Multi-centre point-prevalence survey of hospital-acquired infections in Ghana

Background: There is a paucity of data describing hospital-acquired infections (HAIs) in Africa. Objective: To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Methods: Between September and December 2016, point-prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. Medical records of eligible inpatients at or before 8am on the survey date were reviewed to identify HAIs present at the time of the survey. Findings: Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5% to 14.4%, with higher proportions of infections in secondary and tertiary care facilities. The most common HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%) and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a micro-organism was reported; the most commonly isolated micro-organism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the survey date. The strongest independent predictors for HAI were the presence of an invasive device before onset of infection and duration of hospital stay. Conclusion: A low HAI burden was found compared with findings from other low- and middle-income countries

In vivo digestibility of six selected fodder species by goats in northern Ghana

An in vivo digestibility trial was conducted to evaluate the digestibility of six forages. These were selected indigenous browse species and groundnut haulms in Lawra and Jirapa Districts of the UpperWest Region of Ghana. Groundnut haulms served as a control due to its known good digestibility in small ruminants. Thirty West African Dwarf (WAD) young castrated billy goats with a mean age of 8 months were used. The average live body weight was 8.9 ± 0.1 kg. The animals were randomly assigned to the six treatments and replicated five times in a completely randomized design. They were confined in metabolism cages. The adaptation period was 3 weeks after which data was taken for 10 days. The treatments were the leaves and tiny twigs of T1 Annona senegalensis, T2 Ficus gnaphalocarpa, T3 Pericopsis laxiflora, T4 Pterocarpus erinaceus, T5 Afzelia africana, and T6 (control) Arachis hypogaea. Feed intake, faecal matter and urine output were measured. The results indicated that dry matter (DM) contents of the feedstuffs were less than 50% but crude protein (CP) contents were higher than the minimum required for sustaining ruminants. Neutral and acid detergent fibre contents were high, and F. gnaphalocarpa, in particular, contained a higher level of phosphorus (P). The amounts of feed intakes were typical of most fodder species with the exception of P. laxiflora and P. erinaceus, which were lower (P < 0.05). The apparent digestibility values were also typical of most fodder species but the digestibility of A. africana fibre appeared to be lower. Nitrogen retention was positive for all test species with the exception of P. laxiflora, which was negative. Mortality was recorded in animals on P. laxiflora, and the rate was high. Pericopsis laxiflora leaves, even though morphologically similar to the leaves of P. erinaceus, were not a suitable fodder. Ficus gnaphalocarpa appeared to be the overall best fodder species in terms of nutrient uptake

Epidemic of hypertension in Ghana: a systematic review

Background Hypertension is a major risk factor for many cardiovascular diseases in developing countries. A comprehensive review of the prevalence of hypertension provides crucial information for the evaluation and implementation of appropriate programmes. Methods The PubMed and Google Scholar databases were searched for published articles on the population-based prevalence of adult hypertension in Ghana between 1970 and August 2009, supplemented by a manual search of retrieved references. Fifteen unique population-based articles in non-pregnant humans were obtained. In addition, two relevant unpublished graduate student theses from one university department were identified after a search of its 1996-2008 theses. Results The age and sex composition of study populations, sampling strategy, measurement of blood pressure, definition of hypertension varied between studies. The prevalence of hypertension (BP ≥ 140/90 mmHg ± antihypertensive treatment) ranged from 19% to 48% between studies. Sex differences were generally minimal whereas urban populations tended to have higher prevalence than rural population in studies with mixed population types. Factors independently associated with hypertension included older age group, over-nutrition and alcohol consumption. Whereas there was a trend towards improved awareness, treatment and control between 1972 and 2005, less than one-third of hypertensive subjects were aware they had hypertension and less than one-tenth had their blood pressures controlled in most studies. Conclusion Hypertension is clearly an important public health problem in Ghana, even in the poorest rural communities. Emerging opportunities such as the national health insurance scheme, a new health policy emphasising health promotion and healthier lifestyles and effective treatment should help prevent and control hypertension