Prevalence of Risk Factors for Non-Communicable Diseases for New Patients Reporting to Korle-Bu Teaching Hospital

Background: The risk factors of Noncommunicable diseases (NCDs) are not routinely monitored, especially among populace reporting to hospitals to detect and also advise on preventive measures, a key strategy to reducing the impact of NCDs on the Health Care System and population.Methods: A cross-sectional survey was carried out between the months of May and June, 2010 among a sample representative of the medical and surgical out-patients population to determine the prevalence of certain risk factors of non-communicable diseases (NCDs). Participants (n = 230) were selected by systematic random sampling. Standardised international protocols were used to measure the prevalence of smoking, alcohol consumption, physical inactivity, obesity, raised blood pressure, raised blood glucose and total cholesterol.Results: The obesity level of the study population was 40.4% with 54% being overweight. Tobacco use among the respondents was 4.8%. Alcohol consumption was 64.8%, with 54.3% of the study population being physically inactive. Almost 48%and 70.9% of the participants consumed fruits and vegetables respectively, at least three days in a week. The prevalence of hypertension was 33.6% for men and 35.2% for women. The prevalence of raised glucose and total blood cholesterol level among the study population was 6.5%. Almost 62% of the participants had a combination of three or more risk factors.Conclusion: The prevalence of the significant risk factors in this study were physical inactivity (54.3%), alcohol consumption (64.8%), overweight (54%), obesity (40.4%) and raised blood pressure (34.3%). Hospitals should therefore include NCD risk factor monitoring as part of routine services.Keywords: Non-communicable disease, obesity, blood pressure, blood sugar, blood cholesterol, physical inactivity, Korle-Bu Teaching Hospita

Accelerating reproductive and child health program development: The Navrongo initiative in Ghana

Successive global health and development agendas have been embraced by African governments—Alma Ata in 1978, the Bamako Initiative in 1987, the 1994 Cairo International Conference on Population and Development, and more recently the Millennium Development Goals (MDGs)—only to be followed by widespread implementation failure. This paper presents an approach to program development in Ghana that is using research to accelerate policy implementation. Originally launched in 1994 as a participatory pilot project of the Navrongo Health Research Centre, a controlled experimental study was initiated in 1996 to assess the fertility and child-survival impact of alternative community health and family planning service strategies. Posting nurses to communities reduced childhood mortality rates by half, accelerating attainment of the childhood-survival MDG within five years. Adding community-mobilization strategies and volunteer outreach to this approach led to a 15-percent reduction in fertility. When a replication project in the Volta Region demonstrated that the Navrongo service model could be transferred to a nonresearch setting, the Government of Ghana adopted the Navrongo approach as the health component of its national poverty-reduction strategy. In 2000, the Community-based Health Planning and Services (CHPS) initiative was launched to accelerate implementation of this policy. By mid-2005, CHPS was fully operational in 20 districts and under development in nearly every other district of Ghana. Analysis of successive phases of the Ghana program-development process demonstrates feasible means of improving national access to reproductive and child health services

Impact of primary health care on childhood and mortality in rural Ghana: the Gomoa experience

A CAJM article on the impact of primary healthcare activities in Ghana.The impact of a combination of PHC intervention activities on child survival, growth, morbidity and mortality was assessed in three selected rural communities (Gomoa Fetteh, Gomoa Onyadze/Otsew Jukwa and Gomoa Mprumem) in the Central Region of Ghana from 1987 to 1990. EPI, provision of basic essential drugs and supplies for the treatment of common childhood diseases, treatment of the sick child, growth monitoring, health education, provision of antenatal services, family planning, training and supervision of Community Health Workers, disease surveillance and special studies were the major PHC strategies used to improve the health of the child and the pregnant woman in the three communities

Health impact assessment for promoting sustainable development: the HIA4SD project

Health is central to sustainable development, and thus a cross-cutting issue of the SustainableDevelopment Goal (SDG) 2030 agenda. Natural resource extraction projects in Africa haveconsiderable potential to impact on health-related targets of the SDGs. This paper introducesthe rationale and organization of the HIA4SD Project; a 6-year research for development (r4d)project that aims to inform and facilitate a policy dialogue at the national and internationallevel on whether current regulatory approaches to impact assessment in Africa promotesustainable development, placing emphasis on SDG3Good Health and Well-being. TheHIA4SD Project has a focus on large-scale natural resource extraction projects and is imple-mented in four African countries, namely Burkina Faso, Ghana, Mozambique and Tanzania

Social Interaction and Contraceptive Change in Northern Ghana

The role of diffusion in reproductive change has received great attention in the literature. Underlying the various studies is the assumption that the information or behaviour of one person can have spillover effects on the motivations of another (Montgomery and Casterline, 1998). Two fundamental components of diffusion are identified: social learning and social influence. Social learning refers to the acquisition of information from others, which in the case of fertility control may include information on the types of contraceptive methods available, the health side effects of the methods and the cost of the methods. Social influence, on the other hand, refers to the power that individuals exercise over each other through authority, deference, and social conformity pressures. Using data obtained from the 1995 and 1998 demographic and health panel surveys we examine the impact of social interaction on the adoption of contraception in the Kassena-Nankana district of Northern Ghana. Three major distinct groups of respondents were defined by the social interaction variable: women whose family planning discussion partners are contraceptive users or encouragers (or both); women whose family planning conversational partners are neither users nor encouragers; women who reported never having discussed family planning with their social network partners. While the social interaction variable pertains to the time of the 1995 survey, contraceptive use is at the time of the 1998 survey. Results from this study suggest that social interaction about family planning triggers changes in contraceptive behaviour in the rural areas of Northern Ghana. For the majority of women, the decision to initiate family planning practice is facilitated by informal discussions with social network partners who encourage contraceptive adoption.Beaucoup a \ue9t\ue9 dit et \ue9crit sur le r\uf4le de la diffusion dans l'\ue9volution de la reproduction avec comme hypoth\ue8se sous-jacente que l'information \ue0 propos de ou le comportement d'une personne peut avoir des effets d'entra\ueenement sur les motivations d'une autre personne (Montgomery and Casterline, 1998). La diffusion comporte deux composantes principales : l'apprentissage social et l'impact social. L'apprentissage social porte sur l'acquisition de l'information \ue0 partir d'autres personnes, ce qui, en mati\ue8re de contr\uf4le de la f\ue9condit\ue9, concerne l'information sur les types de contraceptions disponibles, les effets secondaires sur la sant\ue9 des m\ue9thodes ainsi que le co\ufbt des m\ue9thodes. Pour ce qui concerne l'impact social, il s'agit du pouvoir que les personnes peuvent exercer les unes sur les autres par l'autorit\ue9, le respect, les pesanteurs de la conformit\ue9 sociale. En utilisant les donn\ue9es des Enqu\ueates d\ue9mographiques et de sant\ue9 de 1995 et 1998, nous examinons l'impact possible de l'interaction sociale sur l'adoption de la contraception dans la r\ue9gion Kassena-Nankana du Nord du Ghana. Pour les besoins de la variable interaction sociale, trois grands groupes de personnes ont \ue9t\ue9 interrog\ue9es : les femmes dont les partenaires dans les focus group utilisent et/ou encouragent l'utilisation de la contraception ; celles dont les partenaires dans les focus group ne sont ni utilisateurs ni n'encouragent l'utilisation de la contraception ; celles ayant admis n'avoir jamais discut\ue9 de la contraception avec les r\ue9seaux sociaux de leurs partenaires. Si la variable interaction sociale porte sur l'enqu\ueate de 1995, celle sur l'utilisation de la contraception porte sur l'enqu\ueate de 1998. Les r\ue9sultats obtenus montrent que l'interaction sociale en ce qui concerne le planning familial entra\ueene des changements dans le comportement en mati\ue8re de contraception dans les zones rurales du Nord du Ghana. Pour la majeure partie des femmes, la d\ue9cision de commencer le planning familial est largement facilit\ue9e par des discussions informelles avec les membres des r\ue9seaux sociaux qui encouragent l'adoption de la contraception

The impact of immunization on the association between poverty and child survival: Evidence from Kassena-Nankana District of northern Ghana

Research conducted in Africa has demonstrated consistently that parental poverty and low educational attainment adversely affect child survival. Relative poverty has a pronounced effect on the survival of children, even in a setting where nearly all families are poor. Results from the research presented in the working paper lend strong support to the United Nations’ goal of reducing excess childhood mortality among the poor by directing a particular focus on immunization. Findings in this working paper show that the adverse effects of poverty disappear and that the effects of educational attainment are reduced in survival models that control for immunization status. This finding lends empirical support to policies that promote immunization as a strategic component of poverty-reduction programs

INCIDENCE OF SYMPTOMATIC AND ASYMPTOMATIC \u3ci\u3ePLASMODIUM FALCIPARUM\u3c/i\u3e INFECTION FOLLOWING CURATIVE THERAPY IN ADULT RESIDENTS OF NORTHERN GHANA

Adult residents of holoendemic malaria regions in Africa have a naturally acquired immunity (NAI) to malaria that renders them more resistant to new infections, limits parasitemia, and reduces the frequency and severity of illness. Given such attributes, it is not clear how one might evaluate drug or vaccine efficacy in adults without serious confounding. To determine symptomatic and asymptomatic malaria attack rates in adults of northern Ghana, 197 men and women underwent curative therapy for any pre-existing malaria infections at the start of the high transmission (wet) season. They were monitored for first parasitemia and first clinical episode of infection by Plasmodium falciparum over a 20-week period (May–October 1996). The cumulative incidence of primary infection by P. falciparum was 0.98 and incidence density of infection was calculated to be 7.0 cases/person-year. Symptoms were reported by 19.5% of the individuals at the time of first recurrent parasitemia. Incidence of infection, parasite density, and the frequency of symptoms were comparable in males and females. The results suggest that NAI did not provide these adults with significant defense against rapid re-infection and suggest that this population-infection design could serve to demonstrate the efficacy of a drug or vaccine in preventing parasitemia

Trends in Weekly Reported Net use by Children During and after Rainy Season in Central Tanzania.

The use of long-lasting insecticidal nets (LLINs) is one of the principal interventions to prevent malaria in young children, reducing episodes of malaria by 50% and child deaths by one fifth. Prioritizing young children for net use is important to achieve mortality reductions, particularly during transmission seasons. Households were followed up weekly from January through June 2009 to track net use among children under seven under as well as caretakers. Net use rates for children and caretakers in net-owning households were calculated by dividing the number of person-weeks of net use by the number of person-weeks of follow-up. Use was stratified by age of the child or caretaker status. Determinants of ownership and of use were assessed using multivariate models. Overall, 60.1% of the households reported owning a bed net at least once during the study period. Among net owners, use rates remained high during and after the rainy season. Rates of use per person-week decreased as the age of the child rose from 0 to six years old; at ages 0-23 months and 24-35 months use rates per person-week were 0.93 and 0.92 respectively during the study period, while for children ages 3 and 4 use rates per person-week were 0.86 and 0.80. For children ages 5-6 person-week ratios dropped to 0.55. This represents an incidence rate ratio of 1.67 for children ages 0-23 months compared to children aged 5-6. Caretakers had use rates similar to those of children age 0-35 months. Having fewer children under age seven in the household also appeared to positively impact net use rates for individual children. In this area of Tanzania, net use is very high among net-owning households, with no variability either at the beginning or end of the rainy season high transmission period. The youngest children are prioritized for sleeping under the net and caretakers also have high rates of use. Given the high use rates, increasing the number of nets available in the household is likely to boost use rates by older children

Community perceptions of a malaria vaccine in the Kintampo districts of Ghana.

BACKGROUND: Malaria remains the leading cause of morbidity and mortality in sub-Saharan Africa despite tools currently available for its control. Making malaria vaccine available for routine use will be a major hallmark, but its acceptance by community members and health professionals within the health system could pose considerable challenge as has been found with the introduction of polio vaccinations in parts of West Africa. Some of these challenges may not be expected since decisions people make are many a time driven by a complex myriad of perceptions. This paper reports knowledge and perceptions of community members in the Kintampo area of Ghana where malaria vaccine trials have been ongoing as part of the drive for the first-ever licensed malaria vaccine in the near future. METHODS: Both qualitative and quantitative methods were used in the data collection processes. Women and men whose children were or were not involved in the malaria vaccine trial were invited to participate in focus group discussions (FGDs). Respondents, made up of heads of religious groupings in the study area, health care providers, traditional healers and traditional birth attendants, were also invited to participate in in-depth interviews (IDIs). A cross-sectional survey was conducted in communities where the malaria vaccine trial (Mal 047RTS,S) was carried out. In total, 12 FGDs, 15 IDIs and 466 household head interviews were conducted. RESULTS: Knowledge about vaccines was widespread among participants. Respondents would like their children to be vaccinated against all childhood illnesses including malaria. Knowledge of the long existing routine vaccines was relatively high among respondents compared to hepatitis B and Haemophilus influenza type B vaccines that were introduced more recently in 2002. There was no clear religious belief or sociocultural practice that will serve as a possible barrier to the acceptance of a malaria vaccine. CONCLUSION: With the assumption that a malaria vaccine will be as efficacious as other EPI vaccines, community members in Central Ghana will accept and prefer malaria vaccine to malaria drugs as a malaria control tool. Beliefs and cultural practices as barriers to the acceptance of malaria vaccine were virtually unknown in the communities surveyed

A simplified high-throughput method for pyrethroid knock-down resistance (kdr) detection in Anopheles gambiae

BACKGROUND: A single base pair mutation in the sodium channel confers knock-down resistance to pyrethroids in many insect species. Its occurrence in Anopheles mosquitoes may have important implications for malaria vector control especially considering the current trend for large scale pyrethroid-treated bednet programmes. Screening Anopheles gambiae populations for the kdr mutation has become one of the mainstays of programmes that monitor the development of insecticide resistance. The screening is commonly performed using a multiplex Polymerase Chain Reaction (PCR) which, since it is reliant on a single nucleotide polymorphism, can be unreliable. Here we present a reliable and potentially high throughput method for screening An. gambiae for the kdr mutation. METHODS: A Hot Ligation Oligonucleotide Assay (HOLA) was developed to detect both the East and West African kdr alleles in the homozygous and heterozygous states, and was optimized for use in low-tech developing world laboratories. Results from the HOLA were compared to results from the multiplex PCR for field and laboratory mosquito specimens to provide verification of the robustness and sensitivity of the technique. RESULTS AND DISCUSSION: The HOLA assay, developed for detection of the kdr mutation, gives a bright blue colouration for a positive result whilst negative reactions remain colourless. The results are apparent within a few minutes of adding the final substrate and can be scored by eye. Heterozygotes are scored when a sample gives a positive reaction to the susceptible probe and the kdr probe. The technique uses only basic laboratory equipment and skills and can be carried out by anyone familiar with the Enzyme-linked immunosorbent assay (ELISA) technique. A comparison to the multiplex PCR method showed that the HOLA assay was more reliable, and scoring of the plates was less ambiguous. CONCLUSION: The method is capable of detecting both the East and West African kdr alleles in the homozygous and heterozygous states from fresh or dried material using several DNA extraction methods. It is more reliable than the traditional PCR method and may be more sensitive for the detection of heterozygotes. It is inexpensive, simple and relatively safe making it suitable for use in resource-poor countries