A historical overview of Western medicine and health in Ghana in the twentieth century

Traditional therapy was dominant in Ghana. However, by the 19th to 20th centuries, scientific medicine had been fully introduced to the people of Ghana. There is a growing tendency in the research of medicine in Ghana. Some scholarly works had been published on Western medicine; however, all these works had not been brought together in analyzing the history of scientific medicine in Ghana. This work conducts an opportunistic historical overview of Western medicine and health in Ghana through the twentieth century. This is to bring to light some scholarly literature on Western medicine in Ghana, of which further research could be conducted. Some selected works that were relevant in the study of the history of western medical practices and health issues in Ghana were looked at

NEO-MEDICAL PRACTICE AND DISEASE CONTROL IN GHANA: PERSPECTIVES ON ATIWA DISTRICT (1960–2010)

Using a qualitative research approach, this study focuses on the major medical systems; traditional and western medical practices in the Atiwa District of Ghana from 1960 to 2010 with particular emphasis on western medicine. The people of Atiwa District accessed the two medical systems to combat diseases and also to ensure a healthy life. Before the advent of western medical practice in the Atiwa District, people travelled to Nkawkaw, Koforidua, and Kyebi for medical treatment. Upon the establishment of health centres and hospitals with related impediments, that is, lack of access to health facilities due to long distance, bad roads and low levels of finance from the indigenous population among other things, the local population were not entirely convinced from discontinuing to access the services of traditional medical practitioners in addition to these basic neo-medical facilities. Diseases that were common among the people were malaria, skin diseases and stomach pains among others. However, new and different diseases in other regions also gradually infected the people within the district. They include cerebro-spinal meningitis (CSM), tuberculosis and HIV/AIDS among others within the period under review

Western Medicine in a Community in Ghana: A Social Change Review

This study focuses on Western medical practices in the Atiwa District of Ghana. The people of Atiwa District accessed Western medicinal practice to prevent and cure diseases. Before the advent of Western medical practice in the Atiwa District, people were unable to access Western medicine due to the challenges with travelling or trekking from rural communities to the towns where they would find limited Western oriented health centres/hospitals. Although there were challenges, the local population continued to highly embrace practitioners and also accessed the basic Western oriented medical facilities. Western medical strategies were used to combat skin diseases, stomach aches, and malaria that was prevalent in the Atiwa District. The other diseases which afflicted the people and which required urgent attention included cerebrospinal meningitis (CSM), tuberculosis and HIV/AIDS among others. Findings from the study revealed that the introduction and success of western medical practice in the Atiwa District could not have been possible without a positive reception from the indigenous people. Importantly, this study has projected the relevance of public health in the history of the people of Atiwa and the significant roles played by governments to ensure the promotion of good health at the District

Comparative efficacy of low-dose versus standard-dose azithromycin for patients with yaws: a randomised non-inferiority trial in Ghana and Papua New Guinea

Summary: Background: A dose of 30 mg/kg of azithromycin is recommended for treatment of yaws, a disease targeted for global eradication. Treatment with 20 mg/kg of azithromycin is recommended for the elimination of trachoma as a public health problem. In some settings, these diseases are co-endemic. We aimed to determine the efficacy of 20 mg/kg of azithromycin compared with 30 mg/kg azithromycin for the treatment of active and latent yaws. Methods: We did a non-inferiority, open-label, randomised controlled trial in children aged 6–15 years who were recruited from schools in Ghana and schools and the community in Papua New Guinea. Participants were enrolled based on the presence of a clinical lesion that was consistent with infectious primary or secondary yaws and a positive rapid diagnostic test for treponemal and non-treponemal antibodies. Participants were randomly assigned (1:1) to receive either standard-dose (30 mg/kg) or low-dose (20 mg/kg) azithromycin by a computer-generated random number sequence. Health-care workers assessing clinical outcomes in the field were not blinded to the patient's treatment, but investigators involved in statistical or laboratory analyses and the participants were blinded to treatment group. We followed up participants at 4 weeks and 6 months. The primary outcome was cure at 6 months, defined as lesion healing at 4 weeks in patients with active yaws and at least a four-fold decrease in rapid plasma reagin titre from baseline to 6 months in patients with active and latent yaws. Active yaws was defined as a skin lesion that was positive for Treponema pallidum ssp pertenue in PCR testing. We used a non-inferiority margin of 10%. This trial was registered with ClinicalTrials.gov, number NCT02344628. Findings: Between June 12, 2015, and July 2, 2016, 583 (65·1%) of 895 children screened were enrolled; 292 patients were assigned a low dose of azithromycin and 291 patients were assigned a standard dose of azithromycin. 191 participants had active yaws and 392 had presumed latent yaws. Complete follow-up to 6 months was available for 157 (82·2%) of 191 patients with active yaws. In cases of active yaws, cure was achieved in 61 (80·3%) of 76 patients in the low-dose group and in 68 (84·0%) of 81 patients in the standard-dose group (difference 3·7%; 95% CI −8·4 to 15·7%; this result did not meet the non-inferiority criterion). There were no serious adverse events reported in response to treatment in either group. The most commonly reported adverse event at 4 weeks was gastrointestinal upset, with eight (2·7%) participants in each group reporting this symptom. Interpretation: In this study, low-dose azithromycin did not meet the prespecified non-inferiority margin compared with standard-dose azithromycin in achieving clinical and serological cure in PCR-confirmed active yaws. Only a single participant (with presumed latent yaws) had definitive serological failure. This work suggests that 20 mg/kg of azithromycin is probably effective against yaws, but further data are needed. Funding: Coalition for Operational Research on Neglected Tropical Diseases