Browsing by Author "Ansah, A."
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Item Pregnancy-related mortality in Africa and Asia: Evidence from INDEPTH health and demographic surveillance system sites(Global Health Action, 2014-10) Kim Streatfield, P.; Alam, N.; Compaoré, Y.; Rossier, C.; Soura, A.B.; Bonfoh, B.; Jaeger, F.; Ngoran, E.K.; Utzinger, J.; Gomez, P.; Jasseh, M.; Ansah, A.; Debpuur, C.; Oduro, A.; Addei, S.; Williams, J.; Gyapong, M.; Kukula, V.A.; Bauni, E.; Mochamah, G.; Ndila, C.; Williams, T.N.; Desai, M.; Chihana, M.; Moige, H.Background:Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps. Objective: To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates. Design: Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death. Results: These analyses are based on reports from 14 INDEPTH sites, covering 14,198 deaths amongWRAover 2,595,605 person-years observed. MMRs varied between 128 and 461 per 100,000 live births, while maternal mortality rates ranged from 0.11 to 0.74 per 1,000 person-years. Detailed rates per cause are tabulated, including analyses of direct maternal, indirect maternal, and incidental pregnancy-related deaths across the 14 sites. Conclusions: As expected, these findings confirmed unacceptably high continuing levels of maternal mortality. However, they also demonstrate the effectiveness of INDEPTH sites and of the VA methods applied to arrive at measurements of maternal mortality that are essential for planning effective solutions and monitoring programmatic impacts. © 2014 Cecilia Fernbrant et al.Item Severe falciparum malaria in young children of the Kassena-Nankana district of northern Ghana.(2007) Oduro, A.R.; Koram, K.A.; Rogers, W.; Atuguba, F.; Ansah, P.; Anyorigiya, T.; Ansah, A.; Anto, F.; Mensah, N.; Hodgson, A.; Nkrumah, F.Study design. Severe falciparum malaria in children was studied as part of the characterization of the Kassena-Nankana District Ghana for future malaria vaccine trials. Children aged 6-59 months with diagnosis suggestive of acute disease were characterized using the standard WHO definition for severe malaria. Results. Of the total children screened, 45.2% (868/1921) satisfied the criteria for severe malaria. Estimated incidence of severe malaria was 3.4% (range: 0.4-8.3%) cases per year. The disease incidence was seasonal: 560 cases per year, of which 70.4% occurred during the wet season (June-October). The main manifestations were severe anaemia (36.5%); prolonged or multiple convulsions (21.6%); respiratory distress (24.4%) and cerebral malaria (5.4%). Others were hyperpyrexia (11.1%); hyperparasitaemia (18.5%); hyperlactaemia (33.4%); and hypoglycaemia (3.2%). The frequency of severe anaemia was 39.8% in children of six to 24 months of age and 25.9% in children of 25-60 months of age. More children (8.7%) in the 25-60 months age group had cerebral malaria compared with 4.4% in the 6-24 months age group. The overall case fatality ratio was 3.5%. Cerebral malaria and hyperlactataemia were the significant risk factors associated with death. Severe anaemia, though a major presentation, was not significantly associated with risk of death. Conclusion. Severe malaria is a frequent and seasonal childhood disease in northern Ghana and maybe an adequate endpoint for future malaria vaccine trials. © 2007 Oduro et al; licensee BioMed Central Ltd.