Browsing by Author "Nyarko, K.M."

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Bovine Tuberculosis Surveillance System Evaluation, Greater-Accra Region, Ghana, 2006-2011
(2016) Lopes, P.H.; Akweongo, P.; Wurapa, F.; Afari, E.; Sackey, S.; Ocansey, D.; Nyarko, K.M.
INTRODUCTION: Bovine tuberculosis (bTB) is a chronic, zoonotic, multi-species disease of cattle caused by Mycobacterium bovis. In developed countries, effective surveillance and enforcement of regulations on bTB control resulted in significant reduction of infections in cattle and hence, humans. However, in developing countries, weak surveillance systems affect accurate and timely reporting of bTB in humans and cattle. In Ghana, transhumance movement of cattle increases the risk of bTB importation and spread, however, the extent to which surveillance detects bTB is unknown. We therefore evaluated the bTB surveillance system in the Greater-Accra Region to determine its performance and assessed its attributes.METHODS: We interviewed stakeholders, and reviewed bTB surveillance data for all ten districts in the region from 2006-2011 using the CDC Guidelines for Evaluation of public health surveillance systems.RESULTS: From 2006-2011, bTB was suspected in 284/244,576 (0.12%) cattle slaughtered, of which 7/284 (2.5%) were submitted for laboratory confirmation and all tested positive. Predictive value positive was 100%. There is no standard case definition which guides bTB detection. Fifty percent of carcasses slip through inspection, and confirmed cases are not traced back. There were 99/284 (34.9%) condemnations from suspected carcasses and 57/97 (58.8%) from positive reactors from screening. Ninety percent (9/10) of districts submitted reports late to the region whereas representativeness was 30%. Regional and district data were manually stored with no electronic backups. The region's cattle population is unknown.CONCLUSION: Although the bTB surveillance system is sensitive, it is under performing, and the possibility of bTB transmission from cattle to humans is high.
Capacity assessment of selected health care facilities for the pilot implementation of Package for Essential Non-communicable Diseases (PEN) intervention in Ghana
(2016) Nyarko, K.M.; Ameme, D.K.; Ocansey, D.; Commeh, E.; Markwei, M.T.; Ohene, S.-A.
INTRODUCTION: Non-communicable diseases (NCDs) continue to pose threats to human health and development worldwide. Though preventable, NCDs kill more people annually than all other diseases combined. The four major NCDs namely cardiovascular diseases, chronic respiratory diseases, diabetes and cancers share common modifiable risk factors. In order to prevent and control NCDs, Ghana has adopted the World Health Organisation Package for Essential NCD (WHO-PEN) intervention, to be piloted in selected districts before a nationwide scale-up. We assessed the capacity of these facilities for the implementation of the WHO-PEN pilot.METHODS: We conducted a cross-sectional health facility-based survey using a multistage sampling technique. We collected data on human resource, equipment, service utilization, medicines availability and health financing through interviews and observation. Descriptive data analysis was performed and expressed in frequencies and relative frequencies.RESULTS: In all, 23 health facilities comprising two regional hospitals, three district hospitals, nine health centres and nine Community-based Health Planning and Services (CHPS) compounds from three regions were surveyed. All the hospitals had medical officers whilst 4 (44.4%) of the health centres had physician assistants. Health financing is mainly by the National Health Insurance Scheme (NHIS). None of the health facilities had spacers and only one health centre had oxygen cylinder, glucometer and nebulizer.CONCLUSION: Gaps exist in the human resource capacity and service delivery at the primary care levels, the focus of WHO-PEN intervention. Adequately equipping the primary health care level with trained health workers, basic equipment, medications and diagnostics will optimize the performance of WHO-PEN intervention when implemented.
Cervical Cancer in the Greater Accra and Ashanti Regions of Ghana
(Journal of Global Oncology, 2017-12) Nartey, Y.; Hill, P.C.; Amo-Antwi, K.; Nyarko, K.M.; Yarney, J.; Cox, B.
Purpose Cervical cancer is a common cancer among women worldwide. An estimated 528,000 new cases and 266,000 deaths occurred in 2012. More than 85% of invasive cervical cancer cases occur in low- and middle-income countries. Cervical cancer ranks as the most common cancer among women in Ghana. We conducted a retrospective study to assess the descriptive epidemiology of cervical cancer in Ghana. We describe cervical cancer incidence and mortality rates for the regions served by two large hospitals in Ghana. Patients and Methods Information for women diagnosed with invasive cervical cancer between 2010 and 2013 was collected from the Komfo Anokye and Korle Bu Teaching Hospitals through review of medical, computer, and pathology records at the oncology units and the obstetrics and gynecology departments. Telephone interviews were also conducted with patients and relatives. Data were analyzed using summary statistics. Results A total of 1,725 women with cervical cancer were included in the study. Their ages ranged from 11 to 100 years (mean, 56.9 years). The histology of the primary tumor was the basis of diagnosis in 77.5% of women and a clinical diagnosis was made in 22.5% of women. For the 1,336 women for whom tumor grade was available, 34.3% were moderately differentiated tumors. Late stage at presentation was common. The incidence and mortality rates of cervical cancer increased with age up until the 75 to 79–year age group and began to decrease at older ages. The Greater Accra region had higher overall incidence and mortality rates than the Ashanti region. Conclusion Our study suggests that improvements in the application of preventive strategies could considerably reduce the burden of cervical cancer in Ghana and other low- and middle-income countries. The study provides important information to inform policy on cancer prevention and control in Ghana.
Characteristics of Women Diagnosed with Invasive Cervical Cancer in Ghana
(Asian Pacific Journal of Cancer Prevention, 2018-02) Nartey, Y.; Hill, P.C.; Amo-Antwi, K.; Nyarko, K.M.; Yarney, J.; Cox, B.
OBJECTIVE: To describe the characteristics of women diagnosed with invasive cervical cancer from 2010 to 2013 in two large hospitals in Ghana. METHOD: Medical records and other hospital data on women diagnosed with invasive cervical cancer were collected from the Komfo Anokye and Korle-Bu Teaching Hospitals. Data were recorded onto a standardized data collection sheet and analyzed using summary statistics. RESULTS: For of the 1,725 women with invasive cervical cancer who were included in the study, parity was high (5 and more births). The most common diagnostic investigation undertaken was a cervical biopsy, performed for 95.5% of cases. Few women had an imaging test performed as part of the diagnostic process (3.3%). Some had comorbid conditions at diagnosis (29.3%). Only 61% of women attended at least one follow-up appointment after diagnosis of their cancer. CONCLUSION: Our study suggests that more work is needed to improve patient education and access to diagnostic and treatment facilities to reduce the incidence and mortality of cervical cancer in Ghana. Additionally, improvement in data quality is needed to provide more complete data for cancer control in Ghana.
Cholera outbreak following a marriage ceremony in Medinya, Western Ghana
(2016) Acquah, H.; Malm, K.; Der, J.; Kye-Duodu, G.; Mensah, E.K.; Sackey, S.O.; Nyarko, K.M.; Afari, E.
INTRODUCTION: Cholera is a diarrhoea disease caused by the bacterium e. On 13th June 2011, there was a reported outbreak of acute watery diarrhoea at Medinya among people who eat at a mass traditional wedding ceremony in the Western Region of Ghana. We investigated to characterize the outbreak, and implement control and preventive measures.METHODS: We conducted a retrospective cohort study. We interviewed health workers, reviewed medical records, conducted environmental assessment and obtained water and stool samples for laboratory investigation. A suspected cholera-case defined as a person with acute watery diarrhoea, with or without vomiting, who ate food prepared at the mass traditional wedding in Medinya on 10th June 2011. We performed univariate and bivariate analysis.RESULTS: Of the 17 case-patients, 9 (52.9%) were males. The overall attack rate was 11.18% and case fatality rate was 5.9%. The most affected age group was 6-10 years (23.53%) with median age of 20 and ranged 6 to 38 years. Time of onset of symptoms was 2.00am and peaked at 10.am on 13th June. Compared to other food served, fufu with groundnut soup was more likely to have been contaminated (RR=7.3, 95%CI: 1.8-29.3). We isolated e serotype ogawa from stool samples. We observed open defaecation and poor personal hygiene.CONCLUSION: e serotype ogawa caused a high case-fatality outbreak in Medinya. Contaminated fufu and groundnut soup were the sources. Hand washing with soap was initiated and a make shift latrine constructed following our health education and recommendations.
Costs, effects and cost-effectiveness of breast cancer control in Ghana
(2012-08) Zelle, S.G.; Nyarko, K.M.; Bosu, W.K.; Aikins, M.; Niëns, L.M.; Lauer, J.A.; Sepulveda, C.R.; Hontelez, J.A.; Baltussen, R.
OBJECTIVE: Breast cancer control in Ghana is characterised by low awareness, late-stage treatment and poor survival. In settings with severely constrained health resources, there is a need to spend money wisely. To achieve this and to guide policy makers in their selection of interventions, this study systematically compares costs and effects of breast cancer control interventions in Ghana. METHODS: We used a mathematical model to estimate costs and health effects of breast cancer interventions in Ghana from the healthcare perspective. Analyses were based on the WHO-CHOICE method, with health effects expressed in disability-adjusted life years (DALYs), costs in 2009 US dollars (US$) and cost-effectiveness ratios (CERs) in US$ per DALY averted. Analyses were based on local demographic, epidemiological and economic data, to the extent these data were available. RESULTS: Biennial screening by clinical breast examination (CBE) of women aged 40-69 years, in combination with treatment of all stages, seems the most cost-effective intervention (costing $1299 per DALY averted). The intervention is also economically attractive according to international standards on cost-effectiveness. Mass media awareness raising (MAR) is the second best option (costing $1364 per DALY averted). Mammography screening of women of aged 40-69 years (costing $12,908 per DALY averted) cannot be considered cost-effective. CONCLUSIONS: Both CBE screening and MAR seem economically attractive interventions. Given the uncertainty about the effectiveness of these interventions, only their phased introduction, carefully monitored and evaluated, is warranted. Moreover, their implementation is only meaningful if the capacity of basic cancer diagnostic, referral and treatment and possibly palliative services is simultaneously improved.
Determinants of Ebola Virus Disease Infection among Healthcare Workers, Montserrado County, Liberia
(University of Ghana, 2016-09) Shannon, F.Q. II; Nyarko, K.M.; University of Ghana, College of Health Sciences School of Public Health
Background: Ebola Virus Disease (EVD) is a zoonotic and fatal illness. The fatality rates in outbreaks have ranged from 25% to 90%. An outbreak of EVD hit West Africa in 2014, especially Guinea, Liberia and Sierra Leone; claiming more than 2000 lives, including 881 health care workers. EVD caused about 378 cases and 192 deaths among healthcare workers in Liberia; Montserrado County was the hardest hit with over 90 cases and about 60 deaths. This research determined risk factors associated with Ebola Virus Disease infection among health workers in Montserrado County. Method: An unmatched case control study design was employed. It involved 168 participants (42 cases, and 126 controls). The study covered the period from May 2014 to May 2015. Cases (selected from health workers survivor database) included all healthcare workers reported as confirmed EVD cases in the Epi-surveillance and survivor database within the period of the outbreak. Controls included healthcare workers working (within the same one year period) in the same health facility or environment as the case subjects but did not have EVD. Self-administered questionnaires were employed. Data entry and analysis was conducted using Epi Info version 3.4.5. Result: Mean age of the study participants was 31.6 years (std. dev 7.1). The odds of being exposed to EVD in a health facility was 5.3 (CI 2.2-12.9) times higher in the cases compared to the controls. Maternity ward (OR 6.6, CI 2.1-21.0) and inpatient room/ward (OR 5.2, CI 1.9-14.1) were the places with the highest and significant odds of exposure to EVD in cases compared to their controls. Functions which had very high and significant odds of exposure among the cases compared to their controls included providing injection (OR 29.4, CI 3.5-243.4), placing intravascular device (OR 18.4, CI 4.9-68.7), providing medication (OR 16.9, CI 3.5-82.1), and emptying bedpan (OR 12.4, CI 2.5-62.4). Hand hygiene and wearing of Personal Protective Equipment (PPE) was relatively poor. Conclusion & Recommendations: Health care workers were at high risk for EVD infection during service provision especially when providing injection, placing intravascular device, providing medication, and emptying bed pan. Therefore, the need to address these risks and others cannot be overemphasized, as measures to prevent and manage future outbreaks and consequences that come along. Thus health authorities at all levels must ensure heightened vigilance and improved occupational safety measures, especially in the health facilities to prevent and manage EVD infection among health care workers.
Determinants of Stillbirths in the Tamale Metropolitan Area
(University of Ghana, 2014-07) Badimsuguru, A.B.; Nyarko, K.M.; University of Ghana, College of Health Sciences, School of Nursing 9
Stillbirths are more common than the death of a baby after birth and remained a serious public health issue in the developing world. Although stillbirths are preventable, there has been a sharp increase in the rate of stillbirths in the Tamale Metropolitan area of Northern Ghana in the last couple of years. Majority of the causes and risk factors remained unknown. This study was conducted to assess the sociodemographic, obstetric and maternal medical related determinants of stillbirths. The findings will be used to guide policy change in stillbirth control and provide a basis for future studies of stillbirths in the Tamale Metropolitan area. Method A1:1 unmatched case control study was conducted in the Tamale Metropolitan area. Cases were defined as resident mothers of Tamale Metropolis who delivered singleton lifeless babies at or after 28 weeks of gestation from 1st January, 2012 to 31st December, 2013. Controls were those who had live births within the same period. We abstracted data from maternal health record booklets used in index pregnancies. Also, personal interviews with mothers on home visits was conducted. We estimated both crude and adjusted odds ratios, 95% confidence intervals and p values. Results A total of 368 mothers (184 cases and 184 controls) participated in the study. Maternal age of ≤ 24, prolonged labour (> 12 hours) and diastolic blood pressure of less than80mmHg in late pregnancy were significant determinants of stillbirths (aOR 3.0, 95% CI = 1.08 – 8.39; aOR 3.5, 95% CI = 1.94 – 6.61 and aOR 2.2, 95% CI = 1.04 – 4.54 respectively) Conclusion Low diastolic blood pressure in late pregnancy, young maternal age and prolonged labour were the key determinants of stillbirths in the Tamale Metropolis. Improvement of community moral practices and discouraging early marriage will help reduce the menace of stillbirths. Monitoring of blood pressure and labour should be prioritized Key: stillbirth, determinants, Tamale Metropolitan area
Direct observation of outpatient management of malaria in a rural ghanaian district
(Pan African Medical Journal, 2014-12) Ameme, D.K.; Afari, E.A.; Nyarko, K.M.; Malm, K.L.; Sackey, S.; Wurapa, F.
Introduction: in Ghana, malaria continues to top outpatient morbidities; accounting for about 40% of all attendances. Effective case-management is key to its control. We evaluated case-management practices of uncomplicated malaria in Kwahu South District (KSD) health facilities to determine their conformity to guidelines.Methods: we conducted a cross sectional survey at all public health facilities in three randomly selected sub-districts in KSD. A non-participatory observation of suspected malaria consultations was conducted. Suspected malaria was defined as any person with fever (by history or measured axillary temperature > or equal 37.5 oC) presenting at the selected health facilities between 19th and 29th April 2013. Findings were expressed as frequencies, relative frequencies, mean (± standard deviation) and median.Results: of 70 clinical observations involving 10 prescribers in six health facilities, 40 (57.1%) were females and 16 (22.9%) were below five years. Median age was 18 years (interquartile range: 5-33). Overall, 63 (90.0%) suspected case-patients had diagnostic tests. Two (3.6%) were treated presumptively. All 31 confirmed and 10 (33.3%) of the test negative case-patients received Artemisinin-based Combination Therapies (ACTs). However, only 12 (27.9%) of the 43 case-patients treated with ACT received Artesunate-Amodiaquine (AA). Only three (18.8%) of the under-fives were examined for non-malarial causes of fever. Mean number of drugs per patient was 3.7 drugs (± 1.1). Only 45 (64.3%) patients received at least one counseling message.Conclusion: conformity of malaria case-management practices to guidelines in KSD was suboptimal. Apart from high rate of diagnostic testing and ACT use, prescription of AA, physical examination and counseling needed improvement. © Donne Kofi Ameme et al.
Dog Bites and Rabies in the Eastern Region of Ghana in 2013–2015: A Call for a One-Health Approach
(Journal of Tropical Medicine, 2018-07) Adomako, B.Y.; Baiden, F.; Sackey, S.; Ameme, D.K.; Wurapa, F.; Nyarko, K.M.; Kenu, E.; Afari, E.
Background. A One-Health approach is advocated to ensure effective rabies surveillance in sub-Saharan Africa. Information is needed to assess the current state of dog bites and rabies in Ghana. We analyzed data on reported events in the Eastern Region of Ghana from 2013 to 2015 to generate information that can be used for rabies elimination in Ghana through the One-Health approach. Method. We extracted data on dog bites and rabies from the database of the regional health service and performed descriptive analysis using Epi Info version 7™. We followed up with interviews with three key informants from the health and veterinary services on issues related to surveillance and data quality. Results. Overall, 4821 dog bites were reported over the three-year period. This translated into an annual incidence of 172 cases per a population of 100,000. Most of cases were in children aged less than 10 yrs. Fifteen (53.3% males) cases of rabies were recorded in seven out of the 26 municipalities and districts, translating into a rabies to dog bite ratio of 3: 1000. The median age of victims was 9 years (range: 3-72 years). A parallel and uncoordinated system of rabies surveillance is maintained by the health and veterinary services, with gross disparities in the number of reported events and overall impression of underreporting. Conclusion. Rabies remains an important cause of preventable deaths in this region. An integrated approach to surveillance based on the One-Health concept needs to be adopted.
Evaluation of the enhanced meningitis surveillance system, Yendi municipality, northern Ghana, 2010-2015
(BioMed Central Ltd., 2017) Kaburi, B.B.; Kubio, C.; Kenu, E.; Nyarko, K.M.; Mahama, J.Y.; Sackey, S.O.
Background: Meningitis is the inflammation of the meninges of the brain and or spinal cord. Global mortality rates vary from 2% to 30%. Epidemic meningitis remains a public health concern along the meningitis belt of Africa. Despite the operation of an enhanced meningitis surveillance system in Ghana, institutional mortality rates are estimated to range from 36% to 50%. In 2014, Yendi recorded 83 confirmed cases; with focal epidemics in some sub-municipals. We evaluated the system over a five-year period to find out whether it was achieving its objectives of systematic collection and analyses of data for the prevention or early detection of meningitis epidemics. Methods: We used cross-sectional design. Both qualitative and quantitative data from Yendi Municipality between January 2010 and December 2015 were collected and analyzed. The updated guidelines for evaluating surveillance systems from Centers for Disease Control and Prevention were used. Content analysis was performed on the responses of key informants. Surveillance data was analyzed using MS-Excel. Results: Fifteen healthcare workers were interviewed. For the period under evaluation, the annual incidence of meningitis ranged from 1.6/100,000 in 2012 to 62.6/100,000 in 2014. The average case fatality rate for the period was 8.3%. The system was sensitive, representative, and acceptable. The predictive value positive was 100% from 2010 to 2014 and 63.3% in 2015. Data quality was good, but timeliness of reporting was poor. Conclusions: The enhanced meningitis surveillance system in Yendi Municipality is achieving most of its objectives. However, financial constraints and poor personnel motivation pose threats to the sustainability of the system.
Factors Influencing Contraceptive uptake among Reproductive Women in Tamale Metropolis
(University of Ghana, 2015-07) Abdulai, M.; Nyarko, K.M.; Tawiah, E.K.; Akweongo, P.; University of Ghana, College of Health Sciences School of Public Health; University of Ghana, College of Health Sciences School, of Public Health
Introduction Contraceptive uptake can accelerate the achievement of not only the four Millennium Developments Goals( MDGs) that are directly related to reproductive health, but can also help in the elimination of poverty and hunger as well as environmental sustainability. Despite these benefits, modern contraceptive uptake among reproductive women, in Ghana is still below the national target of 51 %. The Northern Region has one of the lowest contraceptive uptake in the country over the past decade. The study therefore assessed factors that influence contraceptive uptake among reproductive women in the Tamale Metropolis. Methods A cross sectional study using both qualitative and quantitative approach was used to elicit information from reproductive women between the ages of 15-49years from all the three sub Metropolis in Tamale from February to March 2015. The study used cluster sampling to recruit 475 women and interviewed them using a structured questionnaire. In addition, nine focus group discussions (FGDs) were held among community members who were purposively selected. The quantitative data were analyzed using Stata version 13. Multiple logistic regression was used to identify factors associated with contraceptive uptake. Both crude and adjusted odds ratios were estimated at 95% confidence intervals. Socio-economic status was determined using principal component analysis. FGDs were recorded, transcribed verbatim and analyzed with Nvivo 10 software. Both the quantitative and qualitative data were later triangulated in reporting the results of the study. Results A total of 475 reproductive age women were studied. The mean age was 26years. The prevalence of contraceptive uptake among reproductive women was 36.8 %( 165 out of 448) while that of married women was 34.3%. Women with secondary education [AOR=4.4(95%CI, 1.6-12.4)], occupation [AOR=0.3(95%CI, 0.1-0.8)], having separate facilities to serve adults and adolescents [AOR=0.4(95%CI, 0.2-0.7)] and my partner does not know I use contraceptives [AOR=0.4(95%CI, 0.2-0.9)] were identified as factors affecting contraceptive uptake among women in the Metropolis. Conclusion The study found contraceptive prevalence rate (CPR) among women in reproductive age in the Metropolis to be 36.8%. Factors that were identified to significantly affect contraceptive uptake within the Metropolis were, attitude of contraceptive service providers towards clients, prior public education on contraceptives by service providers, the environment where the services are provided and partner involvement in contraceptive uptake. A concerted effort from all stake holders including religious, opinion leaders, health authorities the government as well as community members is necessary to scaling up contraceptive uptake in the region Keywords: Contraceptives, Contraceptive Uptake, Tamale Metropolis, Reproductive, Women, MDGs, Prevalence and Ghana.
Foodborne Illness Among School Children in Ga East, Accra
(Ghana Medical Journal, 2015-06) Malm, K.L.; Nyarko, K.M.; Yawson, A.E.; Gogo, B.; Lawson, A.; Afari, E.
A food borne illness was reported in Ga-East district of Greater Accra Region among school children in May, 2007 after eating food provided at school. The objective of the investigation was to determine the source, mode of contamination and the causative agent. A case-control study was conducted, cases were schoolchildren with abdominal symptoms and controls were children of the same sex and class without any symptom during the same period. The school children were selected by systematic sampling. Food handlers and the children were interviewed by a structured questionnaire. Food handlers were physically examined and their stools and blood examined. The kitchen for food preparation was inspected. Risks of food borne infection from the foods eaten were determined using attack rates. The minimum, peak and maximum incubation periods were 2, 11 and 61 hours respectively. The source was rice and groundnut soup (with the highest attack rate difference). Stool and blood samples of food handlers were not infective. Storage facility for food items was poor. No food samples were available for organism isolation. A protocol to prevent such outbreaks was nonexistent. The short incubation period and symptoms presented suggest an infective origin. The storage of the meat may potentially have been the point of contamination. The study showed that the schoolchildren ate contaminated food although the investigation could not determine the causative agent. Protocols to prevent such outbreaks need to be developed for the schools. (PDF) Foodborne Illness Among School Children in Ga East, Accra. Available from: https://www.researchgate.net/publication/280626402_Foodborne_Illness_Among_School_Children_in_Ga_East_Accra [accessed Sep 18 2018].
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.
Hospital All-Risk Emergency Preparedness in Ghana
(Ghana medical journal, 2012-03) Norman, I.D.; Aikins, M.; Binka, F.N.; Nyarko, K.M.
Objective: This paper assessed the emergency preparedness programs of health facilities for all-risks but focused on Road Traffic Accidents, (RTA) resulting in surge demand. It adopted W. H. O checklist covering hospital preparedness, equipment, manpower and surge capacity planning as best practices for the mitigation of public health emergencies. Method: This is a cross-sectional study of purposively selected health facilities. The method used consisted of site visit, questionnaire survey, literature and internet review. The W. H. O. standard for emergency preparedness of health facilities was used to evaluate and assess the nation’s hospitals surge capacity programs. The study was conducted between March-June, 2010. A total of 22 district and regional health facilities including teaching hospitals participated in the study. All 10 regions of the country were covered. Result: These were: (1) many of the nation’s hospitals were not prepared for large RTA’s resulting in surge demands, and did not possess general emergency preparedness programs. (2) The hospitals’ respective abilities to handle large scale RTA’s were compromised by the lack of competent medical and allied health personnel and adequate supplies. Discussion: The inadequacies of the hospital system in responding to emergencies raise serious public health concerns. The biggest challenge facing the hospitals in their emergency intervention is the lack of preemergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The paper ended with recommendations on how the nation’s hospitals and their supervisory agencies could improve emergency preparedness.
Household exposure and animal-bite surveillance following human rabies detection in Southern Ghana
(2016) Afakye, K.; Kenu, E.; Nyarko, K.M.; Johnson, S.A.; Wongnaah, F.; Bonsu, G.K.
INTRODUCTION: Rabies remains a neglected tropical zoonotic disease with 100% case fatality rate and estimated 6,000 global mortality annually, and yet vaccine preventable. In Ghana, rabies outbreaks receive poor response. We investigated rabies in a 5-year old boy to find the source of infection, identify exposed persons for post-exposure prophylaxis and describe animal-bite surveillance in Manya-Krobo District of Ghana.METHODS: We actively searched for cases and exposures by interviewing household members of the victim, schoolmates, and health professionals using WHO case definition, interview guide and checklist. We reviewed health and veterinary records and reports, and interviewed stakeholders. Descriptive data analyses were carried out and presented using tables and charts. Recorded responses were transcribed into thematic areas and analysed.RESULTS: Child had dog-bite at the wrist, and developed hyperactivity, hydrophobia and hyperventilation 2 months post bite. He was hospitalised and died from respiratory failure day 3 after admission. Thirty-three persons were exposed to rabies infectious material. Females were 66%, age-groups 5-15yrs and 30-59 yrs were 33.3% and 39.4% respectively. A third (11/33) were category II exposure by WHO classification and were recommended for post-exposure prophylaxis. Surveillance records showed ninety-two animal-bite cases were reported for past 12 months. Half were females, and 18-59yrs age-group was 43%. Surveillance data quality was poor.CONCLUSION: Rabies remains a public health burden inGhana with domestic dog as reservoir of the virus and females more vulnerable to secondary exposures. Health education on rabies should be intensified, and robust animal-bite surveillance system put in place.
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.
Next-generation sequencing of a human-animal reassortant G6P[14] rotavirus A strain from a child hospitalized with diarrhoea
(Archives of Virology, 2020-02-10) Damanka, S.A.; Dennis, F.E.; Lartey, B.L.; Nyarko, K.M.; Agbemabiese, C.A.; Armah, G.E.
We previously reported the VP4 and the VP7 genotypes of the first G6P[14] rotavirus strain (RVA/Human-wt/GHA/M0084/2010/G6P[14]) from the stool of an infant with diarrhoea in Ghana. In the current study, we obtained the complete genome sequences using Illumina MiSeq next-generation sequencing to enable us to determine the host species origin of the genes by phylogenetic analysis. The genotype constellation was G6-P[14]-I2-R2-C2-M2-A11-N2-T6-E2-H3. Phylogenetic analysis showed that M0084 was a reassortant strain from RVAs of both artiodactyl and human host species origin. The level of sequence identity of the individual genes of M0084 to other sequences in the GenBank ranged from 95.2 to 99.5%; however, there was no single strain from the GenBank database with a complete genome sequence that was highly similar to that of M0084. To help trace the source of such unique gene pools being introduced into human RVAs, it will be useful to examine RVA sequences from potential reservoirs such as sheep and goats, which are common domestic animals in this locality.
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.
Outbreak of foodborne gastroenteritis in a senior high school in South-eastern Ghana: A retrospective cohort study
(BioMed Central Ltd., 2016) Ameme, D.K.; Alomatu, H.; Antobre-Boateng, A.; Zakaria, A.; Addai, L.; Fianko, K.; Janneh, B.; Afari, E.A.; Nyarko, K.M.; Sackey, S.O.; Wurapa, F.
Background: On 4th February 2015, a group of Senior High School students from Fanteakwa district presented to the emergency unit of the district hospital with complaints of abdominal pain, vomiting and diarrhoea. All the students had eaten from a specific food vendor and had neither eaten any other common meal that day nor the previous day. A foodborne disease outbreak was suspected. We investigated to verify the outbreak, determine its magnitude, identify the source and implement control measures. Methods: A retrospective cohort study was conducted. We reviewed medical records and interviewed patrons of the food vendor. We collected data on age, sex, signs and symptoms, date of illness onset, date of admission, date of discharge, treatments given and outcome. A case of foodborne disease was any person in the school with abdominal pain, vomiting and or diarrhoea from 4th to 11th February 2015 and had eaten from the food vendor. We conducted active case search to identify more cases. We conducted environmental assessment and collected clinical and food samples for laboratory testing. Descriptive and inferential statistical analyses were performed using Stata 12.0. Results: A total of 68 cases were recorded giving overall attack rate of 35.79 % (68/190) with no death. Of these, 51.47 % (35/68) were males. Mean age of case-patients was 17.8 (standard deviation +/-1.62). The index case, a 17-year-old female student ate from the food vendor on 4th February at 9:00 am and fell ill at 3:40 pm later that day. Compared to those who ate other food items, students who drank water from container at the canteen were more likely to develop foodborne disease at statistically significant levels [RR = 2.6, 95 % CI = (2.11-3.15)]. Clostridium perfringens (C. perfringens) and Salmonella species (Salmonella spp) were isolated from water and stew respectively. Clinical features of case-patients were compatible with both organisms. Conclusion: A foodborne gastroenteritis outbreak occurred in a Senior High School in Fanteakwa District from 4th to 7th February 2015. The most probable aetiologic agent was C. perfringens with contaminated water at canteen as the vehicle of transmission. Concurrent Salmonella spp infection could not be ruled out. Rapid outbreak response helped in controlling the outbreak.