Browsing by Author "Nortey, P.A."
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Item Adverse drug reaction reporting by community pharmacists in the Greater Accra Region of Ghana, 2016(Ghana Med J, 2021) Osei, J.Y.; Nortey, P.A.; Bandoh, D.A.; Kenu, E.; Addo-lartey, A.A.Objectives: To assess adverse drug reactions (ADRs) reporting and identify factors to improve ADR reporting among community pharmacists in the Greater Accra Region of Ghana. Design: A quantitative cross-sectional study. Setting: Community pharmacies in the Greater Accra Region of Ghana. Participants: We randomly selected 210 pharmacists from a list community of pharmacies in Accra, Ghana. All participants had been practicing in the past one year, with this study being conducted from June to July 2016. Main outcome measure: Prevalence of ADR reporting by community pharmacists in Accra, Ghana. Results: Of the 210 community pharmacists interviewed 54.0% were males. Mean age was 32±10 years. Majority (96.0%) had heard of ADR reporting in Ghana, yet 18% had never seen the ADR reporting form. Reasons given for failure to report suspected ADRs included unavailability of reporting forms (83.1%), uncertainty about a causal rela tionship between the drug and the suspected ADR and classification of the reaction as “normal” with the medication being taken (23.6%). Only 34.0% of pharmacists had the ADR reporting forms available in their facilities. Marital status was the only factor significantly associated with ADR reporting (OR 3.18, 95%CI 1.02 – 9.12). Conclusion: ADR reporting by community pharmacists in Ghana remains low. To improve the proportion of report ing, ADR forms should be made available in all pharmacies, pharmacists and the general public should be made aware of online reporting systems, with continuous professional development in Pharmacovigilance with the advice that all suspected ADRs should be reported irrespective of uncertainty about causalityItem Adverse events and adherence to HIV post-exposure prophylaxis: A cohort study at the Korle-Bu Teaching Hospital in Accra, Ghana Environmental health(BioMed Central Ltd., 2015) Tetteh, R.A.; Nartey, E.T.; Lartey, M.; Mantel-Teeuwisse, A.K.; Leufkens, H.G.M.; Nortey, P.A.; Dodoo, A.N.O.Background: There is strong evidence that post-exposure prophylaxis (PEP) with antiretroviral drugs in the timely management of occupational exposures sustained by healthcare workers decreases the risk of HIV infection and PEP is now widely used. Antiretroviral drugs have well documented toxicities and produce adverse events in patients living with HIV/AIDS. In the era of "highly active antiretroviral therapy", non-adherence to treatment has been closely linked to the occurrence of adverse events in HIV patients and this ultimately influences treatment success but the influence of adverse events on adherence during PEP is less well studied. Methods: Following the introduction of a HIV post-exposure prophylaxis program in the Korle-Bu Teaching Hospital in January 2005, the incidence of adverse events and adherence were documented in occupationally-exposed healthcare workers (HCWs) and healthcare students (HCSs). Cohort event monitoring was used in following-up on exposed HCWs/HCSs for the two study outcomes; adverse events and adherence. All adverse events reported were grouped by MedDRA system organ classification and then by preferred term according to prophylaxis regimen. Adherence was determined by the completion of prophylaxis schedule. Cox proportional regression analysis was applied to determine the factors associated with the cohort study outcomes. Differences in frequencies were tested using the Chi square test and p∈<∈0.05 was considered statistically significant. Results: A total of 228 exposed HCWs/HCSs were followed up during the study, made up of 101 exposed HCWs/HCSs administered lamivudine/zidovudine (3TC/AZT) for 3 days; 75 exposed HCWs/HCSs administered lamivudine/zidovudine (3TC/AZT) for 28 days; and 52 exposed HCWs/HCSs administered lamivudine/zidovudine/lopinavir-ritonavir (3TC/AZT/LPV-RTV) for 28 days. The frequency of adverse events was 28 % (n∈=∈28) in exposed HCWs/HCSs administered 3TC/AZT for 3 days, 91 % (n∈=∈68) in exposed HCWs/HCSs administered 3TC/AZT for 28 days and 96 % (n∈=∈50) in exposed HCWs/HCSs administered 3TC/AZT/LPV-RTV for 28 days. Nausea was the most commonly reported adverse events in all three regimens. Adherence was complete in all exposed HCWs/HCSs administered 3TC/AZT for 3days, 56 % (n∈=∈42) in exposed HCWs/HCSs administered 3TC/AZT for 28 days and 62 % (n∈=∈32) in exposed HCWs/HCSs administered 3TC/AZT/LPV-RTV for 28 days. In the Cox regression multi-variate analysis, exposed HCWs/HCSs administered 3TC/AZT for 3 days were 70 % less likely to report adverse events compared with exposed HCWs/HCSs administered 3TC/AZT for 28 days (Adjusted HR∈=∈0.30 [95 % CI, 0.18-0.48], p∈<∈0.001). Exposed HCWs/HCSs administered 3TC/AZT for 3 days were 75 % more likely to adhere to the schedule compared with exposed HCWs/HCSs administered 3TC/AZT for 28 days (Adjusted HR∈=∈1.75 [95 % CI, 1.16-2.66], p∈=∈0.008). Conclusion: The intolerance to adverse events was cited as the sole reason for truncating PEP, thereby indicating the need for adequate, appropriate and effective counselling, education, active follow-up (possibly through mobile /phone contact) and management of adverse events. Education on the need to complete PEP schedule (especially for exposed HCWs/HCSs on 28-day schedule) can lead to increased adherence, which is very critical in minimizing the risk of HIV sero-conversion. The present results also indicate that cohort event monitoring could be an effective pharmacovigilance tool in monitoring adverse events in exposed HCWs/HCSs on HIV post-exposure prophylaxis.Item ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: A mixed method study(BioMed Central Ltd., 2016) Ankomah, A.; Ganle, J.K.; Lartey, M.Y.; Kwara, A.; Nortey, P.A.; Okyerefo, M.P.K.; Laar, A.K.Background: Timely and enduring access to antiretroviral therapy (ART) by HIV-infected individuals has been shown to substantially reduce HIV transmission risk, HIV-related morbidity and mortality. However, there is evidence that in addition to limited supply of antiretrovirals (ARVs) and linkage to ART in many low-income countries, HIV+ persons often encounter barriers in accessing ART-related services even in contexts where these services are freely available. In Ghana, limited research evidence exists regarding the barriers HIV+ persons already linked to ART face. This paper explores ART access-related barriers that HIV+ persons linked to care in southern Ghana face. Methods: A mixed method study design, involving a cross-sectional survey and qualitative in-depth interviews, was conducted to collect data from four healthcare providers and a total of 540 adult HIV+ persons receiving ART at four treatment centres in Ghana. We used univariate analysis to generate descriptive tabulations for key variables from the survey. Data from qualitative in-depth interviews were thematically analysed. Results from the survey and in-depth interviews were brought together to illuminate the challenges of the HIV+ persons. Results: All (100%) the HIV+ persons interviewed were ARV-exposed and linked to ART. Reasons for taking ARVs ranged from beliefs that they will suppress the HIV virus, desire to maintain good health and prolong life, and desire to prevent infection in unborn children, desire both to avoid death and to become good therapeutic citizens (abide by doctors' advice). Despite this, more than half of the study participants (63.3%) reported seven major factors as barriers hindering access to ART. These were high financial costs associated with accessing and receiving ART (26%), delays associated with receiving care from treatment centres (24%), shortage of drugs and other commodities (23%), stigma (8.8%), fear of side effects of taking ARVs (7.9%), job insecurity arising from regular leave of absence to receive ART (5.3%), and long distance to treatment centres (4.9%). Conclusions: The results in this study suggest that efforts to provide and scale-up ART to all HIV+ persons must be accompanied by interventions that address structural and individual level access barriers.Item ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study.(The Open Access Publisher, 2016) Ankomah, A.; Kuumuori Ganle, J.; Lartey, M.A.; Kwara, A.; Nortey, P.A.; Okyerefo, M.P.K.; Laar, A.K.Background Timely and enduring access to antiretroviral therapy (ART) by HIV-infected individuals has been shown to substantially reduce HIV transmission risk, HIV-related morbidity and mortality. However, there is evidence that in addition to limited supply of antiretrovirals (ARVs) and linkage to ART in many low-income countries, HIV+ persons often encounter barriers in accessing ART-related services even in contexts where these services are freely available. In Ghana, limited research evidence exists regarding the barriers HIV+ persons already linked to ART face. This paper explores ART access–related barriers that HIV+ persons linked to care in southern Ghana face. Methods A mixed method study design, involving a cross-sectional survey and qualitative in-depth interviews, was conducted to collect data from four healthcare providers and a total of 540 adult HIV+ persons receiving ART at four treatment centres in Ghana. We used univariate analysis to generate descriptive tabulations for key variables from the survey. Data from qualitative in-depth interviews were thematically analysed. Results from the survey and in-depth interviews were brought together to illuminate the challenges of the HIV+ persons. Results All (100%) the HIV+ persons interviewed were ARV-exposed and linked to ART. Reasons for taking ARVs ranged from beliefs that they will suppress the HIV virus, desire to maintain good health and prolong life, and desire to prevent infection in unborn children, desire both to avoid death and to become good therapeutic citizens (abide by doctors’ advice). Despite this, more than half of the study participants (63.3%) reported seven major factors as barriers hindering access to ART. These were high financial costs associated with accessing and receiving ART (26%), delays associated with receiving care from treatment centres (24%), shortage of drugs and other commodities (23%), stigma (8.8%), fear of side effects of taking ARVs (7.9%), job insecurity arising from regular leave of absence to receive ART (5.3%), and long distance to treatment centres (4.9%). Conclusions The results in this study suggest that efforts to provide and scale-up ART to all HIV+ persons must be accompanied by interventions that address structural and individual level access barriers.Item Cervical Human Papillomavirus Prevalence, Genotypes, and Associated Risk Factors among Female Sex Workers in Greater Accra, Ghana(Journal of Oncology, 2019-06-02) Adams, A.R.; Nortey, P.A.; Dortey, B.A.; Asmah, R.H.; Wiredu, E.K.Cervical cancer is a largely preventable disease mediated by persistent infectionwith high-riskHuman Papillomaviruses (Hr-HPV). There are now three approved vaccines against themost common HPV genotypes. In Ghana,mortality due to cervical cancer is on the rise, due to the absence of an organized and effective cervical cancer prevention and control program. Data on circulatingHPV genotypes is important for studying the likely impact of mass introduction of HPV vaccination of the female population before sexual debut. High HPV prevalence has been reported in Female Sex Workers (FSWs), who constitute an important active group for maintenance of HPV in the population.This study was conducted to determine the size of HPV prevalence in this group and to provide information for future assessment of the impact of vaccine introduction in the country.We conducted a cross-sectional study where the snowballing technique was used to identify and select FSW’s ≥18 years, operating within suburbs of Greater Accra Region (GAR). A risk factor assessment interview was conducted and cervical swabs were collected for HPV-DNA detection and genotyping by Nested Multiplex PCR. Hundred participants, age ranging from 18 to 45 years, median 24 years, were studied.The prevalence of Cervical HPV was 26%. Eleven genotypes were detected comprising 9 high-risk in order of decreasing prevalence HPV-16 (8%), HPV-35 (5%), HPV-33/39/-68 (3%), HPV-52/51/59 (2%) and HPV-18 (1%) and 2 Low-risk types, HPV-42(3%), and HPV-43 (1%).Three women had HPV types that could not be genotyped by our method. Oral contraceptives use was associated with a reduced chance of HPV infection (P=0.002; OR=0.19, 95% CI 0.07-0.54).This study found a high HPV prevalence among FSWs in the GAR. A high number of Hr-HPV genotypes seen are vaccine preventable, providing additional compelling argument for implementing a national cervical cancer prevention plan including vaccinationItem Coping with Adversity: Resilience Dynamics of Livestock Farmers in Two Agroecological Zones of Ghana(MDPI, 2021) Nuvey, F.S.; Addo-Lartey, A.; Nortey, P.A.; Addo, K.K.; Bonfoh, B.Despite the increasing occurrence of adverse events including droughts and conflicts, livestock farmers in Ghana continue to raise animals to support their livelihoods and the national economy. We assessed the resilience of cattle farmers (CF) to adverse events they faced using a cross-sectional survey of 287 CF in two agroecological zones in Ghana. Resilience to adversities was assessed using the Resilience Scale (RS-14). Resilience scores and categories were computed and factors that explained variations in resilience categories assessed. The farmers kept, on average, 31 cattle per household, with a majority (91%) also growing crops. Key adverse events confronting them in both districts were animal disease outbreaks, pasture shortages, and theft, with 85% (240/287) losing, on average, seven cattle (15% of the herd size) over a one-year period. The mean resilience score was 71 (SD = 8) out of 98; 52% were highly resilient. Resilience was higher in the southern district (72 versus 70), albeit not statistically significant (p = 0.06). The resilience significantly improved with age, each unit increase in cattle in the herd, and having experience raising livestock (p < 0.001). The CF have relatively high resilience to adverse events affecting their productivity. The findings provide relevant information for implementing mitigation measures to improve production by reducing animal mortalities through high-quality veterinary services.Item Determinants of Low Birth Weight in Neonates Born in Three Hospitals in Brong Ahafo Region(University of Ghana, 2016-07) Adam , Z.; Nortey, P.A.; University of Ghana, College of Health Sciences, School of Public HealthIntroduction: Low birth weight is the weight of the newborn measured immediately after birth and is less than 2500 grams. The global prevalence of LBW is 15.5 percent, which amounts to about 20 million LBW infants born each year. A high proportion (96.5%) of LBW babies are born in developing countries (Wardlaw, T., Blanc, A., Zupan, J., & Ahman, E. 2005). In Ghana, the recent incidence of LBW infants was estimated at 160 per 1000 births and has not witnessed any reduction in the last decade (Kayode et al., 2014). In the Brong Ahafo region the estimated prevalence of LBW is 91.9 per 1000 live births with a neonatal mortality rate at 6.6 per 1000 live births (DHIMS 2015). The objective of the study is to determine the factors that influence low birth weight (LBW) delivery in three hospitals in the Brong Ahafo Region. Method: Unmatched Case-control study design was used; A case was defined as a mother who delivers a baby with a birth weight below 2500grams in any of the study sites and a control defined as mothers with delivery of a baby with weight between 2500 grams and 3400 grams at the same site as a case within 24 hours of delivery of the case. A sample of 120 cases and 240 control mothers with singleton deliveries were recruited for the study. Case controls were collected in a ratio of 1:2 respectively. Three hospitals in Brong Ahafo Region, Ghana were used as the study sites. Results: The factors with their adjusted odds which influenced the delivery of a low birth weight baby included; first trimester hemoglobin <11g/dl(aOR 3.14; 95%CI 1.50-6.58), delivery at 32-36weeks gestation (aOR 13.70; 95%CI 4.64-40.45), delivery below 32weeks gestation (aOR 58.50; 95%CI 6.66-513.87), 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 3.95; 95%CI 1.33-11.74), and not taking iron supplements during pregnancy (aOR 3.19; 95%CI 1.07-9.54) were found to be the determinant factors of LBW . Conclusion: The study in these three facilities showed that the determinant factors for the delivery of a LBW were; delivery at preterm, Educational level of mothers being secondary, living alone during pregnancy, not taking iron supplementation and mothers with first trimester hemoglobin below 11g/dl.Item Dispensing practices for anti‑malarials in the La Nkwantanang‑Madina municipality, Greater Accra, Ghana: a cross‑sectional study(Malaria Journal, 2019-07-23) Nortey, P.A.; Amankwa, C.E.; Bonful, H.A.; Agyabeng, K.Background: Despite recent strides made towards reducing the emergence of artemisinin resistance, inappropriate dispensing practices for anti-malarials in both private and public sectors affect treatment outcomes negatively. In Ghana, private retail pharmacies are the most accessible health facilities for managing diseases of common occurrence. However, there is growing concern about the number of patients harmed by dispensing errors in the management of malaria in retail pharmacies. Although considerable work has been done in this area, several questions regarding dispensing practices remain unanswered. This study, therefore, sought to investigate the predictors of appropriate dispensing practices for anti-malarials in community pharmacies in the La Nkwantanang-Madina municipality of Greater Accra, Ghana. Methods: A cross-sectional analytic study was conducted in sixty-one randomly selected community pharmacies in the La Nkwantanang-Madina. Data from 230 clients and 106 dispensers were analysed. It was checked for internal consistency and completeness then entered and analysed using STATA I/C version 14.0. Frequencies, Chi square tests, and logistic regression analyses were conducted, accounting for clustering. Results and discussion: Of the 106 dispensers interviewed, 71.4% were medicine counter assistants. The mean age of dispensers was 30.4 years (SD 8.8). Over 88.0% of clients were advised to complete the full course of their antimalarials. However, the 8-h loading dose principle for artemether-lumefantrine was not explained to 88.3% of the clients. More than half of the clients (52.2%) were given appropriate dispensing information on anti-malarial use. Most clients (66.1%), were dispensed anti-malarials without malaria tests. Dispensers with more than a 10-years experience were less likely to dispense artemisinin-based combinations appropriately relative to dispensers with less than 2 years experience (AOR = 0.04, 95% CI 0.002–0.802 p-value = 0.036) while pharmacy interns were about 19 times more likely (AOR = 18.5, 95% CI 1.40–245.6 p-value = 0.03) to dispense artemisinin-based combinations appropriately compared to pharmacists. Conclusion: Dispensing practices for anti-malarials is unsatisfactory. There is a need to enforce existing legislation with educational programmes directed towards dispensers especially those with more than 10 years experience. Specific adherence to the World Health Organization Test, Treat and Track initiative should be encouraged to ensure effective use of anti-malarials.Item Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014(BioMed Central Ltd., 2017) Ohene-Adjei, K.; Kenu, E.; Bandoh, D.A.; Addo, P.N.O.; Noora, C.L.; Nortey, P.A.; Afari, E.A.Background: Cholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked. Methods: We carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission. Results: Up to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis. Conclusions: The 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.Item Extent of inappropriate prescription of artemisinin and anti‑malarial injections to febrile outpatients, a cross‑sectional analytic survey in the Greater Accra region, Ghana(BMC Malaria Journal, 2019-09-27) Adanu, R.M.K.; Bonful, H.A.; Awua, A.K.; Adjuik, M.; Tsekpetse, D.; Nortey, P.A.; Ankomah, A.; Koram, K.A.Background: Febrile children seen in malaria hypo-endemic settings, such as the Greater Accra region (GAR) of Ghana are more likely to be suffering from a non-malarial febrile illness compared to those seen in hyper-endemic settings. The need for prescribers to rely on malaria test results to guide treatment practices in the GAR is even greater. This study was designed to investigate the factors associated with inappropriate artemisinin-based combination therapy (ACT) prescription. Methods: A survey was conducted in six health facilities in the region in 2015. Treatment practices for febrile outpatient department (OPD) patients were obtained from their records. Prescribers were interviewed and availability of malaria commodities were assessed. The primary outcome was the proportion of patients prescribed ACT inappropriately. Independent variables included patient age and access to care, prescriber factors (professional category, work experience, access to guidelines, exposure to training). Data were analysed using Stata at 95% CI (α-value of 0.05). Frequencies and means were used to describe the characteristics of patients and prescribers. To identify the predictors of inappropriate ACT prescription, regression analyses were performed accounting for clustering. Results: Overall, 2519 febrile OPD records were analysed; 45.6% (n = 1149) were younger than 5 years. Only 40.0% of patients were tested. The proportion of patients who were prescribed ACT inappropriately was 76.4% (n = 791 of 1036). Of these 791 patients, 141 (17.8%) were prescribed anti-malarial injections. Patients seen in facilities with rapid diagnostic tests (RDT) in stock were less likely to be prescribed ACT inappropriately, (AOR: 0.04, 95% CI 0.01–0.14, p < 0.001) compared to those seen in facilities with RDT stock-outs. Prescribers who had been trained on malaria case management within the past year were 4 times more likely to prescribe ACT inappropriately compared to those who had not been trained (AOR: 4.1; 95% CI (1.5–11.6); p < 0.01). Patients seen by prescribers who had been supervised were 8 times more likely to be prescribed ACT inappropriately. Conclusion: Inappropriate ACT prescription to OPD febrile cases was high. Training and supervision of health workers appears not to be yielding the desired outcomes. Further research is needed to understand this observation.Item Factors associated with malaria vaccine uptake in Sunyani Municipality, Ghana(Malaria Journal, 2021) Tabiri, D.; Ouédraogo, J.C.R.P.; Nortey, P.A.Background: Malaria continues to be a major disease of public health concern afecting several million people worldwide. The World Health Organization (WHO) started a pilot study on a malaria vaccine (RTS,S) in Ghana and two other countries in 2019. This study aimed at assessing the factors associated with uptake of the vaccine in the Sunyani Municipality of Ghana. Methods: The study was a cross-sectional study employing a quantitative approach. Stratifed sampling technique was used to select respondents. A structured questionnaire was administered to parents/caregivers with children eligible to have taken the frst three doses of the malaria vaccine by December 2019. The Child Welfare Clinic (CWC) cards of the eligible children were also inspected. Ordinal logistic regression analysis was done to determine the asso ciation between the independent variables and full vaccine uptake. Results: Uptake of RTS,S 1 was 94.1%. However, this fgure reduced to 90.6% for RTS,S 2, and 78.1% for RTS,S 3. Chil dren with a parent who had been educated up to the tertiary level had 4.72 (AOR: 4.72, 95% CI 1.27–17.55) increased odds of full uptake as compared to those who completed secondary education. Parents whose children had expe rienced fever as an adverse reaction were more likely to send their children for the malaria vaccine as compared to those whose children had ever sufered abscess as an adverse reaction (AOR: 2.27, 95% CI 1.13–5.10). Children with parents who thought vaccines were becoming too many for children had 71% (AOR: 0.29, 95% CI 0.14–0.61) reduced odds of full uptake as compared to those who thought otherwise. Conclusion: Uptake of RTS,S 1 and RTS,S 2 in Sunyani Municipality meets the WHO’s target coverage for vaccines, however, RTS,S 3 uptake does not. Furthermore, there is a growing perception amongst parents/caregivers that vac cines are becoming too many for children which negatively afects uptake.Item Food elimination, food substitution, and nutrient supplementation among ARV-exposed HIV-positive persons in southern Ghana(Journal of health, population, and nutrition, 2018-12) Laar, A.K.; Lartey, M.Y.; Ankomah, A.; Okyerefo, M.P.K.; Ampah, E.A.; Letsa, D.P.; Nortey, P.A.; Kwara, A.Background Optimal nutrition is a determinant of health in all persons. In persons living with HIV (PLHIV), nutrition is particularly important. Various factors, including dietary practices, play a role in guaranteeing nutritional health. Objectives We investigated multiple non-prescription drugs use among HIV-positive persons receiving antiretroviral therapy (ART) from four treatment centers in southern Ghana. This paper, however, focuses on nutrient supplement use, food elimination, and food substitution practices by the PLHIV. Methods Using quantitative and qualitative methods, we collected data from 540 HIV-positive persons at the health facility level. This paper focuses on only the quantitative data. Individual study participants were selected using a systematic random sampling procedure. Participants were interviewed after informed consent. We used univariate analysis to generate descriptive tabulations for key variables. Multivariable logistic regression modeling identified predictors of three practices (nutrient supplementation, food elimination, and food substitution). P value less than 0.05 or 95% confidence intervals facilitated determination of statistical significance. All analyses were performed using IBM SPSS Statistics for Windows, version 20.0. Results The use of nutrient supplements was a popular practice; 72% of the PLHIV used various kinds. The primary motive for the practice was to boost appetite and to gain weight. A little over 20% of the participants reportedly eliminated certain foods and beverages, while 17% introduced new foods since their initial HIV diagnosis. All the three practices were largely driven by the quest for improved health status. We determined predictors of nutrient supplementation to be ART clinic location and having an ART adherence monitor. Having an ART adherence monitor was significantly associated with reduced odds of nutrient supplementation (AOR = 0.34; 95% CI 0.12–0.95). The only predictor for food elimination was education level (AOR = 0.29; 95% CI 0.30–0.92); predictors of food substitution were ART clinic location (AOR = 0.11; 95% CI 0.02–0.69) and anemia (defined as hemoglobin concentration less than 11.0 g/dl) (AOR = 0.21; 95% CI 0.12–0.85). Conclusions The practice of supplementation is popular among this group of PLHIV. Food elimination and substitution are practiced, albeit in moderation. The predictors identified may prove helpful in provider-client encounters as well as local HIV programming.Item Knowing your HIV/AIDS response: A pilot test of a new service mapping toolkit in Ghana(Urban and Partner, 2016) Laar, A.; Sutherland, A.J.; Sutherland, E.; Manu, A.; Dzokoto, A.W.; Ankomah, A.; Nortey, P.A.; Derry, S.K.K.; Tetteh, E.K.Background “Knowing” an HIV response in a country is a complex undertaking. This requires knowing what actions key implementers in all sectors (government, non-government, public, and private) are deploying; what populations they serve; what the reach of these programs are, amongst others. Aim We aimed to pilot test a set of newly developed data collection tools referred to as the Know Your Response (KYR) toolkit in Ghana. The KYR toolkit addresses three key concepts that are critical for an improved understanding of the HIV-prevention response in terms of location, scale, and needs. Materials and methods Data were collected on HIV programming being undertaken in each of the 16 metropolitan, municipal, and district assemblies (MMDAs) in the Greater Accra region of Ghana. Analysis and dissemination of data includes the generation of univariate and bivariate tabulations as well as production of maps of HIV services using Geographic Information System (GIS) technology. Results The toolkit was successful in collecting a great deal of data that describe, at the district level, who is working in HIV prevention, what interventions they are providing, where these interventions are being provided, and to whom the interventions are being targeted. The data generated allows for mapping and understanding of the scope and scale of the HIV-prevention response at the district level. It also identifies challenges and opportunities for scaling the exercise nationally. Conclusions The study provides information needed to guide prioritization, and/or adjustment of the national HIV-prevention programs and interventions being carried out in the Greater Accra region. © 2016 Polish AIDS Research SocietyItem Outcomes of a postexposure prophylaxis program at the Korle-Bu Teaching Hospital in Ghana: A retrospective cohort study(Journal of the International Association of Providers of AIDS Care, 2013-10) Tetteh, R.A.; Nartey, E.T.; Lartey, M.; Mantel-Teeuwisse, A.K.; Leufkens, H.G.M.; Nortey, P.A.; Dodoo, A.N.O.The risk for occupational exposure to HIV is a serious public health problem that is well characterized in the developed world, but less so in the developing countries such as Ghana. This study was undertaken to examine the characteristics of occupational exposure to HIV and the utilization of a risk assessment system (RAS)-based postexposure prophylaxis (PEP) among health care workers (HCWs) and health care students (HCSs) in the Korle-Bu Teaching Hospital (KBTH). During the study period (January 2005-December 2010), a total of 260 and 35 exposures were reported by HCWs and HCSs, respectively. Ward attendants reported the highest incidence rate of 6.46 of 100 person-years (P-Y). The incidence of high-risk exposures was 0.33 of 100 P-Y (n = 65); 60.0% occurred during a procedure of disposing of a needle and 24.6% during a cannula insertion. A total of 289 of the 295 individuals were administered PEP, of which 181 (62.6%) completed the 6-month follow-up testing schedule and none sero-converted. This shows that with a good RAS in place, it is possible to deploy an effective PEP program in a typical African teaching hospital like the KBTH in Accra, Ghana. © SAGE Publications.Item Poor mental health of livestock farmers in Africa: a mixed methods case study from Ghana(BMC Public Health, 2020-06-01) Nuvey, F.S.; kreppel, K.; Nortey, P.A.; Addo-Lartey, A.; Sarfo, B.; Fokou, G.; Ameme, D.K.; Kenu, E.; Sackey, S.; Addo, K.K.; Afari, E.; Chibanda, D.; Bonfoh, B.Background: Agriculture represents the mainstay of African economies and livestock products are essential to the human population’s nutritional needs. However, in many developing countries, including Ghana, livestock production fails to meet demand due to population growth and negative effects of climate change. One of the challenges to production is livestock loss affecting farmers. However, despite stressful events experienced, livestock farmers’ mental health is poorly documented. This study aims to identify the root causes of livestock losses and their influence on pastoralists’ mental health. Methods: We conducted a mixed methods study in two districts in the Northern and Southern Belts of Ghana. Using the Depression Anxiety and Stress Scale–21 and guided interviews, we collected quantitative and qualitative data from 287 livestock farmers and 24 key-informants respectively. Mental health scores were categorized using standard guidelines. We evaluated the factors that explained variations in mental wellbeing using general linear models (α = 0.05). Results: About 85% (240/287) of the livestock farmers lost cattle within 1 year. Of these, 91% lost cattle to animal diseases, 50% to theft and 27% to pasture shortages. Qualitative findings reveal that due to poor access to veterinary services, farmers treat livestock diseases themselves with drugs from unregulated sources and often sell diseased cows for meat to recover losses. Findings showed that 60% of livestock farmers had poor mental health. Of those, 72% were depressed, 66% anxious and 59% stressed. Mental wellbeing was negatively associated with the number of adverse events experienced, proportion of livestock lost to most of the major loss factors, emotional attachment to livestock and self-reported physical illnesses in farmers, but positively associated with increasing herd size [F (8,278) = 14.18, p < 0.001, R2 = 0.29].Conclusions: Livestock diseases are the leading cause of losses to livestock farmers, whose mental wellbeing is negatively affected by these losses. Although an adaptive strategy by farmers to compensate for poor veterinary services, the arbitrary use of veterinary drugs and sale of diseased cattle pose health risks to the public. Further research to evaluate the performance of veterinary services in Ghana, mental health problems and risk to human health due to potential high-risk meat entering the food chain, is needed.Item Six Differences in the Efficacy of Antimalarial Drugs and Related Changes in the Haemoglobin Levels of Children Under Five in Ghana(University of Ghana, 2012-07) Walter-Rodney, N.; Nortey, P.A.; University of Ghana, College of Health Sciences, School of Public HealthBackground: One of the consequences of drug resistance to malaria parasites, is poor haematological recovery (Bloland et al., 1993; Verhoeff et al., 1997; Ekvall et al., 1998). Use of the right antimalarial is the key to avert this situation. Few studies have explored sex differences of these drug interventions in pediatric populations. ( Domellöf M et al 2002 and Songül S et al 2009). Methods: This study is a descriptive study analyzing secondary data collected from a primary comparative efficacy study of four antimalarials in Ghanaian children under five in 2005. Age, sex, haemoglobin levels, parasite counts and temperature between sexes were used for the analysis. Pearson Chi square test, ANOVA and paired t-test were performed between sexes and day of treatment. Comparison of means, standard deviation, risk difference and mean difference were done where it applies stating p values of <0.05 as significant and 95% confidence intervals. Results: The treatment groups were distributed as follows at baseline; Chloroquine (CQ) 36, Artesunate-Amodiaquine (ART/AMQ) 27, Sulphadoxine-Pyrimethamine (SP) 29, and Artemether –Lumefantrine (AL) 19. The mean age was highest in the AL group 38.6 months (SD±9.9). Adequate Clinical and Parasitological Response for evaluable patients was also highest among females in the AL group 72% (13/18) at day 14 and followed a similar trend at day 28; 69.23% (9/18). About 70% (62/94) of all males in all treatment groups were anaemic while 43% (40/94) of all females were anaemic at baseline. A total of 88.3% in both sexes and treatment groups were still anaemic by day 7 assessment. Haemoglobin (Hb) levels increased in both sexes and all groups during and after treatment but the cross comparisons between days were mostly significant among ACT females. Among the ACT’s, females in AL were always significant comparing Hb’s levels on any day of treatments but only significant at day 0 and 28 for ART/AMQ (p=0.0188). Conclusion: No significant difference in efficacy was found between males and females and between antimalarial treatment groups. This could be attributed to a small sample size used in the evaluation. Considering the permuted days of comparisons in both ACT groups, females were found to have a statistically significant haematological recovery than boys with mean ages in months of 35.1 and 31.5 respectively. Further studies to establish local haematological reference values, followed by studies to ascertain haematological recovery rates among Ghanaian children are recommended.Item Use of non-Prescription remedies by Ghanaian human immunodeficiency Virus-Positive Persons on antiretroviral Therapy.(Frontiers, 2017) Laar, A.K.; Kwara, A.; Nortey, P.A.; Ankomah, A.K.; Okyerefo, M.P.; Lartey, M.Y.Background Inappropriate use of non-prescription remedies by persons living with human immunodeficiency virus (PLHIV) may result in adverse events or potentiate non-adherence to prescribed medications. This study investigated the use of non-prescription remedies among PLHIV receiving antiretroviral therapy (ART) from four treatment centers in southern Ghana. Methods A mixed method design using quantitative and qualitative methods was used. This article focuses on the quantitative survey of 540 respondents. Univariate analysis was used to generate descriptive tabulations of key variables. Bivariate analysis and logistic regression modeling, respectively, produced unadjusted and adjusted associations between background attributes of PLHIV and the use of non-prescription remedies. A p-value of < 0.05 was considered statistically significant. All analyses were performed using IBM SPSS Statistics for Windows, Version 20.0. Results One out of three respondents reported the use of non-prescription remedies at least once within 3 months of the survey. Most of these were locally made and included “Angel natural bitters, concoctions from the Christian prayer centers, garlic, and mahogany syrups.” These remedies were used concomitantly with antiretroviral medications (ARVs)—46% or administered with ARVs but at different times during the day (43%). Some of the remedies were reportedly prescribed by health workers, or self-initiated during periods of ARVs shortage. Others took them based on their perception of their efficacy. Bivariate level analysis identified ART clinic site, place of residence, and ARV adherence monitoring to be significantly associated with the use of non-prescription remedies (p < 0.05). Multiple logistic regression analysis controlling for covariates confirmed the location of ART clinic as the only predictor of the use of non-prescription remedies. Compared to clients at the large urban teaching hospital (Korle-Bu Fevers Unit ART center), those at the district level (Atua ART center) were ninefold more likely to use non-prescription remedies [adjusted odds ratio (AOR) = 8.84; 95% confidence interval (CI) 2.83–33.72]. Those from a district level mission hospital (St. Martin’s ART center) were threefold as likely to use these remedies (AOR = 2.610; 95% CI 1.074–9.120). Conclusion The use of non-prescription remedies by PLHIV on ART is common in southern Ghana. Usage is mostly self-initiated because of perceived efficacy of remedy, and was more common among clients attending rural ART clinics