Fertility Preferences of Women Living with HIV in the Kumasi Metropolis, Ghana

This study sought to determine fertility preferences and their predictors among women living with HIV. A survey of 295 women aged 18 to 49 years living with HIV, and attending two HIV/AIDS clinics in the Kumasi metropolis, was conducted between July and August 2012. We administered questionnaires, and retrieved records of clinical status for review. We conducted multiple logistic regressions with fertility preference as the dependent variable. Fifty-eight percent of the respondents desired to have a child. The desire to have children was associated with age > 40years (AOR 0.25; 95% CI: 0.06-1.00), parity >3 (AOR 0.07; 95% CI: 0.01-0.78), those that responded that their HIV status did not affect fertility preference were more likely to desire a child (AOR 4.37; 95% CI: 1.28-14.95) and those whose partner’s did not desire to have children were less likely to desire to have children (AOR 0.06; 95% CI: 0.02-0.18). Most of the respondents do not discuss their fertility preferences with healthcare providers. Policy makers should protect the health of women living with HIV by putting in place counselling and support services with regular antiretroviral medications. If implemented, this has the potential to reduce mother-to-child transmission of HIV. Keywords: Desire to have a child, HIV- positive women, KumasiRésuméCette étude visait à déterminer les préférences de fécondité et leurs indices chez les femmes vivant avec le VIH. Une enquête de 295 femmes âgées de 18 à 49 ans vivant avec le VIH, et qui fréquentent deux cliniques du VIH / SIDA dans la métropole de Kumasi, a été menée entre juillet et août 2012. Nous avons administré des questionnaires, et avons récupéré les dossiers de l'état clinique pour les étudier. Nous avons effectué une régression logistique multiple avec la préférence de fécondité comme un variable dépendant. Cinquante-huit pour cent des interrogées ont souhaité avoir un enfant. Le désir d'avoir des enfants a été associée à l'âge> 40 années (AOR 0,25; IC à 95%: 0,06 à 1,00), la parité> 3 (AOR 0,07; IC à 95%: 0,01 à 0,78), celles qui ont répondu que leur état du VIH n'a pas affecté la préférence de la fécondité étaient plus susceptibles de désirer un enfant (AOR 4,37; IC à 95%: 1,28 à 14,95) et celles dont la partenaire n'a pas le désir d'avoir des enfants étaient moins susceptibles de vouloir avoir des enfants (AOR 0,06; IC à 95%: 0,02 à 0,18 ). La plupart des interrogées ne discutent pas leurs préférences de fécondité avec les fournisseurs de soins de santé. Les décideurs politiques devraient protéger la santé des femmes vivant avec le VIH en mettant en oeuvres des services d’orientation et de soutien avec les médicaments antirétroviraux réguliers. Si ceci est réalisées, il a le potentiel de réduire la transmission du VIH de la mère à l'enfantMots-clés: désir d'avoir un enfant, femmes séropositives, Kumas

Feasibility of abstinence as a preventive strategy for HIV/AIDS control in the University student community in Kumasi, Ghana.

HIV is spreading and the youth bear the brunt of its onslaught. Though abstinence until marriage is thought to be the most effective method of HIV prevention for the youth, others think it is ineffective. This study assessed the feasibility of abstinence in preventing HIV/AIDS spread among tertiary students of the KNUST. Study type was non- interventional, descriptive and design current cross- sectional. Study participants were selected by stratified sampling, followed by systematic sampling. A total of 300 participants were sampled. Seventy nine (79%) (95% CI, 73.9-83.8) said STIs could be avoided by abstaining from sex. Ninety six (96%) (95% CI, 93.5-98.3%) said HIV could be acquired via sex. Ninety six (96%) (95% CI, 93.8- 98.5%) of those who said HIV could be avoided said it could be done by abstaining from sex. Seventy two (72%) were of the view that sex should start only after marriage. Sixty nine 69% (95% CI, 63.3-74.4%) said they would wait till after marriage to involve in sex. Sixty seven (67%) (95% CI, 60.7- 72.1%) were encouraged by peers to abstain from sex, Seventy four (74%) (95% CI, 68.5- 79.1%) thought colleagues their age had premarital sex and 28% (95% CI, 22.5- 33.4%) said they were pressured to have sex. Thirty one (31%) (95% CI, 25.6- 36.7%) of respondents were sexually experienced. There is the general view that HIV/AIDS spread among the youth can be reduced by abstaining from sex until marriage and that abstinence could and should be encouraged as a preventive strategy for HIV/AIDS.Journal of Science and Technology (Ghana) Vol. 27 (2) 2007: pp. 1-

Determinants of Under-Five Mortality in Builsa District, Upper East Region, Ghana

Under-five mortality rate is an important indicator of a community’s social development. The Upper East region, one of the most poverty-stricken regions in Ghana, has however recorded a dramatic decline in its under-five mortality rate since 1993; from 180 per 1000 live births to 79 per 1000 live births in 2003. The aim was to identify the determinants of under-five mortality in Builsa district. A case-control study was used to collect data from mothers of 60 cases and 120 controls matched for age, sex and place of residence. Even though 70% of mothers were illiter-ate, the educational level of mothers did not influence the child’s risk of death (OR 1.1). Chil-dren of mothers who had had previous child deaths were about 8 times more likely to die (OR 7.45,) while those who had not had vitamin A supplementation were about 10 times more likely to die (OR 9.57). Over 90% of mothers had an insecticide-treated bednet and more than 50% of them exclusively breastfed their children for the first 6 months of life. Protective risk factors identified included: exclusive breastfeeding (OR 0.72), use of an insecticide-treated bednet (OR 0.12), the number of live children a mother had (OR 0.54) and immunization (OR 0.53). Even in poverty, it is possible to improve the child health status of communities. Health staff should be equipped to pay special attention to mothers with previous child deaths in order to assist them to prevent further deaths.Keywords: Under-five mortality, determinants, case-control study, Builsa distric

Health-seeking behaviour of tuberculosis patients and related factors in the central region of Ghana

The health seeking behaviour of TB patients and health service related barriers have been cited to have an influence on the management of the disease in countries with high incidence of TB. Using close and open-ended questionnaires, an assessment of the health seeking behaviour of 302 TB patients selected from 24 DOTS centres in six districts in the Central  Region of Ghana was carried out. Under service-related barriers, distance from home to DOTS centre significantly impacted on the management of TB among sufferers (p=0.025). Though not significant, patients  acknowledged the good reception by staff at treatment centres with 99.3% of them being comfortable with staff and services provided at centres. Majority (46.7%) of patients perceived TB to be caused by the oral route while only 9.3% knew the causative agent to be bacteria. Compared with males, quite a number of women did not have adequate knowledge on TB (p<0.05). More than half of the respondents sought treatment elsewhere as first point of treatment before reporting to the DOTS centre. Health insurance played an important role in the health seeking behaviour of respondents; 45.9% of TB patients with health insurance visited the health facility as 1st provider whilst 49.4% without health insurance visited prayer camps (p=0.001). Our study has revealed that factors such as staff  attitude, distance to treatment centres, gender, employment and education are key factors that affect the health-seeking behaviour of TB patients in the Central Region of GhanaKeywords: Tuberculosis, Health, barriers, Central Regio

Smoking in Ghana: a review of tobacco industry activity

BACKGROUND: African countries are a major potential market for the tobacco industry, and the smoking epidemic is at various stages of evolution across the continent. Ghana is an African country with a low prevalence of smoking despite an active tobacco industry presence for over 50 years. This study explores potential reasons for this apparent lack of industry success. OBJECTIVE: To explore the history of tobacco industry activity in Ghana and to identify potential reasons for the current low prevalence of smoking. METHODS: A search was made of tobacco industry archives and other local sources to obtain data relevant to marketing and consumption of tobacco in Ghana. FINDINGS: British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954. After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006. CONCLUSION: The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions, which may have restricted industry growth, are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date

Missed Opportunities for the Diagnosis of Pulmonary Tuberculosis in Ashanti and Western Regions of Ghana; Polymerase Chain Reaction, A Better Tool

The diagnosis of Pulmonary Tuberculosis (PTB) has mainly relied on sputum microscopy and culture. The use of molecular techniques such as the Polymerase Chain Reaction (PCR) and its overwhelming advantages compared with conventional diagnostic methodologies cannot be overemphasized. The main aim of this work was to compare the diagnostic sensitivities of microscopy, culture and PCR. Suspected PTB sputum samples were prospectively collected from six hospitals in the Ashanti and Western regions of Ghana. Microscopy was carried out on all samples at the field sites. Apart from culture and PCR, repeat sputum microscopy was carried out in the laboratories of the Kumasi Centre for Collaborative Research (KCCR). Out of the total 425 cases recruited for the study, 123 (29.0%) were smear positive on site in contrast to 275 (64.7%) positivity rate at KCCR. Regarding culture, 254 (59.9%) samples were culture positive whilst PCR technique using INS 1&2 and PR 8&9 primers were positive in 59.9 % and 56% of cases respectively. The proportion of missed positive cases of microscopy were 131 (51%) compared with culture and 1.1% missed cases when compared with PCR. The sensitivity and specificity of microscopy were 123/254 (48.4%) and 154/302 (50.99%). The study confirms the superiority of PCR in the diagnosis of PTB and indicates that a substantial proportion of PTB cases are missed when microscopy alone is used. In areas where the incidence of PTB is high and at referral hospitals, PCR can be done to augment the diagnosis of TB.Keywords: Pulmonary Tuberculosis, Sputum Microscopy, Culture, Polymerase Chain Reactio

Stroke in Ashanti region of Ghana

Objective: To determine the morbidity and mortality in adult in-patients with stroke admitted to the KomfoAnokye Teaching Hospital (KATH).Methods: A retrospective study of in-patients with stroke admitted to the KATH, from January 2006 todecember 2007 was undertaken. Data from admission and discharge registers were analysed to determinestroke morbidity and mortality.Results: Stroke constituted 9.1% of total medical adult admissions and 13.2% of all medical adult deathswithin the period under review. The mean age of stroke patients was 63.7 (95% ci=62.8, 64.57) years. Males were younger than females. The overall male to female ratio was 1:0.96, and the age-adjusted risk of death from stroke was slightly lower for females than males (relative risk= 0.88; 95% ci=0.79, 1.02, p=0.08). The stroke case fatality rate was 5.7% at 24 hours, 32.7% at 7 days, and 43.2% at 28 days.Conclusion: Stroke constitutes a significant cause of morbidity and mortality in Ghana. Major efforts are needed in the prevention and treatment of stroke. Population-based health education programs and appropriate public health policy need to be developed. This will require a multidisciplinary approach of key players with a strong political commitment. There is also a clear need for further studies on this topic including, for example, an assessment of care and quality of life after discharge from hospital. The outcomes of these studies will provide important information for the prevention efforts.Keywords: Stroke, Cerebrovascular disease, CVD, Komfo Anokye Teaching Hospital, Ghan