Browsing by Author "Frimpong, J.A."
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Item Adherence to the test, treat and track strategy for malaria control among prescribers, Mfantseman Municipality, Central Region, Ghana(PLOS ONE, 2023) Agbemafle, E.E.; Addo-Lartey, A.; Odikro, M.A.; Frimpong, J.A.; Kubio, C.; Ameme, D.K.; Sackey, S.O.; Bonful, H.A.The test, treat, and track (T3) strategy is directed at ensuring diagnosis and prompt treatment of uncomplicated malaria cases. Adherence to T3 strategy reduces wrong treatment and prevents delays in treating the actual cause of fever that may otherwise lead to complications or death. Data on adherence to all three aspects of the T3 strategy is sparse with previous studies focusing on the testing and treatment aspects. We determined adherence to the T3 strategy and associated factors in the Mfantseman Municipality of Ghana. Methods We conducted a health facility based cross-sectional survey in Saltpond Municipal Hospital and Mercy Women’s Catholic Hospitals in Mfantseman Municipality of the Central Region, Ghana in 2020. We retrieved electronic records of febrile outpatients and extracted the test ing, treatment and tracking variables. Prescribers were interviewed on factors associated with adherence using a semi-structured questionnaire. Data analyses was done using descriptive statistics, bivariate, and multiple logistic regression. Results Of 414 febrile outpatient records analyzed, 47 (11.3%) were under five years old. About 180 (43.5%) were tested with 138 (76.7%) testing positive. All positive cases received antimalar ials and 127 (92.0%) were reviewed after treatment. Of 414 febrile patients, 127 (30.7%) were treated according to the T3 strategy. Higher odds of adherence to T3 were observed for patients aged 5–25 years compared to older patients (AOR: 2.5, 95% CI: 1.27–4.87, p = 0.008). Adherence was low among physician assistants compared to medical officers (AOR 0.004, 95% CI 0.004–0.02, p<0.001). Prescribers trained on T3 had higher adherence (AOR: 99.33 95% CI: 19.53–505.13, p<0.000). Conclusion Adherence to T3 strategy is low in Mfantseman Municipality of the Central Region of Ghana. Health facilities should perform RDTs for febrile patients at the OPD with priority on low cadre prescribers during the planning and implementation of interventions to improve T3 adherence at the facility level.Item 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.Item Evaluation of the adverse events following immunization surveillance system, Ghana, 2019(PLOS ONE, 2022) Larye, E.B.; Frimpong, J.A.; Noora, C.L.; Tengey, J.; Bandoh, D.; Sabblah, G.; Ameme, D.; Kenu, E.; Amponsa-Achiano, K.Background With over 80% of children worldwide vaccinated, concerns about vaccine safety continues to be a public health issue. Ghana’s Adverse Events Following Immunization surveillance started in 1978 with the objective to promptly detect and manage AEFI cases either real or perceived. Periodic evaluation of the surveillance system is critical for optimal performance; hence we evaluated the system to assess its attributes, usefulness and system’s performance in meeting its objectives. Methods A case of AEFI was defined as any untoward medical event occurring within 28 days after vaccination and may not necessarily have causal relationship with the vaccine use. We reviewed surveillance data and procedures for the period 2014 to 2018 and interviewed key stakeholders. Adapting the CDC’s Updated Guidelines for Evaluating Public Health Surveillance Systems, we assessed the system’s attributes and usefulness. We performed summary descriptive statistics on quantitative data and directed content analysis on information gathered from interviews. Results In all, 2,282 AEFI cases including 476 (21%) serious cases (life threatening events) were reported for the period. The highest case detection rates of 61.45 AEFIs per 100,000 surviving infants was recorded in 2018. Reporting forms were modified to accommodate new indicators without any disruption in the function of the system. At the national level, completeness of 100 randomly sampled reporting forms (100%) and was higher than the region (27%) but timeliness (50%) was lower than the region (83%). All (16/16) Community Health Nurses interviewed indicated “fear of being victimized” as the reason for underreporting, nonetheless, the system was useful as it made them cautious when vaccinating children to prevent reactions. Data on AEFI surveillance was also useful in guiding training needs and provision of vaccination logistics. Conclusion The AEFI surveillance system is useful at all levels but partially meeting its objective due to underreporting. We recommend training and supportive supervision to improve timeliness of reporting, data completeness and acceptability.Item Housing And Household Characteristics And Payment For Solid Waste Disposal In The Greater Accra Region, Ghana(University of Ghana, 2013-07) Frimpong, J.A.; Codjoe, S.N.A.; University of Ghana, College of Humanities, Regional Institute for Population StudiesRapid urbanisation, population growth, introduction of environmentally unfriendly materials like plastics and changing lifestyles have created serious environmental problems in most districts and localities within the Greater Accra Region especially in the area of solid waste disposal, management and financing. This study analyses the factors that influence household’s payment for solid waste disposal in the Greater Accra Region of Ghana. Using the Ghana Living Standard Survey data set, 2006, a total of 1, 257 households were selected for the study. A binary logistic model was employed to estimate household payment for solid waste disposal. The results indicated that all the variables but the household size had significant influence on respondents’ payment for waste disposal at the bivariate level of analyses. However, only type of dwelling, place of residence and wealth quintile were significant at the binary logistic analysis level. The study further revealed that a larger segment of households in the high-wealth quintile bracket subscribe mostly to waste disposal methods that are paid for. The study, therefore, opines the need for increase in budgetary allocations to the various District Assemblies in the region. Subsequently, there is the need for the various District Assemblies to consider adopting an economic funding model by raising fees on high-income households to cover the services of low-income neighborhoods to facilitate broad service coverage.Item Incidence of medically attended influenza among residents of Shai-Osudoku and Ningo-Prampram Districts, Ghana, May 2013 - April 2015(BioMed Central Ltd., 2016) Ntiri, M.P.; Duque, J.; McMorrow, M.L.; Frimpong, J.A.; Parbie, P.; Badji, E.; Nzussouo, N.T.; Benson, E.-M.; Adjabeng, M.; Dueger, E.; Widdowson, M.-A.; Dawood, F.S.; Koram, K.; Ampofo, W.Background: Influenza vaccination is recommended by the World Health Organization for high risk groups, yet few data exist on influenza disease burden in West Africa. Methods: We estimated medically attended influenza-associated illness rates among residents of Shai-Osudoku and Ningo Pram-Pram Districts (SONPD), Ghana. From May 2013 to April 2015, we conducted prospective surveillance for severe acute respiratory illness (SARI) and influenza-like illness (ILI) in 17 health facilities. In 2015, we conducted a retrospective assessment at an additional 18 health facilities to capture all SONPD SARI and ILI patients during the study period. We applied positivity rates to those not tested to estimate total influenza cases. Results: Of 612 SARI patients tested, 58 (9%) were positive for influenza. The estimated incidence of influenza-associated SARI was 30 per 100,000 persons (95% CI: 13-84). Children aged 0 to 4years had the highest influenza-associated SARI incidence (135 per 100,000 persons, 95% CI: 120-152) and adults aged 25 to 44years had the lowest (3 per 100,000 persons, 95% CI: 1-7) (p<0.01). Of 2,322 ILI patients tested, 407 (18%) were positive for influenza. The estimated incidence of influenza-associated ILI was 844 per 100,000 persons (95% CI: 501-1,099). The highest incidence of influenza-associated ILI was also among children aged 0 to 4ears (3,448 per 100,000 persons, 95% CI: 3,727 - 3,898). The predominant circulating subtype during May to December 2013 and January to April 2015 was influenza A(H3N2) virus, and during 2014 influenza B virus was the predominant circulating type. Conclusions: Influenza accounted for 9% and 18% of medically attended SARI and ILI, respectively. Rates were substantive among young children and suggest the potential value of exploring the benefits of influenza vaccination in Ghana, particularly in this age group.Item Information gaps in surveillance data and effects on the Ghanaian response to the Ebola outbreak in West Africa(Ghana medical journal, 2017-09) Awini, E.A.; Bonney, J.H.K.; Frimpong, J.A.; Ampofo, W.K.; Koram, K.A.Background: Complete and accurate information on disease occurrence is crucial for effective public health response to disease outbreaks. In response to the 2014 Ebola epidemic in West Africa, Ghana intensified surveillance for the disease across the country. However, the case definition provided by the Ministry of Health was not uniformly applied at all reporting health facilities.Objective: This paper analyses the accompanying Case Record Forms (CRFs) submitted to Noguchi Memorial Institute for Medical Research to determine its completeness and appropriateness for instituting an effective response to the epidemic.Methods: We determined the proportions of completeness in reporting for all criteria provided by the MOH for the clinical diagnosis of Ebola. New indicators were generated to measure the completeness of each variable. Tables and graphs of completeness of indicators were produced and presented.Results: Of the 156 samples, 69% were from males. Approximately 4.5% had no record for age. The date of specimen collection was filled for 96%; 34.6% (54) did not have date of onset of symptoms. In 37.8% (59) of cases, location was blank. In 12% of cases, no symptoms were recorded and about 30% had no record of fever. Travel history, especially to affected areas, was missing for 40.4%.Conclusions: Gaps on CRFs can significantly reduce the utility of results of laboratory analysis for outbreak control. Although all the samples analysed were negative for Ebola Virus, the high proportion of missing data on the forms should be a source of concern. We recommend that frontline health staff be trained on the importance of capturing all information required on the form.Source of funding: The funding for the analysis of suspected samples were provided partially by Ghana Health Servce and research funding from Noguchi Memorial Institute for Medical Research.Item 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.Item Modeling the environmental suitability of anthrax in Ghana and estimating populations at risk: Implications for vaccination and control(PLoS Neglected Tropical Diseases, 2017-10) Kracalik, I.T.; Kenu, E.; Ayamdooh, E.N.; Allegye-Cudjoe, E.; Polkuu, P.N.; Frimpong, J.A.; Nyarko, K.M.; Bower, W.A.; Traxler, R.; Blackburn, J.K.Anthrax is hyper-endemic in West Africa. Despite the effectiveness of livestock vaccines in controlling anthrax, underreporting, logistics, and limited resources makes implementing vaccination campaigns difficult. To better understand the geographic limits of anthrax, elucidate environmental factors related to its occurrence, and identify human and livestock populations at risk, we developed predictive models of the environmental suitability of anthrax in Ghana. We obtained data on the location and date of livestock anthrax from veterinary and outbreak response records in Ghana during 2005–2016, as well as livestock vaccination registers and population estimates of characteristically high-risk groups. To predict the environmental suitability of anthrax, we used an ensemble of random forest (RF) models built using a combination of climatic and environmental factors. From 2005 through the first six months of 2016, there were 67 anthrax outbreaks (851 cases) in livestock; outbreaks showed a seasonal peak during February through April and primarily involved cattle. There was a median of 19,709 vaccine doses [range: 0–175 thousand] administered annually. Results from the RF model suggest a marked ecological divide separating the broad areas of environmental suitability in northern Ghana from the southern part of the country. Increasing alkaline soil pH was associated with a higher probability of anthrax occurrence. We estimated 2.2 (95% CI: 2.0, 2.5) million livestock and 805 (95% CI: 519, 890) thousand low income rural livestock keepers were located in anthrax risk areas. Based on our estimates, the current anthrax vaccination efforts in Ghana cover a fraction of the livestock potentially at risk, thus control efforts should be focused on improving vaccine coverage among high risk groups. © 2017 Public Library of Science. All Rights Reserved.Item Social Support for the Aged: The Role of Private Care Homes in Accra(University of Ghana, 2015-07) Frimpong, J.A.; Sackey, B.M.; University of Ghana, College of Humanities Centre for Social Policy StudiesThis study sought to investigate the role of Private Care Homes in supporting the aged in Accra. The study adopted a mixed research technique in the data collection and analysis. It also used a cross sectional survey design. The data was collected from mainly primary sources using interview guide and questionnaire from Private Care Homes in Accra, Adenta, Osu and Dzorwulu. The data was analysed using descriptive statistics and thematic analysis. The findings of the study indicated that private Care Homes primarily provide their patrons services ranging from training in care for the elderly, medical services, social services and other home related services, as well as recreation. The study found that reasons why some aged people patronise services of private care homes are due to the busy schedule of their children, and neglect by their children, and modernisation. It also found that the challenges Private Care Homes face include (1) lack of or inadequate specialist staff, (2) committed or dedicated staff to provide services for aged people, (3) financial constraints, (4) lack of regulatory framework, among others. Lastly, it found that aged people in care homes are likely to face social inclusion problems, and institutional abuse in the form of being forced to eat or go to bed at a particular time, financial difficulties, as well as lack of choice and alternatives in service provision. It was however found that physical abuse between residents in private care homes will not exist and pose problem to the occupants. Consequently, services provided by private care homes suggestedly have affirmative impact on welfare of aged people. Based on these outcomes, the study made some recommendations which will significantly influence public policy in effective management of aged people and administration Care Homes in Ghana specially and Africa in general.Item Status of biodiesel research and development in Kenya(Taylor & Francis Group, 2021) Takase, M.; Kipkoech, R.; Essandoh, P.K.; Afrifa, E.A.; Frimpong, J.A.Research has established that biodiesel performs well in engine and is considered to be fuel with low carbon emission. This gives it a possibility of replacing it with fuel obtained from fossil sources and whose amount is dwindling as they are not renewable. Biodiesel development in Kenya has begun to receive high levels from the government due to continued rise in the cost of fossil fuels. Various stakeholders in biodiesel industries formed the National Biodiesel Committee in January 2006 under the Ministry of Energy to have a collective voice in promoting policies such as blending mandates, tax mandates and production subsidies. This review therefore, focus on status of biodiesel research and development in Kenya. Among the areas of focus include development of biodiesel in various Kenyan institutions, impact of jatropha on Kenya’s biodiesel plans, status of biodiesel research using indigenous jatropha oil, physicochemical properties of Jatropha curcas seed oil, formulation of biodiesel policy, possibility of harnessing indigenous algae for biodiesel production and the possibility of re-using waste vegetable oil and animal fat for biodiesel. The various works reviewed revealed that the energy requirement of Kenya can be met and the looming energy crisis averted.Item Troop education and avian influenza surveillance in military barracks in Ghana, 2011(2012-11-08) Odoom, J.K.; Bel-Nono, S.; Rodgers, D.; Agbenohevi, P.G.; Dafeamekpor, C.K.; Sowa, R.M.L.; Danso, F.; Tettey, R.; Suu-Ire, R.; Bonney, J.H.K.; Asante, I.A.; Aboagye, J.; Abana, C.Z.Y.; Frimpong, J.A.; Kronmann, K.C.; Oyofo, B.A.; Ampofo, W.K.Abstract Background Influenza A viruses that cause highly pathogenic avian influenza (HPAI) also infect humans. In many developing countries such as Ghana, poultry and humans live in close proximity in both the general and military populations, increasing risk for the spread of HPAI from birds to humans. Respiratory infections such as influenza are especially prone to rapid spread among military populations living in close quarters such as barracks making this a key population for targeted avian influenza surveillance and public health education. Method Twelve military barracks situated in the coastal, tropical rain forest and northern savannah belts of the country were visited and the troops and their families educated on pandemic avian influenza. Attendants at each site was obtained from the attendance sheet provided for registration. The seminars focused on zoonotic diseases, influenza surveillance, pathogenesis of avian influenza, prevention of emerging infections and biosecurity. To help direct public health policies, a questionnaire was used to collect information on animal populations and handling practices from 102 households in the military barracks. Cloacal and tracheal samples were taken from 680 domestic and domesticated wild birds and analysed for influenza A using molecular methods for virus detection. Results Of the 1028 participants that took part in the seminars, 668 (65%) showed good knowledge of pandemic avian influenza and the risks associated with its infection. Even though no evidence of the presence of avian influenza (AI) infection was found in the 680 domestic and wild birds sampled, biosecurity in the households surveyed was very poor. Conclusion Active surveillance revealed that there was no AI circulation in the military barracks in April 2011. Though participants demonstrated good knowledge of pandemic avian influenza, biosecurity practices were minimal. Sustained educational programs are needed to further strengthen avian influenza surveillance and prevention in military barracks.