Conceptualisation of Disaster Recovery: A Harmonisation of Theoretical and Conceptual Arguments for Effective Assessment and Comparison

Despite the general recognition of the importance of disaster recovery in disaster management efforts, there is conceptual confusion among researchers and practitioners over the appropriate paradigm to assess disaster recovery. Whereas some writers argue that disaster recovery should be measured in relation to the pre-disaster conditions, others contend that disaster recovery should be measured in reference to a counterfactual state, which would have existed if the disaster had not occurred. This conceptual confusion has made it difficult to develop a comprehensive theory to explain disaster recovery. It has also created methodological challenges in comparing disaster recovery efforts across institutions and countries.Disaster recovery is the most poorly understood and least well researched among researchers and practitioners in the disaster management cycle. At the operational level, broad knowledge of what to do is still lacking, and thus the ability to act properly and effectively also is deficient. Although this problem has been recognised for over 25 years, little has been done to address it. This study sought to contribute to the building of knowledge and understanding on disaster recovery by harmonising the various arguments advanced to measure the concept. The study used the Darwin’s evolution theory to explain the recovery processes following disaster. The main elements presented in the various conceptualisations of disaster recovery were discussed under the study and concluded that disaster recovery should be conceptualised as the deliberate incorporation of hazard mitigation mechanisms, through both endogenous and exogenous efforts, to restore disaster victims and impact areas to pre-disaster situation. Keywords: Conceptualisation of disaster recovery, Disaster, Disaster recovery, Disaster recovery framework, Theoretical argument for disaster recover

Heavy metal levels in analytical laboratories waste: a study for the implementation of a programme for the control and disposal of waste from microbiology and chemical analysis laboratories

Dissertação de mest., Qualidade em Análises, Faculdade de Ciências e Tecnologia, Univ. do Algarve, 2012Analytical Laboratories daily routine analyses leads to the generation of solid and liquid waste. Quality assurance and quality control procedures are employed in most of these laboratories to ensure that accurate results are obtained and the waste generated out of these analyses are properly stored for collection by waste treatment companies. The cost associated with waste treatment varies with the type of waste generated. Liquid waste are quantified or priced according to the volume of waste. Microbiology waste are inactivated and added to solid waste for collection and treatment but residues from Chemical Analysis Laboratories cannot be emptied down the drainage systems since it can contain some levels of heavy metals which can be dangerous to the environment or human. Therefore the objective of this thesis was to characterize some of these important heavy metals so that they can be treated and discarded by the laboratory staff leading to reduction in payment for their treatment by external companies. The research involved the determination of total heavy metal (Pb, Cu Zn, Cr, Cd, Ni, Fe, As, Hg, Al) levels in Microbiology (M) and Chemical (C ) samples using the Atomic Absorption Spectroscopy (AAS). Flame technique was used for the analysis of Cd, Cu, Zn, Fe, Pb, Cr, Ni and Al was analyzed with Furnace technique. However, hydride generation and cold vapour procedures were used for As and Hg respectively. The mean concentration of all the Heavy metals analyzed from the chemical (c) and microbiology (M) samples were all below the Guidelines for Maximum Admissible values for parameter in industrial water residuals with the exception of Fe, Al, As and Hg levels in the DRAAL and LAQ chemical samples which showed concentrations values of 5.0, 89.5, 5.93, 0.42 mg/L and 21.9, 19.0, 3.59, 0.11mg/L respectively, which were higher than the recommended levels of 2.0, 10, 0.5, 0.05mg/L respectively. The microbiological samples were cultured for microorganisms by employing the Incorporation Technique with PCA and PDA. No growth was recorded for both media after 24 and 48 hours of incubation. The results obtained could be used to implement the WC-D programme (Waste-Control and Disposal programme) for microbiological and chemical analysis laboratories of the University

Susceptibility pattern of uropathogens to ciprofloxacin at the Ghana police hospital

Introduction: Reports of increasing resistance of uropathogens to antimicrobials is of global concern. Culture and drug susceptibility tests remain a vital guide to effective therapy. The aim of this study was to determine the susceptibility pattern of isolated uropathogens to ciprofloxacin at the Ghana Police Hospital. Methods: A total of 705 mid-stream urine samples were collected from patients suspected of having  urinary tract infection, and visited the Ghana Police Hospital's laboratory from December 2013 to March  2014. Samples were cultured and isolates identified by standard methods, after which isolates  susceptibility to ciprofloxacin was determined. Results: Prevalence of urinary tract infection among patients' whose samples were analyzed was 15.9%. Predominant uropathogens isolated were E .coli (46.4%), Coliform (41.1%) and Coliform spp. with Candida (6.2%). Other isolates were Pseudomonas spp. (2.7%), Salmonella spp. (1.8%), Candida spp. (0.9%) and Klebsiella spp (0.9%). The overall resistance among the top three isolated uropathogens to ciprofloxacin was 35.9%. Resistance pattern demonstrated by  respective isolates to ciprofloxacin were: E. coli (38.5%), Coliform (54.3%), and Coliform spp. with Candida (15%). The other isolates showed 100% sensitivity.Conclusion: This study revealed a relatively high ciprofloxacin resistance among isolated uropathogens,  hence, the need for prudent prescribing and use of  ciprofloxacin in urinary tract infection management.Key words: Urinary tract infection, isolates, susceptibility, antibiotics, uropathogen

Adherence to Artesunate-Amodiaquine Therapy for Uncomplicated Malaria in Rural Ghana: A Randomised Trial of Supervised versus Unsupervised Drug Administration

Introduction. To enhance effective treatment, african nations including Ghana changed its malaria treatment policy from monotherapy to combination treatment with artesunate-amodiaquine (AS+AQ). The major challenge to its use in loose form is adherence. Objective. The objectives of this study were to investigate adherence and treatment outcome among patients treated with AS+AQ combination therapy for acute uncomplicated malaria. Methodology. The study was conducted in two rural districts located in the middle belt of Ghana using quantitative methods. Patients diagnosed with acute uncomplicated malaria as per the Ghana Ministry of Health malaria case definitions were randomly allocated to one of two groups. All patients in both groups were educated about the dose regimen of AS+AQ therapy and the need for adherence. Treatment with AS+AQ was supervised in one group while the other group was not supervised. Adherence was assessed by direct observation of the blister package of AS+AQ left on day 2. Results. 401 participants were randomized into the supervised (211) and unsupervised (190) groups. Compliance in both supervised (95.7%) and unsupervised (92.6%) groups were similar (P = .18). The commonest side-effects reported on day 2 among both groups were headaches, and body weakness. Parasite clearance by day 28 was >95% in both groups. Discussion/Conclusions. Administration of AS-AQ in both groups resulted in high levels of adherence to treatment regimen among adolescent and adult population in central Ghana. It appears that high level of adherence to AS-AQ is achievable through a rigorous education programme during routine clinic visits

Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Background: Under-five mortality is a major public health problem and one of the health indicators of health care in sub-Saharan Africa. In order to address inefficient health systems, there is a need to identify the spatial distribution of under-five mortality, especially areas of high mortality clustering. This study aimed to explore spatial and temporal clustering in under-five mortality in the Kassena-Nankana District of the Upper East region. Methods: We used data from the Navrongo Health and Demographic Surveillance System in the Kassena- Nankana District of northern Ghana, which had an average population of 140,000 of which about 18,400 were under five years of age. We analysed under-five mortality in 49 villages during the period 1997–2006. We calculated total under-five mortality rates and investigated their geographical distributions. A spatial scan statistic was used to test for clustering of the mortality in both space and time. Results: Under-five mortality has been declining during the period. However, the data show a persistently higher than average clustering of mortality over the period among villages mainly in the north-eastern parts of the district. Conclusion: There is a higher than average under-five mortality clustering in the villages in the north-east of the district and this may suggest a relatively poor health care system despite the many health interventions that took place over time in the district, including the Community Health and Family Planning Project, whose impact may not have been felt in these parts of the district between 1995 and 2004

Predictors of abortions in Rural Ghana: a cross-sectional study.

BACKGROUND: Abortion continues to be used as a method of family planning by many women. The complications of unsafe abortions are a major contributor to maternal mortality in sub-Saharan Africa, including Ghana. This study explored the influence of socio-demographic characteristics on abortions in 156 communities within the Kintampo Health and Demographic Surveillance System (KHDSS) area located in the middle part of Ghana. METHODS: A survey on Sexual and Reproductive Health among a representative sample of females aged 15-49 years was conducted in 2011. They were asked about the outcome of pregnancies that occurred between January 2008 and December 2011. Data on their socio-demographic characteristics including household assets were accessed from the database of the KHDSS. Univariate and multivariate random effects logistic regression models were used to explore the predictors of all reported cases of abortion (induced or spontaneous) and cases of induced abortion respectively. RESULTS: A total of 3554 women were interviewed. Of this total, 2197 women reported on the outcomes of 2723 pregnancies that occurred over the period. The number of all reported cases of abortions (induced and spontaneous) and induced abortions were 370 (13.6%) and 101 (3.7%) respectively. Unmarried women were more likely to have abortion as compared to married women (aOR = 1.77, 95% CI [1.21-2.58], p = 0.003). Women aged 20-29 years were 43% less likely to have abortion in comparison with those within the ages 13-19 years (aOR = 0.57, 95% CI [0.34-0.95], p = 0.030). Women with primary, middle/junior high school (JHS) and at least secondary education had higher odds of having abortion as compared to women without education. Compared with the most poor women, wealthiest women were three-fold likely to have abortion. Unmarried women had higher odds of having induced abortion as compared to married women (aOR = 7.73, 95% CI [2.79-21.44], p < 0.001). Women aged 20-29 years, 30-39 years and 40-49 years were less likely to have induced abortion as compared to those 13-19 years of age. CONCLUSION: Extra efforts are needed to ensure that family planning services, educational programs on abortion and abortion care reach the target groups identified in this study

Trends in multiplicity of Plasmodium falciparum infections among asymptomatic residents in the middle belt of Ghana.

BACKGROUND: Malaria is the most important cause of mortality and morbidity in children living in the Kintampo districts in the middle part of Ghana. This study has investigated the multiplicity of infection (MOI) within asymptomatic residents of the Kintampo districts, and the influence of age and seasonality on MOI, by studying the distribution of the polymorphic Plasmodium falciparum antigen merozoite surface protein 2 (MSP2). METHODS: DNA was extracted from an asymptomatic cohort of children and adults infected with P. falciparum during the period November 2003 to October 2004. Polymerase chain reaction was carried out and multiplicity of infection (MOI) was determined. RESULTS: Children under 10 years of age had an average MOI of 2.3 while adults 18 years and above had an average MOI of 1.4. Children below five years had high and low average MOIs of 2.8 in the March/April survey and 0.9 in the May/June survey respectively. A similar trend in the monthly distribution of MOI was observed for the entire cohort. IC/3D7 strains outnumbered the FC27 strains throughout the year by a ratio of about 4:1 with the difference between the prevalence of the two strains being least marked in the March/April survey, at the beginning of the rainy season. MOI was not linked to the level of malaria transmission as measured by the entomological inoculation rate. DISCUSSION/CONCLUSION: The impact of interventions, introduced since this baseline study was carried out on the parasite diversity of asymptomatic residents will be the subject of further investigations

Assessing the climate security sensitivity of the Gulf of Guinea Northern Regions Social Cohesion Project (SOCO) in Ghana

The CGIAR Climate Security has developed a safeguard programming assessment tool for conflict-sensitive and peace-responsive climate action in agricultural settings. The Climate Security Sensitivity Tool (CSST) is used to evaluate, ex-ante, the extent to which a proposed climate adaptation intervention addresses local drivers of conflict and insecurity and recommends strategies to strengthen their suitability. It seeks to prevent unintended consequences, avoid conflict relapses, and contribute to peacebuilding. This Info Note reports on the CSST case study application for the Gulf of Guinea Northern Regions Social Cohesion Project (SOCO). It highlights the recommendations formulated by the CSST for the implementation of the SOCO Project in Ghana and the practitioners’ feedback on these results

Assessing the performance of only HRP2 and HRP2 with pLDH based rapid diagnostic tests for the diagnosis of malaria in middle Ghana, Africa.

BACKGROUND: Rapid diagnostic test (RDT) kits have been useful tools to screen for the presence of infection with malaria parasites. Despite the improvement, false results from RDTs present a greater challenge. The need for quality test kits is desirable. We evaluated the diagnostic accuracy of three malaria RDTs. METHOD: The team consented and enrolled 754 participants from the two major public hospitals in Kintampo districts of Ghana from June 2014 to August 2014. Venous blood samples were obtained by trained personnel and samples were screened for malaria using CareStart and SD Bioline HRP2 and HRP2 with pLDH based RDTs with blood slides for malaria microscopy as "gold standard". Geometric mean parasite densities were estimated and parasite densities were used to estimate the quantitative limits of the RDTs. The sensitivities, specificities and other performance criteria were calculated using statistical analytical software. RESULT: The median age of participants was 21 (range 5-31) years. There were 28.6% (215/752) were males and 71.4% (537/752) were females. Comparing with microscopy, the sensitivity, specificity, positive predictive value, negative predictive value and the ROC were for CareStart (HRP2), 98.2%, 66.5%, 82.6%, 95.6%, 0.82; for CareStart (HRP2/pLDH) 98.2%, 66.5%, 82.6%, 95.6%, 0.82 and for SD-Bioline (HRP2/pLDH) RDTs 98.2%, 69.2%, 84.2%, 96.0%, 0.84 respectively. The performance for all the kits were acceptable at a cut-off of 25 or more parasites/μl of blood. CONCLUSIONS: The diagnostic performance of the three malaria RDTs was acceptable, according to the World Health Organisation criteria, to detect densities ≥25 parasite/μl of blood. The RDTs with HRP2/pLDH targets were comparable to those with only HRP2 and could successfully substitute current and commonly used HRP2-based RDTs

Associations between red cell polymorphisms and Plasmodium falciparum infection in the middle belt of Ghana.

BACKGROUND: Red blood cell (RBC) polymorphisms are common in malaria endemic regions and are known to protect against severe forms of the disease. Therefore, it is important to screen for these polymorphisms in drugs or vaccines efficacy trials. This study was undertaken to evaluate associations between clinical malaria and RBC polymorphisms to assess biological interactions that may be necessary for consideration when designing clinical trials. METHOD: In a cross-sectional study of 341 febrile children less than five years of age, associations between clinical malaria and common RBC polymorphisms including the sickle cell gene and G6PD deficiency was evaluated between November 2008 and June 2009 in the middle belt of Ghana, Kintampo. G6PD deficiency was determined by quantitative methods whiles haemoglobin variants were determined by haemoglobin titan gel electrophoresis. Blood smears were stained with Giemsa and parasite densities were determined microscopically. RESULTS: The prevalence of clinical malarial among the enrolled children was 31.9%. The frequency of G6PD deficiency was 19.0% and that for the haemoglobin variants were 74.7%, 14.7%, 9.1%, 0.9% respectively for HbAA, HbAC, HbAS and HbSS. In Multivariate regression analysis, children with the HbAS genotype had 79% lower risk of malaria infection compared to those with the HbAA genotypes (OR = 0.21, 95% CI: 0.06-0.73, p = 0.01). HbAC genotype was not significantly associated with malaria infection relative to the HbAA genotype (OR = 0.70, 95% CI: 0.35-1.42, p = 0.33). G6PD deficient subgroup had a marginally increased risk of malaria infection compared to the G6PD normal subgroup (OR = 1.76, 95% CI: 0.98-3.16, p = 0.06). CONCLUSION: These results confirm previous findings showing a protective effect of sickle cell trait on clinical malaria infection. However, G6PD deficiency was associated with a marginal increase in susceptibility to clinical malaria compared to children without G6PD deficiency