Browsing by Author "Forgor, A.A."
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Item Control of Yaws in the Asuogyaman District. Can Community Involvement Make The Difference?(University of Ghana, 2001-08) Forgor, A.A.; Wurapa, F.K.; Gyapong, J.; University of Ghana, College of Health Sciences, School of Public HealthCommunity involvement in the control of yaws is a participatory approach to healthcare that is organized from the perspective of the recipient. This study was prompted by the fact that, in 1998 Addofound that community participation in the control of yaws was poor, 3.4% of the population is infected with yaws, yaws now ranking 3rd (1997-2000) from 6th position in 1996. This study looked at how a rural district (Asuogyaman) in the Eastern region of Ghana perceive and manage yaws and the extent to which the communities are involved in the control of the disease. It also looked at the health service and community factors, which affect community participation in the district. Focus group discussions, in-depth interviews, observations (participatory and nonparticipatory) involving 172 participants/respondents (key informants, level B health workers, herbalists and victims of yaws). Yaws was mainly perceived by the community (121 out of 153) to be caused by poor personal and environmental hygiene and sanitation. The disease was perceived by the community (74 out of 95 respondents) to be transmitted mainly by the sharing of toiletries, clothing and direct contact. The prevention of yaws was found to be by health education, avoidance of direct contact with the lesions of the affected person and observation of personal and environmental hygiene and sanitation. Though these perceptions about yaws are true, this knowledge was not reflected in their practices or treatment of the disease. The two main forms of treatment were traditional and modem. "Blue-stone" (copper sulphate) was found to be the most popular form of traditional treatment of the disease by some communities. Of the 153 respondents, 90 did not know that treatment of the disease was available/possible at the hospitals/clinics; 63 knew, 11 had no idea and 48 gave various answers. Health education on yaws was found to be inadequate. Yaws was perceived to have been eradicated and accorded least importance. The participation of the communities in the control of yaws was assessed by using Rifkin's method based on 5 factors- needs assessment, management, resource mobilization, leadership and organization. The participation of the communities was small. Presence of community health structures and their orientation, incentives to community health agents, free treatment, prompt response (by health workers) to reports made by community health agents and frequent interaction between health workers and the communities promoted participation. Knowledge about the disease enhanced participation. Conflicts, embezzlement of funds, failure to act on /respond to complaints made by community health agents, failure to complement community initiatives inhibited community participation. The response rate of the study was 91.5% (172 out of 188). Lack of time, funds and personnel, poor road network, conflicts, rains, limited the study. The Rifkin method itself had limitations. Health education and house-to-house treatment of yaws should be intensified. The study concluded that yaws, which is endemic in the district, could be effectively controlled with community involvement.Item The economic burden of meningitis to households in Kassena-Nankana District of Northern Ghana(Public Library of Science, 2013) Akweongo, P.; Dalaba, M.A.; Hayden, M.H.; Awine, T.; Nyaaba, G.N.; Anaseba, D.; Hodgson, A.; Forgor, A.A.; Pandya, R.Objective: To estimate the direct and indirect costs of meningitis to households in the Kassena-Nankana District of Ghana. Methods: A Cost of illness (COI) survey was conducted between 2010 and 2011. The COI was computed from a retrospective review of 80 meningitis cases answers to questions about direct medical costs, direct non-medical costs incurred and productivity losses due to recent meningitis incident. Results: The average direct and indirect costs of treating meningitis in the district was GH¢152.55 (US$101.7) per household. This is equivalent to about two months minimum wage earned by Ghanaians in unskilled paid jobs in 2009. Households lost 29 days of work per meningitis case and thus those in minimum wage paid jobs lost a monthly minimum wage of GH¢76.85 (US$51.23) due to the illness. Patients who were insured spent an average of GH¢38.5 (US$25.67) in direct medical costs whiles the uninsured patients spent as much as GH¢177.9 (US$118.6) per case. Patients with sequelae incurred additional costs of GH¢22.63 (US$15.08) per case. The least poor were more exposed to meningitis than the poorest. Conclusion: Meningitis is a debilitating but preventable disease that affects people living in the Sahel and in poorer conditions. The cost of meningitis treatment may further lead to impoverishment for these households. Widespread mass vaccination will save households' an equivalent of GH¢175.18 (US$117) and impairment due to meningitis.Item Erratum to: The role of weather in meningitis outbreaks in navrongo, Ghana: A generalized additive modeling approach(2012) Dukić, V.; Hayden, M.; Forgor, A.A.; Hopson, T.; Hodgson, A.; Pandya, R.Item A phase II, randomized study on an investigational DTPw-HBV/Hib-MenAC conjugate vaccine administered to infants in Northern Ghana(Public Library of Science, 2008) Hodgson, A.; Forgor, A.A.; Chandramohan, D.; Reed, Z.; Binka, F.; Bevilacqua, C.; Boutriau, D.; Greenwood, B.Background: Combining meningococcal vaccination with routine immunization in infancy may reduce the burden of meningococcal meningitis, especially in the meningitis belt of Africa. We have evaluated the immunogenicity, persistence of immune response, immune memory and safety of an investigational DTPw-HBV/Hib-MenAC conjugate vaccine given to infants in Northern Ghana. Methods and Findings: In this phase II, double blind, randomized, controlled study, 280 infants were primed with DTPw-HBV/Hib-MenAC or DTPw-HBV/Hib vaccines at 6, 10 and 14 weeks of age. At 12 months of age, children in each group received a challenge dose of serogroup A+C polysaccharides. Antibody responses were assessed pre, and one month-post dose 3 of the priming schedule and pre and 1 month after administration of the challenge dose. One month post-dose 3, 87.8% and 88.2% of subjects in the study group had bactericidal meningococcal serogroup A (SBA-MenA) and meningococcal serogroup C (SBA-MenC) antibody titres ≥1:8 respectively. Seroprotection/seropositivity rates to the 5 antigens administered in the routine EPI schedule were non-inferior in children in the study group compared to those in the control group. The percentages of subjects in the study group with persisting SBA-MenA titres ≥ 1:8 or SBA-MenC titres >1:8 at the age of 12 months prior to challenge were significantly higher than in control group (47.7% vs 25.7% and 56.4% vs 5.1% respectively). The administration of 10 μg of serogroup A polysaccharide increased the SBA-MenA GMT by 14.0-fold in the DTPW-HBV/HibMenAC-group compared to a 3.8 fold increase in the control-group. Corresponding fold-increases in SBA-MenC titres following challenge with 10 μg of group C polysaccharide were 18.8 and 1.9 respectively. Reactogenicity following primary vaccination or the administration of the challenge dose was similar in both groups, except for swelling (Grade 3) after primary vaccination which was more frequent in children in the vaccine than in the control group (23.7%; 95%CI [19.6-28.1] of doses vs 14.1%; 95% CI [10.9-17.8] of doses). Fifty-nine SAEs (including 8 deaths), none of them related to vaccination, were reported during the entire study. Conclusions: Three dose primary vaccination with DTPw-HBV/Hib-MenAC was non-inferior to DTPw-HBV/Hib for the 5 common antigens used in the routine EPI schedule and induced bactericidal antibodies against Neisseria meningitidis of serogroups A and C in the majority of infants. Serogroup A and C bactericidal antibody levels had fallen below titres associated with protection in nearly half of the infants by the age of 12 months confirming that a booster dose is required at about that age. An enhanced memory response was shown after polysaccharide challenge. This vaccine could provide protection against 7 important childhood diseases (including meningococcal A and C) and be of particular value in countries of the African meningitis belt.Item Using weather forecasts to help manage meningitis in the West African Sahel(Bulletin of the American Meteorological Society, 2015-03) Pandya, R.; Hodgson, A.; Hayden, M.H.; Akweongo, P.; Hopson, T.; Forgor, A.A.; Yoksas, T.; Dalaba, M.A.; Dukic, V.; Mera, R.; Dumont, A.; McCormack, K.; Anaseba, D.; Awine, T.; Boehnert, J.; Nyaaba, G.; Laing, A.; Semazzi, F.Understanding and acting on the link between weather and meningitis in the Sahel could help improve vaccinedistribution and save lives. People living there know that meningitis epidemics occur in the dry season and end after thestart of the rainy season. Integrating and analyzing newly available epidemiological and meteorological data quantifiedthis relationship, showing that that the risk of meningitis epidemics climbed from a background level of 2% to amaximum risk of 25% during the dry season. These data also suggested that, of all meteorological variables, relativehumidity has the strongest correlation to cases of meningitis.Weather acts alongside a complex set of environmental, social, and economic drivers, and a complementaryinvestigation of local and regional knowledge, attitudes, and practices suggested several additional interventions tomanage meningitis. These include improved awareness of early meningitis symptoms and vaccinations for farmworkerswho migrate seasonally. An economic survey showed that the cost of a single case of meningitis is 3 times the averageannual household income, underscoring the need for improved vaccination strategy.Using these insights, meteorologists and public health workers developed a tool to guide vaccination decisions. Iterativedevelopment allowed a multinational team of public health officials to use the tool while guiding its refinement anddirected research toward maximum practical use. That meant focusing on predicting areas where high humidity wouldnaturally end epidemics so vaccines could be moved elsewhere. Using this tool and this approach could have preventedan estimated 24,000 cases of meningitis over a 3-yr period. © 2015 American Meteorological Society.