Factors affecting birth weight in Cape Coast, Ghana

Background: This study aimed at determining the incidence of low birth weight among live births and maternal anaemia and to investigate the association between some maternal factors and birth weight.Methods: This was a retrospective cross sectional study that involved mothers who regularly attended antenatal clinics and had delivered singleton live births between January 2014 to December 2014 in the University of Cape Coast Hospital, Cape Coast, Ghana.Results: Out of the 405 newborns included in the study, 194 (47.90%) were females and 211 (52.10%) males with a mean birth weight of 3.25±0.52kg. There was a low birth weight prevalence of 7.7% and a maternal anaemia prevalence of 38.8%. The period of gestation (p=0.00001), maternal anaemia (p=0.0217) and maternal age (p=0.0030) were found to be significantly associated with birth weight. Sex of baby (p=0.6668), parity of mother (p=0.6959) and maternal sickling status (p=0.7915) were not significantly associated with birth weight.Conclusions: As far as low birth weight is concerned, frequency is not high among live babies born to mothers who regularly attended antenatal clinics. This agrees with studies that suggest that antenatal clinic attendance positively affects birth weight. Thus in order to reduce the high prevalence of low birth weight and maternal anaemia in developing countries all pregnant women must be encouraged to attend antenatal clinics regularly

Prevalence of intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) use during pregnancy and other associated factors in Sekondi-Takoradi, Ghana

Background: Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) has been adopted as policy by most countries in sub-Saharan Africa. This cross-sectional study assessed the prevalence of IPTp-SP usage for prevention of malaria among pregnant women as well as evaluated factors associated with IPTp-SP use during pregnancy in Sekondi-Takoradi region of Ghana.Methods: Pregnant women attending their antenatal-care with either clinical/ultrasound evidence of pregnancy were recruited. Venous blood was screened for malaria using RAPID response antibody kit and Giemsa staining. Haemoglobin estimations were done by cyanmethemoglobin method while Human Immunodeficiency Virus (HIV) screening was performed by the national diagnostic algorithm of two rapid antibody test and western blot confirmation.Results: Of the 754 consented pregnant women interviewed in this study, 57.8% had received IPTp-SP while 42.2% had not at their first contact with the study personnel. Furthermore, 18.6% (81/436) of those that received IPTp-SP were malaria positive while 81.4% (355/436) were malaria negative. The results also indicated that 47.7% (51/107) of the pregnant women in their third trimester who were meant to have received at least two-doses of SP had received ≥2 doses while 35.5% (38/107) had received 1 dose. In multivariable logistic regression analysis, pregnant women in their third trimester who received ≥2 doses of SP showed decreased likelihoods of malaria (adjusted OR, 0.042; 95% CI, 0.003-0.51; P = 0.013).Conclusion: IPTp-SP usage among pregnant women in Sekondi-Takoradi reduces malaria and its use for malaria prevention should be strengthened with proper dosage completion and coverage.Keywords: Malaria in pregnancy, IPTp-SP, anaemia, Ghan

Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%−104.70% of stated content by manufacturer). The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%–111.87%). Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market

Prevalence of intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) use during pregnancy and other associated factors in Sekondi-Takoradi, Ghana

Background: Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) has been adopted as policy by most countries in sub-Saharan Africa. This cross-sectional study assessed the prevalence of IPTp-SP usage for prevention of malaria among pregnant women as well as evaluated factors associated with IPTp-SP use during pregnancy in Sekondi-Takoradi region of Ghana. Methods: Pregnant women attending their antenatal-care with either clinical/ultrasound evidence of pregnancy were recruited. Venous blood was screened for malaria using RAPID response antibody kit and Giemsa staining. Haemoglobin estimations were done by cyanmethemoglobin method while Human Immunodeficiency Virus (HIV) screening was performed by the national diagnostic algorithm of two rapid antibody test and western blot confirmation. Results: Of the 754 consented pregnant women interviewed in this study, 57.8% had received IPTp-SP while 42.2% had not at their first contact with the study personnel. Furthermore, 18.6% (81/436) of those that received IPTp-SP were malaria positive while 81.4% (355/436) were malaria negative. The results also indicated that 47.7% (51/107) of the pregnant women in their third trimester who were meant to have received at least two-doses of SP had received 652 doses while 35.5% (38/107) had received 1 dose. In multivariable logistic regression analysis, pregnant women in their third trimester who received 652 doses of SP showed decreased likelihoods of malaria (adjusted OR, 0.042; 95% CI, 0.003-0.51; P = 0.013). Conclusion: IPTp-SP usage among pregnant women in Sekondi-Takoradi reduces malaria and its use for malaria prevention should be strengthened with proper dosage completion and coverage

Factors affecting birth weight in Cape Coast, Ghana

Background: This study aimed at determining the incidence of low birth weight among live births and maternal anaemia and to investigate the association between some maternal factors and birth weight.Methods: This was a retrospective cross sectional study that involved mothers who regularly attended antenatal clinics and had delivered singleton live births between January 2014 to December 2014 in the University of Cape Coast Hospital, Cape Coast, Ghana.Results: Out of the 405 newborns included in the study, 194 (47.90%) were females and 211 (52.10%) males with a mean birth weight of 3.25±0.52kg. There was a low birth weight prevalence of 7.7% and a maternal anaemia prevalence of 38.8%. The period of gestation (p=0.00001), maternal anaemia (p=0.0217) and maternal age (p=0.0030) were found to be significantly associated with birth weight. Sex of baby (p=0.6668), parity of mother (p=0.6959) and maternal sickling status (p=0.7915) were not significantly associated with birth weight.Conclusions: As far as low birth weight is concerned, frequency is not high among live babies born to mothers who regularly attended antenatal clinics. This agrees with studies that suggest that antenatal clinic attendance positively affects birth weight. Thus in order to reduce the high prevalence of low birth weight and maternal anaemia in developing countries all pregnant women must be encouraged to attend antenatal clinics regularly

Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana

The clinical outcome of falciparum malaria in endemic areas is influenced by erythrocyte polymorphisms including the ABO blood groups. Studies have reported association of ABO blood group to resistance, susceptibility, and severity of P. falciparum malaria infection. Individuals with blood group “A” have been found to be highly susceptible to falciparum malaria whereas blood group “O” is said to confer protection against complicated cases. We analyzed samples from 293 young children less than six years old with malaria in the Korle-Bu Teaching Hospital in Accra, Ghana. It was observed that group O was present in about 16.1% of complicated cases weighed against 40.9% of uncomplicated controls. Individuals with complicated malaria were about twice likely to be of blood groups A and B compared to group O (A versus O, OR = 1.90, 95% CI = 1.59–2.26, P<0.0001; B versus O, OR = 1.82. 95% CI = 1.57–2.23, P<0.0001). Blood group O participants with complicated diseases had low parasitaemia compared to the other blood groups (P<0.0001). This may give blood group O individuals a survival advantage over the other groups in complicated malaria as suggested. Participants with complicated falciparum malaria were generally anaemic and younger than those with uncomplicated disease

Quality of Sulfadoxine-Pyrimethamine Given as Antimalarial Prophylaxis in Pregnant Women in Selected Health Facilities in Central Region of Ghana

The use of sulfadoxine-pyrimethamine (SP) as an intermittent preventive treatment (IPT) against malaria during pregnancy has become a policy in most sub-Sahara African countries and crucially depends on the efficacy of SP. This study sets out to evaluate the effectiveness of the SP given to the pregnant women in some selected health facilities in the Central Region of Ghana to prevent maternal malaria in pregnant women. A total of 543 pregnant women recruited from 7 selected health centres in Central Region of Ghana participated in the study. Parasite density of Plasmodium falciparum was determined from peripheral blood of the pregnant women using microscopy. High performance liquid chromatography (HPLC) and dissolution tester were used to determine the quality of the SP. Malaria infection was recorded in 11.2% of pregnant women who had a history of SP consumption. SP failed the dissolution test. Pregnant women who did not receive IPT-SP were 44%. Low haemoglobin level was recorded in 73.5% of the pregnant women. The results indicated that SP was substandard. IPT-SP is ineffective in preventing malaria infection

Effectiveness of Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine against Submicroscopic falciparum

Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR) (submicroscopic malaria) are common in endemic areas like Ghana. Submicroscopic malaria has been linked with severe pregnancy outcomes as well as contributing to malaria transmission. In this cross-sectional study 872 consenting pregnant women (gestation ≥ 20 weeks) were recruited from 8 hospitals in Central Region, Ghana, between July and December 2009. Malaria infection was detected by microscopy and PCR. Haemoglobin was measured and anaemia was defined as haemoglobin lower than 11 g/dL. Majority of the women, 555 (63.6%), were Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) users while 234 (36.4%) were nonusers. The prevalence of malaria by microscopy was 20.9% (182/872) and 9.7% (67/688) of microscopy negative women had submicroscopic malaria. IPTp-SP usage significantly (odds ratio = 0.13, 95% confidence interval = 0.07–0.23, p=0.005) reduced the prevalence of submicroscopic malaria as more nonusers (51/234) than users (16/454) were PCR positive. After controlling for other variables the effect of IPTp-SP remained statistically significant (odds ratio = 0.11, 95% confidence interval = 0.02–0.22, p=0.006). These results suggest that Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine is useful in the reduction of submicroscopic malaria in pregnancy