Comparison of antibiotic resistance patterns between laboratories in Accra East, Ghana

Antibiotic resistance is increasing rapidly and developing countries are the worse affected since they provide conditions and practices that support the development and spread of resistant microbes. For better health policy on antibiotic use a national surveillance program is needed to provide baseline data from different settings. This study determines the distribution of antibiotic resistant microbes in two different laboratories and compares the results using statistical methods to ascertain if there is a variation due to human factors. Patients attending two laboratories in east Accra were recruited and samples obtained from them were cultured for microbial growth. Microbes isolated were characterized and their sensitivity to different antibiotics tested. A total of 513 samples were collected from the patients who were mostly females; 68%. The cultures that were mostly infected were urine (331), wound (116), HVS (78) and ear (26). There were few cases of throat, blood, uterus cultures but were all infected. Microbial isolates common in the different laboratories included S. aureus (96), E. coli (90), Pseudomonas aeruginosa and Proteus spp.. Microbes isolated in the different laboratories were Salmonella typhi, Shigella spp. and Streptococcus pneumonia. Microbial isolates were found resistant (over 65%) to the antibiotics ampicillin (71% and 95%), cotrimoxazole (68% and 75%) and tetracycline (70% and 80%) and moderately resistant to gentamycin (29% and 23%), erythromycin (39% and 36%) and streptomycin, and sensitive to ceftazidine and minomycin. Statistically the results from the different laboratories were found to be similar hence having the same trend. The importance of incooperating a statistical method in national surveillance program to compare results from different settings is discussed

Improving access to lymphatic filariasis MMDP services through an enhanced evidence-based, cascaded training model for health worker capacity strengthening in Ghana: an evaluation study

IntroductionGhana has made significant progress in reducing the transmission rate of lymphatic filariasis. However, very little progress has been made in the provision of morbidity management and disability prevention (MMDP) services, which is one of the key requirements for certification of elimination as a disease of public health importance. This study was designed to compare pre-post- intervention to determine the feasibility and effectiveness of a cascade training model for health worker capacity strengthening in Ghana, using the WHO recommended minimum intervention package to improve access to MMDP services.MethodsThis study used a quasi-experimental design to assess the impact of evidence-based training of patients with lymphatic filariasis (LF) in the Upper West region of Ghana. All lymphedema patients who were available at the time of data collection participated in the study before and after the training.ResultsThe mean age of respondents was 54.67 years (SD ± 16.89 years) at baseline and 54.70 years (SD ± 15.80 years) at evaluation. The majority (i.e., 76.30% at baseline and 80.50% at evaluation) of the respondents were female. Most of the respondents had not completed primary school (83.82% at baseline and 85.40% at evaluation). We found an improvement in the quality of life among LF patients, that is, the proportion of respondents who reported having a high quality of life increased from 2.9% at baseline to 20.12% at evaluation (p < 0.001). The lymphedema management practice of “hygiene/washing and drying of affected limb” was reported by 73.17% of respondents at evaluation compared with only 32.95% of respondents at baseline (p < 0.001). The acute attack management technique of “cooling the affected limb in cool water/cold compress” was reported by 70.15% of respondents at evaluation compared with 23.70% of respondents at baseline (p < 0.001).ConclusionThe research confirmed that LF-related perceptions remained generally the same at baseline and evaluation among community members. The implementation of the LF-related morbidity management (MMDP) project has led to a significant improvement in the morbidity management practices among patients at evaluation compared with baseline. Our findings also showed that self-care led to an improvement in patients’ quality of life. This justifies the need for investment in morbidity management interventions in endemic communities

Improving drug delivery strategies for lymphatic filariasis elimination in urban areas in Ghana

<div><p>The Global Program to Eliminate Lymphatic Filariasis (GPELF) advocates for the treatment of entire endemic communities, in order to achieve its elimination targets. LF is predominantly a rural disease, and achieving the required treatment coverage in these areas is much easier compared to urban areas that are more complex. In Ghana, parts of the Greater Accra Region with Accra as the capital city are also endemic for LF. Mass Drug Administration (MDA) in Accra started in 2006. However, after four years of treatment, the coverage has always been far below the 65% epidemiologic coverage for interrupting transmission. As such, there was a need to identify the reasons for poor treatment coverage and design specific strategies to improve the delivery of MDA. This study therefore set out to identify the opportunities and barriers for implementing MDA in urban settings, and to develop appropriate strategies for MDA in these settings. An experimental, exploratory study was undertaken in three districts in the Greater Accra region. The study identified various types of non-rural settings, the social structures, stakeholders and resources that could be employed for MDA. Qualitative assessment such as in-depth interviews (IDIs) and focus group discussions (FGDs) with community leaders, community members, health providers, NGOs and other stakeholders in the community was undertaken. The study was carried out in three phases: pre-intervention, intervention and post-intervention phases, to assess the profile of the urban areas and identify reasons for poor treatment coverage using both qualitative and quantitative research methods. The outcomes from the study revealed that, knowledge, attitudes and practices of community members to MDA improved slightly from the pre-intervention phase to the post-intervention phase, in the districts where the interventions were readily implemented by health workers. Many factors such as adequate leadership, funding, planning and community involvement, were identified as being important in improving implementation and coverage of MDA in the study districts. Implementing MDA in urban areas therefore needs to be given significant consideration and planning, if the required coverage rates are to be achieved. This paper, presents the recommendations and strategies for undertaking MDA in urban areas.</p></div