Postpartum Implanon/Nexplanon continuation rates and associated factors among women who ever used Implanon/Nexplanon in a tertiary hospital in Accra, Ghana

Background: Postpartum Implanon use serves as an important conduit to bridge the wide gap of unmet need for contraception. The study sought to determine the continuation rates of postpartum Implanon/Nexplanon use and factors associated with it.Methods: A retrospective review of electronic data of 391 women who had received postpartum Implanon/Nexplanon insertions from January 2012 to December 2015 was conducted at a family planning hospital in Accra, Ghana. Continuation rates and factors associated with discontinuation at 6 months, one year and two years post-partum were determined. Data were analysed using IBM Statistical Package for Social Science (SPSS) version 20.Results: A total of 391 postpartum Implanon/Nexplanon insertions were done during study period. Their mean age was 28.51±5.29 years and median parity was 2.0. Continuation rates of postpartum Implanon/Nexplanon at 6 months, 1 year and 2 years post uptake were 94.9%, 92.8% and 86.4% respectively. Women with tertiary level education were 64% less likely to continue Implanon/Nexplanon use at one-year post uptake (OR=0.36, CI=0.16-0.85). Women with education up to Senior High School were 62% less likely to continue postpartum Implanon/Nexplanon use at 2 years after uptake (OR=0.38, CI=0.18-0.81). Women between ages 20 and 29 years were 53% less likely to continue postpartum Implanon/Nexplanon use at 2 years (OR=0.47, CI=0.26-0.86). Reasons for discontinuation of postpartum Implanon/Nexplanon use were wishes to get pregnant and side effects of the method.Conclusions: Post -partum Implanon/Nexplanon continuation rates are high and remain as a viable choice for reduction of unplanned pregnancies post- delivery

Postpartum implanon/nexplanon uptake in a tertiary hospital in West Africa

Background: The postpartum period is viewed as an opportune period for uptake of contraception. Ghana has an unmet need for family planning of 30%. This study sought to determine the postpartum Implanon/Nexplanon uptake among women at a tertiary hospital.Methods: This was a retrospective study that analysed 391 Implanon/Nexplanon insertions between 2012 and 2015 at the reproductive health and family planning unit at the Korle-Bu teaching hospital.Results: Almost 69% (391/565) of all Implanon/Nexplanon insertions conducted between 2012 and 2015 were conducted in the postpartum period. Out of these postpartum insertions, 2.3% were done in the immediate postpartum period, 27.6% were done during the interval postpartum period and 70.1% were in the delayed postpartum period. Age and implant insertion status (first time ever or continuing) were significant determinants of postpartum Implanon/Nexplanon insertions. Compared to women less than 20 years of age, women in the age group 20-29 and 30-39 were 76% (AOR=0.24, CI=0.62-0.97) and 80% (AOR=0.20, CI=0.05-0.86) respectively less likely to have postpartum Implanon/Nexplanon  insertions done. Continuing users of implant insertions were 45% (AOR=0.55, CI=0.37-0.82) less likely to have post-partum Implanon/Nexplanon insertions done compared to first ever users.Conclusions: There is a high uptake of postpartum Implanon/Nexplanon use among patients who receive implant insertions at the Korle-Bu Teaching Hospital. However immediate postpartum Implanon/Nexplanon insertions are low. There is the need to educate women and couples on the benefits of immediate postpartum implant insertion to avoid rapid repeat pregnancies

Effets des pratiques biopesticides sur l’entomofaune et la production de tomate (Solanum lycopersicum) dans la station expérimentale de l’ISAE (Dakar-Sénégal)

In Senegal, the tomato represents 22.5% of the overall vegetable production estimated at 70,000 tons and is the second most important vegetable crop. However, its production is exposed to many constraints, including the threat of insects. To face the problems posed by these pests, it is necessary to implement effective control methods, capable of reducing the pest population to a tolerable economic threshold. For this reason, this study was conducted in the experimental field of application and incubator of ISAE at UCAD in 2021 in order to test the effectiveness of biological controls on insect pests and tomato yield. A Fisher experimental set-up consisting of three (3) blocks divided into nine (9) plots was installed. The results of this study show that the number of insects is significantly higher (14.7) in untreated plants. On the other hand, the incidence of insects is significantly lower (8.08) with plants treated with Capscicum annum than with plants treated with Azadirachta indica (8.5). Key words: Azadirachta indica, Capscicum annum, incidence, Production, pest, TomatoAu Sénégal, la tomate représente 22,5 % de la production globale de légumes estimée à 710 000 tonnes et occupe la deuxième place des cultures maraichères. Cependant, sa production est exposée à de nombreuses contraintes dont la menace des insectes. Pour faire face aux problèmes posés par ces déprédateurs, il est nécessaire de mettre en œuvre des méthodes de lutte efficaces, capables de réduire la population des ravageurs à un seuil économique tolérable. C’est pour cela que cette étude a été réalisée dans le champ d’expérimentation d’application et incubateur de l’ISAE à l’UCAD en 2021 dans le but de tester l’efficacité des luttes biologiques sur les insectes ravageurs et sur le rendement de la tomate. Un dispositif expérimental de Fisher constitué en trois (3) blocs repartis en neuf (9) placettes a été installé. Les résultats de cette étude montrent que le nombre d’insectes est significativement plus élevé (14,7) sur les plantes non traitées. Par contre, l’incidence des insectes est significativement plus faible (8,08) avec les plantes traitées avec le Capscicum annum qu’avec les plantes traitées à l’Azadirachta indica (8,5). Mots clés : Azadirachta indica, Capscicum annum, incidence, Production, ravageur, Tomat

Household crowding, social mixing patterns and respiratory symptoms in seven countries of the African meningitis belt.

OBJECTIVES: To describe the variation in household crowding and social mixing patterns in the African meningitis belt and to assess any association with self-reported recent respiratory symptoms. METHODS: In 2010, the African Meningococcal Carriage Consortium (MenAfriCar) conducted cross-sectional surveys in urban and rural areas of seven countries. The number of household members, rooms per household, attendance at social gatherings and meeting places were recorded. Associations with self-reported recent respiratory symptoms were analysed by univariate and multivariate regression models. RESULTS: The geometric mean people per room ranged from 1.9 to 2.8 between Ghana and Ethiopia respectively. Attendance at different types of social gatherings was variable by country, ranging from 0.5 to 1.5 per week. Those who attended 3 or more different types of social gatherings a week (frequent mixers) were more likely to be older, male (OR 1.27, p<0.001) and live in urban areas (OR 1.45, p<0.001). Frequent mixing and young age, but not increased household crowding, were associated with higher odds of self-reported respiratory symptoms (aOR 2.2, p<0.001 and OR 2.8, p<0.001 respectively). A limitation is that we did not measure school and workplace attendance. CONCLUSION: There are substantial variations in household crowding and social mixing patterns across the African meningitis belt. This study finds a clear association between age, increased social mixing and respiratory symptoms. It lays the foundation for designing and implementing more detailed studies of social contact patterns in this region

Sociodemographic and clinical characteristics of the first cohort of COVID-19 recoveries at two national treatment centres in Accra, Ghana

Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical features are still evolving, new tests are being developed with inherent challenges regarding interpretation of tests results. There is generally, a gap in knowledge on the virus globally as the pandemic evolves and in Ghana, there is dearth of information and documentation on the clinical characteristics of the virus. With these in mind, we set out to profile the initial cohort of COVID-19 patients who recovered in Ghana. Methods: We reviewed clinical records of all confirmed cases of COVID-19 who had recovered from the two main treatment centres in Accra, Ghana. Descriptive data analysis was employed and presented in simple and relational tables. Independent t-test and ANOVA were used to determine differences in the mean age of the sexes and the number of days taken for the first and second retesting to be done per selected patient characteristics. Results: Of the 146 records reviewed, 54% were male; mean age of patients was 41.9 ± 17.5 years, nearly half were asymptomatic, with 9% being severely ill. The commonest presenting symptoms were cough (22.6%), headache (13%) and sore throat (11%) while the commonest co-morbidities were hypertension (25.3%), diabetes mellitus (14%) and heart disease (3.4%). Conclusion: COVID-19 affected more males than females; nearly half of those infected were asymptomatic. Cough, headache and sore throat were the commonest symptoms and mean duration from case confirmation to full recovery was 19 days. Further research is required as pandemic evolve

Clinical features of COVID-19 in Ghana: symptomatology, illness severity and comorbid non-communicable diseases

Objective: This analysis described the clinical features of COVID-19 in the early phase of the pandemic in Ghana.Methods: Data were extracted from two national COVID-19 treatment centers in Ghana for over 11 weeks(from March to May 2020). Descriptive and inferential statistics were performed. Modified Ordered Logistic and Negative Binomial Regression analysis were applied to establish factors associated with illness severity and Non-communicable Disease (NCDs) counts respectively. All analysis was conducted at the 95% confidence level (p-value ≤ 0.05) using Stata 16.Results: Among the 275 patients, the average age was 40.7±16.4, with a preponderance of males (54.5%). The three commonest symptoms presented were cough (21.3%), headache (15.7%), and sore throat (11.7%). Only 7.6% of the patients had a history of fever. Most patients were asymptomatic (51.65). Approximately 38.9% have an underlying co-morbid NCDs, with Hypertension (32.1%), Diabetes (9.9%), and Asthma (5.2%) being the three commonest. The odds of Moderate/severe (MoS) was significantly higher for those with unknown exposures to similar illness [aOR(95%CI) = 4.27(1.12-10.2)] compared with non-exposure to similar illness. An increased unit of NCD’s count significantly increased the odds of COVID-19 MoS illness by 26%[cOR(95%CI) =1.26(1.09-1.84)] and 67% (adjusting for age) [aOR(95%CI)=1.67(1.13-2.49)].Conclusion: The presence of cardiovascular co-morbidities dictated the frequency of reported symptoms and severity of COVID-19 infection in this sample of Ghanaians. Physicians should be aware of the presence of co-morbid NCDs and prepare to manage effectively among COVID-19 patients

Chest CT features of patients under investigation for Covid-19 pneumonia in a Ghanaian tertiary hospital: a descriptive study

Background: Coronavirus disease 2019 (COVID-19) has since December 2019 become a problem of global concern. Due to the virus’ novelty and high infectivity, early diagnosis is key to curtailing spread. The knowledge and identification of chest Computerized Tomography (CT) features in Patients Under Investigation (PUI) for the disease would help in its management and containment. Objectives: To describe the chest CT findings of PUI for COVID-19 pneumonia referred to the Department of Radiology of the Korle Bu Teaching Hospital; as well as to determine the relationship between symptom onset and severity of the chest CT findings. Methods: The study was retrospective and included 63 PUI for COVID-19 referred to the Department between 11th April, 2020 and 10th June, 2020, for non-enhanced chest CT imaging. Clinical data were obtained from patients’ records and Reverse Transcriptase–Polymerase Chain Reaction (RT-PCR) results were acquired after the CT evaluation. Results: The mean age in years was 51.1±19.9 SD. More males (52.8%) than females (47.2%) tested positive for COVID-19 and the age range for positive cases was 7 months to 86 years, with a mean of 53.2±21 SD years. Common features of COVID-19 pneumonia were bilateral posterior basal consolidations, Ground Glass Opacities (GGO) and air bronchograms. Findings were worse in patients scanned 5–9 days after onset of symptoms. Conclusion: Adequate knowledge of chest CT features of COVID-19 pneumonia, proves a valuable resource in triaging of symptomatic patients and consequent containment of the disease in the hospital setting

Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana

Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors.Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done.Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significantResults: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value&lt; 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher prevalence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia.Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensified to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key

Overview of preparedness and response to COVID-19 in Ghana

The Coronavirus disease 2019 (COVID-19) outbreak in Ghana is part of an ongoing pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The first two cases of COVID-19 were confirmed in Ghana on 12th March 2020. COVID-19 was consequently declared a Public Health Emergency of National Concern, triggering several response actions, including enhanced surveillance, case detection, case management and contact tracing, closure of borders, suspension of international flights, ban on social gatherings and closure of schools. Preparedness and response plans were activated for implementation at the national, regional, district and community levels. Ghana’s Strategic approaches were to limit and stop the importation of cases; detect and contain cases early; expand infrastructure, logistics and capacity to provide quality healthcare for the sick; minimise disruption to social and economic life and increase the domestic capacity of all sectors to deal with existing and future shocks. The health sector strategic frame focused on testing, treatment, and tracking. As of 31st December 2020, a total of 535,168 cases, including 335 deaths (CFR: 0.61%), have been confirmed with 53,928 recoveries and 905 active cases. All the regions have reported cases, with Greater Accra reporting the highest number. The response actions in Ghana have seen highlevel political commitment, appropriate and timely decisions, and a careful balance of public health interventions with economic and socio-cultural dynamics. Efforts are ongoing to intensify non-pharmaceutical interventions, sustain the gains made so far and introduce COVID-19 vaccines to reduce the public health burden of the disease in Ghan

Pathogenic potential and virulence genotypes of intestinal and faecal isolates of porcine post-weaning enteropathogenic Escherichia coli

Enteropathogenic Escherichia coli (EPEC) are frequent causes of diarrhoea in infants and in young mammals by inducing attaching effacing (AE) lesions of the intestinal epithelium. EPEC bacteria have also been implicated in cases of porcine post-weaning diarrhoea but their pathogenicity for conventional weaned pigs remains less elucidated. This present study investigates differences in pathogenic potential and virulence genotypes of intestinal and faecal isolates of EPEC from newly-weaned pigs. For this we inoculated ligated ileal loops of four weeks old weaned pigs to assess EPEC adherence to enterocytes by histology and immunohistology. Virulence gene patterns were identified by using a PCR-microarray. Intestinal EPEC isolates of sero −/intimin types O45:H11:eae-β, O49:NM:eae-β, O84:H7:eae-γ, and O123:H11:eae-β formed adherent microcolonies of EPEC with AE lesions on ileal villi more frequently than faecal isolates of O28:H28:eae-NT, O108:H9:eae-β, O145:H28:eae-γ and O157:H2:eae-β (p ≤ 0.05). The PCR-array analysis of both groups detected all together 25 virulence genes of LEE (Locus of Enterocyte Effacement), and of non-LEE pathogenicity islands, of plasmids and phages characteristic to EPEC. Intestinal isolates carried significantly more virulence genes than faecal isolates (p ≤ 0.05). Intestinal isolates possessed efa1, lpfA, and tsh genes most likely contributing to enterocyte adhesion while faecal isolates did not carry these genes (p ≤ 0.05). Overall, the ileal loop model in weaned pigs combined with virulence genotyping PCR-array indicated a greater pathogenic potential of intestinal isolates over faecal isolates of porcine post-weaning EPEC. Differing virulence genotypes of the intestinal and faecal isolates as demonstrated here suggests dynamic evolutionary events within the population of porcine EPEC. © 2017 Elsevier Lt