Family and community support systems for expectant mothers on birth preparedness in Northern Ghana

Background: While maternal mortality ratio in under-developed countries has declined significantly since 1990, much work still needs to be done in addressing inequities to accessing maternal health services by poor, vulnerable and marginalized women. In an effort to improve maternal and newborn health (MNH) services, Community Support System (CmSS) is an approach for community involvement and ownership. The objective of the study includes, this study specifically examined support systems on birth preparedness among expectant mothers attending antenatal clinic at Tamale Teaching Hospital.Methods: A facility-based cross-sectional study was conducted from February, 2016 to April, 2016 among mothers who attended antenatal care at Tamale Teaching Hospital, Ghana. A systematic random sampling technique was used to select pregnant women for the study. Using structured questionnaires, the women were assessed on the availability of community support systems during pregnancy and childbirth. Data quality was ensured via crosschecks and double entry into the Statistical Package for Social Sciences (SPSS) software version 20.01 for analysis. Data were summarized and described using frequency tables. At the 95% confidence interval, a p-value less than 0.05 was statistically significant.Results: About 74.2% of respondents lacked husbands` company to antenatal clinic and 88.4% received no support from community leadership.Conclusions: Based on these findings, it is recommended that an emergency response system at the community level to provide emergency funds, transport, and blood donors be put in place and made known to the public

Neonatal Sepsis in Rural Ghana: A Case Control Study of Risk Factors in a Birth Cohort

Neonatal sepsis poses a major challenge to achieving the MDG-4 due to lack of facilities to implement proposed management guidelines. Identifying risk factors of neonatal sepsis will help put strategies in place to prevent sepsis. This prospective case control study investigated risk factors of neonatal sepsis in the Asutifi District a typical rural setting of the Brong Ahafo Region of Ghana. A semi-structured check list was used to collect clinical and demographic data from 196 neonates (96 with sepsis as case and 100 without sepsis as control) and respective mothers. Maternal factors that were significantly associated with neonatal sepsis were foul smelling liquor (p=0.001), meconium stained amniotic fluid (p= 0.000), parity (p=0.000), history of UTI/STI (p=0.002) and maternal age (0.017). Neonatal factors that were significantly associated with sepsis include male sex (p=0.040), preterm (p=0.000), not crying immediately after birth (p=0.001), low birth weight \u3c2500g \u3e(p=0.000), APGAR score less than 7 (p=0.000) and resuscitation at birth (p=0.004). Priority attention must be given to neonates and mothers with the aforementioned characteristics during antenatal and postnatal care to prevent sepsis

Schistosoma haematobium co-infection with soil-transmitted helminthes: prevalence and risk factors from two communities in the central region of Ghana

Background: Schistosoma haematobium co-infection with S. mansoni and  soil-transmitted helminthes afflict most-at-risk populations in endemic communities in the developing world. Aim: This study investigated S. haematobium co-infection with soil-transmitted helminthes, and host risk factors in two communities in the central region of Ghana. Methods: Schools and children were selected by stratified cluster and random sampling methods respectively. A total of 250 school children (aged 5 - > 20 years) were recruited. Teachers issued questionnaires to obtain information on host risk factors, water-contact activities and knowledge of S.  haematobium infection. Urine and stool samples were examined for S. haematobium infection and S. mansoni and soil-transmitted helminthes using sedimentation quantitative and direct smear/formol-ether sedimentation concentration techniques respectively.Results: S. haematobium infection (1 - 50 eggs/10 ml urine)  prevalence at Apewosika and Putubiw were 27.5 % and 17 % respectively. Males were more at risk of S. haematobium infection than females. S. haematobium co-infection with soil-transmitted helminthes (A. lumbricoides, E. histolytica, and T. trichuria) was recorded in Putubiw, with females more at risk than males. Children aged 16-19 and 10-15 were more at risk of S. haematobium infection and  helminthic co-infection respectively. Haematuria and proteinuria were predictive of S. haematobium infection. School children had poor knowledge of S. haematobium infection. Water-contact activity was common.Conclusion: S. haematobium prevalence and its co-infection with soil-transmitted helminthes were common in Putubiw. Watercontact activity and poor knowledge about S. haematobium infection were major risk factors. Increased education on preventive and control measures especially in schools is recommended.Key words: Haematuria, proteinuria, Schistosoma haematobium, S. mansoni, helminthes, Bulinus globosu

Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana

Aims: The aims of this study were: 1) to assess the level of knowledge of women about Pap smear tests, 2) to determine the practices of women regarding Pap smear tests, and 3) to determine the barriers to Pap smear tests in Elmina, Ghana. Methods: A cross-sectional study was conducted with 392 randomly selected sexually active females aged 10–74 years using structured interview questions. The Institutional Review Board of the University of Cape Coast gave ethical approval for the study and informed consent was obtained from participants. Data were analyzed with SPSS software (v19.0) using frequencies, chi-square test, and exploratory factor analysis. Results: The results revealed that 68.4% had never heard about cervical cancer, 93.6% had no knowledge on the risk factors, nine (2.3%) reported multiple sexual partners and being sexually active as risk factors, and 92% did not know about the prevention and treatment of cervical cancer. The majority (97.7%) had never heard of the Pap smear test. Only three (0.8%) women out of 392 had had a Pap smear test. Reasons for seeking a Pap smear test included referral, fear of cervical cancer, and radio campaigns. A significant association was found between institutional and personal barriers and having a Pap smear test. Conclusion: Comprehensive education on cervical cancer screening and removal of access barriers are critical in reducing risk associated with the disease and promoting women\u27s health

Chlamydia trachomatis infection and maternal outcomes in Southern Ghana

Background: Despite the fact that Chlamydia trachomatis (CT) infection in pregnancy is known to have grave impact on maternal and neonatal health, routine CT screening in pregnancy is not available in Ghana The main aim of this study was to determine the prevalence and adverse maternal outcomes of CT infection among pregnant women attending antennal clinic at the Cape Coast Teaching Hospital.Methods: Two hundred and thirty two (232) pregnant women screened for CT infection by PCR were purposively selected and enrolled into the study after informed consent had been obtained. They included one hundred and twelve (112) participants with positive CT (cases) and 120 participants without CT infections (control). A structured questionnaire was used to collect their socio demographic, obstetric and medical history. They were monitored thereafter and data on maternal outcomes were collected.Results: The prevalence of CT infection was 5.6% (112/2014). A history of STI/UTI (p<0.001) spontaneous abortion (p=0.02), preterm labour (p<0.001) and intrapartum or postpartum fever (p<0.001) were found to be associated with CT infection. However a history of Stillbirth, PID and having been treated for infertility were not associated with CT infection. Participants with CT infection were more likely to have PROM (p<0.001) and FSL (p<0.001) than those who were not infected. Parity and mode of delivery on the other hand were not associated with CT infection.Conclusions: To alleviate the adverse maternal outcomes, screening for CT infection in pregnancy should be offered routinely to pregnant women to promote early detection and treatment.  

HIV diagnosis disclosure to infected children and adolescents; challenges of family caregivers in the Central Region of Ghana

Background Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about the child’s HIV status should be shared with him/her and how to go about it. The aim of the study was to identify family caregiver factors associated with non-disclosure of HIV status to infected children and adolescents accessing Antiretroviral Therapy (ART) at the three main ART sites within the Central Region of Ghana. Methods A quantitative analytical survey was conducted among 103 family caregivers of HIV infected children (aged 6–17 years) assessing ART services in the Central Region of Ghana. Data were analyzed using SSPS version 21. Results The age range of caregivers was 20–69 years. The study found a low disclosure rate (23.3%) among caregivers. Majority of the caregivers (80.6%) lacked knowledge on the process of disclosure (how and what to tell child), and majority (64%) also had never received guidance about the disclosure process from their healthcare providers. The main barriers to disclosure were caregiver lack of knowledge regarding the disclosure process and when to disclose, the fear of child’s reaction, and fear of stigmatization and associated negative social consequences. Conclusion These findings suggest a lesser involvement of health care providers in preparing caregivers for the disclosure process. This therefore highlight the need for the National HIV/AIDS/STI Control Program to strengthen the involvement and training of healthcare providers in HIV diagnosis disclosure to infected children, based on context-specific policy guidelines informed by the WHO recommendations

Effects of Chronic Hepatitis B Infection on Pregnancy and Birth Outcomes in Ghana

Ghana is a known endemic area for hepatitis B virus (HBV) infections, yet the consequences of HBV infection on pregnancy outcomes are unknown. This prospective cohort study was thus conducted among 512 pregnant women attending antenatal clinic in the Cape Coast Teaching Hospital, Ghana, between January, 2011 and December, 2013 to determine the effects of hepatitis B during pregnancy on birth outcomes in Ghana. The HBsAg status of all pregnant women was determined by the latex agglutination test while a researcher administered semi-structured checklist was used to collect demographic/obstetric/medical data of respondents. We obtained 262 HBsAg positive and 250 HBsAg negative women most of whom were aged 20-29 (40%), classified themselves as low income earners (50%), and had attained primary education (42%). Logistic regression analysis showed that pregnant women who had chronic hepatitis B were more likely to develop PROM (p=0.008) and foul smelling liquor (p=0.024) at delivery. Moreover, neonatal consequences for chronic hepatitis B were; preterm babies (p=0.002), underweight (p\u3c0.001), Apgar score lower than 7 (p\u3c0.001), asphyxia at birth (p=0.006) and still birth (p=0.04). We conclude that babies born to mothers with positive HBsAg status have a higher risk for vertical transmission as well as adverse neonatal consequences

Family and community support systems for expectant mothers on birth preparedness in Northern Ghana

Background: While maternal mortality ratio in under-developed countries has declined significantly since 1990, much work still needs to be done in addressing inequities to accessing maternal health services by poor, vulnerable and marginalized women. In an effort to improve maternal and newborn health (MNH) services, Community Support System (CmSS) is an approach for community involvement and ownership. The objective of the study includes, this study specifically examined support systems on birth preparedness among expectant mothers attending antenatal clinic at Tamale Teaching Hospital.Methods: A facility-based cross-sectional study was conducted from February, 2016 to April, 2016 among mothers who attended antenatal care at Tamale Teaching Hospital, Ghana. A systematic random sampling technique was used to select pregnant women for the study. Using structured questionnaires, the women were assessed on the availability of community support systems during pregnancy and childbirth. Data quality was ensured via crosschecks and double entry into the Statistical Package for Social Sciences (SPSS) software version 20.01 for analysis. Data were summarized and described using frequency tables. At the 95% confidence interval, a p-value less than 0.05 was statistically significant.Results: About 74.2% of respondents lacked husbands` company to antenatal clinic and 88.4% received no support from community leadership.Conclusions: Based on these findings, it is recommended that an emergency response system at the community level to provide emergency funds, transport, and blood donors be put in place and made known to the public

Levels of serum alanine/aspartate aminotransferase and urea in apparently healthy rural community in Ghana: A case study in Sabin-Akrofrom and Trede in the Ashanti region

Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and urea levels were assessed in 27 males (mean age 32.33 yrs) and in 34 females (mean age 27.85yrs) Ghanaian rural dwellers to determine the functional status of their liver (ALT/AST) and kidney (Urea). No significant (P&ge;0.05) differences were observed between the sexes in all the assessed parameters. Mean values of 28.92 U/L, 31.64 U/L, 9.04 mmol/L for males and 30.09 U/L, 33.92 U/L, 8.72 mmol/L for females were obtained respectively for ALT, AST and Urea. The serum levels of ALT, AST and AST to ALT ratio indicated that both groups had normal functioning liver but theurea levels for both sexes appear to suggest renal impairment. Further investigations are needed to establish the underlying pathology

Chlamydia trachomatis infection and maternal outcomes in Southern Ghana

Background: Despite the fact that Chlamydia trachomatis (CT) infection in pregnancy is known to have grave impact on maternal and neonatal health, routine CT screening in pregnancy is not available in Ghana The main aim of this study was to determine the prevalence and adverse maternal outcomes of CT infection among pregnant women attending antennal clinic at the Cape Coast Teaching Hospital.Methods: Two hundred and thirty two (232) pregnant women screened for CT infection by PCR were purposively selected and enrolled into the study after informed consent had been obtained. They included one hundred and twelve (112) participants with positive CT (cases) and 120 participants without CT infections (control). A structured questionnaire was used to collect their socio demographic, obstetric and medical history. They were monitored thereafter and data on maternal outcomes were collected.Results: The prevalence of CT infection was 5.6% (112/2014). A history of STI/UTI (p&lt;0.001) spontaneous abortion (p=0.02), preterm labour (p&lt;0.001) and intrapartum or postpartum fever (p&lt;0.001) were found to be associated with CT infection. However a history of Stillbirth, PID and having been treated for infertility were not associated with CT infection. Participants with CT infection were more likely to have PROM (p&lt;0.001) and FSL (p&lt;0.001) than those who were not infected. Parity and mode of delivery on the other hand were not associated with CT infection.Conclusions: To alleviate the adverse maternal outcomes, screening for CT infection in pregnancy should be offered routinely to pregnant women to promote early detection and treatment.