Browsing by Author "Nortey, P."

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Antimicrobial drug usage and poultry production: Case study in Ghana
(Animal Production Science, 2019-01) Johnson, S.; Bugyei, K.; Nortey, P.; Tasiame, W.
Antimicrobial use in food animal production could lead to the occurrence of antimicrobial residues in the animal products. In Ghana, there is no monitoring program for antimicrobial residue in foods of animal origin. We determined the types of antimicrobial drugs used in poultry production in Dormaa municipality and the levels of residue found in poultry products. Performing a cross-sectional study, a structured questionnaire and direct observation methods were used to assess antimicrobial usage, knowledge of and adherence to withdrawal periods in randomly selected poultry farms. Eggs and ready-for-sale broilers were purchased from selected respondents' farms for detection and quantification of residues using the microbial inhibition plate assay. A total of 132 farmers were interviewed from 115 farms. Farms (86%) administered drugs to birds for prophylactic purposes. A total of 28 (24.3%) farms had tetracycline residue in eggs, 25 (21.7%) in kidney and 14 (12.2%) in liver. Mean (±s.d.) tetracycline concentration (μg/g) found were: eggs 0.02 ± 0.003 kidneys 0.02 ± 0.01 and liver 0.01 ± 0.008. Twenty-six farms (92.9% ρ > 0.05) that had residues in eggs had sold eggs during treatment of the laying birds. A disinfectant and two antibiotics in human formulations were administered to birds in 44.3%, 17.4% and 2.6% farms respectively on an extra-label basis. Tetracyclines were the main antimicrobial drugs used in poultry farming in the study area with little or no regard to withdrawal periods. Tetracycline residue was found in poultry but below the Maximum Residue Level set by Codex Alimentarius. Extra-label use of disinfectant to water-medicate birds poses a health hazard to farmers and consumers alike. © 2019 CSIRO.
Assessing the sensitivity and specificity of First Response HIV-1-2 test kit with whole blood and serum samples: a cross-sectional study
(2016-02-16) Boadu, R.; Darko, G.; Nortey, P.; Akweongo, P.; Sarfo, B.
Abstract Background Human immunodeficiency virus (HIV) Rapid diagnostic Test (RDT) kits are the preferred assays for HIV testing in many countries. Prevention of Mother-to-Child Transmission, Know Your Status Campaigns, Blood-Safety, Voluntary Counseling and Testing are major strategies adapted to control transmission of the virus and the pivot of these interventions is either screening or diagnosing individuals through testing. There are reports of inconsistent sensitivity and specificity with whole blood and serum samples collected from the same individual. Little is known about the diagnostic characteristics of First Response HIV-1-2 RDT kit, used as a single test kit in national HIV prevention and control programmes. The debate has always centered on choosing between whole blood and serum in a case where a single test kit that runs on only blood specimen will be used for testing. The variations in specificities and sensitivities with whole blood and serum samples imply that some individuals who might be true positives will be missed and elude care. This study determined the best blood-based specimen type (whole blood or serum) that improves performance of First Response HIV RDT kit in detecting HIV-specific antibodies. Methods A hospital-based cross-sectional study was conducted on 280 HIV infected and non-infected patients from May 2015 to June 2015. Blood samples from each participant were separated into whole blood and serum, and tested on First Response HIV-1-2 kits (Premier Medical Corporation Ltd., Kachigam, India) using Electro-chemi-luminescence assay (ECLIA) as reference assay. Results First Response HIV-1-2 RDT kit showed 100 % sensitivity and 100 % specificity with whole blood specimen and 100 % sensitivity and 82.86 % specificity with serum specimen for the detection of HIV-1. The positive and negative predictive values were 100, 100 and 85.35, 82.86 % for whole blood and serum respectively. Conclusion Whole blood specimen(s) from an individual have higher specificity, positive and negative predictive values than serum. Whole blood is the primary specimen to use on First Response HIV-1-2 RDT kit when screening peripheral blood for HIV-1-specific antibodies.
Barriers to Glycaemic Control Among Diabetes Patients at the Korle-Bu Teaching Hospital
(University of Ghana, 2012-07) Akotey, E.A.A.; Nortey, P.
Background: Diabetes is a condition whereby the body fails to regulate levels of glucose in the body, resulting in too much glucose being present in the body. Despite the strong consensus that good glycaemic control minimizes the risk of developing complications such as nephropathy, and cardiovascular diseases in Type 2 Diabetes Mellitus (T2DM), only few patients can obtain optimal glycaemic control. Objective: This study was to explore factors associated with poor glycaemic control among diabetes patients at the Korle-Bu Teaching Hospital. Design: A case control study of 230 diabetes patients consisting of 115 cases with HbA1c value ≥7, and 115 controls with HbA1c value <7. Method: Data was collected by trained interviewers through questionnaire interviews of a total of 230 diabetes patients older than 20 years of age, and who had an HbA1c test within the previous three months. Univariate and multivariate logistic regression analysis were carried out to identify socio demographic factors, and to find out if there was association between lifestyle factors, knowledge about diabetes and hypertension that were likely to influence glycaemic control. Results: Poor glycaemic control was found to be significantly associated with persons aged >40 years (OR: 3.99) and persons who were retired from active work but still working. Women were at a higher risk of having poor glycaemic control than men (OR: 3.57). People who had poor knowledge of their fasting plasma glucose (FPG) were found to have a higher risk of poor glycaemic control (OR: 5.71). There was a significant association of poor glycaemic control and increasing number of pills to swallow daily (OR: 2.86), and persons who did not adhered to medication regimen and missed out on some medications. Furthermore, poor glycaemic control was found to be significantly associated with persons who defaulted in follow up review visits to the physician’s office (OR: 2.56), and persons who visited the physician’s office for treatment every three month (OR: 4.65 95% 0.07, 0.68) with p-value 0.008. Hypertension was found not to be statistically associated with poor glycaemic control. Conclusion: There is evidence suggesting that some socio demographic factors such as age and sex, knowledge about fasting plasma glucose, and lifestyle factors such as non adherence to medication regimen and follow up visit to the hospital/physicians’ office were significantly associated with poor glycaemic control. Therefore a good control is essential for the future well being of all diabetes patients. Addressing these issues may help to decrease the disparities that currently exist in diabetes management.
Burden of malaria in children under fve and caregivers’ health-seeking behaviour for malaria-related symptoms in artisanal mining communities in Ghana
(Parasite & Vector, 2021) Dao, F.; Djonor, F.K.; Ayin, C.T-M.; Adu, G.S.; Sarfo, B.; Nortey, P.; Akuffo, K.O.; Danso-Appiah, A.
Background: Artisanal mining creates enabling breeding ground for the vector of malaria parasites. There is paucity of data on the efects of artisanal mining on malaria. This study assessed burden of malaria and caregivers’ health seeking behaviour for children under fve in artisanal mining communities in East Akim District in Ghana. Methods: A cross-sectional study involving caregivers and their children under fve was conducted in three artisanal mining communities in the East Akim District in Ghana. Caregivers were interviewed using a structured questionnaire. Finger prick blood samples were collected and analysed for haemoglobin concentration using a rapid diagnostic test, and thick and thin blood smears were analysed to confrm the presence of malaria parasites. Results: Of the 372 children under 5 years included in the study, 197 (53.1%) were male, with a mean age (±SD) of 23.0±12.7 months. The proportion of children with malaria (Plasmodium falciparum and P. malariae) was 98.1% and 1.9%, respectively, whilst the proportion with anaemia (Hb<11.0 g/dl) was 39.5% (n=147). Almost all caregivers were female (98.9%), and 28.6% (n=106) did not have access to any malaria control information. Caregivers associated malaria infection with mosquito bites (68.3%, n=254) and poor sanitation (21.2%, n=79). Malaria in children under fve was signifcantly associated with anaemia (OR 11.07, 95% CI 6.59–18.68, n=111/160, 69.4%; P<0.0001), residing close to stagnant water (≤25 m) from an artisanal mining site (AOR 2.91, 95% CI 1.47–5.76, P=0.002) and caregiver age younger than 30 years (OR 0.44, 95% CI 0.208–0.917, n=162, 43.55%, P=0.001). Conclusions: There is a high burden of malaria and anaemia among children under fve in artisanal mining com‑ munities of the East Akim District, and far higher than in non-artisanal mining sites. Interventions are needed to efectively regulate mining activities in these communities, and strengthen malaria control and health education campaigns to curtail the high malaria burden and improve health-seeking behaviour.
Determinants of low birth weight in neonates born in three hospitals in Brong Ahafo region, Ghana, 2016- an unmatched case-control study
(BMC Pregnancy and Childbirth, 2019-04-25) Nortey, P.; Adam, Z.; Ameme, D.K.; Afari, E.A.; Kenu, E.
Background: Each year, about 20 million Low Birth Weight (LBW) babies are born with very high proportion (96.5%) occurring in developing countries. In the last decade, the incidence of LBW in Ghana has not declined. Brong Ahafo Region of Ghana recorded a LBW prevalence of 11% which was higher than the national average of 10%. This study identified determinants of LBW delivery in the Brong Ahafo Region. Methods: We conducted a 1:2 unmatched case control study among mothers with singleton deliveries in 3 major health facilities in the Brong Ahafo Region. A case was defined as a mother who delivered a baby weighing less than 2500g in any of the three selected health facilities between 1st December, 2015 and 30th April, 2016. A control was defined as a mother who within 24 h of delivery by a case, delivered a baby weighing at least 2500g and not exceeding 3400g in the same health facility. Deliveries that met the inclusion criteria for cases were selected and two controls were randomly selected from the pool of deliveries that meet criteria for controls within 24 h of delivery of a case. A total of 120 cases and 240 control were recruited for the study. We computed odds ratios at 95% confidence level to determine the associations between low birth weight and the dependent factors. Results: After controlling for confounders such as planned pregnancy, mode of delivery, parity and previous LBW in stepwise backward logistic regression, first trimester haemoglobin < 11 g/dl (aOR 3.14; 95%CI: 1.50–6.58), delivery at 32-36 weeks gestation (aOR 13.70; 95%CI: 4.64–40.45), delivery below 32 weeks gestation (aOR 58.5; 95%CI 6.7–513.9), secondary education of mothers (aOR 4.19; 95%CI 1.45–12.07), living with extended family (aOR 2.43; 95%CI 1.15–5.10, living alone during pregnancy (aOR 3.9; 95%CI: 1.3–11.7), and not taking iron supplements during pregnancy (aOR 3.2; 95%CI: 1.1–9.5) were found to be significantly associated with LBW. Conclusion: Determinants of LBW were: preterm delivery, mothers with secondary education, living alone during pregnancy, not taking daily required iron supplementation and mothers with first trimester haemoglobin below 11 g/dl. Education during antenatal sessions should be tailored to address the identified risk factors in the mother and child health care services.
Efficacy and possible adverse effects of the oral iron chelator 1,2-dimethyl-3-hydroxypyridin-4-one (L1) in thalassemia major
(Blood, 1992) Al-Rafaie, F.N.; Wonke, B.; Hoffbrand, A.V.; Wickens, D.G.; Nortey, P.; Kontoghiorghes, G.J.
Eleven patients with beta thalassemia major were entered into the trial of the oral chelator 1,2-dimethyl-3-hydroxypyrid-4-one (L1). Their ages ranged from 17 to 26 years (mean +/- SD, 22.3 +/- 2.7). Six were male and five were female. L1 was administered at an initial daily dose of 42.5 to 60 mg/kg as a single dose. After 4 weeks, the dose was increased to 85 to 119 (102 +/- 10.7) mg/kg for 191 to 352 days divided into either two or four doses daily, except for one patient who developed agranulocytosis after 11 weeks and was taken off the trial. Initial serum ferritin values in the remaining 10 patients ranged between 1,000 and 9,580 (5,549 +/- 3,333) micrograms/L and at end of the trial their mean serum ferritin was significantly lower (4,126 +/- 2,278; P less than .05 using the paired t-test). Urinary iron excretion at a daily dose of 85 to 119 mg/kg administered as two divided doses ranged between 0.14 and 0.82 (0.44 +/- 0.26) mg/kg/24 h. In three patients, the four doses per day schedule caused substantially more iron excretion than the same total dose divided into two. During the course of the trial, several possible adverse effects have been encountered. One patient (female, aged 20) developed agranulocytosis 11 weeks after starting treatment and 6 weeks after beginning treatment with a daily dose of 105 mg/kg. This patient's neutrophil count recovered spontaneously 7 weeks after the discontinuation of L1. A decrease in serum zinc levels to subnormal levels was observed in four patients with symptoms of dry skin, with an itchy scaly rash in two that was associated with low serum zinc levels that responded to zinc therapy. Urinary zinc levels ranged from 4.7 to 23.4 (13 +/- 5.5) mumol/24 h and were above 9 mumol/24 h (upper limit of normal) in eight patients. Mild nausea occurred in three patients and transient diarrhea in a fourth. Mild musculoskeletal symptoms occurred in three patients but settled without discontinuation of L1 therapy in two and with temporary discontinuation of L1 in the third. A transient increase in serum aspartate transaminase was also noted in five patients, but serum aspartate transaminase levels subsequently decreased in all of them. No cardiovascular, neurologic, renal, or retinal toxicities were demonstrable. These results confirm that L1 is an effective oral iron chelator. Further clinical trials are needed to determine the incidence and severity of adverse effects.
Factors affecting dental diseases presenting at the University of Ghana Hospital
(SpringerPlus, 2016-10) Nimako-Boateng, J.; Owusu-Antwi, M.; Nortey, P.
Dental diseases are common in man and range from a toothache to cancers of the head and neck. Dental conditions can affect our capacity to function effectively in areas such as smiling, chewing and speaking. The objective of this study was to describe the main types of dental conditions presenting at the University Hospital between January 2006 and December 2011 and to determine factors associated with the top five diagnosed conditions as well as the acute and chronic conditions. A retrospective review of all 5012 clinical records of dental patients visiting the dental unit within the period stated was carried out. A total of 4196 records which passed the inclusion/exclusion criteria were analysed. Most of the patients who presented were adults. The top 5 dental conditions were apical periodontitis (50.4 %), reversible pulpitis (23.3 %), Gingivitis (11.4 %), Periodontitis (6.2 %) and Halitosis/bad breadth (8.8 %). The top 5 conditions constituted over 75 % of the cases seen. About 84 % of the presentation was acute whilst 16 % was chronic. For the entire dataset and also the top five conditions, approximately 53.0 % were males and 47.0 %. Males outnumbered females on all occasions except for halitosis and most patients presented within 1 month of experiencing symptoms of dental disease. Some significant association was found between the presence of multiple chronic conditions and reversible/irreversible pulpitis. The main dental conditions presenting at the University Hospital during the stated period (i.e. between January 2006 and December 2011) were: apical periodontitis (50.4 %), reversible pulpitis (23.3 %), gingivitis (11.4 %), periodontitis (6.2 %) and halitosis/bad breadth (8.8 %). © 2016, The Author(s).
Factors Contributing to Outcomes of the Pmtct Intervention in the Western Region of Ghana
(University of Ghana, 2015-03) Amo-Addae, P. K.; Nortey, P.
Background: In 2009, when the UNAIDS called for the elimination of mother-to-child transmission of HIV (MTCT) by 2015, Ghana was found to be one of 20 countries accounting for 80% of the global burden of prevention of MTCT (PMTCT). MTCT is the main source of pediatric HIV, accounting for over 90% of cases worldwide. This study contributes to the assessment of Ghana‟s performance towards achieving the elimination of MTCT. The study described the coverage and outcomes of the PMTCT intervention from 2010 to 2013, assessed the knowledge of midwives regarding the intervention and sought to identify maternal and pregnancy-related factors contributing to PMTCT outcome by 6weeks after delivery in the Western Region of Ghana. Methods: Quantitative and qualitative methods were applied in the study. Records reviews and indepth interviews were conducted to describe the PMTCT coverage and outcomes and to assess the knowledge and practices of midwives implementing PMTCT. A nested case control design was used to determine factors contributing to PMTCT outcome. The Epiinfo statistical package was used for the analysis. Results: Facilities providing PMTCT services are available in all districts of the Region. However, 42 private facilities and CHPS compounds* offering ANC services within these districts do not conduct HIV testing for clients. From 2010 to 2013, a total of 36.3% of ANC clients (147,990 out of 408,201) were not tested for HIV. However, the prevalence of HIV among the ANC clients tested in the Region shows a downward trend from 2.3% in 2010 to 1.9% in 2013. There is low patronage of the early infant diagnosis (EID) service at the Regional Public Health Laboratory. EID records were available for only 13.4% of exposed babies from November 2011 to November 2013. Midwives providing the PMTCT service were unaware of the PMTCT national target and had weak follow-up systems to trace defaulting clients. Spousal influence and fear of the unknown was the main reason for opting out of HIV testing at ANC. None of the maternal and pregnancy-related variables studied (including age, concurrent illness, IPT compliance and birth order) was found to contribute significantly to PMTCT outcomes in the Western Region but twin delivery and female sex had higher risk of MTCT. The MTCT rate was 5.5% among a group of mothers and their babies whose ART history could not be ascertained, but surprisingly higher at 12.1% among PMTCT clients who had benefitted from ART. Conclusion: There is adequate distribution of PMTCT services in the Western Region of Ghana. An MTCT rate of 5.5% to 12% was observed. Some gaps identified in achieving elimination of MTCT were the non-availability of HIV testing at some ANC sites, missed opportunities for HIV testing at ANC clinics and low knowledge and patronage of EID by midwives and their clients resulting in the loss of many babies along the continuum of care. Twin gestation and having a female baby may be associated with higher MTCT risk but this requires further research. Key words: PMTCT, MTCT, risk, elimination, outcomes, ANC, EID *Community-based Health Planning and Services (CHPS) compounds are primary level healthcare facilities operating at the community.
Factors Influencing Adherence To Oral Antihypertensive Medication Amongst Patients Attending The Korle-Bu Teaching Hospital
(University of Ghana, 2013-07) Laryea, J.G.; Nortey, P.; University of Ghana, College of Health Sciences, School of Public Health
Introduction: Medication adherence is an integral component in the management of hypertension. Poor adherence to medications is one of the major public health challenges. Sub optimal adherence to antihypertensive medication is a major risk factor for many cardiovascular diseases. Good medication adherence would ensure adequate blood control and therefore reduce cardiovascular morbidity and mortality. The objective was to measure adherence levels amongst hypertensive patients and to determine factors influencing their adherence to antihypertensive medications. Method: A cross sectional study was conducted at the O.P.D of the Korle Bu Teaching Hospital in Accra amongst 413 hypertensive patients aged 18 years and above. The Morisky Medication Adherence Scale (MMAS-8) was used to determine the levels of adherence. Good adherence was defined as MMAS scores of 6 and more out of a total score of 8. Results: Overall, 197(47.7%) patients had good adherence to antihypertensive medication. After multivariate adjustment marital status was the most significant; compared with the singles the adjusted odds for the divorced was lower, OR 0.19 (95%CI, 0.06 – 0.65). Additionally being a professional, earning a monthly income of ₵601 and above, duration of 5 to 10 years hypertension , presence of side effects, taking more antihypertensive tablets daily, and unacceptable waiting time at the clinic were all associated with poor adherence. Conclusion: There is an overall poor adherence rate of 52.3% among adult hypertensive users at KBTH. This prompts the need for continuous health education especially amongst new hypertensive patients with emphasis on its causes, severity, medications and consequences of non adherence with treatment.
Factors Influencing Alcohol Consumption among Adult Residents of Osu District, Greater Accra Region
(University of Ghana, 2015) Mccarthy-Boham, L.; Nortey, P.; University of Ghana, College of Health Sciences, School of Public Health
Introduction: Alcohol is a powerful psychoactive substance and nervous system depressant. Alcohol consumption is of public health concern globally. Osu is renowned for its numerous drinking centres which continues to grow in number. This study sought to investigate the factors influencing alcohol among adult residents of Osu (18 years and above) and provide current relevant knowledge on alcohol consumption in Ghana. Method: Data on factors which influences alcohol consumption among adult Osu residents was collected using a structured questionnaire. Out of 1052 houses, 405 were randomly selected from which respondents were interviewed. The data collected were processed and analysed using Stata and Microsoft Excel computer software. The association between these factors and alcohol consumption was determined by using Pearson’s chi square test of 5% confidence level and logistic regression. Results: The proportion of respondents who currently consume alcohol was 39% out of this, 72.8% were males. Sex, employment status and income were the socio-demographic factors that were significantly associated with alcohol consumption among the respondents. Conclusion: A greater proportion of males consume alcohol than females, corresponding with worldwide trend. Drinkers are more likely to be employed than unemployed. Beer was the most preferred alcoholic beverage among the adult residents of Osu. Funds for education on alcohol consumption should be increased. Keywords: alcohol consumption, adult residents, Osu, Ghana
Factors Influencing Hiv Preventive Practices among Female Sex Workers in Takoradi
(University of Ghana, 2016-07) Habib, H.H.; Nortey, P.; University of Ghana, College of Health Sciences School of Public Health
BACKGROUND: Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome, (HIV-AIDS) is an incurable disease estimated to cause an annual worldwide mortality of above 1 million, most of which are in Sub Saharan Africa alone (WHO, 2014). Female Sex Workers are a higher risk Key Population where HI is concentrated. FSW HIV prevalence in Ghana is 11.1%, several times higher than the national prevalence of 1.3% (NACP, 2014). This study focused on FSW in Takoradi, a city which has recently encountered a large influx of moneyed migrants working in the petroleum sector due to oil finds off the western coast of Ghana. AIM: The aim of the study was to investigate factors influencing HIV preventive practices among Female Sex Workers in Takoradi. METHOD: The study was a cross sectional study involving 121 FSW from the Takoradi Metropolis. A standardised questionnaire was administered to FSW in different hotspots to collect socio-demographic, comprehensive HIV knowledge, condom use and other relevant data. Data collected were audited, coded, entered into STATA version 13 and subsequently cleaned. Frequencies were run for each variable to determine statistics. Bivariate analyses was conducted to investigate the relationships between variables at P<0.05 significance. RESULTS: A total of 121 FSWs participated in the study out of which 58.68 % were brothel based and 41.32% were street/pub/club based. Awareness of HIV, condom use and knowledge of modes of transmission were highly reported although comprehensive knowledge on HIV was relatively low (26.45%). Self-perceived risk was also low. Most FSW reported high condom usage and negotiation efficacy with their paying clients although out of those who had non-paying partners, majority reported no condom usage and negotiation efficacy. Although there was significant level of alcohol and drug consumption, they did not significantly affect preventive behaviour. CONCLUSION: Findings indicate that although there is knowledge about HIV, it is only superficial. Moreover, risky sexual practices exist between FSW and their non-paying partners which indicates a gap in preventive behaviour and a necessity for appropriate targeted interventions.
Factors Influencing HIV Testing And Counseling Uptake In The Cape Coast Metropolitan Of Ghana
(University of Ghana, 2013-07) Filiatreau, L.M.; Nortey, P.; University of Ghana, College of Health Sciences, School of Public Health
Only 25% of individuals aged 15-49 in the African Region know their HIV sero-status. In the Cape Coast Metropolitan Area of Ghana, just 3.2% of men and 6.7% of women aged 15-49 had been tested within the past 12 months and knew their status at the time of the 2008 Demographic and Health Survey. At 9.6%, the Cape Coast sentinel site reported the highest prevalence of HIV in the country in 2011. The Central Region as a whole saw an increase in prevalence from 1.7% to 3.7% from 2010 to 2011. The main objective of this study was to determine factors influencing HIV testing and counseling uptake in the Cape Coast Metropolitan Area. A population based cross-sectional study was carried out among 75 males and 145 females aged 15-49 in the study area. Multi-stage cluster sampling was used to obtain this population-representative sample in 12 enumeration areas throughout the Metropolitan. The random walk method was utilized in sampled enumeration areas to obtain study participants. Trained research assistants verbally administered the survey questionnaire. From the study, more females than males (33.1% versus 24.0%) had been tested for HIV within the past 12 months and received their results. The primary reason among both sexes for failure to test was fear of stigmatization (63.6% and 72.1%), followed closely by fear of test results (54.6% and 60.3%). For male respondents, HTC uptake was 12.44 (1.83, 91.24) times higher in individuals that had traveled 5 or more times within the past twelve months in comparison to no travel at all. Uptake was 90% (aOR=0.1029, 95% CI= 0.01, 0.72) lower in individuals that believed HTC uptake could lead to an early death. For females, testing was lower among those that had only attended some secondary high school (aOR=0.0766, 95% CI=0.0098, 0.5968), believed HTC could lead to an early death (aOR=0.2480, 95% CI=0.0653, 0.9412), and had not has sexual intercourse within the past 12 months (aOR=0.025, 95% CI= 0.001,0.6195). Females that were not currently working as students, traders, or civil servants were 35 times more likely (CI=2.4680, 516.07) to have been tested than those currently attending school.
Factors that affect Glycaemic Control among Type 2 Diabetes Mellitus Patients in Kwahu South District Eastern Region, Ghana
(University of Ghana, 2012-07) Tengey, J.; Nortey, P.
Diabetes mellitus (DM) has become one of the most common chronic diseases globally, and it has assumed an epidemic status in the past few decades especially in low and middle income countries. The most frequent form is Type 2 diabetes which represents more than 85% of cases; other forms are Type 1 (10%) and Gestational diabetes (5%). Type 2 diabetes is a progressive disease associated with an increased risk of developing several complications which include; cardiovascular diseases, diabetic retinopathy and nephropathy. These complications are directly and strongly related to hyperglycaemia. Aggressive treatment to control hyperglycaemia is much more effective in reducing the number of complications than standard treatment. The study aims to determine the proportion of poor glycaemic control and identify the factors affecting the glycaemic control of type 2 DM. The glycated haemoglobin (HbA1c) of 382 type 2 diabetes mellitus patients attending diabetic clinic at Atibie Government Hospital were determined. Simple random sampling was applied to select 100 patients who had HbA1c > 6.5% as cases, and 100 with HbA1c < 6.5% as controls. Using a multivariate logistic regression model, factors that are associated with poor glycaemic control were determined. Majority had well controlled glycaemic status (64%). The commonest comorbidity was hypertension (60.5%). Patients with no family support are six times more likely to have poor glycaemic control as compare to those with family support (OR 6.40, 95% CI 1.70, 23.9 0, p= 006). Income level less than Gh₵ 250, and High Density Lipoprotein were strongly associated with poor glycaemic control (OR 0.063, 95% CI 0.008, 0.505 p=0.009, OR 0.31, 95% CI 0.17, 0.56, p<0.001) respectively. Prevalence of poor glycaemic control was 36%. Low income level and HDLP were significant risk factor for poor glycaemic control. We recommended that HbA1c assay equipment and reagents should be provided for all district hospitals, regular lipid profile should be carried out at regular short intervals. Diabetic patients with low financial status should be assisted.
Hepatitis B virus genotypes among chronic hepatitis B patients reporting at Korle-Bu teaching hospital, Accra, Ghana
(SAGE Publications Ltd, 2016) Dongdem, A.Z.; Dzodzomenyo, M.; Asmah, R.H.; Nyarko, K.M.; Nortey, P.; Agyei, A.; Adjei, D.N.; Kenu, E.; Adjei, A.A.
INTRODUCTION: Knowledge of hepatitis B virus (HBV) genotype is an important predictive variable which might have an impact in management and treatment of patients with chronic hepatitis B infection. In Ghana very little information is available on hepatitis B genotypes. This study was conducted to determine the distribution of HBV genotypes circulating among chronic hepatitis B patients reporting at the Korle-Bu Teaching Hospital (KBTH), Accra, Ghana.METHODS: Blood samples (10 ml) were collected from 250 consenting patients. DNA was extracted and amplified using polymerase chain reaction technique. Restriction fragment length polymorphism (RFLP) was used for the detection of genotypes.RESULTS: Out of the 250 chronic hepatitis B patients who were HBsAg positive, 91 (36.4%) were males aged 29.8 ± 9.1 and 159 (63.6%) females aged 33± 12.1 years. HBV DNA was detected in 111 (44.4%) but only 58 (52%) of these were typeable. These were classified as genotype A, 8 (7.2%); genotype D, 3 (2.7%) and genotype E, 47 (42.3%). Our results did not show any association between the infecting genotype and age (X2= 0.923; p-value=0.623) or gender (X2= 0.283, p= 0.579).CONCLUSION: Consistent with similar studies worldwide, the results suggest that genotypes A, D and E were the genotypes circulating among chronic hepatitis B patients who reported to the Korle-Bu Teaching Hospital with genotype E being the most predominant and therefore constitutes an important public health concern. We recommend further epidemiological studies to understand the implication of genotype E in terms of disease progression and treatment.
Impact evaluation of the free maternal healthcare policy on the risk of neonatal and infant deaths in four sub-Saharan African countries: a quasi-experimental design with propensity score Kernel matching and difference in differences analysis
(BMJ Open, 2020-03-19) Dwomoh, D.; Agyabeng, K.; Agbeshie, K.; Incoom, G.; Nortey, P.; Yawson, A.; Bosomprah, S.
Objective Despite the huge financial investment in the free maternal healthcare policy (FMHCP) by the Governments of Ghana and Burkina Faso, no study has quantified the impact of FMHCP on the relative reduction in neonatal and infant mortality rates using a more rigorous matching procedure with the difference in differences (DID) analysis. This study used several rounds of publicly available population-based complex survey data to determine the impact of FMHCP on neonatal and infant mortality rates in these two countries. Design A quasi-experimental study to evaluate the FMHCP implemented in Burkina Faso and Ghana between 2007 and 2014. Setting Demographic and health surveys and maternal health surveys conducted between 2000 and 2014 in Ghana, Burkina Faso, Nigeria and Zambia. Participants Children born 5 years preceding the survey in Ghana, Burkina Faso, Nigeria and Zambia. Primary outcome measures Neonatal and infant mortality rates. Results The Propensity Score Kernel Matching coupled with DID analysis with modified Poisson showed that the FMHCP was associated with a 45% reduction in the risk of neonatal mortality rate in Ghana and Burkina Faso compared with Nigeria and Zambia (adjusted relative risk (aRR)=0.55, 95% CI: 0.40 to 0.76, p<0.001). In addition, infant mortality rate has reduced significantly in both Ghana and Burkina Faso by approximately 54% after full implementation of FMHCP compared with Nigeria and Zambia (aRR=0.46, 95% CI: 0.36 to 0.59, p<0.001). Conclusion The FMHCP had a significant impact and still remains relevant in achieving Sustainable Development Goal 3 and could provide lessons for other sub-Saharan countries in the design and implementation of a similar policy.
Knowledge of standard precautions and barriers to compliance among healthcare workers in the Lower Manya Krobo District, Ghana
(BioMed Central Ltd., 2015) Akagbo, S.E.; Nortey, P.; Ackumey, M.M.
Background: Implementing standard precautions (SP) has been a major challenge for health care workers (HCWs) especially those in developing countries thereby compromising their safety and increasing their exposure to blood-related pathogens. Compliance with safety precautions and occupational accidents among health workers are often unreported. The literature on knowledge and compliance to SP in Ghana is scanty. We report findings of a study that examined knowledge of SP, compliance and barriers to compliance with SP among HCWs in two health facilities in Ghana. Methods: This is a facility-based cross-sectional study involving 100 HCWs from two health facilities in the Lower Manya Krobo District of the Eastern region. Statistical analysis summarised data on socio-demographic characteristics of respondents, knowledge of SP and compliance and barriers to SP in frequencies and percentages. Results: Most respondents had been working as health staff for 0-5 years (65.0%). Generally, knowledge of the basic concepts of SP was low; only 37.0% of HCWs knew that SP includes hand washing before and after any direct contact with the patient, 39.0% knew about cough etiquettes and 40.0% knew about aseptic techniques which involve infection prevention strategies to minimise the risks of infection. Fifty percent of respondents always protect themselves against BBFs of patients. About a quarter of the respondents do not recap needles after use and 28.0% of respondents sometimes promptly wipe all blood spills. HCWs were of the opinion that wearing PPEs - such as gloves, aprons, gowns and goggles - might cause patients to panic sometimes (63.0%) and complying with SP sometimes interferes with the ability to provide care (38.0%). Sometimes, because of the demands of patient care, HCWs do not have enough time to comply with the rigours of SP (44.0%) and sometimes PPEs are not available. Conclusion: Education programmes on the benefits of SP should be organised frequently. The OHS national policy together with the application of the IPC training manual in all health care facilities must be enforced. Communities of practice should be established and sanctions and rewards should be introduced to limit negative behavior and reinforce positive attitudes as regards SP.
Knowledge of standard precautions and barriers to compliance among healthcare workers in the Lower Manya Krobo District, Ghana
(BMC Research Notes, 2017) Akagbo, S.E.; Nortey, P.; Ackumey, M.M.
Background: Implementing standard precautions (SP) has been a major challenge for health care workers (HCWs) especially those in developing countries thereby compromising their safety and increasing their exposure to blood-related pathogens. Compliance with safety precautions and occupational accidents among health workers are often unreported. The literature on knowledge and compliance to SP in Ghana is scanty. We report findings of a study that examined knowledge of SP, compliance and barriers to compliance with SP among HCWs in two health facilities in Ghana. Methods: This is a facility-based cross-sectional study involving 100 HCWs from two health facilities in the Lower Manya Krobo District of the Eastern region. Statistical analysis summarised data on socio-demographic characteristics of respondents, knowledge of SP and compliance and barriers to SP in frequencies and percentages. Results: Most respondents had been working as health staff for 0-5 years (65.0%). Generally, knowledge of the basic concepts of SP was low; only 37.0% of HCWs knew that SP includes hand washing before and after any direct contact with the patient, 39.0% knew about cough etiquettes and 40.0% knew about aseptic techniques which involve infection prevention strategies to minimise the risks of infection. Fifty percent of respondents always protect themselves against BBFs of patients. About a quarter of the respondents do not recap needles after use and 28.0% of respondents sometimes promptly wipe all blood spills. HCWs were of the opinion that wearing PPEs - such as gloves, aprons, gowns and goggles - might cause patients to panic sometimes (63.0%) and complying with SP sometimes interferes with the ability to provide care (38.0%). Sometimes, because of the demands of patient care, HCWs do not have enough time to comply with the rigours of SP (44.0%) and sometimes PPEs are not available. Conclusion: Education programmes on the benefits of SP should be organised frequently. The OHS national policy together with the application of the IPC training manual in all health care facilities must be enforced. Communities of practice should be established and sanctions and rewards should be introduced to limit negative behavior and reinforce positive attitudes as regards SP. © 2017 The Author(s).
Long-term trial with the oral iron chelator 1, 2-dimethyl-3-hydroxypyrid-4-one (L1). I. Iron chelation and metabolic studies
(British Journal of Haematology, 1990) Kontoghiorghes, G.J.; Bartlett, A.N.; Hoffbrand, A.V.; Goddard, J.G.; Sheppard, L.; Barr, J.; Nortey, P.
Summary A long-term clinical trial of 1-15 months has been carried out with the oral iron chelator 1.2-dimethyl-3-hydroxypyrid-4-one (L1) in 13 transfusion-dependent ironloaded patients. Urinary iron excretion was greatest in patients with thalassaemia major and was related to the number of previous transfusions but not to the serum ferritin level. Substantial increases of urinary iron were observed in all the patients when the frequency of the daily dose was doubled and in response to 2 ± 3 g L1 daily 11 of 12 patients tested excreted > 2 5 mg iron daily, the mean daily intake of iron from transfusion. Serum ferritin levels have fluctuated but overall have remained unchanged. Pharmacological studies in five patients have indicated rapid absorption probably from the stomach and variable plasma half life of 77 ± 35 min (SD). Glucuronation was identified as a major route of L1 metabolism. Short-term intensive chelation studies using repeated administration of L1 resulted in further increases of urinary iron excretion by comparison to a single dose. In one case 325 mg of iron were excreted in the urine following the administration of 16g (5 ± 2g + 2 ± 3g) within 24 h. Iron excretion studies were carried out in six transfusional iron-loaded patients who were maintained on a low iron diet before and during chelation. No significant increases of faecal iron excretion were observed with L1 using daily doses of up to 3.3 g and 4 ± 2 g. The high level of compliance during treatment with L1 and the levels of urine iron excretion that can be achieved increase the prospects for oral chelation in transfusional iron-loaded patients.
Malaria and typhoid fever among patients presenting with febrile illnesses in Ga West Municipality, Ghana
(PLOS, 2023) Ayin, C. T. M.; Nortey, P.; Rufai, T.; et al
Background Clinicians in areas where malaria and typhoid fever are co-endemic often treat infected patients irrationally, which may lead to the emergence of drug resistance and extra cost to patients. This study determined the proportion of febrile conditions attributable to either malaria and/or typhoid fever and the susceptibility patterns of Salmonella spp. isolates to commonly used antimicrobial agents in Ghana. Methods One hundred and fifty-seven (157) febrile patients attending the Ga West Municipal Hospital, Ghana, from February to May 2017 were sampled. Blood samples were collected for cultivation of pathogenic bacteria and the susceptibility of the Salmonella isolates to antimicrobial agents was performed using the Kirby-Bauer disk diffusion method with antibiotic discs on Mu¨ller Hinton agar plates. For each sample, conventional Widal test for the detection of Salmonella spp was done as well as blood film preparation for detection of Plasmodium spp. Data on the socio-demographic and clinical characteristics of the study participants were collected using an android technology software kobo-collect by interview. Results Of the total number of patients aged 2–37 years (median age = 6 years, IQR 3–11), 82 (52.2%) were females. The proportion of febrile patients with falciparum malaria was 57/157 (36.3%), while Salmonella typhi O and H antigens were detected in 23/157 (14.6%) of the samples. The detection rate of Salmonella spp in febrile patients was 10/157 (6.4%). Malaria and typhoid fever coinfection using Widal test and blood culture was 9 (5.7%) and 3 (1.9%), respectively. The isolates were highly susceptible to cefotaxime, ceftriaxone, ciprofloxacin, and amikacin but resistant to ampicillin, tetracycline, co-trimoxazole, gentamicin, cefuroxime, chloramphenicol, and meropenem. Conclusion Plasmodium falciparum and Salmonella spp coinfections were only up to 1.9%, while malaria and typhoid fever, individually, were responsible for 36.3% and 6.4%, respectively. Treatment of febrile conditions must be based on laboratory findings in order not to expose patients to unnecessary side effects of antibiotics and reduce the emergence and spread of drug resistance against antibiotics.
Obstetric determinants of preterm delivery in a regional hospital, Accra, Ghana 2016
(BMC Pregnancy and Childbirth, 2019-07-08) Aseidu, E.K.; Bandoh, D.A.; Ameme, D.K.; Nortey, P.; Akweongo, P.; Sackey, S.O.; Afari, E.; Nyarko, K.M.; Kenu, E.
Background: Globally, prematurity is a major determinant of morbidity and mortality contributing 30–40% of neonatal mortality. The consequences of preterm deliveries are enormous with developmental and childhood complications as well as high economic and psycho-social burden on the parents (family) and society. Some risk factors include ever having preterm delivery, multiple births and some medical conditions like sexually transmitted infection and urinary tract infections but these have not been ascertained in our study area. Much research into these risk factors is needed in Ghana. We assessed the obstetric determinants of preterm delivery. Methods: We conducted a 1:2 unmatched case-control study in Greater Accra Regional Hospital (GARH) -Ridge, a secondary referral facility in Accra, Ghana (from October, 2015 -May, 2016). A case was a mother who delivered between 28 and 36 weeks of gestation (preterm) and a control was a mother who delivered after 37 to 42 completed weeks (term). We used structured questionnaire to collect data, reviewed maternal and foetal records using a checklist. Categorical variables were analysed and expressed as frequencies and proportions. We determined the association between obstetric factors and preterm delivery with multiple logistic regression. Significance level of the strength of association was determined at 95% CI and p-value < 0.05. Results: We recruited 390 mothers, 130 had preterm deliveries (cases) and 260 had term deliveries (controls). Experiencing premature rupture of membrane (aOR: 2.3; 95% CI:1.0–5.5), pre-eclampsia/eclampsia (aOR: 3.4; 95% CI: 1.0–11.9) were found to be associated with preterm delivery. However, four or more ANC visit was protective factor for preterm delivery (aOR: 0.2; 95% CI: 0.1–0.4). Conclusion: Premature rupture of membrane, hypertensive complications and antepartum haemorrhage were found to be risk factors associated with preterm delivery in Ridge Hospital. Health workforce providing ANC services need to identify risk factors and refer these mothers to the doctor for early management and improved outcome decreasing preterm delivery.