Prevalence of red blood cell antibodies among transfused patients at Komfo Anokye teaching (Kath) hospital, Ghana

Red blood cell (RBC) alloimmunisation is a common problem in transfused patients because of the possibility of haemolytic reaction and limited availability of compatible blood. In highincome countries, pre-transfusion antibody screening is performed routinely. In Ghana, patients are transfused with ABO Rh ‘D’ compatible blood without screening for immune antibodies. We therefore studied the prevalence and specificities of RBC antibodies in transfused patients at Komfo Anokye Teaching hospital, Ghana. The study was cross-sectional, involving previously transfused patients who required another transfusion. Participants’ basic data on demography and transfusion history were recorded. Blood samples were screened and subsequently typed for RBC antibodies using a column gel agglutination test. A total of 106 transfused patients, 52 male and 54 females were enrolled. The patients had previously received a median of 4 RBC units (range 1-14). Of these, ten patients (9.4%) had 11 RBC alloantibodies, whose specificities were 2 anti-K; 2 anti-C; one each of anti-D, -E, -M, and -S; and 3 were pan-reactive. The number of transfusion episodes was significantly associated with the rate of alloimmunisation (p=0.000). In conclusion the overall alloimmunisation rate in the study was 9.4% and this was significantly associated with increasing number of transfusion episodes. Antibodies were mainly directed against antigens in the Rhesus system and K antigen. We recommend that antibody screening be incorporated into routine pre-transfusion testing procedures in Ghana. Keywords: Alloimmunisation, multi transfusion, Alloantibod

Association between risky sexual behaviour and HIV risk perception among in-school adolescents in a municipality in Ghana

Background: Studies considering the association between adolescents’ risky sexual behaviour and how they perceive themselves to be at risk of HIV infection are scares in Ghana. The study assessed the association between HIV risk perception and risky sexual behaviour among in-school adolescents in a municipality in Ghana. Method: A cross sectional study was conducted among 706 students, using a questionnaire. Logistic regression analyses were used to assess the association between HIV risk perception and risky sexual behaviour. Results: Of all the adolescents, 27.7% were sexually active. Among the sexually active, 51.8 % had sexual intercourse below 14 years, 65.4% did not used condom at their last sexual intercourse, and 37.2% had multiple sexual partners. Only 20.5% of the adolescents perceived themselves to be at risk of HIV infection. Being sexually active was independently associated with having HIV risk perception (OR 1.54; 95% CI: 1.03–2.27). Adolescents who had multiple sexual partners were more likely than their counterparts with single sexual partners to perceive themselves to be at risk of HIV infection (AOR 2.39; 95% CI: 1.10 – 5.20). Non-use of condom at least sexual intercourse and early sexual debut were not associated with HIV risk perception. Conclusion: Except for those with multiple sexual partners, the adolescents generally did not perceive themselves to be at risk of HIV infection despite their involvement in risky sexual behaviour. Interventions that help adolescents to correctly assess their HIV risk perception and build on their susceptibility to HIV infection are needed. Funding: Personal funding Keywords: Risky sexual behaviour, HIV risk perception, Adolescents, Association, Ghana

Health care seeking in modern urban LMIC settings: evidence from Lusaka, Zambia

BACKGROUND: In an effort to improve population health, many low- and middle-income countries (LMICs) have expanded access to public primary care facilities and removed user fees for services in these facilities. However, a growing literature suggests that many patients bypass nearby primary care facilities to seek care at more distant or higher-level facilities. Patients in urban areas, a growing segment of the population in LMICs, generally have more options for where to seek care than patients in rural areas. However, evidence on care-seeking trajectories and bypassing patterns in urban areas remains relatively scarce. METHODS: We obtained a complete list of public health facilities and interviewed randomly selected informal sector households across 31 urban areas in Lusaka District, Zambia. All households and facilities listed were geocoded, and care-seeking trajectories mapped across the entire urban area. We analyzed three types of bypassing: i) not using health centers or health posts for primary care; ii) seeking care outside of the residential neighborhood; iii) directly seeking care at teaching hospitals. RESULTS: A total of 620 households were interviewed, linked to 88 health facilities. Among 571 adults who had recently sought non-emergency care, 65% sought care at a hospital. Among 141 children who recently sought care for diarrhea, cough, fever, or fast breathing, 34% sought care at a hospital. 71% of adults bypassed primary care facilities, 26% bypassed health centers and hospitals close to them for more distant facilities, and 8% directly sought care at a teaching hospital. Bypassing was also observed for 59% of children, who were more likely to seek care outside of the formal care sector, with 21% of children treated at drug shops or pharmacies. CONCLUSIONS: The results presented here strongly highlight the complexity of urban health systems. Most adult patients in Lusaka do not use public primary health facilities for non-emergency care, and heavily rely on pharmacies and drug shops for treatment of children. Major efforts will likely be needed if the government wants to instate health centers as the principal primary care access point in this setting

Consumer food storage practices and methods at the household-level: a community study in Ghana

IntroductionHousehold-level food storage can make food available to consumers, and promotes food security. Nevertheless, attention is mostly devoted to enhancing food storage at the farmer and national levels, neglecting the household level. It is therefore critical to assess food storage practices of households. This study examined food storage practices of households, evaluated expert opinions on household-level food storage, and assessed the effect household characteristics has on food storage and food security.MethodsDzorwulu and Jamestown communities in Accra, Ghana, were chosen as the study locations. The study consisted of a survey, expert interviews and structural equation modeling. For the survey, 400 food household heads selected using systematic sampling method responded to a semi-structured questionnaire. Seventeen (17) experts were also purposively sampled and interviewed.Results and DiscussionThe results showed that, most households stored foodstuffs they often consumed, with generally low storage of fruits and vegetables. Perishable foods such as cassava, tomato, yam, and banana were stored by 37.8, 42, 38.3 and 43.8% of households, respectively, for 1–3 days. Households often stored food within a period of 2 weeks, due to poor storage facilities and lack of food storage knowledge. About 85.8% of households had never received training on food storage. Most households used baskets, bowls, sacks and polyethylene bags to store food at home, and some used refrigerators and deep freezers. Regarding the link between food storage and food security, household heads’ income showed a significant positive moderating effect (p ≤ 0.01), households’ socioeconomic status had a positive effect, while household size indicated a significant negative moderating effect (p ≤ 0.01). The experts asserted that, household-level food storage enhances food security and food safety, and reduces food expenditure and food wastage. The limited food storage knowledge of households should be a basis for intervention to enhance proper food storage practices within households

Agronomic potentials of quality protein maize hybrids developed in Ghana

A quality protein maize (QPM) hybrid programme was started in 1991 to develop and promote high and stableyielding QPM hybrids to increase production of nutritionally superior maize varieties in Ghana. Six 3- way QPM hybrids developed from inbred lines originating from germplasm of the International Centre for Maize and Wheat Improvement (CIMMYT) were evaluated on research stations and in farmers\' fields in Ghana from 1995 to 1996. In the on-station evaluations, grain yields across 10 sites in both years averaged 6.0 ton ha-1 for the three hybrids (GH132-28, GH110-5 and GH2328-88), 5.22 ton ha-1 for Obatanpa, and 3.60 ton ha-1 for the local maize variety. In farmers\' fields, data from over 50 farm sites in 1995 and 1996 showed mean yields of 4.95 ton ha-1 for the three hybrids, and 4.28 ton ha-1 for Obatanpa compared to 3.59 ton ha-1 for farmers\' varieties. On the average, the hybrids were similar to Obatanpa in days to 50 per cent silking, but were shorter in plant height and ear placement. Consumer preference tests showed that the three hybrids were rated similar to the local variety in popular traditional food preparations such as ‘kenkey\' and ‘tuo zafi\'. In 1997, the National Variety Release Committee approved the release of GH132-28, GH110-5, and GH2328-88 under the local names Dadaba, Mamaba, and CIDA-ba, respectively. These hybrids are recommended for planting in all the major agro-ecologies to boost maize production in Ghana.Les variétés de maïs hybride (Zea mays L.) dont les plus sésirées que les variétés de pollinisation libre à cause de leur uniformté et leurs potentiels de rendement plus élevés. Pour augmenter la production de variétés de maïs nutritionnellement supérieures au Ghana, I\'Institut de Recherche de Cultures a mis en place un programme hybrid de maïs protéique de qualité (MPQ) en 1991 pour développer et promouvoir des hybrides de MPQ de rendement élevés et stable. Six hybrids en trois de MPQ développés d\'issu de la même souch provenant de germeplasmes de CIMMYT (Centre International pour I\'amélioration de maïs et de blé) étaient évalués aux stations de recherches et aux champs d\'agriculteurs au Ghana de 1995 à 1996. Dans les évaluations sur place, les rendements de grain à travers 10 sites dans les deux années ont atteint la moyenne de 6.0 ton ha-1 pour les trois hybrids (GH132-28, GH110-5 et GH2328-88), 5.22 ton ha-1 pour \'Obatanpa\' et 3.60 ton ha-1 pour la variétés de maïs local. Sur les champs d\'agriculteurs des données de plus que 50 sites de champs en 1995 et 1996 montraient les rendements moyens de 4.95 ton ha-1 pour les trois hybrids et 4.28 ton ha-1 pour les \'Obatanpa\' comparées à 3.59 ton ha-1 pour les variétés d\'agriculteurs. En moyenne, les hybrides étaient semblables à \'Obatanpa\' en jours jusqu à 50% d\'apparition de soie maïs étaient plus courtes en taille de plante et en placement d\'épi. Les essais de préférence de consommateur montraient que les trios hybrides étaient évalués semblables à la variété locale dans les préparations de nouriture traditionnelle populaire telle que \'kenkey\' et \'tuo zafi\'. En 1997, le comité pour la mise en vente de Variété Nationale a approuvé la mise en vente de GH132-28, GH110-5 et GH2328-88 sous les noms locaux respectifs de Dadaba, Mamaba, et CIDA-ba. Ce hybrides sont recommandés pour la popultion dans toutes les agroéclogies majeures pour stimuler la production de maïs au Ghana. Ghana Journal of Agricultural Science Vol. 40 (1) 2007: pp. 81-8

The modern pollen-vegetation relationship of a tropical forest-savannah mosaic landscape, Ghana, West Africa

Transitions between forest and savannah vegetation types in fossil pollen records are often poorly understood due to over-production by taxa such as Poaceae and a lack of modern pollen-vegetation studies. Here, modern pollen assemblages from within a forest-savannah transition in West Africa are presented and compared, their characteristic taxa discussed, and implications for the fossil record considered. Fifteen artificial pollen traps were deployed for 1 year, to collect pollen rain from three vegetation plots within the forest-savannah transition in Ghana. High percentages of Poaceae and Melastomataceae/Combretaceae were recorded in all three plots. Erythrophleum suaveolens characterised the forest plot, Manilkara obovata the transition plot and Terminalia the savannah plot. The results indicate that Poaceae pollen influx rates provide the best representation of the forest-savannah gradient, and that a Poaceae abundance of >40% should be considered as indicative of savannah-type vegetation in the fossil record

Malaria, Intestinal Helminths and Other Risk Factors for Stillbirth in Ghana

Objective. The objective of the study was to assess Plasmodium/intestinal helminth infection in pregnancy and other risk factors for stillbirth in Ghana. Methods. A cross-sectional study of women presenting for delivery in two hospitals was conducted during November-December 2006. Data collected included sociodemographic information, medical and obstetric histories, and anthropometric measures. Laboratory investigations for the presence of Plasmodium falciparum and intestinal helminths, and tests for hemoglobin levels were also performed. Results. The stillbirth rate was relatively high in this population (5%). Most of the stillbirths were fresh and 24% were macerated. When compared to women with no malaria, women with malaria had increased risk of stillbirth (OR = 1.9, 95% CI = 1.2–9.3). Other factors associated with stillbirth were severe anemia, low serum folate concentration, past induced abortion, and history of stillbirth. Conclusion. The fact that most of the stillbirths were fresh suggests that higher quality intrapartum care could reduce stillbirth rates

High degree of prostate related LUTS in a prospective cross-sectional community study in Ghana (Mamprobi)

BACKGROUND: Changing voiding patterns, volume and frequency, may sometimes be mistaken for anxiety, stress or increase in fluid consumption. In the aging male population, the commencement of lower urinary tract symptoms (LUTS) may be silent and perceived as "normal" and unrelated to Benign prostatic enlargement (BPE). The purpose of the study was to determine the prevalence of apparently "silent LUTS" (perceived asymptomatic LUTS) in men in a Ghanaian Community as well as its underlying risk factors. METHODS: One hundred and eleven (111) men (40-70 years) were recruited from a community in Ghana. The International Prostate Symptoms Score (IPSS) questionnaire (administered in the local language and English) and ultrasonographic imaging of the prostate volume (PV) were utlized to collect data. IPSS score >7 plus PV > 30 cm3 was definitive of lower urinary tract symptoms. Eighty-one (81) participants were classified "LUTS Negative" (LN) and 30, "LUTS Positive" (LP). Risk factors i.e., cholesterol (CHOL), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), very low-density lipoprotein (VLDL), coronary risk (CR), BMI and Blood Pressure were also determined. RESULTS: The prevalence of LUTS using only IPSS definition alone was 42.3%. However, IPSS in combination with Prostate Volume gave a prevalence of 27.0%. LN subjects had enlarged prostate (41.98%) and LP, 100%. Quality of life (QoL) was better in the LUTS Negative than LUTS Positive group (p < 0.001). In the univariant analysis coronary risk, triglyceride and VLDL contributed to LUTS (p = 0.023, 0.22, 0.22, respectively). In a multivariant analysis HDL-C (p = 0.027), BMI (p = 0.047) and triglyceride (p = 0.019) significantly contributed to LUTS. CONCLUSIONS: The prevalence of LUTS (42.3%) is high. Components of Metabolic Syndrome- HDL-C, BMI, and coronary risk were associated with LUTS. This emphasizes the need for community education

Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented

Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base

Short-term safety evaluation of processed calcium montmorillonite clay (NovaSil) in humans

Abstract NovaSil clay (NS) provides significant protection from the adverse effects of aflatoxins (AFs) in multiple animal species by decreasing bioavailability from the gastrointestinal tract. It is postulated that NS clay can be safely added to human diets to diminish exposure and health risks from AF contaminated food. To determine the safety and tolerance of NS in humans and establish dosimetry protocols for long-term efficacy studies, a randomized and double-blinded phase I clinical trial was conducted. Volunteers (20-45 yr in age), were clinically screened for confirmation of their health status. Fifty subjects (23 males and 27 females) were randomly divided into two groups: The low-dose group received nine capsules containing 1.5 g/day, and the high-dose group received nine capsules containing 3.0 g/day for a period of 2 wk. NS capsules were manufactured in the same color and size and were distributed to each participant three times a day at designated sites where follow-up was taken to record any side effects and complaints. Blood and urine samples were collected before and after the study for laboratory analysis. All participants completed the trial and compliance was 99.1%. Mild GI effects were reported in some participants. Symptoms included abdominal pain (6%, 3/50), bloating (4%, 2/50), constipation (2%, 1/50), diarrhea (2%, 1/50), and flatulence (8%, 4/50). No statistical significance was found between the two groups for these adverse effects ( p &gt; 0.25). No significant differences were shown in hematology, liver and kidney function, electrolytes, vitamins A and E, and minerals in either group. These results demonstrate the relative safety of NS clay in human subjects and will serve as a basis for long-term human trials in populations at high risk for aflatoxicosis