Prevalence of Parasitaemia, Anaemia and treatment outcomes of Malaria among School Children in a Rural Community in Ghana

A cross-sectional survey was conducted in the Ejisu-Juaben District to determine the prevalence of asymptomatic malaria and anaemia, and treatment outcomes in pupils of seven public schools public schools in a rural community in the forest belt of Ghana. Children with confirmed malaria parasites were randomly assigned to be treated with Artemisinin-based combination therapies available on the Ghanaian market. Post-treatment days 14 and 28 follow-up blood samples were taken to determine the treatment outcomes on peripheral parasitaemia and haemoglobin (Hb) concentrations. Out of 812 pupils (without malaria symptoms) who were screened, the baseline parasitaemia prevalence was 58.6%. Parasitaemia prevalence across the seven (7) public schools ranged from 49.7% to 71.0% (p =0.002). Post-treatment parasitaemia among the different treatment regimes were significant only at day 28 (p<0.001). The mean Hb concentration on the screening day was 10.5g/dl and over 60% of pupils were mildly anaemic (Hb <11.0g/dl) whereas 14% had Hb <8.0g/dl. Post-treatment Hb concentrations of pupils by days 14 and 28 were 11.4g/dl and 11.7g/dl with an improvement of 0.7g/dl and 0.9g/dl respectively over the baseline Hb concentration (p<0.001). The overall proportion of children with Hb concentrations <11.0g/dl was 32.6% and 25.3% by days 14 and 28 respectively. The burden of malaria and anaemia among school children is high and warrants investment to reduce these levels. These findings could be a reflection of the health situation that pertains in the basic public schools especially in the rural forest areas of Ghana.Keywords: asymptomatic malaria, parasitaemia, anaemia, pupils, rural Ghan

Fertility Preferences of Women Living with HIV in the Kumasi Metropolis, Ghana

This study sought to determine fertility preferences and their predictors among women living with HIV. A survey of 295 women aged 18 to 49 years living with HIV, and attending two HIV/AIDS clinics in the Kumasi metropolis, was conducted between July and August 2012. We administered questionnaires, and retrieved records of clinical status for review. We conducted multiple logistic regressions with fertility preference as the dependent variable. Fifty-eight percent of the respondents desired to have a child. The desire to have children was associated with age > 40years (AOR 0.25; 95% CI: 0.06-1.00), parity >3 (AOR 0.07; 95% CI: 0.01-0.78), those that responded that their HIV status did not affect fertility preference were more likely to desire a child (AOR 4.37; 95% CI: 1.28-14.95) and those whose partner’s did not desire to have children were less likely to desire to have children (AOR 0.06; 95% CI: 0.02-0.18). Most of the respondents do not discuss their fertility preferences with healthcare providers. Policy makers should protect the health of women living with HIV by putting in place counselling and support services with regular antiretroviral medications. If implemented, this has the potential to reduce mother-to-child transmission of HIV. Keywords: Desire to have a child, HIV- positive women, KumasiRésuméCette étude visait à déterminer les préférences de fécondité et leurs indices chez les femmes vivant avec le VIH. Une enquête de 295 femmes âgées de 18 à 49 ans vivant avec le VIH, et qui fréquentent deux cliniques du VIH / SIDA dans la métropole de Kumasi, a été menée entre juillet et août 2012. Nous avons administré des questionnaires, et avons récupéré les dossiers de l'état clinique pour les étudier. Nous avons effectué une régression logistique multiple avec la préférence de fécondité comme un variable dépendant. Cinquante-huit pour cent des interrogées ont souhaité avoir un enfant. Le désir d'avoir des enfants a été associée à l'âge> 40 années (AOR 0,25; IC à 95%: 0,06 à 1,00), la parité> 3 (AOR 0,07; IC à 95%: 0,01 à 0,78), celles qui ont répondu que leur état du VIH n'a pas affecté la préférence de la fécondité étaient plus susceptibles de désirer un enfant (AOR 4,37; IC à 95%: 1,28 à 14,95) et celles dont la partenaire n'a pas le désir d'avoir des enfants étaient moins susceptibles de vouloir avoir des enfants (AOR 0,06; IC à 95%: 0,02 à 0,18 ). La plupart des interrogées ne discutent pas leurs préférences de fécondité avec les fournisseurs de soins de santé. Les décideurs politiques devraient protéger la santé des femmes vivant avec le VIH en mettant en oeuvres des services d’orientation et de soutien avec les médicaments antirétroviraux réguliers. Si ceci est réalisées, il a le potentiel de réduire la transmission du VIH de la mère à l'enfantMots-clés: désir d'avoir un enfant, femmes séropositives, Kumas

Determinants of Under-Five Mortality in Builsa District, Upper East Region, Ghana

Under-five mortality rate is an important indicator of a community’s social development. The Upper East region, one of the most poverty-stricken regions in Ghana, has however recorded a dramatic decline in its under-five mortality rate since 1993; from 180 per 1000 live births to 79 per 1000 live births in 2003. The aim was to identify the determinants of under-five mortality in Builsa district. A case-control study was used to collect data from mothers of 60 cases and 120 controls matched for age, sex and place of residence. Even though 70% of mothers were illiter-ate, the educational level of mothers did not influence the child’s risk of death (OR 1.1). Chil-dren of mothers who had had previous child deaths were about 8 times more likely to die (OR 7.45,) while those who had not had vitamin A supplementation were about 10 times more likely to die (OR 9.57). Over 90% of mothers had an insecticide-treated bednet and more than 50% of them exclusively breastfed their children for the first 6 months of life. Protective risk factors identified included: exclusive breastfeeding (OR 0.72), use of an insecticide-treated bednet (OR 0.12), the number of live children a mother had (OR 0.54) and immunization (OR 0.53). Even in poverty, it is possible to improve the child health status of communities. Health staff should be equipped to pay special attention to mothers with previous child deaths in order to assist them to prevent further deaths.Keywords: Under-five mortality, determinants, case-control study, Builsa distric

Feasibility of abstinence as a preventive strategy for HIV/AIDS control in the University student community in Kumasi, Ghana.

HIV is spreading and the youth bear the brunt of its onslaught. Though abstinence until marriage is thought to be the most effective method of HIV prevention for the youth, others think it is ineffective. This study assessed the feasibility of abstinence in preventing HIV/AIDS spread among tertiary students of the KNUST. Study type was non- interventional, descriptive and design current cross- sectional. Study participants were selected by stratified sampling, followed by systematic sampling. A total of 300 participants were sampled. Seventy nine (79%) (95% CI, 73.9-83.8) said STIs could be avoided by abstaining from sex. Ninety six (96%) (95% CI, 93.5-98.3%) said HIV could be acquired via sex. Ninety six (96%) (95% CI, 93.8- 98.5%) of those who said HIV could be avoided said it could be done by abstaining from sex. Seventy two (72%) were of the view that sex should start only after marriage. Sixty nine 69% (95% CI, 63.3-74.4%) said they would wait till after marriage to involve in sex. Sixty seven (67%) (95% CI, 60.7- 72.1%) were encouraged by peers to abstain from sex, Seventy four (74%) (95% CI, 68.5- 79.1%) thought colleagues their age had premarital sex and 28% (95% CI, 22.5- 33.4%) said they were pressured to have sex. Thirty one (31%) (95% CI, 25.6- 36.7%) of respondents were sexually experienced. There is the general view that HIV/AIDS spread among the youth can be reduced by abstaining from sex until marriage and that abstinence could and should be encouraged as a preventive strategy for HIV/AIDS.Journal of Science and Technology (Ghana) Vol. 27 (2) 2007: pp. 1-

An Assessment of Female Prisoners’ Perception of the Accessibility of Quality Healthcare: A Survey in the Kumasi Central Prisons, Ghana

Background: Accessibility of quality healthcare across the globe has generated a lot of attention among public health practitioners.Aim: This study explored the background characteristics of female  prisoners and how it influences their assessment of the quality of  accessible healthcare in the Kumasi Female Prison. Subjects and Methods: This descriptive cross-sectional survey was  conducted at the Female section of the Kumasi Central Prisons from June to December 2011. We used pretested questionnaires to obtain   quantitative data from all 39 inmates of the female Prisons. An in-depth interview was used to obtain qualitative data from the prison healthcare giver. Data were analyzed with Epi Info Version 3.5.1, (Centers for Disease Control and Prevention), Excel, and Graph Pad Prism version 5.00 for Windows (Graph Pad software, San Diego California USA,   www.graphpad.com). Results: Using a 12.point scale inventory questionnaire, inmates with no formal education gave the highest mean health provision assessment score (6.0) whereas those with tertiary education gave the lowest (4.5). Females serving prison sentences gave the highest mean health  assessment score whereas remand prisoners gave the lowest. Single femalesf mean health assessment score was 5.7 whereas that of married inmates was 4.9. Unemployed inmates scored 5.8, informal 5.4 while civil servants scored 5.0.Conclusion: Access to quality healthcare was poor and demographic characteristics, marital status, educational background, and occupation influenced inmatesf perceptions of accessibility to quality healthcare. Inmates should be encouraged to be proactive in seeking healthcare irrespective of their background characteristics.Keywords: Accessibility, Female, Kumasi, Perception Prisons, Quality of health car

Multi-channel SPR biosensor based on PCF for multi-analyte sensing applications

This paper presents a theoretical investigation of a novel holey fiber (Photonic Crystal Fiber (PCF)) multi-channel biosensor based on surface plasmon resonance (SPR). The large gold coated micro fluidic channels and elliptical air hole design of our proposed biosensor aided by a high refractive index over layer in two channels enables operation in two modes; multi analyte sensing and self-referencing mode. Loss spectra, dispersion and detection capability of our proposed biosensor for the two fundamental modes (HE x 11 and HE y 11 ) have been elucidated using a Finite Element Method (FEM) and Perfectly Matching Layers (PML)

Effects of computerized decision support on maternal and neonatal health-worker performance in the context of combined implementation with performance-based incentivisation in Upper East Region, Ghana: a qualitative study of professional perspectives

BACKGROUND: Computerized decision support systems (CDSS) and performance-based incentives (PBIs) can improve health-worker performance. However, there is minimal evidence on the combined effects of these interventions or perceived effects among maternal and child healthcare providers in low-resource settings. We thus aimed to explore the perceptions of maternal and child healthcare providers of CDSS support in the context of a combined CDSS-PBI intervention on performance in twelve primary care facilities in Ghana's Upper East Region. METHODS: We conducted a qualitative study drawing on semi-structured key informant interviews with 24 nurses and midwives, 12 health facility managers, and 6 district-level staff familiar with the intervention. We analysed data thematically using deductive and inductive coding in NVivo 10 software. RESULTS: Interviewees suggested the combined CDSS-PBI intervention improved their performance, through enhancing knowledge of maternal health issues, facilitating diagnoses and prescribing, prompting actions for complications, and improving management. Some interviewees reported improved morbidity and mortality. However, challenges described in patient care included CDSS software inflexibility (e.g. requiring administration of only one intermittent preventive malaria treatment to pregnant women), faulty electronic partograph leading to unnecessary referrals, increased workload for nurses and midwives who still had to complete facility forms, and power fluctuations affecting software. CONCLUSION: Combining CDSS and PBI interventions has potential to improve maternal and child healthcare provision in low-income settings. However, user perspectives and context must be considered, along with allowance for revisions, when designing and implementing CDSS and PBIs interventions

Home birth without skilled attendants despite millennium villages project intervention in Ghana: insight from a survey of women’s perceptions of skilled obstetric care

BACKGROUND: Skilled birth attendance from a trained health professional during labour and delivery can prevent up to 75 % of maternal deaths. However, in low- and middle-income rural communities, lack of basic medical infrastructure and limited number of skilled birth attendants are significant barriers to timely obstetric care. Through analysis of self-reported data, this study aimed to assess the effect of an intervention addressing barriers in access to skilled obstetric care and identified factors associated with the use of unskilled birth attendants during delivery in a rural district of Ghana. METHODS: A cross-sectional survey was conducted from June to August 2012 in the Amansie West District of Ghana among women of reproductive age. Multi-stage, random, and population proportional techniques were used to sample 50 communities and 400 women for data collection. Weighted multivariate logistic regression analysis was used to identify factors associated with place of delivery. RESULTS: A total of 391 mothers had attended an antenatal care clinic at least once for their most recent birth; 42.3 % of them had unskilled deliveries. Reasons reported for the use of unskilled birth attendants during delivery were: insults from health workers (23.5 %), unavailability of transport (21.9 %), and confidence in traditional birth attendants (17.9 %); only 7.4 % reported to have had sudden labour. Other factors associated with the use of unskilled birth attendants during delivery included: lack of partner involvement aOR = 0.03 (95 % CI; 0.01, 0.06), lack of birth preparedness aOR = 0.05 (95 % CI; 0.02, 0.13) and lack of knowledge of the benefits of skilled delivery aOR = 0.37 (95 % CI; 0.11, 1.20). CONCLUSIONS: This study demonstrated the importance of provider-client relationship and cultural sensitivity in the efforts to improve skilled obstetric care uptake among rural women in Ghana

Prevalence of refractive errors among junior high school students in the Ejisu Juaben municipality of Ghana

Among school children, uncorrected refractive errors have a considerable impact on their participation and learning in class. The aim of this study was to assess the prevalence of refractive error among students in the Ejisu-Juabeng Municipality of Ghana. A survey with multi-stage sampling was undertaken. We interviewed 504 students aged 12-17 years and examined them for refractive errors. The prevalence of refractive errors among those with and without refractive error was compared by means of the chi-square test. Logistic regression analysis using refractive error as the dependent variable and adjusting for risk factors were performed. The overall prevalence rate of refractive errors was 7.5%. Out of the number of children with refractive errors, 39.5% had astigmatism, 31.6% had hyperopia and 28.9% had myopia. The prevalence rate was significantly higher among urban compared with rural students. Astigmatic refractive errors consists of with–the–rule (WTR) astigmatism 66.7%, against–the–rule (ATR) astigmatism 26.7% and oblique astigmatism (OBL) 6.6%. WTR and ATR astigmatism were more common in females than males. Multivariate logistic regression models showed no substantial confounding effects between near work, sex, and residence, suggesting that each covariate has an independent association with refractive error. In conclusion, near work, sex and high parental education level are factors contributing to refractive errors. Children in urban areas are at higher risk compared with their rural counterparts. We suggest that an efficient pre-school vision examination must be made part of the admission policy of all schools in Ghana.Keywords: Prevalence, refractive error, students, visual impairment, Ejisu-Juaben Municipalit