Are risk factors for non-communicable diseases in adolescents a problem in senior high schools in Accra?

Background: We assessed risk factors of noncommunicable diseases (NCDs) among adolescents in a senior high schoolDesign: We conducted a cross-sectional study in 2016Setting: Senior High School in AccraParticipants: Adolescents in senior high schoolInterventions: Adolescents were interviewed with a structured questionnaire designed using the WHO STEPS framework. Data on tobacco use, alcohol consumption, physical activity and physical measurements of respondents were taken.Main outcome measures: risk factors of noncommunicable diseases among adolescentsResults: A total of 360 adolescents in the school were assessed. Mean age was (17±1.21) years with minimum age being 13 and maximum 19 years. Females were 51% (184/360). About 75% (271/360) reported low physical activity, 15% (55/360) were overweight or obese (95%CI: 0.0317-0.078), 7.0% (25/360) consumed alcohol (95%CI: 0.054-0.111) and 2.5% (9/360) smoked tobacco (95%CI: 0.013- 0.048). Majority of the respondents (346/360) were exposed or at risk of developing at least one risk factor. However, no one was found to be at risk of all five risk factors assessed. Females were three times more likely to be overweight or obese compared to their male counterparts (OR:3,95%CI:1.581-5.624)Conclusion: We found that majority of the children had low physical activity and more than 90% of the respondents had at least one NCD risk factor.Keywords: noncommunicable diseases, risk factors, physical activity, tobacco use, consumption of alcoholFunding: This work was funded by the author

Building the required skillsets for a resilient public health workforce: A decade of field epidemiology training in Ghana

The emergence and re-emergence of infectious and non-infectious diseases is a major issue of public health concern. The outbreak of Ebola, Lassa Fever, Meningitis and the ongoing COVID-19 pandemic has highlighted the need to have a multisectoral public health workforce with the requisite skillsets to effectively address these situations.As part of the strategies to build these skillsets for public health professionals, the United States Centers for Disease Control and Prevention (US CDC) has assisted countries and territories to establish Field Epidemiology Training Programs. The aim of the FETP training is to provide the public health workforces with the ability to prevent, early detect and respond to threats with the skills to collect, analyse and interrupt disease information so that prompt action can be taken to save live

Compliance with the WHO strategy of test, treat and track for malaria control at Bosomtwi District in Ghana

Background: We reviewed malaria morbidity data to assess compliance to malaria T3 strategy in Bosomtwi District, Ashanti Region, Ghana.Design: The study was descriptive secondary data analysisSetting: Bosomtwi DistrictData source: District Health Information Management Systems (DHIMS2)Main outcome: Proportion of recorded cases tested, proportion of tested cases treated and proportion of cases trackedResults: Data for suspected and tested malaria cases was complete for only 3 years (2014-2016). Malaria testing reduced from 84.4% in 2015 to 76.8% in 2016 (national average 77.3%; regional average 70%). The proportion of untested but treated malaria cases declined from 46.3% in 2015 to 4.9% in 2016. Proportion of confirmed malaria cases put on antimalarial drugs was highest in 2016 at 63.9%. Pramso sub-district although home to largest facility in the district, under prescribed antimalarial drugs. Reports generated on malaria showed information on only confirmed suspected cases, under five, and above five malaria mortalities. The district did not determine their malaria thresholds.Conclusion: The malaria-testing rate in the Bosomtwi District is higher than the regional average and close to the national average. About a third of confirmed malaria cases missed getting appropriate antimalarial drugs. Limited analysis on malaria data reduced the information required to inform policy.Keywords: Malaria, Test, Treat and Track (T3), DHIMS2, Bosomtwi, Ghana.Funding: Author GO was fully sponsored by 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

Descriptive data analysis of tuberculosis surveillance data, Sene East District, Ghana, 2020

Introduction: On 20th February 2017, health officials in Nadowli-Kaleo District (NKD) of Ghana's Upper West Region received reports of an upsurge in the number of meningitis case-patients reporting to the district's health facilities. The number of cases had exceeded the alert but not epidemic threshold for meningitis for the district. We investigated to identify the aetiologic agent, determine the risk factors and implement control measures. Methods: We conducted an unmatched case-control study. A meningitis case-patient was any NKD resident with any of the following signs and symptoms: neck stiffness, convulsion, bulging fontanelle (infants), altered consciousness or other meningeal signs with or without fever, from 1st January to 30th March 2017. For each case-patient, 2 controls (neighbours of case-patients without meningitis signs and symptoms) were identified. Demographic and clinical data were obtained through records review and case-patient interviews. Cerebrospinal fluid (CSF) samples were collected for laboratory investigation. Significant risk factors were identified using multivariable logistic regression. Results: In all 67 case-patients comprising 35 (52.2%) males and two (3%) children aged < 5 years were identified. The median age of case-patients was 24 years (interquartile range: 15–46 years). Ten deaths were recorded (case fatality rate: 14.9%). Most affected age group was 15-24 years with 18 (26.9%) case-patients and an age-specific attack rate of 170.8/100000 population. Nadowli Central sub-district, the epicenter, recorded 14 (22.4%) cases. Dominant aetiologic agent was Neisseria meningitidis isolated from 17 (58.6%) of 29 culture-positive CSF samples. Compared to controls, meningitis case-patients had higher odds of living in single window rooms (adjusted odds ratio (aOR) =5.05; 95% confidence interval (CI) =1.35-11.66), or in rooms inhabited by more than two people (aOR=3.28, CI=1.57-7.73). Conclusion: Neisseria meningitidis caused the upsurge in meningitis cases in NKD, with the youth being the most affected age group. Living in poorly ventilated rooms and overcrowded rooms were risk factors. Prompt casemanagement and health education helped control the occurrence and prevented an outbreak

Sexual experiences of adolescents and young adults living with HIV attending a specialized clinic in Accra, Ghana

Background: We assessed sexual experiences among adolescent and young adults living with HIV (AYALHIV) attending the adolescent HIV care clinic in Korle Bu Teaching Hospital (KBTH)Design: Cross-sectional study conducted in 2015.Setting: HIV clinic at KBTHParticipants: AYALHIV who attended the adolescent HIV care clinicInterventions: AYALHIV were interviewed with a structured questionnaire to obtain data on their socio-demographic characteristics and sexual experiences. The data was analyzed with STATA version 13.Main outcome measures: sexual experiences of adolescents and young people living with HIVResults: Of 101 participants, 60.4% (61/101) were males. The mean age of respondents was (18±3.2) years with an average age at sexual debut (16.2±4.2) years. A third of the respondents (34/101) had had sex before and out of them 76.5% (26/34) were males. Seventeen percent (4/23) had multiple sexual partners and 38.1% (8/21) of sexually active use condom at last sexual intercourse. Eighty-six percent (87/101) of respondents knew their HIV status, 66.7% (58/87) of them were males. There was a significant association (p<0.05) between being male and knowledge of HIV positive status. Knowledge of a respondents’ HIV positive status was found to be positively associated with ever using condom.Conclusion: Sexual experience prevalence is high among AYALHIV. More males were sexually active, not using condom and had multiple sexual partners. Safer sexual practices such as consistent use of condoms, need to be intensifiedespecially during counselling sessions. This could contribute to the reduction in prevalence of HIV among the adolescents in the country.Keywords: adolescents; young people; HIV; sex education; sexual experienceFunding: This work was funded by the author

Evaluation of timeliness of treatment initiation among smear positive pulmonary tuberculosis patients in Brong Ahafo Region, Ghana, 2015

Background: We evaluated timeliness and factors influencing treatment initiation (TI) among smear positive pulmonary tuberculosis (PTB+) patients in Brong Ahafo Region (BAR), Ghana.Design and Setting: We conducted a cross-sectional study in health facilities (HF) in six districts in BAR, from November 2014 to May 2015. Newly diagnosed smear positive PTB patients were selected randomly proportionate to size of facility cases. Timeliness of symptoms, diagnosis, TI and factors for delay were assessed using structured questionnaire. Patient delay was defined as presentation to a health care provider after 21 days of the onset of TBrelated symptoms and TI delay as therapy initiated after 30-days of onset of TB-related symptoms. We determined median patient timeliness, HF, and TI timeliness. We identified factors associated with TI delay using logistic regression.Results: There were a total of 237 PTB+ patients; median patient timeliness of 30 days (IQR:14, 60). The median health facility timeliness was 8 days (IQR:4, 10); and the median TI timeliness was 36 days (IQR:25, 69). Majority (58.7%) of patients delayed in seeking treatment. TI delay was associated with: unemployment [aOR=7.4, 95%CI(1.9–28.8)], fear of losing job [aOR=3.4, 95%CI(1.3–8.5)], traditional healer as first port of call [aOR=10.6, 95%CI(13.0-66.8)], and initially being treated for HIV [aOR=4.9, 95%CI(1.6-14.8)].Conclusion: There were delays in treatment initiation and patient treatment seeking timeliness. One-third of patients would prefer traditional healers/self-treatment/drug store as an option. A concerted effort by stakeholders is needed toimprove behaviour change communication on good health seeking behaviour for persons living with TB to reduce delays in seeking treatment.Keywords: Pulmonary tuberculosis; timeliness, delay; Brong Ahafo Region; GhanaFunding: The study was funded by the author

Progress towards eliminating tuberculosis in Ga West Municipality, Ghana: analysis of tuberculosis surveillance data, 2017

Objective: To assess the progress made towards the actualization of the 80% reduction in incident cases, monitor trends and to assess the quality of GWM TB surveillance data from 2012 to 2016.Design: The study was descriptive secondary data analysisData Source: Tuberculosis cases recorded in the District Health Information Management Systems (DHIMS) and municipal TB registers. The Municipal TB Coordinator was interviewed for clarification on the data. A TB patient was defined as one who coughed persistently for two weeks or more.Main outcome measure: Trend of TB cases in Ga West MunicipalityResults: A total of 441 TB cases were registered of which 68.9% were smear positive. Males were (67%). Age group 35-44 years were the most affected (28.6%). The incidence rose from 21.5 (2012) to 41.6 (2015). The 2016 incidence was 40.7 (± 5.63) per 100,000 population. This is significantly different from the current national incidence of 156 (p < 0.05). Data was 95% complete. Discrepancies existed between data in registers compared to the DHIMS but were not statistically significant.Conclusion: The 80% reduction in incident cases target may not be attained by the GWM due to the rising number of incident cases. However, data quality is good.Keywords: Tuberculosis, data analysis, DHIMS 2, tuberculosis, incident casesFunding: The study 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

Community acceptance of COVID-19 and demystifying stigma in a severely affected population in Ghana

Objective: We assessed the level of community acceptance of COVID-19, identified and implemented strategies to demystifying stigma in a severely affected population in Tema.Design and Setting: We conducted a cross-sectional study to assess stigma among the Tema community, then identified and implemented interventions to demystify COVID-19 stigma. We interviewed positive cases, their contacts, contact tracers, case management team members, and community members who shared their first hand experiences and knowledge on the current pandemic.Intervention: Based on the information received, we came up with ways of reducing stigma and implemented them in their community.Main Outcome: Stigma demystifiedResults: Cases and contacts reported being avoided, discriminated against, insulted or had derogatory words used on them by family, friends, work colleagues or the community. Cases and their contacts stated that stigmatisation was fueled by the presence of COVID -19 branded vehicles and security officials at their homes or workplaces. Stakeholder engagement, education and extensive sensitisation of community members were implemented to reduce stigma.Conclusion: We observed deeply entrenched stigma to COVID - 19 positive patients and their contacts in the community. Health care response mechanisms such as the presence of security personnel with contact tracers and case managers and the use of COVID -19 branded vehicles fueled stigma. A multifaceted approach through the engagement of key stakeholders, training of health workers and extensive education and community sensitisation was essential in reducing stigma