Browsing by Author "Emerson, P.M."
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Item Achieving trachoma control in Ghana after implementing the SAFE strategy(2009-10) Yayemain, D.; King, J.D.; Debrah, O.; Emerson, P.M.; Aboe, A.; Ahorsu, F.; Wanye, S.; Ansah, M.O.; Gyapong, J.O.; Hagan, M.The Ghana Health Service plans to eliminate blinding trachoma by 2010 and has implemented the SAFE strategy since 2001. The programme impact was assessed in all endemic districts. A two-stage, cluster random sample of 720 households was selected in each of 18 endemic districts in Upper West and Northern Regions. All eligible residents were examined for trachoma signs. Household environmental risk factors were assessed. In total, 74 225 persons from 12 679 households were examined. Prevalence of trachomatous inflammation-follicular in 1-9 year-old children was 0.84% (95% CI 0.63-1.05, range of point estimates by district 0.14-2.81%) and prevalence of trichiasis in adults aged ≥15 years was 0.31% (95% CI 0.24-0.38, range by district 0.00-1.07%). An estimated 4950 persons have trichiasis, of whom 72.6% are aged ≥60 years and 71.4% are women. Latrines were observed in 11.6% of households and 79.2% of interview respondents reported use of an improved water source. Active trachoma is no longer a public health problem in Ghana after successful implementation of the SAFE strategy. The programme should maintain health education, advocate for improved water and sanitation and focus on providing surgery. Surveillance activities are needed to ensure sustained control.Item Characteristics of latrine promotion participants and non-participants; inspection of latrines; and perceptions of household latrines in Northern Ghana(Blackwell Publishing, 2007) Rodgers, A.F.; Ajono, L.A.; Gyapong, J.O.; Hagan, M.; Emerson, P.M.Objectives: To examine characteristics of household heads in two districts of Northern Ghana who had or had not participated in latrine promotion programmes; to inspect latrines; and to explore perceptions of latrine ownership. Methods: One hundred and twenty latrine owners and 120 non-owners were randomly selected from all trachoma-endemic villages and interviewed. Structured questionnaires assessed demographics, household data, wealth indicators, and perceptions of latrine ownership. Latrines were inspected. Results: Latrine owners and non-owners were similar demographically, but owners were more likely to report any education or wealth indicators: any education OR ¼ 2.0, (95% CI 1.2–3.4); large family size OR ¼ 4.6 (2.6–8.2); children in school OR ¼ 3.8 (1.3–10.5); and metal roof OR ¼ 9.1 (2.0–40.0). All 120 latrine owners were participating in promotion programmes; no latrines had been self-built without programme support. Inspection showed 73/120 (60.1%) latrines were completed and used. Of the uncompleted latrines 41/47 (87.2%) were more than a year old. Programme participants (regardless of whether they had a completed latrine) had contributed cash (mean $16.74 S.D.18.09) and 117/120 had provided labour and/or construction materials. The most frequently reported advantages of latrine ownership were convenience, cleanliness and health benefits; reported disadvantages were the need for maintenance and cleaning and bad odour. Conclusions: Current latrine promotion programmes do not reach all households equally. Joining a latrine programme was expensive and did not guarantee latrine ownership; this may cause people to lose trust in such programmes. Latrines were perceived to be useful, suggesting unmet demand. Reliable and inclusive programmes that provide low cost latrines may receive community support.