Seroprevalence of Hyperglycaemia in HIV Positive Patients Visiting the Cape Coast Teaching Hospital in Ghana

Background: Hyperglycaemia is a metabolic syndrome and common endocrine disease where there is increased blood glucose level. It can result in long-term damage and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels and finally cause death. This study was conducted to determine the prevalence of hyperglycaemia in HIV subjects visiting the Cape Coast Teaching Hospital (CCTH), Cape Coast and its relationship with Highly Active Antiretroviral Therapy (HAART).  Methods: A cross sectional study was carried out and blood samples of 120 HIV positive subjects of age groups ranging from 2 to 74 were collected for screening and confirmation after an informed consent was obtained from them. The blood glucose level was then tested using OneTouch glucometer and test strips.  The results were analysed using chi square goodness-of-fit and cross tabulation.  Results: A total of 9 patients out of the 120 HIV subjects had an increased glucose level, giving a prevalence rate of 7.5%. They were within the ages of 20-60 years and were significantly lower compared to those without hyperglycaemia (p<0.05), those married (p=0.001) and those divorced (p=0.001).  There was an inverse relationship between the period of living with HIV and the high glycaemia status (r= -0.949, p=0.017). There was also an inverse relationship between the use of HAART and high glycaemia status (r=-0.071, p=0.0028). There was a significant number of participants, who were experiencing increased thirst (p=0.003). Also a significant number of participants experienced increased hunger (p=0.010). Conclusion: The study revealed that there was hyperglycaemia among the study population. This may be reduced during therapy and changes in their lifestyle. Regular monitoring of glucose level in HIV infected patients and counselling on lifestyle changes are recommended. Keywords: Seroprevalence, hyperglycaemia, HI

Determinants of early initiation of breastfeeding in Papua New Guinea: a population-based study using the 2016-2018 demographic and health survey data

Background Initiation of breastfeeding after birth comes with a wide range of benefits to the child. For example, it provides the child with all essential nutrients needed for survival within the first six months of birth. This study sought to determine the prevalence and factors associated with early initiation of breastfeeding (EIB) in Papua New Guinea. Methods We utilized the Demographic and Health Survey data of 3198 childbearing women in Papua New Guinea. We employed descriptive and binary logistic regression analyses. We presented the results as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR), with 95% confidence intervals (CI) signifying level of precision. Level of statistical significance was set at p < 0.05. Results Women aged 20–29 [AOR = 1.583, CI = 1.147–2.185] and those aged 30+ [AOR = 1.631, CI = 1.140–2.335] had higher odds of EIB, compared to those aged 15–19. Women from the Islands region had lower odds [AOR = 0.690, CI = 0.565–0.842] of EIB, compared to those in Southern region. Women who delivered through caesarean section had lower odds of EIB, compared to those who delivered via vaginal delivery [AOR = 0.286, CI = 0.182–0.451]. Relatedly, women who delivered in hospitals had lower odds of EIB [AOR = 0.752, CI = 0.624–0.905], compared to those who delivered at home. Women who practiced skin-to-skin contact with the baby [AOR = 1.640, CI = 1.385–1.942] had higher odds of EIB, compared to those who did not. Women who read newspaper or magazine at least once a week had lower odds of EIB [AOR = 0.781, CI = 0.619–0.986], compared to those who did not read newspaper at all. Conclusion The prevalence of EIB in Papua New Guinea was relatively high (60%). The factors associated with EIB are age of the women, region of residence, mode of delivery, place of delivery, practice of skin-to-skin contact with the baby, and exposure to mass media (newspaper). To increase EIB in Papua New Guinea, these factors ought to be considered in the implementation of policies and measures to strengthen existing policies. Health providers should educate mothers on the importance of EIB

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

Background: Women’s health remains a global public health concern, as enshrined in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Ghana. Methods: The study was conducted among 9370 women aged 15–49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions— whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor—was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval. Results: More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45–49 (AOR = 0.65, CI: 0.49–0.86), married women (AOR = 0.71, CI:0.58–0.87), those with a higher level of education (AOR = 0.51, CI: 0.37–0.69), those engaged in clerical or sales occupation (AOR = 0.855, CI: 0.74–0.99), and those who were covered by health insurance (AOR = 0.59, CI: 0.53–0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66–0.90), those who watched television at least once a week (AOR = 0.75, CI: 0.64–0.87), and women in the richest wealth quintile (AOR = 0.47, CI: 0.35–0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR = 1.47, CI: 1.03–2.10), those in the Volta Region (AOR 2.20, CI: I.38–3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32–3.74) had the highest odds of facing barriers to healthcare accessibility. Conclusion: This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana

Providing affordable essential medicines to African households: the missing policies and institutions for price containment.

Medicines are integral of any healthcare system, and limited access to medicines undermines health systems' objectives of equity, efficiency and health development. In African countries, where it is estimated that 50-60% of the populace lack "access" to essential medicines, health problems associated with limited drug benefits are more damaging. However, there is no single solution to medicine access problem given its multiple dimensions: availability, acceptability, affordability and accessibility. This paper explores affordability dimension of medicine access and concentrates solely on price regulatory policies and institutional structures that national and international policy makers may consider in making prices of essential drugs compatible to the purchasing power of African households. The main theme is the application of the concept of bilateral dependence in creating price-sensitive purchasers to exert countervailing market power on drug price setting in African healthcare systems

Providing affordable essential medicines to African households: The missing policies and institutions for price containment

Medicines are integral of any healthcare system, and limited access to medicines undermines health systems' objectives of equity, efficiency and health development. In African countries, where it is estimated that 50-60% of the populace lack "access" to essential medicines, health problems associated with limited drug benefits are more damaging. However, there is no single solution to medicine access problem given its multiple dimensions: availability, acceptability, affordability and accessibility. This paper explores affordability dimension of medicine access and concentrates solely on price regulatory policies and institutional structures that national and international policy makers may consider in making prices of essential drugs compatible to the purchasing power of African households. The main theme is the application of the concept of bilateral dependence in creating price-sensitive purchasers to exert countervailing market power on drug price setting in African healthcare systems.Africa Bilateral dependence solution Procurement Price containment and regulation Medicine access

Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014.

BackgroundThe past few decades witnessed a considerable decline in total fertility rates globally. However in Ghana, there has been a slight increase in the fertility rate with little understanding of the reason for the increment. To understand this change, it is important to first examine the trend over a considerable period of time while taking into consideration some important inequality dimensions. This informed the need for this present study as we examined the trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014.MethodsData from the 1993-2014 Ghana Demographic and Health Surveys were used for the study, and we relied on the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) software for the analysis. The analysis involved disaggregation of TFR by wealth index, education, place of residence and region. This was followed by the estimation of inequality by Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. In the analysis, we set the statistical significance at a 95% confidence interval.ResultsFor all surveys, the total fertility rate was consistently highest among the poorest women (7.00, 6.28, 6.77, 6.61 and 6.29 in 1993, 1998, 2003, 2008 and 2014, respectively). The highest total fertility rate was recorded among women with no formal education in all the survey years. For instance, in the 2014 survey, the total fertility rate for women with no formal education was 5.98 and those with secondary/higher had a total fertility rate of 3.40. Women in rural areas had a higher total fertility rate compared to those in urban areas (4.90 vs. 3.40 in 2014). In terms of sub-national regions, the Northern region was the region where women consistently had the highest total fertility rate.ConclusionThere is a need for a collective effort to design interventions and policies to create awareness among the people of Ghana especially girls and women on the implications of high fertility

Inequalities in the prevalence of skilled birth attendance in Ghana between 1993 and 2014.

BackgroundGlobally, maternal and neonatal health remains a public health priority, particularly for resource-constrained regions like sub-Saharan Africa (SSA). Skilled birth attendance (SBA) is essential in promoting maternal and neonatal health. This study investigated the inequalities in the prevalence of SBA in Ghana using data from the Ghana Demographic and Health Survey (GDHS) between 1993 and 2014.MethodsData were analysed using the World Health Organization's Health Equity Assessment Toolkit software. In analysing the data, we first disaggregated SBA by four inequality stratifiers: wealth index, education, residence, and region. Second, we measured the inequality through summary measures, namely difference, population attributable risk, ratio, and population attributable fraction. A 95% confidence interval was constructed for point estimates to measure statistical significance.ResultsThroughout the period, SBA was highest among women in the highest wealth quintile and those with a secondary or higher level of education. The analysis also indicated that SBA was highly concentrated among urban residents in 1993 (80.78 [95% uncertainty interval {UI} 76.20-84.66]) and persisted to 2014 (91.55 [95% UI 88.80-93.68]). In 1993, Northern region recorded the lowest prevalence of SBA in Ghana (15.69 [95% UI 11.20-21.54]) and the region consistently recorded the lowest SBA prevalence even into 2014 (38.21 [95% UI 27.44-50.27]).ConclusionsThere are significant inequalities in SBA across education, wealth, residence, and region in Ghana. To enhance SBA, there is the need for policymakers and interventionists to design and develop targeted policies and programs that are tailored to the needs of the subpopulations at risk of low SBA: women with no formal education, those within the poorest wealth quintile, rural-dwelling women and women in the Northern region. This will facilitate the uptake of SBA and ultimately translate into the realization of Sustainable Development Goals 3.1 and 3.2

Surveillance of WHO Priority Gram-Negative Pathogenic Bacteria in Effluents from Two Seafood Processing Facilities in Tema, Ghana, 2021 and 2022: A Descriptive Study

Antimicrobial resistant (AMR) bacteria in effluents from seafood processing facilities can contribute to the spread of AMR in the natural environment. In this study conducted in Tema, Ghana, a total of 38 effluent samples from two seafood processing facilities were collected during 2021 and 2022, as part of a pilot surveillance project to ascertain the bacterial load, bacterial species and their resistance to 15 antibiotics belonging to the WHO AWaRe group of antibiotics. The bacterial load in the effluent samples ranged from 13&ndash;1800 most probable number (MPN)/100 mL. We identified the following bacterial species: E. coli in 31 (82%) samples, K. pneumoniae in 15 (39%) samples, Proteus spp. in 6 (16%) samples, P. aeruginosa in 2 (5%) samples and A. baumannii in 2 (5%) samples. The highest levels of antibiotic resistance (100%) were recorded for ampicillin and cefuroxime among Enterobacteriaceae. The WHO priority pathogens&mdash;E. coli (resistant to cefotaxime, ceftazidime and carbapenem) and K.pneumoniae (resistant to ceftriaxone)&mdash;were found in 5 (13%) effluent samples. These findings highlight the need for enhanced surveillance to identify the source of AMR and multi-drug resistant bacteria and an adoption of best practices to eliminate these bacteria in the ecosystem of the seafood processing facilities