cost burden compared to those in the higher socioeconomic bracket. The implications of the high economic burden resulting from self-funding of healthcare were found from the qualitative study to be: 1) poor access to quality healthcare; (2) poor medication adherence; (3) aggravated direct non-medical and indirect cost; and (4) psychosocial support to help cope with the cost burden. CONCLUSION: The economic burden associated with healthcare in instances of comorbid T2D and hypertension can significantly impact household budget and cause financial difficulty or impoverishment. Policies targeted at effectively managing NCDs should focus on strengthening a comprehensive and reliable National Health Insurance Scheme coverage for care of chronic conditions.

Asunto(s)

Comorbilidad , Costo de Enfermedad , Diabetes Mellitus Tipo 2 , Hipertensión , Población Urbana , Humanos , Ghana/epidemiología , Diabetes Mellitus Tipo 2/economía , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/epidemiología , Hipertensión/epidemiología , Hipertensión/economía , Hipertensión/terapia , Femenino , Masculino , Persona de Mediana Edad , Adulto , Población Urbana/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Grupos Focales , Anciano , Composición Familiar , Pobreza , Investigación Cualitativa

RESUMEN

BACKGROUND: The human hand has constant contact with the environment, hence requires regular hand hygiene. Hand hygiene has gained recognition because of the COVID-19 pandemic and is a largely effective, affordable preventive measure against infectious diseases. This study used both national and sub-national analyses to evaluate the effect of COVID-19 handwashing guidelines on instances of diarrhea in Ghana. METHODS: Data on diarrhea cases spanning February 2018 and March 2022 were retrieved from the District Health Information Management System (DHIMS 2) using a data extraction guide. The data were summarized using descriptive statistics. The difference in diarrhea cases between the pre-COVID-19 and COVID-19 periods was measured using a two-sample t-test across Ghana's 16 administrative areas. Causal Impact package in R statistical software was employed to determine the impact of the introduction of COVID-19 hand hygiene protocols on diarrheal disease. RESULTS: A total of 5,645,533 diarrheal cases reported between February 2018 and March 2022 through the routine MIS (DHIMS2) were examined. Fifty-three percent of the cases occurred before the introduction of the hand hygiene protocol. Descriptive statistics indicated a statistically significant decrease in average diarrheal cases during the hand hygiene implementation era (13,463 cases reduction, p<0.001). Sub-national analyses revealed significant reductions in various regions: Greater Accra, Ashanti, Ahafo, Central, Eastern, Northern, Upper East, Upper West, and Volta (p<0.05). Causal impact analysis confirmed 11.0% nationwide reduction in diarrheal cases attributed to the COVID-19 hand hygiene protocols (p<0.001). CONCLUSION: This study underscores the effectiveness of COVID-19 hand hygiene protocols in reducing diarrheal morbidity in Ghana, with varying regional impacts. These findings advocate for the sustenance of investments and commitments made at the COVID hand hygiene protocols, particularly in this era where the pandemic appears controlled.

Asunto(s)

COVID-19 , Diarrea , Higiene de las Manos , Humanos , Ghana/epidemiología , COVID-19/prevención & control , COVID-19/epidemiología , Diarrea/prevención & control , Diarrea/epidemiología , Diarrea/virología , Higiene de las Manos/métodos , Higiene de las Manos/normas , SARS-CoV-2/aislamiento & purificación , Desinfección de las Manos , Pandemias/prevención & control

RESUMEN

Intervention efforts against falciparum malaria in high-transmission regions remain challenging, with rapid resurgence typically following their relaxation. Such resilience co-occurs with incomplete immunity and a large transmission reservoir from high asymptomatic prevalence. Incomplete immunity relates to the large antigenic variation of the parasite, with the major surface antigen of the blood stage of infection encoded by the multigene and recombinant family known as var. With a stochastic agent-based model, we investigate the existence of a sharp transition in resurgence ability with intervention intensity and identify molecular indicators informative of its proximity. Their application to survey data with deep sampling of var sequences from individual isolates in northern Ghana suggests that the transmission system was brought close to transition by intervention with indoor residual spraying. These results indicate that sustaining and intensifying intervention would have pushed malaria dynamics to a slow-rebound regime with an increased probability of local parasite extinction.

Asunto(s)

Variación Antigénica , Malaria Falciparum , Plasmodium falciparum , Malaria Falciparum/inmunología , Malaria Falciparum/transmisión , Malaria Falciparum/prevención & control , Malaria Falciparum/epidemiología , Malaria Falciparum/parasitología , Humanos , Plasmodium falciparum/inmunología , Plasmodium falciparum/genética , Ghana/epidemiología , Antígenos de Protozoos/inmunología , Antígenos de Protozoos/genética , Proteínas Protozoarias/inmunología , Proteínas Protozoarias/genética , Animales

RESUMEN

INTRODUCTION: People who inject drugs (PWID) and people who use drugs (PWUD) are an important population group that remain under-served in Ghana. Though PWID and PWUD are among the key populations most-at-risk to acquire sexually transmitted or blood-borne diseases, they are among those with the least access to human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses' prevention, care and treatment services in Ghana due to lack of data on them. We provide a rapid assessment of the PWUD and PWID situation in Ghana. METHODS: This rapid cross-sectional design undertook consultative meetings between the study team and relevant stakeholders, including Civil Society Organizations (CSO) working with PWUD/PWID. The assessment considered a representative sample of PWID and PWUD. It was conducted in four (4) selected regions of Ghana (Greater Accra, Ashanti, Western, and Northern). Overall, 323 participants were interviewed using respondent-driven sampling (RDS) approach. Information obtained from participants were demographics, HIV risk behaviors, human immunodeficiency (HIV) and sexually transmitted infections (STI)-related knowledge HIV/HCV/HBV screening, attitude, and practices among others. Analyses were conducted using Stata version 17 and RDSAT version 7.1.46 software. FINDINGS: Drug use was found to be more prevalent among the youth with a median age of 37 years. Majority of the respondents were males (86%). About 28% of the female respondents identified themselves as sex workers, while about 74% have been involved in transactional sex. The median age at which respondents started using and injecting drugs was 20 and 22 years respectively. Majority (68%) of the respondents consume drugs through smoking, with 20% through snorting, inhaling or swallowing and 12% through injection. The drug mostly used among the respondents was heroin (52%). The most commonly injected drug was cocaine (55%). About 64.7% of respondents reported mixing two or more drugs. HIV prevalence among respondents was 2.5%, 12.3% among women and 17.7% among women engaged in sex work, highlighting the overlap vulnerability. The prevalence of hepatitis C was 6.0%, and Hepatitis B was 4.5%. Access to care is limited, with 63% of the respondents never been tested for HIV. CONCLUSION: These rapid assessment findings reveal the challenging conditions for people who use and inject drugs coupled with a relatively high prevalence of HIV and Hepatitis C compared to the general population. However, it also reveals that Ghana has a window of opportunity to prevent an exponential spread of HIV and Hepatitis in this population. Therefore, there is the need to implement prevention and treatment programs for HIV and hepatitis among people who use and inject drugs including essential strategies for an enabling environment in Ghana.

Asunto(s)

Infecciones por VIH , Hepatitis B , Hepatitis C , Abuso de Sustancias por Vía Intravenosa , Humanos , Ghana/epidemiología , Hepatitis C/epidemiología , Femenino , Masculino , Hepatitis B/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/tratamiento farmacológico , Adulto , Abuso de Sustancias por Vía Intravenosa/epidemiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Estudios Transversales , Adulto Joven , Persona de Mediana Edad , Prevalencia , Adolescente , Consumidores de Drogas/estadística & datos numéricos

RESUMEN

BACKGROUND: Globally, the population is rapidly ageing, stemming from a recent decline in mortality, and an increase in life expectancy. About 727 million people globally were aged ≥65 in 2020, and 1 in 6 people will be ≥65 years by 2050. About 7% of Ghana's population was over 60 years in 2010, and projected to be 12% by 2050. However, the aged are confronted with degenerative conditions that translate into difficulty with mobility. The study was conducted to investigate the difficulty with mobility among the aged in Ghana. METHODS: The study utilised a cross-sectional dataset of the 2014/2015 (wave 2) Study on Global Ageing and Adult Health and included 1,856 participants aged ≥50 years. The survey command was applied to adjust for sampling biases and the design of the study. At 5% alpha level, a chi-square test of independence was conducted to determine the association between dependent and independent variables. At 95% confidence interval and 5% alpha level, three-level multilevel logistic regression models were performed. The fixed-effects were presented in odds ratio and the random effects were presented using the Intra-Class Correlation. All analysis were performed using STATA statistical software version 16.0. RESULTS: Out of the 1,856 participants, 40.3% had difficulty with mobility. Additionally, age (80 and above) [AOR = 3.05, 95%CI = 1.78-5.22], self-reported poor/bad health status [AOR = 2.39, 95%CI = 1.35-4.23], having severe/extreme difficulty performing household activities [AOR = 25.12, 95%CI = 11.49-44.91], experienced severe/extreme bodily pains [AOR = 4.56, 95%CI = 2.16-9.64], severe/extreme sleep problems [AOR = 4.15, 95%CI = 1.68-10.29], and participants with difficulty with sight/vision [AOR = 1.56, 95%CI = 1.16-2.10] had higher odds of difficulty with mobility. CONCLUSION: The aged in Ghana had relatively higher prevalence (40.3%) of difficulty with mobility which is influenced by demographics, health status, and degeneration associated with ageing. This highlights the need to provide social support and strengthen social capital for the aged in Ghana, especially those with difficulty with vision, experiencing bodily pains and had poor health status. Additionally, the Government and stakeholders should provide assistive devices for the aged and geriatric care including recreational fields and care homes to address the health and physical needs of the aged in Ghana.

Asunto(s)

Envejecimiento , Limitación de la Movilidad , Humanos , Ghana/epidemiología , Femenino , Anciano , Masculino , Persona de Mediana Edad , Estudios Transversales , Envejecimiento/fisiología , Organización Mundial de la Salud , Anciano de 80 o más Años , Salud Global

RESUMEN

BACKGROUND: Echocardiography can be used to screen, confirm, and assist in the management of some cardiovascular diseases in people living with human immunodeficiency virus (HIV) (PLWH). Thus, complications from subclinical cardiovascular conditions or more apparent conditions, such as massive pericardial effusion with tamponade, can be promptly identified and managed to minimize cardiovascular morbidity and mortality associated with HIV infection. Since the introduction of antiretroviral therapy (ART) in Ghana approximately two decades ago, studies on the prevalence and patterns of echocardiographic abnormalities among PLWH on ART have been limited. This study was designed to assess the prevalence and patterns of echocardiographic abnormalities among PLWH on ART. METHODS: This was a cross-sectional study. PLWH on ART (cases) attending the HIV clinic at Komfo Anokye Teaching Hospital (KATH) and HIV-negative blood donors (controls) were consecutively recruited and enrolled in this study. The interviews were performed via a standardized questionnaire. After a clinical examination was performed, all patients underwent two-dimensional (2D) and Doppler transthoracic echocardiograms. The prevalence and patterns of echocardiographic abnormalities were characterized. RESULTS: There were 117 patients in each arm of the study. There were more females than males among both the cases (92 (78.6%) and controls (80 (68.4%)); however, the sex distribution was similar between the two groups (p = 0.075). For clinical characteristics such as age, weight, height and blood pressure, there were no statistically significant differences between the cases and controls. Echocardiographic abnormalities were more frequently observed and demonstrated a statistically significant difference between cases and controls, with an overall prevalence of 35.0% among cases and 19.7% among controls (p = 0.008). The echocardiographic abnormalities that demonstrated significant differences between the cases and controls were left ventricular (LV) diastolic dysfunction (28.2% versus 8.6%; p = 0.000) and LV hypertrophy (7% versus 0.9%; p = 0.017). CONCLUSION: Nearly 1 in 3 PLWH on ART had an echocardiographic abnormality in this Ghanaian study. Echocardiograms are recommended as helpful screening modalities for diagnosing cardiac abnormalities among PLWH on ART.

Asunto(s)

Fármacos Anti-VIH , Infecciones por VIH , Humanos , Ghana/epidemiología , Femenino , Masculino , Estudios Transversales , Prevalencia , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Adulto , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/efectos adversos , Valor Predictivo de las Pruebas , Ecocardiografía Doppler , Estudios de Casos y Controles , Cardiopatías/epidemiología , Cardiopatías/diagnóstico por imagen , Adulto Joven , Función Ventricular Izquierda/efectos de los fármacos , Resultado del Tratamiento

RESUMEN

The Northern part of Ghana lies within the African meningitis belt and has historically been experiencing seasonal meningitis outbreaks. Despite the continuous meningitis outbreak in the region, the risk factors contributing to the occurrence of these outbreaks have not been clearly identified. This study, therefore, sought to describe the clinical characteristics and possible risk factors associated with meningitis outbreaks in the Upper West Region (UWR). A 1:2 matched case-control study was conducted in May-December 2021 to retrospectively investigate possible risk factors for meningitis outbreak in the UWR of Ghana between January and December 2020. Cases were persons with laboratory confirmed meningitis, and controls were persons of similar age and sex without meningitis living in the same house or neighborhood with a confirmed case. Both primary and secondary data including clinical, socio-demographic and laboratory information were collected and entered on standard questionnaires. Data was analyzed using descriptive statistics and conditional logistic regression. Meningitis cases were mostly due to Streptococcus pneumoniae (67/98; 68.37%), followed by Neisseria meningitides serogroup X (27/98; 27.55%). Fever occurred in 94.03% (63/67) of Streptococcus pneumoniae cases and 100% in both Neisseria meningitidis serogroup X (27/27) and Neisseria meningitidis serogroup W groups (3/3). CSF white cell count was significantly associated with the causative agents of meningitis. Conditional logistic regression analysis showed that, passive exposure to tobacco [AOR = 3.65, 95%CI = 1.03-12.96], bedrooms with 3 or more people [AOR = 4.70, 95%CI = 1.48-14.89] and persons with sore throat infection [AOR = 8.97, 95%CI = 2.73-29.43] were independent risk factors for meningitis infection. Headache, fever and neck pain continue to be the most common symptoms reported by meningitis patients. Education and other preventive interventions targeting exposure to tobacco smoke and crowded rooms would be helpful in reducing meningitis outbreaks in the Upper West Region of Ghana.

Asunto(s)

Brotes de Enfermedades , Humanos , Ghana/epidemiología , Masculino , Femenino , Estudios de Casos y Controles , Factores de Riesgo , Adulto , Adolescente , Niño , Persona de Mediana Edad , Adulto Joven , Preescolar , Meningitis Meningocócica/epidemiología , Meningitis Meningocócica/microbiología , Estudios Retrospectivos , Streptococcus pneumoniae/aislamiento & purificación , Streptococcus pneumoniae/patogenicidad , Neisseria meningitidis/aislamiento & purificación , Lactante , Meningitis Neumocócica/epidemiología

RESUMEN

BACKGROUND: Infectious disease surveillance is difficult in many low- and middle-income countries. Information market (IM)-based participatory surveillance is a crowdsourcing method that encourages individuals to actively report health symptoms and observed trends by trading web-based virtual "stocks" with payoffs tied to a future event. OBJECTIVE: This study aims to assess the feasibility and acceptability of a tailored IM surveillance system to monitor population-level COVID-19 outcomes in Accra, Ghana. METHODS: We designed and evaluated a prediction markets IM system from October to December 2021 using a mixed methods study approach. Health care workers and community volunteers aged ≥18 years living in Accra participated in the pilot trading. Participants received 10,000 virtual credits to trade on 12 questions on COVID-19-related outcomes. Payoffs were tied to the cost estimation of new and cumulative cases in the region (Greater Accra) and nationwide (Ghana) at specified future time points. Questions included the number of new COVID-19 cases, the number of people likely to get the COVID-19 vaccination, and the total number of COVID-19 cases in Ghana by the end of the year. Phone credits were awarded based on the tally of virtual credits left and the participant's percentile ranking. Data collected included age, occupation, and trading frequency. In-depth interviews explored the reasons and factors associated with participants' user journey experience, barriers to system use, and willingness to use IM systems in the future. Trading frequency was assessed using trend analysis, and ordinary least squares regression analysis was conducted to determine the factors associated with trading at least once. RESULTS: Of the 105 eligible participants invited, 21 (84%) traded at least once on the platform. Questions estimating the national-level number of COVID-19 cases received 13 to 19 trades, and obtaining COVID-19-related information mainly from television and radio was associated with less likelihood of trading (marginal effect: -0.184). Individuals aged <30 years traded 7.5 times more and earned GH ¢134.1 (US $11.7) more in rewards than those aged >30 years (marginal effect: 0.0135). Implementing the IM surveillance was feasible; all 21 participants who traded found using IM for COVID-19 surveillance acceptable. Active trading by friends with communal discussion and a strong onboarding process facilitated participation. The lack of bidirectional communication on social media and technical difficulties were key barriers. CONCLUSIONS: Using an IM system for disease surveillance is feasible and acceptable in Ghana. This approach shows promise as a cost-effective source of information on disease trends in low- and middle-income countries where surveillance is underdeveloped, but further studies are needed to optimize its use.

Asunto(s)

COVID-19 , Colaboración de las Masas , Humanos , Ghana/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Proyectos Piloto , Adulto , Masculino , Femenino , Persona de Mediana Edad , Adulto Joven , Vigilancia de la Población/métodos , Estudios de Factibilidad