Outbreak of rabies among humans, dogs and livestock, Awutu-Senya East Municipality, Ghana, 2019

Introduction: Rabies is a neglected zoonotic disease caused by the Rabies virus (RABV). Ninety-percent of human rabies are dog-mediated. Globally there are 59,000 human rabies annually. On June 16 2019, a 4-year-old girl from the Awutu-Senya East Municipal of Ghana, died following symptoms of aggression, hyper-salivation and hydrophobia. She had a dog scratch five weeks prior. We confirmed the outbreak, determined its magnitude, identified associated factors and implemented control measures. Methods: We interviewed community members to understand potential exposures to RABV. We reviewed the animal bite records, clinical notes of human rabies cases and initial line-list. We conducted community-based rabies surveillance for animal bites and confirmed RABV by Polymerase Chain Reaction of brain tissue of dead human and animals. We updated the line-list with demographic, exposure, and outcome variables of bite victims. Quantitative data was analyzed descriptively, and findings presented as frequencies and proportions. Results: Overall, 155 dog bites were identified, among which six human rabies deaths were recorded (Attack rate=3.9%). Males were 51.6% (80/155) of bite victims, whiles children 5-14 years constituted 27% (40/147). About 86.5% (134/155) of bites were by unvaccinated dogs, and stray dogs bit 80.6% (125/155) of individuals. Category III bites were 35% (50/141). RABV was isolated from 16.7% (1/6) of human deaths and 30% (3/10) of rabid dog. We suspected rabies infection in a goat. Dogs roamed unattended within communities. Conclusion: This rabies outbreak was dog-mediated. Poor pet ownership and limited vaccination of dogs were associated factors. Mass dog vaccination, prompt post-exposure prophylaxis and risk communication were critical interventions implemented

Hand hygiene and face mask wearing practices for COVID-19 prevention: a non-intrusive observation of patrons of community convenience shops in Accra, Ghana

Introduction: in the absence of a vaccine and definitive treatment, non-pharmacological measures of physical distancing, regular hand hygiene and wearing of face covering remain the mainstays of mitigating coronavirus disease 2019 (COVID-19). In Ghana, these measures are mandatory in public places and underpin COVID-19 infection prevention and control (IPC). We assessed adherence and appropriate performance of these measures among patrons of community convenience shops in selected hotspots. Methods: we conducted a non-intrusive observation of patrons of convenience shops in COVID-19 burden hotspots. We observed patrons as they entered and exited the shops and collected data on their gender, adherence and appropriate use of face covering and hand hygiene facilities. Data were analyzed descriptively and inferentially to determine factors associated with adherence to IPC guidelines. Results: of 800 patrons observed from eight community shops, 481 (60.1%) were males. Of these, 653 (81.6%) wore face covering and 98 (12.3%) performed hand hygiene; with 92 (11.5%) adhering to both measures. Patrons who wore face mask appropriately were 578; comprising 299 (92.3%) of patrons who wore face mask before entering the shops. Of 89 patrons who washed their hands, appropriate handwashing was recorded among nine (10.1%). Compared to inappropriate handwashing, appropriate handwashing was negatively associated with adherence to IPC guidelines [aOR=0.1 (95% CI=0.01-0.59)]. Conclusion: adherence to and appropriate performance of IPC measures of handwashing and use of face covering in the selected shops was low. There is the need to complement availability of IPC measures with intensification of risk communication messaging targeted at ensuring their appropriate use

Hand hygiene and face mask wearing practices for COVID-19 prevention: a non-intrusive observation of patrons of community convenience shops in Accra, Ghana

Introduction:in the absence of a vaccine and definitive treatment, non-pharmacological measures of physical distancing, regular hand hygiene and wearing of face covering remain the mainstays of mitigating coronavirus disease 2019 (COVID-19). In Ghana, these measures are mandatory in public places and underpin COVID-19 infection prevention and control (IPC). We assessed adherence and appropriate performance of these measuresamong patrons of community convenience shops in selected hotspots.Methods:we conducted a non-intrusive observation of patrons of convenience shops in COVID-19 burden hotspots. We observed patrons as they entered and exited the shops and collected data ontheir gender, adherence and appropriate use of face covering and hand hygiene facilities. Data were analyzed descriptively and inferentially to determine factors associated with adherence to IPC guidelines.Results:of 800 patrons observed from eight community shops, 481 (60.1%) were males. Of these, 653 (81.6%) wore face covering and 98 (12.3%) performed hand hygiene; with 92 (11.5%) adhering to both measures. Patrons who wore face mask appropriately were 578; comprising 299 (92.3%) of patrons who wore face mask before entering the shops. Of 89 patrons who washed their hands, appropriate handwashing was recorded among nine (10.1%). Compared to inappropriate handwashing, appropriate handwashing was negatively associated with adherence to IPC guidelines [aOR=0.1 (95% CI=0.01-0.59)].Conclusion:adherence to and appropriate performance of IPC measures of handwashing and use of face covering in the selected shops was low. There is the need to complement availability of IPC measures with intensification of risk communication messaging targeted at ensuring their appropriate use

Under-reporting of adverse drug reactions: Surveillance system evaluation in Ho Municipality of the Volta Region, Ghana.

BackgroundAdverse Drug Reactions (ADRs) can occur with all medicines even after successful extensive clinical trials. ADRs result in more than 10% of hospital admissions worldwide. In Ghana, there has been an increase of 13 to 126 ADR reports per million population from 2012 to 2018. ADR Surveillance System (ADRSS) also known as pharmacovigilance has been put in place by the Ghana Food and Drugs Authority (FDA) to collect and manage suspected ADR reports and communicate safety issues to healthcare professionals and the general public. The ADRSS in Ho Municipality was evaluated to assess the extent of reporting of ADRs and the system's attributes; determine its usefulness, and assess if the ADRSS is achieving its objectives.MethodsWe evaluated the ADRSS of the Ho Municipality from January 2015 to December 2019. Quantitative data were collected through interviews and review of records. We adapted the updated CDC guidelines to develop interview guides and a checklist for data collection. Attributes reviewed included simplicity, data quality, acceptability, representativeness, timeliness, sensitivity, predictive value positive and stability.ResultsWe found a total of 1,237 suspected ADR during the period, of which only 36 (3%) were reported by healthcare professionals in the Ho Municipality to the National Pharmacovigilance Centre (NPC). Only 43.9% of health staff interviewed were familiar with the ADRSS and its reporting channel. Staff who could mention at least one objective of the ADRSS were 34.2%, and 12.2% knew the timelines for reporting ADR. Reports took a median time of 41 (IQR = 25, 81) days from reporter to NPC. Reports sent on time constituted 37.5%. Fully completed case forms constituted 77.1% and the predictive value positive (PVP) was 20%. About 53% of ADRs were reported for female patients. Up to 88.9% of ADRs were classified as drug related. Anti-tuberculosis agents and other antibiotics constituted (40.6%) and (18.8%) of all reports. The ADRSS was not integrated into the disease surveillance and response system of Ghana's Health Service and so was not flexible to changes. A dedicated ADR surveillance officer in regions helped with the system's stability. Data from Ghana feeds into a WHO database for global decision making.ConclusionsThere was under-reporting of ADRs in the Ho Municipality from January 2015 to December 2019. The ADR surveillance system was simple, stable, acceptable, representative, had a strong PVP but was not flexible or timely. The ADRSS was found useful and partially met its objectives