Associations Between Vitamin D Status, Adiposity, And Inflammatory Biomarkers In Young Women (18 – 30 Years)

We conducted a cross-sectional analysis among 270 (18- to 30-year old) female participants in the UMass Amherst Vitamin D Status Study (n = 270) to assess the extent to which dietary intakes of calcium and vitamin D are associated with obesity markers. We also evaluated the association between serum 25-OHD concentrations and both adiposity and inflammatory biomarkers. Study participants were mostly Caucasians (84.5%) with normal BMI, although about half of women had high adiposity (total body fat ‘TBF’≥ 32%). Women reporting adequate intakes of calcium (≥ 1000 mg/day) but low intakes of vitamin D (\u3c 600 IU/day) were more than twice as likely to have a high percentage of TBF compared to women with adequate intakes of both calcium and vitamin D. In addition, women with lower calcium intake from supplements were twice as likely to have a waist circumference ≥ 80 cm (OR = 2.04; 95% CI: 1.04 – 3.99) compared to women in the highest tertile of calcium intake. The magnitude of this association is important since among young women 18-30 years old, a waist circumference greater than 80 cm indicates central obesity and suggests increased visceral adiposity, which contributes to hyperlipidemia and other obesity-related chronic conditions. Among all women, total vitamin D, food vitamin D, and supplemental vitamin D intake were not associated with serum 25-OHD concentration (P \u3e 0.05). However, among supplement users only, intake of vitamin D supplements was positively correlated with serum 25-OHD levels (ß = 0.03 ± 0.01 nmol/L, P = 0.05). These findings support the notion that serum levels of 25-OHD are influenced by other factors besides the vitamin D content of foods, including the use of vitamin D supplements. Serum 25-OHD concentration tended to be correlated with hs-CRP levels (r = 0.14, P = 0.06), but was not significantly associated with adiposity and inflammatory biomarkers. Among women with low 25-OHD (\u3c 75 nmol/L), serum 25-OHD level was inversely associated with IL-2 and GM-CSF concentrations, and marginally associated with IL-6 and IL-7 concentrations. Additional prospective studies in more heterogeneous populations will help to characterize the relationship between vitamin D status, inflammation and obesity

Evaluation of surveillance system for pneumonia in children below five years, Tema Metropolis, Ghana, 2012 – 2016

Background: We evaluated the pneumonia surveillance system in Tema Metropolis to determine whether it is meeting its objectives and to assess its attributes.Design: Descriptive primary and secondary data analysisData Source: We interviewed health staff on the system’s operation and resources. We also extracted 2012-2016 surveillance dataset for under-five pneumonia cases and deaths from the District Health Information Management System for review.Participants: Health staffIntervention: The Centers for Disease Control (CDC) updated guidelines for evaluating surveillance systems was used to assess system attributes. Main outcome measure: state of the pneumonia surveillance system in TemaResults: A suspected case was defined as fast breathing in any child < 5 years old. The case definition was easy to apply, even at the community level. From 2012 to 2016, a total of 3,337 cases and 54 deaths (case fatality rate 1.6%) was recorded from 13 (23.6%) of 55 health facilities. Two epidemics were missed by the district because data were not being analysed. There were no laboratory data on antimicrobial resistance. Although reporting timeliness increased from 28.1% in 2012 to 83% in 2016, data inconsistencies existed between reporting levels.Conclusion: The surveillance system for under-five pneumonia in Tema Metropolis is simple, stable, flexible, timely,but of low sensitivity and acceptability, and only partly meeting its objectives. Major shortcomings are lack of laboratory data, non-use of data and low representativeness.Keywords: Under-five Pneumonia, Surveillance System Evaluation, Tema, GhanaFunding: The study was supported by a grant to author DB by the President’s Malaria Initiative (PMI) -CDC CoAg 6NU2GGH00187

Factors contributing to road crashes among commercial vehicle drivers in the Kintampo North Municipality, Ghana in 2017

Objective: The study assessed driver, vehicular and road-related factors associated with road crashes (RC) in the Kintampo North Municipality.Design: Cross-sectional studySetting: Kintampo North MunicipalityData source: Demographics, vehicular and road usage information on registered drivers at Ghana Private Road and Transport Union (GPRTU) and Progressive Transport Owners Association (PROTOA) in Kintampo North MunicipalityMain outcome: involvement in road crashes and related factorsResult: A total of 227 drivers were approached for this study. None of them declined participation. They were all males. Most were between 28-37 years (30%). The proportion of drivers that reported RC ever involvement in at least one RC was 55.5% (95% CI: 8.0%, 62.1%). In the bivariate analysis, drink and drive changed lane without signalling, ever bribed police officer, drove beyond the maximum speed limit, paid a bribe at DVLA for driving license, violation of traffic signals were found to be associated with RC involvement (p<0.05). Drivers who violated traffic signals had 2.84 odds of being involved in road crashes compared to those who did not [aOR; 2.84 (95%CI:1.06,7.63)]Conclusion: The proportion of drivers ever involved in road crashes was high. The major factor that is associated with RC involvement was a violation of the traffic light signals. Continuous driver education and enforcement of road traffic regulations by the appropriate authorities could curb the road crash menace in the Municipality.Keywords: commercial drivers, road crashes, vehicle, road signs, traffic light signalFunding: The authors funded this work

Barriers to early infant diagnosis of HIV in the Wa Municipality and Lawra District of Upper West Region, Ghana

Objective: We identified socio-demographic, health system and psycho-social barriers to Early Infant Diagnosis (EID) of HIV in the Upper West Region of Ghana.Design: An unmatched case control study of 96 cases and 96 controls was conducted in the ART centers in Lawra district and Wa Municipality between December 2014 and April 2015.Setting: A public health facilityParticipants: We defined a case as an HIV positive mother with an exposed infant who received EID service between January 2011 and December 2014. A control was defined as HIV Positive Mother with an exposed infant who did not receive EID services between January 2011 and December 2014.Main outcome: EID by dry blood spot Deoxyribonucleic acid Polymerase chain reaction.Results: A total of 192 mother-infant pairs were assessed. The mean age of infants at testing for cases was 17.3±14.9 weeks. Mother-to-child-transmission-rate was 2.3%. Factors associated with EID testing included: mother being formallyemployed (cOR=2.0: 95%CI:1.1-3.8), maternal formal education (cOR=2.0, 95%CI: 1.1-3.6) and maternal independent source of income (cOR 2.2, 95%CI 1.2-4.1). After adjusting for confounders, maternal independent incomebsource was associated with EID testing (aOR 2.2, 95%CI 1.2-4.1). Median turn-around time of EID result was 11 weeks (IQR 4-27weeks).Conclusion: Women need to be empowered to gain an independent source of income. This can help maximize the benefits of e-MTCT and increase EID in the Upper West Region of Ghana.Keywords: Barriers; HIV; early infant diagnosis; DNA-PCR; GhanaFunding: This work was funded by the author

Adverse drug reaction reporting by community pharmacists in the Greater Accra Region of Ghana, 2016

Objectives: To assess adverse drug reactions (ADRs) reporting and identify factors to improve ADR reporting among community pharmacists in the Greater Accra Region of Ghana.Design: A quantitative cross-sectional study.Setting: Community pharmacies in the Greater Accra Region of Ghana.Participants: We randomly selected 210 pharmacists from a list community of pharmacies in Accra, Ghana. All participants had been practicing in the past one year, with this study being conducted from June to July 2016.Main outcome measure: Prevalence of ADR reporting by community pharmacists in Accra, Ghana.Results: Of the 210 community pharmacists interviewed 54.0% were males. Mean age was 32±10 years. Majority (96.0%) had heard of ADR reporting in Ghana, yet 18% had never seen the ADR reporting form. Reasons given for failure to report suspected ADRs included unavailability of reporting forms (83.1%), uncertainty about a causal relationship between the drug and the suspected ADR and classification of the reaction as “normal” with the medication being taken (23.6%). Only 34.0% of pharmacists had the ADR reporting forms available in their facilities. Marital status was the only factor significantly associated with ADR reporting (OR 3.18, 95%CI 1.02 – 9.12).Conclusion: ADR reporting by community pharmacists in Ghana remains low. To improve the proportion of reporting, ADR forms should be made available in all pharmacies, pharmacists and the general public should be made aware of online reporting systems, with continuous professional development in Pharmacovigilance with the advice that all suspected ADRs should be reported irrespective of uncertainty about causality

Prevalence and factors associated with low medication adherence among Type 2 Diabetic patients attending a diabetic clinic at the Tema general hospital, Ghana

Introduction: Poor adherence to diabetes medication has been linked to poor glycemic control, increased cost, morbidity, and mortality rates. This study assessed factors influencing adherence to medication regimens among outpatients with type 2 diabetes mellitus (T2DM) patients at a diabetes clinic, Tema General Hospital, Ghana. Methods: This was a cross-sectional study using quantitative methods. A culturally tailored semi-structured questionnaire and the Morisky Medication Adherence Scale (MMAS-8) were used to evaluate the levels of adherence to T2DM medications. Chi-square test and logistic regression were used to assess the association between exposure variables and medication adherence. Results: A total of 206 T2DM patients aged 24 to 90 years, mean age=59.1(±1) years were interviewed. The majority were female (82.5%) and married (56.8%). The prevalence of low adherence to T2DM medication was 47.6% (95%CI: 0.41-0.55). Respondents who were on herbal medication (AOR: 5.99; 95%CI= (0.21–71.65)) had the lowest adherence compared to those on insulin followed by Insulin +OHA (AOR; 95%CI=3.15(0.79-12.53)) and OHA medication (AOR: 1.24; 95%CI (0.42-3.68)). Among those who reported side effects from medication, the odds of low adherence was 2.9 times compared to those who did not report any (AOR;95%CI=2.91(1.16-7.29)). Those who reported that their pill burden affected the continued usage of medication had 8.3 times the odds of low adherence compared to those who did not (AOR; 95%CI=8.25 (2.95-23.08)). Irregular visits to the health facility (AOR; 95%CI=6.71(2.35-19.16)) and the provision of information on the disease condition by the health provider (AOR; 95%CI= 1.14 (0.15-8.75)) significantly influenced adherence to the medication regimen. Conclusion: The prevalence of low adherence to the T2DM medication regimen was influenced by current medication intake, experiencing side effects from medication, pill burden, irregular visits to the health facility, and adequacy of information provided by health providers on the disease condition. National level interventions are needed to intensify health education on diabetes management

Farm-related determinants of food insecurity among livestock dependent households in two agrarian districts with varying rainfall patterns in Ghana

Background: Despite availability of sufficient arable land, many African countries continue to dawdle in agricultural productivity due to over-reliance on rainfall patterns. Thus, undernourishment levels are disproportionately high in Africa. Even though they play key roles in agricultural production, the food security (FS) levels of livestock dependent households are understudied. Our study assessed the FS level and its determinants in livestock farming households in Ghana. Methods: We compared the FS levels of 287 cattle producing households in two representative agrarian districts with varying rainfall patterns in Ghana (dry vs. wet), using a cross-sectional survey. We assessed household's FS using the Food Insecurity Experience Scale. FS scores and categories were computed, and using generalized linear models, we assessed factors that explained variations in the FS levels among households. Results: The median herd size of households was 31 cattle (lower quartile = 24, upper quartile = 60 cattle), with a majority (91%) engaged in crop cultivation. Households reported experiencing an average of eight adverse events over a five-year recall period (2014–2018) mainly from animal diseases, cattle theft, and pasture shortages. Most households (81%) were food insecure (moderate = 40%, severe = 41%). In an adjusted model, households raising cattle in the dry district [adjusted Odds Ratio (aOR) = 5.43, 95% CI: 1.94, 15.2] and being married (aOR = 9.48, 95% CI: 2.35, 38.3) were associated with moderate food insecurity. While households raising cattle in the dry district [adjusted Odds Ratio (aOR) = 4.17, 95% CI: 1.44, 12.0], being married (aOR = 3.55, 95% CI: 1.03, 12.2), and increase in number of adverse events experienced (aOR = 1.53, 95% CI: 1.20, 1.96), were associated with increased odds of severe food insecurity. Household's odds of severe food insecurity decreased with each additional head of cattle in their herds (aOR = 0.97, 95% CI: 0.96, 0.99). We find no evidence of effect modification by farming district on other predictor's effect on food insecurity. Conclusion: Most of the livestock dependent households are food insecure. The food insecurity levels are worse for households farming in dry areas, those married and who experience increased frequency of adverse events. Government policy interventions focusing on maintaining healthy, secure, and productive animal herds would contribute to improving the productivity of household herds, food safety and food security

Predictors of work-related eye injuries among stone quarry workers in the Ashanti Region of Ghana: A cross-sectional study

Introduction: The occurrence of eye issues among quarry workers in southern Ghana is significant, with 58% reporting irritation and 9.4% experiencing quarry-related eye problems. This study assessed factors associated with work-related eye injuries among stone quarry workers in the Ashanti Region of Ghana. Methods: We conducted a cross-sectional study among stone quarry workers in the Ashanti Region of Ghana. A pretested semi-structured questionnaire was administered to collect data on workers’ socio-demographic factors, occupational factors, lifestyle factors and history of work-related accidental eye injuries. Data was summarized into frequencies, means and odds ratio calculated at 95% CI using STATA. Results: Three hundred and seventy-five stone quarry workers took part in the study with 73 (19.5%) reporting at least one incidence of work-related eye injury. The mean age of the participants was 36.4 ± 11.3 years. Majority of participants 359 (95.7%) were males. Working for more than 8 hours (aOR=4.98, 95%CI: 1.25-19.76), being a smoker (aOR=4.59, 95%CI: 1.39–15.17) and alcohol consumption (aOR=2.15, 95%CI: 1.01-4.55) were associated with increased odds of eye injuries. Using Personal Protective Eye Devices (PPEDs) (aOR=0.07, 95%CI: 0.02-0.27) and education on PPEDs (aOR=0.05, 95%CI: 0.01-0.23) were associated with decreased odds of eye injuries among the workers. Conclusion: This study identifies extended working hours, smoking during course of work, and alcohol consumption as significant risk factors for work-related eye injuries among stone quarry workers. It also emphasizes the importance of implementing and promoting PPEDs use and providing education on their proper usage to mitigate the risk of such injuries

Poor mental health of livestock farmers in Africa: a mixed methods case study from Ghana.

BACKGROUND: Agriculture represents the mainstay of African economies and livestock products are essential to the human population's nutritional needs. However, in many developing countries, including Ghana, livestock production fails to meet demand due to population growth and negative effects of climate change. One of the challenges to production is livestock loss affecting farmers. However, despite stressful events experienced, livestock farmers' mental health is poorly documented. This study aims to identify the root causes of livestock losses and their influence on pastoralists' mental health. METHODS: We conducted a mixed methods study in two districts in the Northern and Southern Belts of Ghana. Using the Depression Anxiety and Stress Scale-21 and guided interviews, we collected quantitative and qualitative data from 287 livestock farmers and 24 key-informants respectively. Mental health scores were categorized using standard guidelines. We evaluated the factors that explained variations in mental wellbeing using general linear models (α = 0.05). RESULTS: About 85% (240/287) of the livestock farmers lost cattle within 1 year. Of these, 91% lost cattle to animal diseases, 50% to theft and 27% to pasture shortages. Qualitative findings reveal that due to poor access to veterinary services, farmers treat livestock diseases themselves with drugs from unregulated sources and often sell diseased cows for meat to recover losses. Findings showed that 60% of livestock farmers had poor mental health. Of those, 72% were depressed, 66% anxious and 59% stressed. Mental wellbeing was negatively associated with the number of adverse events experienced, proportion of livestock lost to most of the major loss factors, emotional attachment to livestock and self-reported physical illnesses in farmers, but positively associated with increasing herd size [F (8,278) = 14.18, p < 0.001, R2 = 0.29]. CONCLUSIONS: Livestock diseases are the leading cause of losses to livestock farmers, whose mental wellbeing is negatively affected by these losses. Although an adaptive strategy by farmers to compensate for poor veterinary services, the arbitrary use of veterinary drugs and sale of diseased cattle pose health risks to the public. Further research to evaluate the performance of veterinary services in Ghana, mental health problems and risk to human health due to potential high-risk meat entering the food chain, is needed

Pooled analysis of the association between mental health and violence against women : evidence from five settings in the Global South

DATA AVAILABILITY STATEMENT : De-identified individual participant data for Stepping Stones and Creating Futures (South Africa), Sonke CHANGE Trial (South Africa), and Evaluation of the RRS-COMBAT intervention (Ghana) and oPt intervention, are available to anyone who wishes to access the data for any purpose at https:// medat.samrc.ac.za/index.php/catalog/WW. De-identified individual participant data from the Indashyikirwa Couples Surveys (Rwanda) are available from the Principal Investigator of the study, Dr Kristin Dunkle: kristin. dunkle@ mrc. ac. za, but may require permission from the Rwandan Ministry of Gender and Family Promotion (MIGEPROF) before transfer.OBJECTIVES : To describe associations between men’s poor mental health (depressive and post-traumatic stress symptomatology) and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV), and women’s mental health and their experiences of IPV and NPSV in five settings in the Global South. DESIGN : A pooled analysis of data from baseline interviews with men and women participating in five violence against women and girls prevention intervention evaluations. SETTING : Three sub-Saharan African countries (South Africa, Ghana and Rwanda), and one Middle Eastern country, the occupied Palestinian territories. PARTICIPANTS : 7021 men and 4525 women 18+ years old from a mix of self-selecting and randomly selected household surveys. MAIN OUTCOME MEASURES : All studies measured depression symptomatology using the Centre for Epidemiological Studies-Depression, and the Harvard Trauma Scale for post-traumatic stress disorder (PTSD) symptoms among men and women. IPV and NPSV were measured using items from modified WHO women’s health and domestic violence and a UN multicountry study to assess perpetration among men, and experience among women. FINDINGS : Overall men’s poor mental health was associated with increased odds of perpetrating physical IPV and NPSV. Specifically, men who had more depressive symptoms had increased odds of reporting IPV (adjusted OR (aOR)=2.13; 95%CI 1.58 to 2.87) and NPSV (aOR=1.62; 95% CI 0.97 to 2.71) perpetration compared with those with fewer symptoms. Men reporting PTSD had higher odds of reporting IPV (aOR=1.87; 95% CI 1.44 to 2.43) and NPSV (aOR=2.13; 95% CI 1.49 to 3.05) perpetration compared with those without PTSD. Women who had experienced IPV (aOR=2.53; 95% CI 2.18 to 2.94) and NPSV (aOR=2.65; 95% CI 2.02 to 3.46) had increased odds of experiencing depressive symptoms compared with those who had not. CONCLUSIONS : Interventions aimed at preventing IPV and NPSV perpetration and experience must account for the mental health of men as a risk factor, and women’s experience.The What Works to Prevent Violence? A Global Programme on Violence Against Women and Girls (VAWG) funded by the UK Government’s Department for International Development (DFID).http://bmjopen.bmj.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-beingSDG-05:Gender equalit