Browsing by Author "Bates, I."
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Item Cohort trial reveals community impact of insecticide-treated net son malaria metric indices in urban Ghana(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2010) Klinkenberg, E.; Onwona-Agyeman, K.A.; McCall, P.J.; Wilson, M.D.; Bates, I.; Verhoeffe, F.H.; Barnish, G.; Donnelly, M.J.The efficacy of insecticide-treated nets (ITNs) in prevention of malaria and anaemia has been shown in rural settings, but their impact in urban settings is unknown. We carried out an ITN intervention in two communities in urban Accra, Ghana, where local malaria transmission is known to occur. There was evidence for amassor community effect, despite ITN use by fewer than 35% of households. Children living within 300m of a household with an ITN had higher haemoglobin concentrations (0.5g/dl higher, P = 0.011) and less anaemia (oddsratio2.21, 95%CI1.08–4.52, P = 0.031atmonth6), than children living more than 300m away from a household with an ITN, although malaria parasitaemias were similar. With urban populations growing rapidly across Africa, this study shows that ITNs will be an effective tool to assist African countries to achieve their Millennium Development Goals in urban settings.Item Cohort trial reveals community impact of insecticide-treated nets on malariometric indices in urban Ghana(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2010-07) Klinkenberg, E.; Onwona-Agyeman, K.A.; McCall, P.J.; Wilson, M.D.; Bates, I.; Verhoeff, F.H.; Barnish, G.; Donnelly, M.J.The efficacy of insecticide-treated nets (ITNs) in prevention of malaria and anaemia has been shown in rural settings, but their impact in urban settings is unknown. We carried out an ITN intervention in two communities in urban Accra, Ghana, where local malaria transmission is known to occur. There was evidence for a mass or community effect, despite ITN use by fewer than 35% of households. Children living within 300 m of a household with an ITN had higher haemoglobin concentrations (0.5. g/dl higher, P=0.011) and less anaemia (odds ratio 2.21, 95% CI 1.08-4.52, P=0.031 at month 6), than children living more than 300 m away from a household with an ITN, although malaria parasitaemias were similar. With urban populations growing rapidly across Africa, this study shows that ITNs will be an effective tool to assist African countries to achieve their Millennium Development Goals in urban settings. [Registered trial number ISRCTN42261314; http://www.controlled-trials.com/ISRCTN42261314]. © 2010 Royal Society of Tropical Medicine and Hygiene.Item Determinants of intention to use mobile phone caller tunes to promote voluntary blood donation: Cross-sectional study(Journal of Medical Internet Research, 2018-05) Appiah, B.; Burdine, J.N.; Aftab, A.; Asamoah-Akuoko, L.; Anum, D.A.; Kretchy, I.A.; Samman, E.W.; Appiah, P.B.; Bates, I.Background: Voluntary blood donation rates are low in sub-Saharan Africa. Sociobehavioral factors such as a belief that donated blood would be used for performing rituals deter people from donating blood. There is a need for culturally appropriate communication interventions to encourage individuals to donate blood. Health care interventions that use mobile phones have increased in developing countries, although many of them focus on SMS text messaging (short message service, SMS). A unique feature of mobile phones that has so far not been used for aiding blood donation is caller tunes. Caller tunes replace the ringing sound heard by a caller to a mobile phone before the called party answers the call. In African countries such as Ghana, instead of the typical ringing sound, a caller may hear a message or song. Despite the popularity of such caller tunes, there is a lack of empirical studies on their potential use for promoting blood donation. Objective: The aim of this study was to use the technology acceptance model to explore the influence of the factors-perceived ease of use, perceived usefulness, attitude, and free of cost-on intentions of blood or nonblood donors to download blood donation-themed caller tunes to promote blood donation, if available. Methods: A total of 478 blood donors and 477 nonblood donors were purposively sampled for an interviewer-administered questionnaire survey at blood donation sites in Accra, Ghana. Data were analyzed using descriptive statistics, exploratory factor analysis, and confirmatory factory analysis or structural equation modeling, leading to hypothesis testing to examine factors that determine intention to use caller tunes for blood donation among blood or nonblood donors who use or do not use mobile phone caller tunes. Results: Perceived usefulness had a significant effect on intention to use caller tunes among blood donors with caller tunes (beta=.293, P<.001), blood donors without caller tunes (beta=.165, P=.02, nonblood donors with caller tunes (beta=.278, P<.001), and nonblood donors without caller tunes (beta=.164, P=.01). Attitudes had significant effect on intention to use caller tunes among blood donors without caller tunes (beta=.351, P<.001), nonblood donors with caller tunes (beta=.384, P<.001), nonblood donors without caller tunes (beta=.539, P<.001) but not among blood donors with caller tunes (beta=.056, P=.44). The effect of free-of-cost caller tunes on the intention to use for blood donation was statistically significant (beta=.169, P<.001) only in the case of nonblood donors without caller tunes, whereas this path was statistically not significant in other models. Conclusions: Our results provide empirical evidence for designing caller tunes to promote blood donation in Ghana. The study found that making caller tunes free is particularly relevant for nonblood donors with no caller tunes. © Bernard Appiah, James N Burdine, Ammar Aftab, Lucy Asamoah-Akuoko, David A Anum, Irene A Kretchy, Elfreda W Samman, Patience B Appiah, Imelda Bates.Item External Financial Aid to Blood Transfusion Services in Sub-Saharan Africa: A Need for Reflection(PLOS Medicine, 2012-09-11) Ala, F.; Allain, J-P.; Bates, I.; Boukef, K.; Boulton, F.; Brandful, J.; Dax, E.M.; Ekiaby, M.E.; Farrugia, A.; Gorlin, J.; Hassall, O.; Lee, H.; Loua, A.; Maitland, K.; Mbanya, D.; Mukhtar, Z.; Murphy, W.; Opare- Sem, O.; Owusu-Ofori, S.; Reesink, H.; Roberts, D.; Torres, O.; Totoe, G.; Ullum, H.; Wendel, S.Over the past ten years, high-income countries in the North have provided considerable financial aid to establish and support national blood transfusion services in low-income countries in sub-Saharan Africa. This action has largely been driven by concerns relating to the contribution of blood transfusion to the HIV epidemic in the region, leading to the overwhelming objective of ‘‘safe blood.’’ Whilst there have been definite benefits to transfusion services, we believe this aid has resulted in unintended but serious negative outcomes, which we describe here and argue should prompt a re-thinking of how to provide support to blood transfusion services in sub-Saharan Africa. Support has targeted either single countries such as Malawi, Rwanda, Burkina Faso, and Uganda [1,2] or multiple countries [3]. Funds, available only for limited periods, have been used to support a combination of infrastructure design and construction; purchase of equipment; screening for transfusion-transmitted infections and quality assurance; and the recruitment of blood donors. As a direct consequence of this funding, some of the underlying principles of transfusion services practised in the high-income donor countries have been applied in sub- Saharan Africa recipient countries (Box 1). These principles may be based on sound practice in wealthy countries but do not necessarily apply to sub-Saharan Africa at this time. We argue that considering the needs of sub-Saharan Africa, external aid was to some extent misdirected in the areas of donor recruitment, overall organisation, and availability of products.Item Haematological Aspects of Tropical Diseases(Postgraduate Haematology, Sixth edition, 2010-11) Bates, I.; Ekem, I.Rapid increases in worldwide travel mean that haematologists need to keep up to date with tropical diseases that can cause haematological abnormalities. This chapter covers tropical diseases associated with organisms in the blood or bone marrow (e.g. malaria, filariasis, sleeping sickness, Chagas disease, leishmaniasis) and diseases which alter the blood count or coagulation systems. This chapter not only describes the haematological abnormalities associated with these conditions but also provides an overview of disease epidemiology, clinical presentation, diagnosis and the haematological complications of treatment.Item UK-based real-time lymphoproliferative disorder diagnostic service to improve the management of patients in Ghana(Indian Journal Dermatol 2(3): 143-149, 2009) Ekem, I.; Parkins, E.; Roger, G.; Owen, G.; Bedu-Addo, G.; Ohene Opare, S.; Adomakoh, Y.; Bates, I.The objective of the study was to evaluate the feasibility of a UK-based real-time service to improve the diagnosis and management of lymphoproliferative disorders (LPDs) in Ghana. Adult patients reporting to hospital with a suspected LPD, during a 1 year period, were prospectively enrolled. Bone marrow and/or lymph node biopsies were posted to the Haematology Malignancy Diagnostic Service (HMDS), Leeds, UK and underwent morphological analysis and immunophenotyping. Results were returned by e-mail. The initial diagnoses made in Ghana were compared with the final HMDS diagnoses to assess the contribution of the HMDS diagnosis to management decisions. The study was conducted at the two teaching hospitals in Ghana-Komfo Anokye, Kumasi and Korle Bu, Accra. Participants comprised 150 adult patients (>/=12 years old), 79 women, median age 46 years. Bone marrow and lymph node biopsy samples from all adults presenting with features suggestive of a LPD, at the two teaching hospitals in Ghana, over 1 year were posted to a UK LPD diagnostic centre, where immunophenotyping was performed by immunohistochemistry. Molecular analysis was performed where indicated. Diagnostic classifications were made according to international criteria. Final diagnosis was compared to the initial Ghanaian diagnosis to evaluate discrepancies; implications for alterations in treatment decisions were evaluated. Median time between taking samples and receiving e-mail results in Ghana was 15 days. Concordance between initial and final diagnoses was 32% (48 of 150). The HMDS diagnosis would have changed management in 31% (46 of 150) of patients. It is feasible to provide a UK-based service for LPD diagnosis in Africa using postal services and e-mail. This study confirmed findings from wealthy countries that a specialised haematopathology service can improve LPD diagnosis. This model of Ghana-UK collaboration provides a platform on which to build local capacity to operate an international quality diagnostic service for LPDs.Item Urban malaria and anaemia in children: A cross-sectional survey in two cities of Ghana(Tropical Medicine and International Health, 2006-05) Klinkenberg, E.; McCall, P.J.; Wilson, M.D.; Akoto, A.O.; Amerasinghe, F.P.; Bates, I.; Verhoeff, F.H.; Barnish, G.; Donnelly, M.J.OBJECTIVE: To describe the epidemiology of urban malaria, an emerging problem in sub-Saharan Africa. METHOD: Cross-sectional surveys of communities in Accra and Kumasi, Ghana, determining risk factors for malaria infection and anaemia in children aged 6-60 months. RESULTS: Malaria prevalence rates ranged from 2% to 33% between urban communities. 47.1% of children were anaemic (Hb < 11.0 g/dl). Factors associated with malaria prevalence were low socio-economic status, age and anaemia. The attributable risks of anaemia and severe anaemia (Hb < 8.0 g/dl) caused by malaria were 5% and 23% respectively. CONCLUSIONS: Malaria in urban areas displayed a heterogeneity and complexity that differed from the rural environment, which has important implications for malaria control. Marked intra-city variation indicates the importance of targeting specific areas or districts. The most vulnerable group, the urban poor, should be prioritized when designing control measures. This would require careful assessment of the malaria risk pattern in any city to guide an integrated control program. © 2006 Blackwell Publishing Ltd.