Browsing by Author "Boateng, D."

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Cardiovascular disease risk prediction in sub-Saharan African populations — Comparative analysis of risk algorithms in the RODAM study
(International Journal of Cardiology, 2018-03) Boateng, D.; Agyemang, C.; Beune, E.; Meeks, K.; Smeeth, L.; Schulze, M.B.; Addo, J.; de-Graft Aikins, A.; Galbete, C.; Bahendeka, S.; Danquah, I.; Agyei-Baffour, P.; Owusu-Dabo, E.; Mockenhaupt, F.P.; Spranger, J.; Kengne, A.P.; Grobbee, D.E.; Klipstein-Grobusch, K.
Background: Validated absolute risk equations are currently recommended as the basis of cardiovascular disease (CVD) risk stratification in prevention and control strategies. However, there is no consensus on appropriate equations for sub-Saharan African populations. We assessed agreement between different cardiovascular risk equations among Ghanaian migrant and home populations with no overt CVD. Methods: The 10-year CVD risks were calculated for 3586 participants aged 40–70 years in the multi-centre RODAM study among Ghanaians residing in Ghana and Europe using the Framingham laboratory and non-laboratory and Pooled Cohort Equations (PCE) algorithms. Participants were classified as low, moderate or high risk, corresponding to < 10%, 10–20% and > 20% respectively. Agreement between the risk algorithms was assessed using kappa and correlation coefficients. Results: 19.4%, 12.3% and 5.8% were ranked as high 10-year CVD risk by Framingham non-laboratory, Framingham laboratory and PCE, respectively. The median (25th–75th percentiles) estimated 10-year CVD risk was 9.5% (5.4–15.7), 7.3% (3.9–13.2) and 5.0% (2.3–9.7) for Framingham non-laboratory, Framingham laboratory and PCE, respectively. The concordance between PCE and Framingham non-laboratory was better in the home Ghanaian population (kappa = 0.42, r = 0.738) than the migrant population (kappa = 0.24, r = 0.732) whereas concordance between PCE and Framingham laboratory was better in migrant Ghanaians (kappa = 0.54, r = 0.769) than the home population (kappa = 0.51, r = 0.758). Conclusion: CVD prediction with the same algorithm differs for the migrant and home populations and the interchangeability of Framingham laboratory and non-laboratory algorithms is limited. Validation against CVD outcomes is needed to inform appropriate selection of risk algorithms for use in African ancestry populations. © 2017 The Authors
Contribution of diabetes to amputations in sub-Sahara Africa: A systematic review and meta-analysis
(Primary Care Diabetes, 2022) Boateng, D.; Ayellah, B.B.; Adjei, D.N.; Agyemang, C.
Diabetes related amputations remain a major global problem, with devastating complications. We critically appraised relevant literature to quantify the prevalence of diabetes related amputations in sub-Saharan Africa (SSA). An electronic search was performed using the EMBASE and PubMed databases until 2020. Twenty-four out of 834 studies retrieved were included. The pooled prevalence of diabetic-related amputations was 36.9% (95%CI: 32.9%–40.8%). Complications of diabetes related amputations included infection, anaemia, foot deformity and mortality. The study revealed a substantial contribution of diabetes to the burden of amputations in SSA and suggests the need for further studies to assess how to reduce the incidence of diabetes, reduce the incidence of and or delay the progression of macro and microvascular complications of diabetes in SSA.
Differential associations between psychosocial stress and obesity among Ghanaians in Europe and in Ghana: findings from the RODAM study
(Social Psychiatry and Psychiatric Epidemiology, 2019-03-11) de‑Graft Aikins, A.; Baratin, C.; Beune, E.; van Schalkwijk, D.; Meeks, K.; Smeeth, L.; Addo, J.; Owusu‑Dabo, E.; Bahendeka, S.; Mockenhaupt, F.P.; Danquah, I.; Schulze, M.B.; Spranger, J.; Boateng, D.; Klipstein‑Grobusch, K.; Stronks, K.; Agyemang, C.
Purpose Psychosocial stress is associated with obesity in some populations, but it is unclear whether the association is related to migration. This study explored associations between psychosocial stress and obesity among Ghanaian migrants in Europe and non-migrant Ghanaians in Ghana. Methods Cross-sectional data from the RODAM study were used, including 5898 Ghanaians residing in Germany, the UK, the Netherlands, rural Ghana, and urban Ghana. Perceived discrimination, negative life events and stress at work or at home were examined in relation to body mass index (BMI) and waist circumference (WC). Linear regression analyses were performed separately for migrants and non-migrants stratified by sex. Results Perceived discrimination was not associated with BMI and WC in both migrants and non-migrants. However, negative life events were positively associated with BMI (β = 0.78, 95% CI 0.34–1.22) and WC (β = 1.96, 95% CI 0.79–3.12) among male Ghanaian migrants. Similarly, stress at work or at home was positively associated with BMI (β = 0.28, 95% CI 0.00–0.56) and WC (β = 0.84, 95% CI 0.05–1.63) among male Ghanaian migrants. Among non-migrant Ghanaians, in contrast, stress at work or at home was inversely associated with BMI and WC in both males (β = − 0.66, 95% CI − 1.03 to − 0.28; β = − 1.71 95% CI − 2.69 to − 0.73, respectively) and females (β = − 0.81, 95% CI − 1.20 to − 0.42; β = − 1.46, 95% CI − 2.30 to − 0.61, respectively). Conclusions Negative life events and stress at work or at home are associated with increased body weight among male Ghanaians in European settings, whereas stress at work or at home is associated with reduced body weight among Ghanaians in Ghana. More work is needed to understand the underlying factors driving these differential associations to assist prevention efforts.
Food variety, dietary diversity, and type 2 diabetes in a multi-center cross-sectional study among Ghanaian migrants in Europe and their compatriots in Ghana: the RODAM study
(European Journal of Nutrition, 2017-09) Danquah, I.; Galbete, C.; Meeks, K.; Nicolaou, M.; Klipstein-Grobusch, K.; Addo, J.; Aikins, A.D.-G.; Amoah, S.K.; Agyei-Baffour, P.; Boateng, D.; Bedu-Addo, G.; Spranger, J.; Smeeth, L.; Owusu-Dabo, E.; Agyemang, C.; Mockenhaupt, F.P.; Beune, E.; Schulze, M.B.
Purpose: The importance of dietary diversification for type 2 diabetes (T2D) risk remains controversial. We investigated associations of between- and within-food group variety with T2D, and the role of dietary diversification for the relationships between previously identified dietary patterns (DPs) and T2D among Ghanaian adults. Methods: In the multi-center cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) Study (n = 3810; Ghanaian residence, 56%; mean age, 46.2 years; women, 63%), we constructed the Food Variety Score (FVS; 0–20 points), the Dietary Diversity Score (DDS; 0–7 points), and the Diet Quality Index-International (DQI-I) variety component (0–20 points). The associations of these scores, of a “rice, pasta, meat and fish” DP, of a “mixed” DP, and of a “roots, tubers and plantain” DP with T2D were calculated by logistic regression. Results: The FVS was inversely associated with T2D, adjusted for socio-demographic, lifestyle, and anthropometric factors [odds ratio (OR) for T2D per 1 standard deviation (SD) increase: 0.81; 95% confidence interval (CI) 0.71–0.93]. The DDS and the DQI-I variety component were not associated with T2D. There was no association of the “mixed” DP and the “roots, tubers and plantain” DP with T2D. Yet, the “rice, pasta, meat and fish” DP is inversely associated with T2D (OR for T2D per 1 SD increase: 0.82; 95% CI 0.71–0.95); this effect was slightly attenuated by the FVS. Conclusions: In this Ghanaian population, between-food group variety may exert beneficial effects on glucose metabolism and partially explains the inverse association of the “rice, pasta, meat and fish” DP with T2D. © 2017 The Author(s)
Growing Trend of Health Infomediaries in Developing Economies: Understanding Motivations, Affordances and Constraints
(University Of Ghana, 2019-07) Boateng, D.
Information Technology (IT) plays a key role in health care management. Over the years, numerous IT artifacts have been introduced to improve health care delivery and access. These artifacts are often largely under the control of health professionals with little or no patient involvement. Recently however, there is a growing phenomenon of user-controlled health IT artifacts that give direct power and control to its users. One of such health IT artifacts are so-called infomediaries which augment decision making of patients, caregivers, and healthcare providers by creating awareness and knowledge sharing of healthful living, wellbeing and wellness among Online Health Information Seekers. There has been a pragmatic development of health infomediaries recently on online media platforms including conventional web portals (like websites, online forums, and chat rooms), social media, mobile Apps and blogs. Considering the rate of use of infomediaries, there are research gaps that need to be addressed, especially to understand the factors that enable the setting up of infomediaries as well as the affordances and constraints. In light of this, Technology Affordance and Constraint Theory was chosen as a theoretical lens to investigate the motivational factors, affordances and constraints behind the establishments of health infomediaries in a developing economy where challenges to health care access and delivery make health infomediaries potent alternatives to health information access. The study used the critical realism paradigm, qualitative research methodology and a case study research strategy to explore the phenomenon. The findings revealed that inherent motivation behind the development of online health platform is not necessarily sequential nor predictable but dynamic due to the changing demand of users, thus the development of health infomediaries is relatively purposive. Also, the findings revealed that there are both intrinsic and extrinsic motivational factors that drive organizations or individuals’ mission to establish health infomediaries. Motivational factors for the development of online health platforms are largely datafication and commodification. Datafication employs collective tools, technologies and processes to ‘data mine’ user data with a view to serving them better through content tailoring. Commodification on the other hand, refers to the way in which user data is transformed into monetary value. In Ghana, infomediaries are more commodification oriented than datafication. In this case study, no evidence was found of infomediaries in Ghana, purposively collecting user data to provide better services or sell the data to other interest parties. Rather, health infomediaries in Ghana apart from providing health information, also advertise and sell health products to consumers. One significant finding was that, some infomediaries even advertise non-health products. It can be inferred that in Ghana, commodification is the main affordance of health infomediaries beyond their primary purpose of providing health information to online health information seekers. The research also found other affordances or action possibilities with health infomediaries in Ghana such as self-aggrandizement, where individuals establishing infomediaries use the medium to promote or make themselves visible to society, possibly for future roles such as pioneer of a health infomediary. In terms of constraints to infomediaries, the research found that the survival and sustenance of online health information platforms is dependent on the management and technical handling of the IT infrastructure. Since most health infomediaries in Ghana are operated by individuals rather than organizations, they tend to lack managerial, financial or technical competencies of maintaining these platforms. The study offered a considerable understanding to the motivational factors behind the development of health infomediaries. Practically, the study will serve as a guide for practitioners to develop health infomediaries not only from the individual’s motivation but inculcate the consumers’ needs. Furthermore, the study advocates for government to institute very effective policies and guidelines and ensure its compliance to achieve an effective publication and use of online health information and development of health infomediaries. The study recommends developers of health infomediaries to identify and also understand the challenges besetting the development of online health platforms. Again, developers of health infomediaries should clearly define the purpose of setting up online health platforms to meet the needs of health consumers. That notwithstanding, commodification of the platform should not override the content related to health. Additionally, developers should be guided by the accepted standards of development of online health platforms. Future research will focus on other actors in the online health information such as regulators and how they perceive issues of privacy and security as well as conflict of interest situations in developing countries.
Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: A systematic review
(PLoS ONE, 2017-12) Boateng, D.; Wekesah, F.; Browne, J.L.; Agyemang, C.; Agyei-Baffour, P.; De-Graft Aikins, A.; Smit, H.A.; Grobbee, D.E.; Klipstein-Grobusch, K.
Introduction Cardiovascular diseases (CVDs) are the most common cause of non-communicable disease mortality in sub-Saharan African (SSA) countries. Gaps in knowledge of CVD conditions and their risk factors are important barriers in effective prevention and treatment. Yet, evidence on the awareness and knowledge level of CVD and associated risk factors among populations of SSA is scarce. This review aimed to synthesize available evidence of the level of knowledge of and perceptions towards CVDs and risk factors in the SSA region. Methods Five databases were searched for publications up to December 2016. Narrative synthesis was conducted for knowledge level of CVDs, knowledge of risk factors and clinical signs, factors influencing knowledge of CVDs and source of health information on CVDs. The review was registered with Prospero (CRD42016049165). Results Of 2212 titles and abstracts screened, 45 full-text papers were retrieved and reviewed and 20 were included: eighteen quantitative and two qualitative studies. Levels of knowledge and awareness for CVD and risk factors were generally low, coupled with poor perception. Most studies reported less than half of their study participants having good knowledge of CVDs and/or risk factors. Proportion of participants who were unable to identify a single risk factor and clinical symptom for CVDs ranged from 1.8% in a study among hospital staff in Nigeria to a high of 73% in a population-based survey in Uganda and 7% among University staff in Nigeria to 75.1% in a general population in Uganda respectively. High educational attainment and place of residence had a significant influence on the levels of knowledge for CVDs among SSA populations. Conclusion Low knowledge of CVDs, risk factors and clinical symptoms is strongly associated with the low levels of educational attainment and rural residency in the region. These findings provide useful information for implementers of interventions targeted at the prevention and control of CVDs, and encourages them to incorporate health promotion and awareness campaigns in order to enhance knowledge and awareness of CVDs in the region. © 2017 Boateng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Molecular epidemiology of bovine tuberculosis in Northern Ghana identifies several uncharacterized bovine spoligotypes and suggests possible zoonotic transmission
(PLOS NEGLECTED TROPICAL DISEASES, 2022) Acquah, S.E.K.; Asare, P.; Danso, E.K; Tetteh, P.; Tetteh, A.Y.; Boateng, D.; Osei-Wusu, S.; Afum, T.; Ayamdooh, Y.I.; Akugre, E.A.; Samad, O.A.; Quaye, L.; Obiri-Danso, K.; Kock, R.; Asante-Poku, A.; Yeboah-Manu, D.
Objective We conducted an abattoir-based cross-sectional study in the five administrative regions of Northern Ghana to determine the distribution of bovine tuberculosis (BTB) among slaughtered carcasses and identify the possibility of zoonotic transmission. Methods Direct smear microscopy was done on 438 tuberculosis-like lesions from selected cattle organs and cultured on Lowenstein-Jensen media. Acid-fast bacilli (AFB) isolates were confirmed as members of the Mycobacterium tuberculosis complex (MTBC) by PCR amplification of IS6110 and rpoß. Characterization and assignment into MTBC lineage and sublineage were done by spoligotyping, with the aid of the SITVIT2, miruvntrplus and mbovis. org databases. Spoligotype data was compared to that of clinical M. bovis isolates from the same regions to identify similarities. Results A total of 319/438 (72.8%) lesion homogenates were smear positive out of which, 84.6% (270/319) had microscopic grade of at least 1+ for AFB. Two hundred and sixty-five samples (265/438; 60.5%) were culture positive, of which 212 (80.0%) were MTBC. Approximately 16.7% (34/203) of the isolates with correctly defined spoligotypes were negative for IS6110 PCR but were confirmed by rpoß. Spoligotyping characterized 203 isolates as M. bovis (198, 97.5%), M. caprae (3, 1.5%), M. tuberculosis (Mtbss) lineage (L) 4 Cameroon sub-lineage, (1, 0.5%), and M. africanum (Maf) L6 (1, 0.5%). A total of 53 unique spoligotype patterns were identified across the five administrative regions (33 and 28 were identified as orphan respectively by the SITVIT2 and mbovis.org databases), with the most dominant spoligotype being SIT1037/ SB0944 (77/203, 37.93%). Analysis of the bovine and human M. bovis isolates showed 75% (3/4) human M. bovis isolates sharing the same spoligotype pattern with the bovine isolates. Conclusion Our study identified that approximately 29% of M. bovis strains causing BTB in Northern Ghana are caused by uncharacterized spoligotypes. Our findings suggest possible zoonotic transmission and highlight the need for BTB disease control in Northern Ghana.
Overweight and obesity epidemic in Ghana - A systematic review and meta-analysis
(BioMed Central Ltd., 2016) Ofori-Asenso, R.; Agyeman, A.A.; Laar, A.A.; Boateng, D.
Background: In many low and middle income countries (LMICs), the distribution of adulthood nutritional imbalance is shifting from a predominance of undernutrition to overnutrition. This complex problem poses a huge challenge to governments, non-state actors, and individuals desirous of addressing the problem of malnutrition in LMICs. The objective of this study was to systematically review the literature towards providing an estimate of the prevalence of overweight and obesity among adult Ghanaians. Methods: This study followed the recommendations outlined in the PRISMA statement. Searches were performed in PubMed, Science Direct, google scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus database. This retrieved studies (published up to 31st March 2016) that reported overweight and obesity prevalence among Ghanaians. All online searches were supplemented by reference screening of retrieved papers to identify additional studies. Results: Forty-three (43) studies involving a total population of 48,966 sampled across all the ten (10) regions of Ghana were selected for the review. Our analysis indicates that nearly 43% of Ghanaian adults are either overweight or obese. The national prevalence of overweight and obesity were estimated as 25.4% (95% CI 22.2-28.7%) and 17.1% (95% CI = 14.7-19.5%), respectively. Higher prevalence of overweight (27.2% vs 16.7%) and obesity (20.6% vs 8.0%) were estimated for urban than rural dwellers. Prevalence of overweight (27.8% vs 21.8%) and obesity (21.9% vs 6.0%) were also significantly higher in women than men. About 45.6% of adult diabetes patients in Ghana are either overweight or obese. At the regional level, about 43.4%, 36.9%, 32.4% and 55.2% of residents in Ashanti, Central, Northern and Greater Accra region, respectively are overweight or obese. These patterns generally mimic the levels of urbanization. Per studies' publication years, consistent increases in overweight and obesity prevalence were observed in Ghana in the period 1998-2016. Conclusions: There is a high and rising prevalence of overweight and obesity among Ghanaian adults. The possible implications on current and future population health, burden of chronic diseases, health care spending and broader economy could be enormous for a country still battling many infectious and parasitic diseases. Public health preventive measures that are appropriate for the Ghanaian context, culturally sensitive, cost-effective and sustainable are urgently needed to tackle this epidemic.
Screening For Plasmodium Falciparum Malaria Using MRD Test In A High Transmission Area Of Ghana: Kintampo District
(University of Ghana, 2013-07) Boateng, D.
Background Malaria has a high burden in sub-Saharan Africa which is caused by Plasmodium falciparum. Delayed or inaccurate diagnosis of malaria could lead to fatal consequences in patients seeking medical care for malaria. Malaria Rapid Diagnostic Tests (mRDT) provide an alternative in the absence of malaria microscopy to provide prompt and accurate diagnosis and is used to complement clinical diagnosis of individuals who report at health facilities with unspecific symptoms. Low sensitivity and specificity of mRDTs may lead to under-diagnosis or over diagnosis of malaria. Hence there is the need to confirm the validity of the mRDT in specific malaria transmission zones. The aim of this study was to assess the sensitivity and specificity of mRDT in the Kintampo Municipality of Ghana. Methods A secondary data analysis was done using a cross sectional study design data from the Kintampo Malarial Drug Trial conducted during the period of June 2005 to May 2006 to assess the efficacy of Artemisinin combination therapy. Cleaned data were analyzed using Stata 11.0 (STATACORP, TX.). Demographic characteristics of study children that were categorical in nature were summarized as proportions, while quantitative variables such as hemoglobin concentration was summarized as means based on their distributions. Sensitivity and specificity analysis of the mRDT was explored using malaria microscopy as the gold standard and Receiver Operating Characteristic (ROC) curve was used to determine the ability of the RDT test to correctly classify patients with or without malaria parasitaemia. Univariate logistic regression was used to explore crude relationships between socio-demographic and potential confounding variables with clinical malaria. Clinical malaria was defined as reported or measured fever with malaria parasite counts >0. All statistically significant variables identified from the univariate analysis were adjusted for in a multivariate logistic regression model. Results: A total of nine hundred and thirty seven (937) children between 0- 10 years who were screened in the primary study were analyzed in this study. About 99% (923/937) of the children enrolled had both malaria parasitaemia and mRDT done. Using microscopy as the gold standard, the overall sensitivity and specificity of the mRDT used were 93.2% (95% CI: 90.7-95.2) and 83.0% (95% CI: 78.9-86.5) with a positive predictive value of (PPV) 88.1% (95% CI: 85.1- 90.6) and negative predictive value (NPV) of 90.1% (95% CI: 86.5-92.9) respectively. The risk of clinical malaria was 1.45 times more likely among children analyzed in this study with abnormal liver function test compared to those with normal liver function test [aOR 1.45 (95% CI:1.05-2.01), p=0.03] after adjusting for age and sex in a multivariate logistic regression model. Conclusion This mRDT maintains its high sensitivity and specificity among patients in the forest-savanna transitional zone of Ghana. The Malaria Rapid Diagnostic Test may be provided to peripheral public health facilities that do not have trained laboratory technicians, electricity and laboratory to appropriately diagnose malaria.
Structured diabetes self- management education and glycaemic control in low- and middle- income countries: A systematic review
(Wiley, 2022) Lamptey, R.; Robben, M.P.; Amoakoh-Coleman, M.; Boateng, D.; Grobbee, D.E.; Davies, M.J.; Klipstein-Grobusch, K.
Aim: To determine the association between structured diabetes self- management education (DSME) and glycaemic control in persons living with diabetes (PLD) in low- and middle- income countries (LMICs).Methods: PubMed, Embase and Cochrane databases were searched up to June 2020 for intervention studies on the effect of structured DSME on glycaemic con-trol in PLD in LMICs (PROSPERO registration CRD42020164857). The primary outcome was reduction in glycated haemoglobin. Included studies were assessed for risk of bias (RoB) with the Cochrane RoB tool for randomised trials. Findings were summarized in a narrative synthesis.Results: Out of 154 abstracts retrieved and screened for eligibility, nine stud-ies with a total of 1389 participants were included in the review. The structured DSME interventions were culturally tailored and were delivered in- person. They were associated with reductions in glycated haemoglobin in all studies: mean/median reduction ranged between 0.5% and 2.6% relative to baseline.Conclusions: There is a dearth of literature on the association between struc-tured DSME and glycaemic control among PLD in LMICs. The evidence available suggests that in LMICs; particularly in sub- Saharan Africa, structured DSME is associated with reduction in glycated haemoglobin. We recommend further in-tervention studies on the effects of structured DSME in LMICs.
Structured diabetes self-management education and glycaemic control in low-and middle-income countries: A systematic review
(Diabetic Medicine, 2022) Lamptey, R.; Robben, M.P.; Amoakoh-Coleman, M.; Boateng, D.; Grobbee, D.E.; Davies, M.J.; Klipstein-Grobusch, K.
Aim: To determine the association between structured diabetes self-management education (DSME) and glycaemic control in persons living with diabetes (PLD) in low-and middle-income countries (LMICs). Methods: PubMed, Embase and Cochrane databases were searched up to June 2020 for intervention studies on the effect of structured DSME on glycaemic control in PLD in LMICs (PROSPERO registration CRD42020164857). The primary outcome was reduction in glycated haemoglobin. Included studies were assessed for risk of bias (RoB) with the Cochrane RoB tool for randomised trials. Findings were summarized in a narrative synthesis. Results: Out of 154 abstracts retrieved and screened for eligibility, nine studies with a total of 1389 participants were included in the review. The structured DSME interventions were culturally tailored and were delivered in-person. They were associated with reductions in glycated haemoglobin in all studies: mean/ median reduction ranged between 0.5% and 2.6% relative to baseline. Conclusions: There is a dearth of literature on the association between structured DSME and glycaemic control among PLD in LMICs. The evidence available suggests that in LMICs; particularly in sub-Saharan Africa, structured DSME is associated with reduction in glycated haemoglobin. We recommend further intervention studies on the effects of structured DSME in LMICs.
To leave or retain? An interplay between quality digital banking services and customer satisfaction
(International Journal of Bank Marketing, 2021) Egala, S.B.; Mensah, S.A.; Boateng, D.
Purpose – In this paper, the authors investigated the impact of quality digital banking services delivered during the COVID-19 pandemic on customers’ satisfaction and retention intentions. Design/methodology/approach – This study combined constructs drawn from the E-S-QUAL and BSQ models to measure the impact of digital banking services on subscribers of digital banking services in Ghana. The study utilized structural equation modeling with partial least squares (PLS-SEM) to analyze 395 responses. Findings – Results revealed a significant direct effect between digital banking services satisfaction and customer retention decisions. The results also revealed that digital banking service quality dimensions such as ease of use, efficiency, privacy/security, and reliability impact customers’ satisfaction and retention intentions. Research limitations/implications – Digital banking service portfolios and their quality dimensions vary among banks. This offers an opportunity for banking institutions and other non-bank financial service providers to be wary of the impact of quality service delivery on customers’ decisions. This paper makes significant theoretical contributions and practical implications on the relevance of quality digital banking services in customers’ retention strategies for competitive advantage. Originality/value – This study has underlined the significance of quality digital banking services in developing countries. The study underscored the need for banking and non-bank financial institutions to embrace the much-anticipated quality service demanded by customers and the need for continuous service improvement relative to the growing deployment of financial technologies.