Research with children: compliance with section 71, South African National Health Act 61 of 2003.

Master of Science in Psychology. University of KwaZulu-Natal, Pietermaritzburg 2017.Abstract available in PDF file

Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana.

OBJECTIVE: This paper describes sexual behaviours and their associated factors among young people. DESIGN: The study design is cross-sectional. SETTING: Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana's Shai-Osudoku and Ningo Prampram districts. PARTICIPANTS: Young people aged 10 to 24 years, median age 17 years. OUTCOME MEASURES: Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant. RESULTS: Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures. CONCLUSION: Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required. FUNDING: No funding was obtained for this paper

Neglected Tropical Diseases as a ‘litmus test’ for Universal Health Coverage? Understanding who is left behind and why in Mass Drug Administration: Lessons from four country contexts

Individuals and communities affected by NTDs are often the poorest and most marginalised; ensuring a gender and equity lens is centre stage will be critical for the NTD community to reach elimination goals and inform Universal Health Coverage (UHC). NTDs amenable to preventive chemotherapy have been described as a ‘litmus test’ for UHC due to the high mass drug administration (MDA) coverage rates needed to be effective and their model of community engagement. However, until now highly aggregated coverage data may have masked inequities in availability, accessibility and acceptability of medicines, slowing down the equitable achievement of elimination goals

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Financial costs and benefits of investing in domesticated “Sonkyi” (Allanblackia spp) in the forest region of Southern Ghana

The integration of “Sonkyi” Allanblackia spp into cocoa farming systems has been initiated in Southern Ghana. Currently, it is a collection activity although its domestication is being championed by Unilever R&D Netherlands in collaboration with the Forestry Research Institute of Ghana. Feasibility studies suggest that the venture is viable for farmers if the financial support assurances by Uniliver would be sustained. It is important to assess the feasibility of ‘no support’ so that those private sector entrepreneurs who want to venture into this activity would understand the real cost and return issues. This paper presents the results of a financial cost-benefit appraisal of AB investment in the Western Region of Ghana. Using alternate viability measures, i.e. Net Present Value (NPV), Benefit-cost ratio (BCR) and Internal Rate of Return (IRR) the results show that the benefits to be derived from the AB investment are quite high; the IRRs range from 26% to 40%. The findings of the study suggest that AB production is a financially viable investment; the only challenge will be how to sustain the sole buyer demand and adequate prices

A major hurdle in the elimination of urogenital schistosomiasis revealed: Identifying key gaps in knowledge and understanding of female genital schistosomiasis within communities and local health workers.

BackgroundUrogenital schistosomiasis is endemic throughout Ghana with elevated infection levels in certain areas e.g. Lake Volta Region. While the primary focus of the national control program is on mass drug administration of praziquantel to school-aged children, Female Genital Schistosomiasis (FGS), a disease-specific affliction of girls and women, has been largely overlooked. To better focus future actions, our study investigated the perceptions, knowledge and understanding of FGS amongst community members and health providers.Method/principal findingsWe used qualitative methods including 12 focus group discussions and 34 in-depth interviews. We purposively selected 16 communities along the Lake Volta in the Shai-Osudoku District. Participant selection was based on gender, age and occupation; providing an opportunity to explore community understanding of FGS through participants own words and perceptions. Awareness of schistosomiasis was reported and is commonly experienced among children (12-17 years) and younger adults (18-25 years) in the study communities but is typically considered a boy's disease. Knowledge of FGS was lacking in women, girls and front-line health workers. There was a general misconception that FGS may be the result of sexual promiscuity. Adolescent girls reporting vaginal discharge and itching were often stigmatized by health workers and treated for sexually transmitted infections. Limited alternatives to the river as key source of water meant that all members of the community faced the regular risk of schistosomiasis.Conclusion/significanceThere is a clear imperative for the national control program to better engage on FGS and implement interventions to meet girls and women's needs. The key consideration is to integrate more adequately preventive services with sexual and reproductive primary health care with future training of health workers for improved management of FGS cases. More broadly, harmonizing the portfolio of all actions on FGS is needed, especially with a call for improved access to safe water and sanitation for all those at current or future risk

Using photovoice to inform and support health systems to reach marginalised populations: experiences from six low- and middle-income countries

Photovoice methodology centralizes the voices of marginalised populations within health systems using photography and critical dialogue to record, reflect and communicate community health issues. This paper presents findings from applying photovoice to explore and document the lived experiences of groups of marginalised populations in six low- and middle-income countries: Cambodia, Ghana, Nepal, Sierra Leone, Uganda and Zambia. The strengths of using photovoice included: creating safe spaces for communication; community solidarity and stakeholder engagement; community ownership of actions and advocacy; developing new soft skills and confidence; capturing hidden community challenges; and taking collective action. Suggestions for use in future photovoice studies include: providing space for the exploration of contextual factors before implementation; developing a capacity strengthening plan to ensure participants have the competencies required to effectively take part in research and dissemination; considering the use of non-visual methods alongside photovoice when needed; and having in place partnership structures between researchers and participants that facilitate power sharing, agency, empowerment and joint decision making. Lastly, we present recommendations that have the potential to strengthen the value and use of photovoice as more than a participatory method but also a vehicle for individual, relational and health systems improvements

African Genomic Medicine Training Initiative (AGMT)

The aim of this Professional Development Course was to provide genomics and genetics education to Nurses, Medical Doctors and Pathologists/Medical Laboratory Scientists & Technicians based in Africa. This course was provided free of charge - there was no cost associated with hosting a classroom for AGMT_2022. Further, attendance for participants and volunteer staff must be completely free-of-charge. If classrooms have running costs, they need to find alternate ways to cover these costs.  AGMT was launched in May 2016, in Senegal, by a group of stakeholders from the H3Africa Consortium and the AfSHG. AGMT course has successfully delivered a genomic medicine course to Nurses in 2017 and 2019. The 2022 iteration will deliver a genomic medicine course not only to Nurses but to Medical Doctors, Pathologists/Medical Laboratory Scientists and Technicians. There is a continuous need for genomic medicine across Africa from various health professionals. AGMT is working towards meeting this demand and accommodating different health professionals in addition to the group that it is currently accommodating.  The 1st AGMT iteration was run in 2017 with 19 classrooms in 11 countries, 1 online class, 225 students registered! The 2nd iteration was run in 2019 with 22 classrooms in 13 countries, 1 online class, 294 students registered. The 3rd iteration was run in 2022 with 24 classrooms (1 face-to-face, 3 blended and 20 online) in 11 countries and more than 800 participants with 261 students officially passing the course.</p