Immunization Coverage of Pregnant Women with Tetanus Toxoid Vaccine in Dormaa East District-Brong Adaro Region, Ghana

This paper examines the immunization coverage of Tetanus toxoid vaccine in the Dormaa East District and then assesses the reasons for the low coverage in the district as to whether it is as a result of the attitude of health staff, knowledge of beneficiaries on its importance or the accessibility of the health facilities. Our findings suggest that, most beneficiaries fail to get immunized due to the reasons that they are not treated well by health workers on their visit to the immunization Centres. The beneficiaries are also unaware of when to be immunized and do not see the relevance of being immunized. Getting access to the vaccination centre is another cause for dropping-out in the course of immunization. It is recommended to the stakeholders to design and implement appropriate and relevant immunization programmes that will serve to improve EPI service utilization in the Dormaa East District Health Administration by embarking on routine educational campaign at both antenatal and postnatal sessions and child welfare clinics. There is the need to stress on the total number of times mothers need to visit the clinic to complete the immunization and the importance of being immunized. Also mother’s immunization for tetanus toxoid vaccine should be given equal attention by all health workers just like the immunization for their children during antenatal care attendance. The health staffs should also try making the beneficiaries feel good when they appear for their service. Enough immunization service centers should be made available close to the various communities to enable the people get quick access to it. Keywords: maternal and neonatal tetanus, Tetanus Toxoid immunization and regression analysis

High prevalence of multidrug-resistant tuberculosis among patients with rifampicin resistance using GeneXpert Mycobacterium tuberculosis/rifampicin in Ghana

AbstractObjective/BackgroundDrug-resistant strains of tuberculosis (TB) represent a major threat to global TB control. In low- and middle-income countries, resource constraints make it difficult to identify and monitor cases of resistance using drug susceptibility testing and culture. Molecular assays such as the GeneXpert Mycobacterium tuberculosis/rifampicin may prove to be a cost-effective solution to this problem in these settings. The objective of this study is to evaluate the use of GeneXpert in the diagnosis of pulmonary TB since it was introduced into two tertiary hospitals in Ghana in 2013.MethodsA 2-year retrospective audit of clinical cases involving patients who presented with clinically suspected TB or documented TB not improving on standard therapy and had samples sent for GeneXpert testing.ResultsGeneXpert identified 169 cases of TB, including 17 cases of rifampicin-resistant TB. Of the seven cases with final culture and drug susceptibility testing results, six demonstrated further drug resistance and five of these were multidrug-resistant TB.ConclusionThese findings call for a scale-up of TB control in Ghana and provide evidence that the expansion of GeneXpert may be an optimal means to improve case finding and guide treatment of drug-resistant TB in this setting

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders