Browsing by Author "Bandoh, D.A."

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Adverse drug reaction reporting by community pharmacists in the Greater Accra Region of Ghana, 2016
(Ghana Med J, 2021) Osei, J.Y.; Nortey, P.A.; Bandoh, D.A.; Kenu, E.; Addo-lartey, A.A.
Objectives: To assess adverse drug reactions (ADRs) reporting and identify factors to improve ADR reporting among community pharmacists in the Greater Accra Region of Ghana. Design: A quantitative cross-sectional study. Setting: Community pharmacies in the Greater Accra Region of Ghana. Participants: We randomly selected 210 pharmacists from a list community of pharmacies in Accra, Ghana. All participants had been practicing in the past one year, with this study being conducted from June to July 2016. Main outcome measure: Prevalence of ADR reporting by community pharmacists in Accra, Ghana. Results: Of the 210 community pharmacists interviewed 54.0% were males. Mean age was 32±10 years. Majority (96.0%) had heard of ADR reporting in Ghana, yet 18% had never seen the ADR reporting form. Reasons given for failure to report suspected ADRs included unavailability of reporting forms (83.1%), uncertainty about a causal rela tionship between the drug and the suspected ADR and classification of the reaction as “normal” with the medication being taken (23.6%). Only 34.0% of pharmacists had the ADR reporting forms available in their facilities. Marital status was the only factor significantly associated with ADR reporting (OR 3.18, 95%CI 1.02 – 9.12). Conclusion: ADR reporting by community pharmacists in Ghana remains low. To improve the proportion of report ing, ADR forms should be made available in all pharmacies, pharmacists and the general public should be made aware of online reporting systems, with continuous professional development in Pharmacovigilance with the advice that all suspected ADRs should be reported irrespective of uncertainty about causality
Community acceptance of COVID-19 and demystifying stigma in a severely affected population in Ghana
(Ghana Med j, 2021) Bandoh, D.A.; Baidoo, A.; Noora, C.L.; Quartey, S.; Frimpong, J.A.; Kenu, E.
Objective: We assessed the level of community acceptance of COVID-19, identified and implemented strategies to demystifying stigma in a severely affected population in Tema. Design and Setting: We conducted a cross-sectional study to assess stigma among the Tema community, then iden tified and implemented interventions to demystify COVID-19 stigma. We interviewed positive cases, their contacts, contact tracers, case management team members, and community members who shared their first hand experiences and knowledge on the current pandemic. Intervention: Based on the information received, we came up with ways of reducing stigma and implemented them in their community. Main Outcome: Stigma demystified Results: Cases and contacts reported being avoided, discriminated against, insulted or had derogatory words used on them by family, friends, work colleagues or the community. Cases and their contacts stated that stigmatisation was fueled by the presence of COVID -19 branded vehicles and security officials at their homes or workplaces. Stakeholder engagement, education and extensive sensitisation of community members were implemented to reduce stigma. Conclusion: We observed deeply entrenched stigma to COVID - 19 positive patients and their contacts in the com munity. Health care response mechanisms such as the presence of security personnel with contact tracers and case managers and the use of COVID -19 branded vehicles fueled stigma. A multifaceted approach through the engagement of key stakeholders, training of health workers and extensive education and community sensitisation was essential in reducing stigma.
Emergency response time and pre-hospital trauma survival rate of the national ambulance service, Greater Accra (January – December 2014)
(BMC Emergency Medicine, 2018-10) Mahama, M.N.; Kenu, E.; Bandoh, D.A.; Zakariah, A.N.
Background Every year, about 1.2 million people die through road traffic crashes worldwide. Majority of these deaths occur in Africa where most of their emergency medical services are underdeveloped. In 2004, Ghana established the National Ambulance Council to provide timely and efficient pre-hospital emergency medical care to the sick and injured. Pre-hospital emergency medical service is essential for accident victims since it has the potential of saving lives. The study sought to determine the relationship between pre-hospital trauma survival rate and response time to emergencies and factors associated to pre-hospital trauma survival in Accra, Ghana. Methods The study was a cross sectional study which reviewed pre-hospital care forms of trauma patients from the fourteen ambulance stations in the Greater Accra region from January to December 2014. Data were extracted from these forms and the response time estimated. Conscious patients who were alert were categorized as responsive under the AVPU scale. The proportion of patients who survived pre-hospital trauma and the time pre-hospital trauma cases were responded to was estimated. Multiple logistic regression analysis was conducted to determine which variables were associated with survival. Results A total of 652 pre-hospital care forms were reviewed. About 87% survived pre-hospital trauma. The average response time to patients was (16.9 ± 0.7) minutes and the median transportation time of the patient was 82 min. Level of consciousness of a patient and response time of patients transported was found to be significantly associated with pre-hospital trauma survival. Conclusion There was a high trauma patient survival rate among victims attended to by an NAS. The average response time in Greater Accra region in the 14 ambulance stations is 16.9 min which is not different from the 17 min recorded in 2013 by NAS. Factors that were associated with pre-hospital survival were alertness in the level of consciousness and response time less than 17 min.
Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014
(BioMed Central Ltd., 2017) Ohene-Adjei, K.; Kenu, E.; Bandoh, D.A.; Addo, P.N.O.; Noora, C.L.; Nortey, P.A.; Afari, E.A.
Background: Cholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked. Methods: We carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission. Results: Up to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis. Conclusions: The 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.
Factors that promote and sustain the use of traditional, complementary and integrative medicine services at LEKMA hospital, Ghana, 2017: an observational study
(BMC Complementary Medicine and Therapies, 2021) Kenu, A.; Kenu, E.; Bandoh, D.A.; Aikins, M.
Background: About 70% of Ghanaians depend on traditional, complementary and integrative medicine (TCIM) practices for primary healthcare needs. It was therefore integrated into mainstream healthcare delivery system by the Ministry of Health in September 2012. LEKMA hospital was one of the institutions for piloting TCIM services. We assessed factors that promote the usage and sustainability of TCIM services within the formal healthcare system. Methods: We conducted a cross-sectional study from April–June 2017 at the LEKMA hospital, Accra, Ghana. Patients and managers of TCIM clinic were interviewed. Data was collected through qualitative and quantitative approaches. We defined usage of TCIM as its current use, and sustainability as structures in place to run TCIM services. For assessing usage, a five-point Likert scale was used to assess five domain areas via exit interviews. Managers were assessed on the sustainability of TCIM services through in-depth interviews. Likert scales responses were analysed quantitatively using descriptive tertile statistics. Thematic analysis was used for qualitative analysis. Results: Overall, 72.7% (40/55) of the clients showed a high preference for TCIM usage and 80.0% (4/5) of the managers valued it as partially sustainable. Eighty per cent (44/55) of patients indicated that the location of TCIM services and availability of visible directional signs influenced the good usage; 84% (46/55) of the patients agreed that the usage of TCIM was influenced by their perceived effectiveness. Managers indicated that human resources for providing services was a challenge and TCIM integration into the operations of the hospital needed to be improved.Conclusion: We observed a high preference for usage of TCIM among users at LEKMA hospital. The general belief in the potency, perceived effectiveness, location and availability of TCIM services are key determinants of the high preference for usage of TCIM. Provision of TCIM services in its current form is partially sustainable from the managers’ perspective. We recommend that the Ministry of Health ensures the availability of staff and create awareness of TCIM services among the general populace.
Factors that promote and sustain the use of traditional, complementary and integrative medicine services at LEKMA hospital, Ghana, 2017: an observational study
(BMC Complementary Medicine and Therapies, 2021) Kenu, A.; Kenu, E.; Bandoh, D.A.; Aikins, M.
Background: About 70% of Ghanaians depend on traditional, complementary and integrative medicine (TCIM) practices for primary healthcare needs. It was therefore integrated into mainstream healthcare delivery system by the Ministry of Health in September 2012. LEKMA hospital was one of the institutions for piloting TCIM services. We assessed factors that promote the usage and sustainability of TCIM services within the formal healthcare system. Methods: We conducted a cross-sectional study from April–June 2017 at the LEKMA hospital, Accra, Ghana. Patients and managers of TCIM clinic were interviewed. Data was collected through qualitative and quantitative approaches. We defined usage of TCIM as its current use, and sustainability as structures in place to run TCIM services. For assessing usage, a five-point Likert scale was used to assess five domain areas via exit interviews. Managers were assessed on the sustainability of TCIM services through in-depth interviews. Likert scales responses were analysed quantitatively using descriptive tertile statistics. Thematic analysis was used for qualitative analysis. Results: Overall, 72.7% (40/55) of the clients showed a high preference for TCIM usage and 80.0% (4/5) of the managers valued it as partially sustainable. Eighty per cent (44/55) of patients indicated that the location of TCIM services and availability of visible directional signs influenced the good usage; 84% (46/55) of the patients agreed that the usage of TCIM was influenced by their perceived effectiveness. Managers indicated that human resources for providing services was a challenge and TCIM integration into the operations of the hospital needed to be improved. Conclusion: We observed a high preference for usage of TCIM among users at LEKMA hospital. The general belief in the potency, perceived effectiveness, location and availability of TCIM services are key determinants of the high preference for usage of TCIM. Provision of TCIM services in its current form is partially sustainable from the managers’ perspective. We recommend that the Ministry of Health ensures the availability of staff and create awareness of TCIM services among the general populace.
Integration of multiple geospatial applications and intelligence for responding to COVID-19 in Ghana
(Ghana Med j, 2021) Owusu, A.B.; Afagbedzi, S.K.; Bandoh, D.A.; Frimpong, J.A.; Kissiedu, I.N.; Aikins, B.E.; Hinneh, R.; Kenu, E.
Objective: We describe the use of integrated geospatial applications for the provision of access to timely and accurate data on samples, visualisation of Spatio-temporal patterns of cases and effective communication between field sample collectors, testing laboratories, Regional Health directors and Government Decision Makers. Design: This study describes how an integrated geospatial platform based on case location and intelligence was de veloped and used for effective COVID-19 response during the initial stages of COVID-19 in Ghana. Data Source: Collector for ArcGIS, ArcGIS Survey123 Main outcome measure: successful development and deployment of integrated geospatial applications and analytics. Results: The Collector for ArcGIS app was customised to collect COVID-19 positive cases location information. Survey 123 was introduced as a COVID-19 contact tracing application to digitise the case-based forms and provide real-time results from the laboratories to GHS and other stakeholders. The laboratory backend allowed the testing laboratories access to specific information about each patient (sample) collected by the fieldworkers. The regional supervisors’ backend web application provided accessing test results for confidentiality and timely communication of results. Conclusion: Geospatial platforms were successfully established in Ghana to provide timely results to Regional Health Directors and Government decision-makers. This helped to improve the timeliness of response and contact tracing at the district level.
Obstetric determinants of preterm delivery in a regional hospital, Accra, Ghana 2016
(BMC Pregnancy and Childbirth, 2019-07-08) Aseidu, E.K.; Bandoh, D.A.; Ameme, D.K.; Nortey, P.; Akweongo, P.; Sackey, S.O.; Afari, E.; Nyarko, K.M.; Kenu, E.
Background: Globally, prematurity is a major determinant of morbidity and mortality contributing 30–40% of neonatal mortality. The consequences of preterm deliveries are enormous with developmental and childhood complications as well as high economic and psycho-social burden on the parents (family) and society. Some risk factors include ever having preterm delivery, multiple births and some medical conditions like sexually transmitted infection and urinary tract infections but these have not been ascertained in our study area. Much research into these risk factors is needed in Ghana. We assessed the obstetric determinants of preterm delivery. Methods: We conducted a 1:2 unmatched case-control study in Greater Accra Regional Hospital (GARH) -Ridge, a secondary referral facility in Accra, Ghana (from October, 2015 -May, 2016). A case was a mother who delivered between 28 and 36 weeks of gestation (preterm) and a control was a mother who delivered after 37 to 42 completed weeks (term). We used structured questionnaire to collect data, reviewed maternal and foetal records using a checklist. Categorical variables were analysed and expressed as frequencies and proportions. We determined the association between obstetric factors and preterm delivery with multiple logistic regression. Significance level of the strength of association was determined at 95% CI and p-value < 0.05. Results: We recruited 390 mothers, 130 had preterm deliveries (cases) and 260 had term deliveries (controls). Experiencing premature rupture of membrane (aOR: 2.3; 95% CI:1.0–5.5), pre-eclampsia/eclampsia (aOR: 3.4; 95% CI: 1.0–11.9) were found to be associated with preterm delivery. However, four or more ANC visit was protective factor for preterm delivery (aOR: 0.2; 95% CI: 0.1–0.4). Conclusion: Premature rupture of membrane, hypertensive complications and antepartum haemorrhage were found to be risk factors associated with preterm delivery in Ridge Hospital. Health workforce providing ANC services need to identify risk factors and refer these mothers to the doctor for early management and improved outcome decreasing preterm delivery.
Self-Medication With Antibiotics Among Out-Patient Attendants At Madina Polyclinic Prior To Medical Consultation
(Ghana Medical Journal, 2023) Asante, A.A.; Bandoh, D.A.; Kenu, E.
Objectives: The study aimed to determine the prevalence of self-medication with antibiotics among attendants of the Out-patient Department (OPD) at Madina Polyclinic before seeking medical consultation and associated factors. Design: Cross-sectional study Setting: The study was conducted at Madina Polyclinic Participants: The study involved 319 general OPD attendants aged 18 years and older accessing healthcare services at the Madina Polyclinic between May and June 2019. Main outcome measures: The prevalence of antibiotic self-medication and the factors associated with this practice Results: From the study, 46.4% (95% CI 40.8%–52.0%) had self-medicated with antibiotics before presenting for medical consultation at the hospital. Less than half of the respondents (44.5%) had adequate knowledge about the use of of antibiotics. Having a tertiary level of education was significantly associated with self-medication (aOR= 8.09, 95% CI 2.31-28.4, p = 0.001), whilst adequate knowledge on the use of antibiotics reduced the odds of self-medication by 53% (aOR = 0.47, 95% CI = 0.23–0.66, p<0.001). The level of education modified the relationship between knowledge and and self-medication with antibiotics. Conclusion: The practice of antibiotic self-medication is rife among OPD attendants. Therefore, adequate public Education on the use of antibiotics and the effects of using them inappropriately must be done. The Antimicrobial Resistance (AMR) policy ought to be reinforced and made known to all, especially among the pharmacies that dispense antibiotics indiscriminately.
Socio-economic determinants of maternal health care utilization in Kailahun District, Sierra Leone, 2020
(BMC, 2022) Kangbai, D.M.; Bandoh, D.A.; Manu, A.; Kangbai, J.Y.; Kenu, E.; Addo‑Lartey, A.
Background: Ascertaining the key determinants of maternal healthcare service utilization and their relative importance is critical to priority setting in policy development. Sierra Leone has one of the world’s highest maternal death ratios in the context of a weak health system. The objectives of this study were to determine; the level of utilization of Antenatal Care (ANC), Skilled Delivery Attendants (SDA), Postnatal Care (PNC) services, and factors that influence the utilization of these services. Methods: We conducted a community-based cross-sectional study involving 554 women of reproductive age (15–49 years) who had at least one delivery in the last 3 years and lived in the Kailahun District, Sierra Leone from November 2019 to October 2020. Data were analysed using analysed using bivariate, multivariate and multinomial logistic regression models. Results: The median age of respondents was 25 years (Q1 = 17 years, Q3 = 30 years). Eighty-nine percent (89%) had 4 or more ANC visits. Only 35.9% of women were delivered by SDA. Women residing in urban areas had over six-fold increased odds of utilizing SDA as compared to women residing in rural areas (AOR = 6.20, 95% CI = 3.61–10.63). Women whose husbands had a primary level of education had 2.38 times increased odds of utilizing SDA than women whose husbands had no education (AOR = 2.38, 95% CI = 1.30–4.35). Women that walked longer distances (30–60 min) to seek healthcare had 2.98 times increased odds of utilizing SBA than those that walked shorter distances (< 30 min) (AOR = 2.98, 95% CI = 1.67–5.33). Women who had a secondary/vocational level of education had 2.35 times increased odds of utilizing the standard PNC category as compared to those with no education (OR = 2.35, 95% CI = 1.19–4.63). Conclusion: The majority of women had 4 or more ANC visits yet the use of skilled birth attendants was low. Urban residence and education were significantly associated with the use of the standard PNC category. To improve the utilization of maternal health care services, national healthcare policies should target the advancement of education, train skilled Maternal Healthcare (MHC) attendants, rural infrastructure, and the empowerment of women.
Sustainability of a field epidemiology and laboratory training programme: The ghanaian story
(The Pan African Medical Journal, 2019-05-29) Bandoh, D.A.; Kenu, E.; Ameme, D.K.; Sackey, S.O.; Wurapa, F.; Afari, E.A.
Introduction: Field Epidemiology Training Programmes (FETPs) are functional ways of strengthening epidemiology, surveillance and outbreak response capacity in countries. However, sustainability of FETPs is a major challenge facing most countries especially in Africa. The Ghana Field Epidemiology and Laboratory Training Program (GFELTP) started in 2007 in the University of Ghana School of Public Health as a solution to gaps in the public health workforce. This paper assessed the sustainability strategies embedded in the Ghana Field Epidemiology and Laboratory Training Programme. Methods: we assessed the sustainability of GFELTP by document reviews and interviews with programme staff and stakeholders to identify sustainability structures (programme, financial and institutional) that were in place. We grouped information into the following headings: programme structure, institutional, financial and political structures. Results: as of July 2017, a total of 350 public health experts have been trained in both frontline and advanced courses since the programme's inception. For funding structures, the programme is funded mainly by its partners and stakeholders who are local government organisations. They provide resources for running of programme activities. Under institutional and political structures, the programme was established as a Ministry of Health/Ghana Health Service programme based in the University of Ghana. The programme steering committee which is currently chaired by the Director Public Health of Ghana Health Service, jointly ensures its implementation. Other structures of sustainability observed were involvement of stakeholders and alumni in human resource of the programme; use of stakeholders as faculty for the programme. These stakeholders include staff from University of Ghana School of Public Health, Ghana Health Service and Veterinary Service Department, World Health Organization and Centers for Disease Control and Prevention. The programme showed evidence of stable sustainability strategies in all four structures evaluated. Conclusion: the assessment found the GFELTP to be sustainable. The main factors that contributed to rendering it sustainable were funding, programme, institutional and political structures embedded in the programme. One remarkable sustainability element observed was the strong collaboration that existed between stakeholders of the programme who worked hand in hand to ensure the programme runs smoothly. However, more sources of funding and other essential resources need to be considered to help the programme obtain a pool of resources for carrying out its activities.
Utility of early diagnosis, contact tracing and stakeholder engagement in outbreak response in three COVID-19 outbreak settings in Ghana
(Ghana Med J, 2021) Amoakoh-Coleman, M.; Bandoh, D.A.; Noora, C.L.; Alomatu, H.; Baidoo, A.; Quartey, S.; Kenu, E.; Koram, K.A.
Objective: To describe how early case detection, testing and contact tracing measures were deployed by stakeholders in response to the COVID-19 outbreak in Ghana – using three outbreak scenarios. Design: A descriptive assessment of three case studies of COVID-19 outbreaks within three settings that occurred in Ghana from March 13 till the end of June 2020. Setting: A construction camp, a factory and a training institution in Ghana. Participants: Staff of a construction camp, a factory, workers and students of a training institution. Interventions: We described and compared the three COVID-19 outbreak scenarios in Ghana, highlighting identifi cation and diagnosis of cases, testing, contact tracing and stakeholder engagement for each scenario. We also outlined the challenges and lessons learnt in the management of these scenarios. Main outcome measures: Approach used for diagnosis, testing, contact tracing and stakeholder engagement. Results: Index cases of the training institution and construction camp were screened the same day of reporting symp toms, whiles the factory index case required a second visit before the screening. All index cases were tested with RT PCR. The training institution followed and tested all contacts, and an enhanced contact tracing approach was con ducted for staff of the other two sites. Multi-sectorial engagement and collaboration with stakeholders enabled effec tive handling of the outbreak response in all sites. Conclusion: Comparing all three settings, early diagnosis and prompt actions taken through multi-sectorial collabo rations played a major role in controlling the outbreak. Engaging stakeholders in the COVID-19 response is an effective way to mitigate the challenges in responding to the pandemic