Abortion in Ghana: Legal or Illegal? An Observation at the Abura Dunkwa District Hospital

Background: Elective abortion with its medico-legal controversies is a major worldwide debatable topic. The question whether to legalize abortion or not continues to be a contentious affair.  The public interest nature of this debate has led to the emergence of two advocacy groups: Pro-Life and Pro-Choice. The former argues that the unborn fetus is human with life. The latter strongly postulates that women should have choices of what happens to their body. Whilst this debate lingers on, we decided to do a four month clinical observation of the reality on the ground in Ghana’s Abura Dunkwa Ditrict Hospital.  Methods: This was a clinical observational study. It covered a four month clinical management of abortion related patients at the Abura Dunkwa district hospital of Ghana.  History of presenting complaints and social/ family histories were particularly noted in details. We then compared our observation against abortion laws around the world and Ghana in particular. Findings: we observed that the lack of publicity and agreed interpretation of Ghana’s abortion laws have resulted in criminal abortions leading to complications such as incomplete abortion, hemorrhage, sepsis, etc. We also discovered that many criminal abortions   in fact met Ghana’s abortion Acts’ ‘exceptions for termination of pregnancy’Conclusion: Ghana’s abortion Acts  though do not make abortion legal, the laws have permitted enough grounds for justifiable  terminations of pregnancies,   yet ignorance of the law has led to women’s continued engagement in criminal and unsafe abortions leading to severe morbidities and  mortalities Keywords: Abortifacients, hemorrhage, sepsis, morbidity, mental health, adjustment disorder DOI: 10.7176/JHMN/61-02 Publication date: April 30th 201

Restoration of degraded forest reserves in Ghana

Deforestation in Ghana has led to a forest loss of almost 20% from 9,924,000 ha in 1990 to 7,986,000 ha today. To restore degraded lands, Forest Landscape Restoration has become a critical approach globally. This study was conducted in Ghana focusing on the examples of two forest landscape restoration projects in the Pamu Berekum Forest Reserve: 10-year-old mixed-stands of two to four native tree species and an exotic species stands, including Triplochiton scleroxylon, Terminalia ivorensis, Ceiba pentandra, Nauclea diderrichii and Cedrela odorata at Pamu Berekum 1 and 4-year-old Tectona grandis and 2-year-old Gmelina arborea monoculture stands at Pamu Berekum 2. Estimates of productivity in the restored forests are described, as well as the effects of the restoration on provision of ecosystem service and benefits obtained by local communities. Stand productivity was assessed as mean annual increment of diameter and height, biomass production, and standing volume. For ecosystem services, carbon stocks were calculated for the restored forests; other ecological benefits, as well as financial benefits, were obtained through interviews with fringe communities. The results indicate that FLR can be implemented successfully using different models provided that local communities are involved during the planning and implementation of interventions. When all stands were projected to 10 years, results show higher productivity in T. grandis (331.77 m3 ha-1) and G. arborea stands (1,785.99 m3ha-1) compared to mixed stand (160.41 m3 ha-1). The Gmelina arborea stand was more productive and had higher carbon stocks (1,350.10 Mg ha-1) relative to the T. grandis stand (159.89 Mg ha-1). Both restoration projects were found to deliver important benefits and ecosystem services at the local and national levels, including direct and indirect benefits. The results provide an example for forest/environmental managers on how FLR might be implemented to create multiple benefits at different levels from local communities to the national level. Thus, these results may be useful for guiding successful restoration activities within the context of the ongoing global Forest Landscape Restoration efforts

From the Singular to the Plural: Exploring Diversities in Contemporary Childhoods in sub-Saharan Africa

The challenges that sub-Saharan Africa has faced in the post-colonial period have come to characterise the way the region is perceived. These narratives are especially evident in the various ways children’s lives are discussed, leading to a particular focus on childhoods in difficult circumstances or at the margins. This has eclipsed the mundanities of everyday life for many children whose lives are not characterised by ‘lacks’. This article seeks to move beyond an overwhelming focus on childhoods defined by what they lack by illustrating the multitude of childhoods which exist in the continent

Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing

Preventive chemotherapy and transmission control (PCT) by mass drug administration is the cornerstone of the World Health Organization (WHO)’s policy to control soil-transmitted helminthiases (STHs) caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm species (Necator americanus and Ancylostama duodenale) which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD) permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance

Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases

BACKGROUND: Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. METHODS: Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. RESULTS: A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANY(r)); 16.8% (50/298) were isoniazid-mono-resistant (INH(r)), 16.8% (50/298) were rifampicin-mono-resistant (RIF(r)), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANY(r) were additionally resistant to at least one second line drug: 7.4% (2 RIF(r), 1 INH(r), and 10 MDR samples) resistant to only FQs and 2.3% (2 RIF(r), 1 INH(r), and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIF(r) and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INH(r) and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. CONCLUSION: The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance

Social research on neglected diseases of poverty: Continuing and emerging themes

Copyright: © 2009 Manderson et al.Neglected tropical diseases (NTDs) exist and persist for social and economic reasons that enable the vectors and pathogens to take advantage of changes in the behavioral and physical environment. Persistent poverty at household, community, and national levels, and inequalities within and between sectors, contribute to the perpetuation and re-emergence of NTDs. Changes in production and habitat affect the physical environment, so that agricultural development, mining and forestry, rapid industrialization, and urbanization all result in changes in human uses of the environment, exposure to vectors, and vulnerability to infection. Concurrently, political instability and lack of resources limit the capacity of governments to manage environments, control disease transmission, and ensure an effective health system. Social, cultural, economic, and political factors interact and influence government capacity and individual willingness to reduce the risks of infection and transmission, and to recognize and treat disease. Understanding the dynamic interaction of diverse factors in varying contexts is a complex task, yet critical for successful health promotion, disease prevention, and disease control. Many of the research techniques and tools needed for this purpose are available in the applied social sciences. In this article we use this term broadly, and so include behavioral, population and economic social sciences, social and cultural epidemiology, and the multiple disciplines of public health, health services, and health policy and planning. These latter fields, informed by foundational social science theory and methods, include health promotion, health communication, and heath education

New approaches to measuring anthelminthic drug efficacy: parasitological responses of childhood schistosome infections to treatment with praziquantel

By 2020, the global health community aims to control and eliminate human helminthiases, including schistosomiasis in selected African countries, principally by preventive chemotherapy (PCT) through mass drug administration (MDA) of anthelminthics. Quantitative monitoring of anthelminthic responses is crucial for promptly detecting changes in efficacy, potentially indicative of emerging drug resistance. Statistical models offer a powerful means to delineate and compare efficacy among individuals, among groups of individuals and among populations.; We illustrate a variety of statistical frameworks that offer different levels of inference by analysing data from nine previous studies on egg counts collected from African children before and after administration of praziquantel.; We quantify responses to praziquantel as egg reduction rates (ERRs), using different frameworks to estimate ERRs among population strata, as average responses, and within strata, as individual responses. We compare our model-based average ERRs to corresponding model-free estimates, using as reference the World Health Organization (WHO) 90 % threshold of optimal efficacy. We estimate distributions of individual responses and summarize the variation among these responses as the fraction of ERRs falling below the WHO threshold.; Generic models for evaluating responses to anthelminthics deepen our understanding of variation among populations, sub-populations and individuals. We discuss the future application of statistical modelling approaches for monitoring and evaluation of PCT programmes targeting human helminthiases in the context of the WHO 2020 control and elimination goals