Evaluation of the tuberculosis surveillance system in the Ashaiman municipality, in Ghana

Introduction: tuberculosis (TB) was the leading cause of death from an infectious illness globally with an estimated 10.4 million new cases and 1.4 million deaths in 2015. In Ghana, from the 2013 TB prevalence survey conducted by the National Tuberculosis Control Programme, the incidence is estimated as 165 per 100,000 population and a mortality rate of 7.5 per 1,000 infected people. The Tuberculosis surveillance system is part of the general framework of the Integrated Disease Surveillance and Response. This evaluation was to assess whether the system is meeting its set objectives, assess its usefulness and describe its attributes. Methods: the TB surveillance system of the Ashaiman municipality was evaluated using Centre for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems 2006. Records review from 2014 to 2016 was done to assess objectives of the system and surveillance data source of 2016 was used to assess attributes. Interviews were conducted at the various levels using semi-structured questionnaire and data analysis done with Epi info 7 and Microsoft Excel to run frequencies and percentages. Results: the surveillance system is well structured with standardized data collection tools. The system was found to be useful, though it just partially met its objectives. It was also found to be simple, flexible and fairly stable with average timeliness. It had low acceptability and is not geographically representative. It had low sensitivity of 45/100,000 and a low predictive value positive of 6.6%. Conclusion: the surveillance system was found to be useful but partially met its objectives. There is the need to improve the sensitivity, predictive value positive timeliness and acceptability

Risk Factors for Buruli Ulcer in Ghana-A Case Control Study in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region

Kenu E, Nyarko KM, Seefeld L, et al. Risk Factors for Buruli Ulcer in Ghana-A Case Control Study in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region. PLoS Neglected Tropical Diseases. 2014;8(11): e3279.Background: Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. Its exact mode of transmission is not known. Previous studies have identified demographic, socio-economic, health and hygiene as well as environment related risk factors. We investigated whether the same factors pertain in Suhum-Kraboa-Coaltar (SKC) and Akuapem South (AS) Districts in Ghana which previously were not endemic for BU. Methods: We conducted a case control study. A case of BU was defined as any person aged 2 years or more who resided in study area (SKC or AS District) diagnosed according to the WHO clinical case definition for BU and matched with age-(+/-5 years), gender-, and community controls. A structured questionnaire on host, demographic, environmental, and behavioural factors was administered to participants. Results: A total of 113 cases and 113 community controls were interviewed. Multivariate conditional logistic regression analysis identified presence of wetland in the neighborhood (OR = 3.9, 95% CI = 1.9-8.2), insect bites in water/mud (OR = 5.7, 95% CI = 2.5-13.1), use of adhesive when injured (OR = 2.7, 95% CI = 1.1-6.8), and washing in the Densu river (OR = 2.3, 95% CI = 1.1-4.96) as risk factors associated with BU. Rubbing an injured area with alcohol (OR = 0.21, 95% CI = 0.008-0.57) and wearing long sleeves for farming (OR = 0.29, 95% CI = 0.14-0.62) showed protection against BU. Conclusion: This study identified the presence of wetland, insect bites in water, use of adhesive when injured, and washing in the river as risk factors for BU; and covering limbs during farming as well as use of alcohol after insect bites as protective factors against BU in Ghana. Until paths of transmission are unraveled, control strategies in BU endemic areas should focus on these known risk factors

Characteristics of confirmed cases of BU in Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region.

<p>Characteristics of confirmed cases of BU in Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region.</p

Univariate analysis of selected variables for BU in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region, Ghana; Community-matched case control study.

<p>*Significant association between variable and BU.</p><p>Univariate analysis of selected variables for BU in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region, Ghana; Community-matched case control study.</p

Map of the study area showing the Basin of the Densu River.

<p>Map of the study area showing the Basin of the Densu River.</p