Browsing by Author "Aryee, E."
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Item Factors Affecting Viral Suppression Among HIV Positive Adults On Art At The 37 Military Hospital(University Of Ghana, 2022-02) Aryee, E.Background: HIV has affected more than 38 million globally with more than 25 million living in SSA. There have been interventions to address and end the HIV/AIDS epidemic by 2030, one of which is ART which facilitates viral suppression levels among PLWHAs. It is expected that, 95% of PLWHAs on ART achieve viral suppression by 2030 in order to achieve the goal of ending the AIDS epidemic. Ghana missed the viral suppression target in 2020 and intensified efforts are required to close the gap and achieve the goal by 2030. It is critical to identify factors affecting viral suppression and address bottlenecks to enhance changes of achieving sustained viral suppression in Ghana, which formed the main objective of this study. Methods: A cross-sectional study with retrospective quantitative analysis of ART and viral load data was conducted at the 37 Military Hospital in Ghana. A census of all HIV positive adults initiating treatment from April 1, 2018 to June 30, 2020 was used for the study. Additional data was collected with a structured questionnaire. Chi square test of independence was used to determine the association of independent variable with viral suppression. However, Fisher’s exact P-values were reported for variable with count items less than 5. The exact logistic regression analysis was further used to determine the main factors affecting viral suppression (significant at α=0.05) Results: A total of 257 patients participated in the study. The mean age of respondents was 40 years (±10.7). Sex distribution was 63% females and 37% males. The adherence rate based on the MMAs-8 was 75.5%. From the study, 61.1% of respondents had undetectable levels of viral load whereas 31.1% and 2.3% had viral load of 20-200copies/ml and 201-999copies/ml respectively. The overall rate of viral suppression was 94.6% among HIV positive adults on ART. The factors affecting viral suppression were adherence to ARTs (AOR = 4.83; 95% CI = 1.35, 17.2; p=0.015) and clinic attendance (AOR = 4.83; 95% CI = 1.35, 17.2; p=0.015). Conclusion: Viral suppression rate observed from the 37 Military Hospital was high among HIV positive adults on ART. It is important to strengthen activities that promote adherence to ARTs to sustain viral suppression levels among PLWHA accessing treatment at the hospital.Item A Single Dose Oral Azithromycin versus Intramuscular Benzathine Penicillin for the Treatment of Yaws-A Randomized Non Inferiority Trial in Ghana(Public Library of Science, 2017) Kwakye-Maclean, C.; Agana, N.; Gyapong, J.; Nortey, P.; Adu-Sarkodie, Y.; Aryee, E.; Asiedu, K.; Ballard, R.; Binka, F.Background: Yaws is a treponemal infection that was almost eradicated fifty years ago; however, the disease has re-emerged in a number of countries including Ghana. A single-dose of intramuscular benzathine penicillin has been the mainstay of treatment for yaws. However, intramuscular injections are painful and pose safety and logistical constraints in the poor areas where yaws occurs. A single center randomized control trial (RCT) carried out in Papua New Guinea in 2012 demonstrated the efficacy of a single-dose of oral azithromycin for the treatment of yaws. In this study, we also compared the efficacy of a single oral dose of azithromycin as an alternative to intramuscular benzathine penicillin for the treatment of the disease in another geographic setting. Methodology: We conducted an open-label, randomized non-inferiority trial in three neighboring yaws-endemic districts in Southern Ghana. Children aged 1–15 years with yaws lesions were assigned to receive either 30mg/kg of oral azithromycin or 50,000 units/kg of intramuscular benzathine penicillin. The primary end point was clinical cure rate, defined as a complete or partial resolution of lesions 3 weeks after treatment. The secondary endpoint was serological cure, defined as at least a 4-fold decline in baseline RPR titre 6 months after treatment. Non- inferiority of azithromycin treatment was determined if the upper bound limit of a 2 sided 95% CI was less than 10%. Findings: The mean age of participants was 9.5 years (S.D.3.1, range: 1–15 years), 247(70%) were males. The clinical cure rates were 98.2% (95% CI: 96.2–100) in the azithromycin group and 96.9% (95% CI: 94.1–99.6) in the benzathine penicillin group. The serological cure rates at 6 months were 57.4% (95% CI: 49.9–64.9) in the azithromycin group and 49.1% (95% CI: 41.2–56.9) in the benzathine penicillin group, thus achieving the specified criteria for non-inferiority. Conclusions: A single oral dose of azithromycin, at a dosage of 30mg/kg, was non-inferior to a single dose of intramuscular benzathine penicillin for the treatment of early yaws among Ghanaian patients, and provides additional support for the WHO policy for use of oral azithromycin for the eradication of yaws in resource-poor settings. Trial Registration: Pan African Clinical Trials Registry PACTR2013030005181 http://www.pactr.org/ © 2017 Public Library of Science. All Rights Reserved.Item Surveillance of Bacterial Pathogens of Diarrhoea in Two Selected Sub Metros Within the Accra Metropolis(Ghana Medical Journal, 2015-06) Dzotsi, E.K.; Dongdem, A.Z.; Boateng, G.; Antwi, L.; Owusu-Okyere, G.; Nartey, D.B.; Olu-Taiwo, M.; Adjabeng, M.J.; Amankwa, J.; Sarkodie, B.; Addo, J.; Antwi, E.; Aryee, E.; Opintan, J.A.In recent years, many localities within the Greater Accra Region (GAR) have witnessed several episodes of cholera outbreaks, with some deaths. Compared to previous epidemics, which usually followed heavy rains, recent outbreaks show no seasonality. To investigate infective bacterial diseases in selected sub metros within the GAR. We used existing disease surveillance systems in Ghana, and investigated all reported cases of diarrhoea that met our case-definition. A three-day training workshop was done prior to the start of study, to sensitize prescribers at the Korle-Bu Polyclinic and Maamobi General hospital. A case-based investigation form was completed per patient, and two rectal swabs were taken for culture at the National Public Health and Reference Laboratory. Serotyping and antibiogram profiles of identified bacteria were determined. Potential risk factors were also assessed using a questionnaire. Between January and June 2012, a total of 361 diarrhoeal cases with 5 deaths were recorded. Out of a total of 218 rectal swabs cultured, 71 (32.6%) Vibrio cholerae O1 Ogawa serotypes, and 1 (0.5%) Salmonella (O group B) were laboratory confirmed. No Shigella was isolated. The Vibrio cholerae isolates were susceptible to ciprofloxacin and tetracycline. Greater than 80% of patients reported having drank sachet water 24 h prior to diarrhoea onset, and many (144/361) young adults (20-29 years) reported with diarrhoea. Enhanced surveillance of diarrhoeal diseases (enteric pathogens) within cholera endemic regions, will serve as an early warning signal, and reduce fatalities associated with infective diarrhoea. (PDF) Surveillance of Bacterial Pathogens of Diarrhoea in Two Selected Sub Metros Within the Accra Metropolis. Available from: https://www.researchgate.net/publication/281031544_Surveillance_of_Bacterial_Pathogens_of_Diarrhoea_in_Two_Selected_Sub_Metros_Within_the_Accra_Metropolis [accessed Sep 18 2018].