Browsing by Author "Ofosu-Amaah, S."
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Item Alternate Eye Care Services in a Ghanaian District(Ghana Medical Journal, 2005-03) Ntim-Amponsah, C.T.; Amoaku, W.M.K.; Ofosu-Amaah, S.OBJECTIVE: To determine eye care services sought outside the regular hospital system and their providers. STUDY SETTING: Akwapim South district METHOD: Questionnaire survey and in depth interviews. RESULTS: We recruited 1,537 persons with a previous history of eye disease and alternate service providers (21 chemical shop attendants and 55 herbalists). There was no significant difference between patronage of the regular and the alternative providers (p value 0.78). Most of the herbalists were trained by relations; parents (29/55) and grandparents (10/55). Two thirds had some formal education and 96% practiced part-time. Over 75% claimed they treated cataracts, eye injuries, and "kooko" and 28% also treated red eyes. Chemical shop attendants were all literates, sold only antibiotic eye drops, and 64% practiced full time. CONCLUSIONS: Herbalists and chemical sellers provided substantive eye care along the regular hospital services but some of their practices may be harmful.Item An assessment of the safety of street foods in the Ga district, of Ghana; Implications for the spread of zoonoses(Acta Tropica, 2000-07) King, L.K.; Awumbila, B.; Canacoo, E.A.; Ofosu-Amaah, S.Street food refers to food and beverages prepared and sold by vendors in streets and other public places for immediate consumption. In Ghana street foods are sold at small eating places popularly known as 'chop bars'. Food safety studies were conducted on the premises of 160 'chop bars' in the Ga District of Ghana in July 1998. Only three (1.8%) of the proprietors met all the requirements (based on a five-point checklist) for basic hygiene. Twenty-four (15%) out of the 160 proprietors had access to potable water while the other 136 (85%) proprietors purchased water from vendors and six used pond water. These two latter sources of water were of poor microbiological quality (as shown by faecal coliform values which ranged from 1.0x102-1.9x105 cfu/ml). One hundred and five proprietors (65.6%) did not obtain their meat supply from an approved source. Factors influencing the purchase of meat from an approved source included the proximity of a chop bar to a slaughter facility, the conduct of meat inspection personnel and affordable user fees. Copyright (C) 2000 Elsevier Science B.V.Item Causes Of Low Epi Coverage In The Osudoku Sub-District Of The Dangme West District In The Greater Accra Region of Ghana(University of Ghana, 1999-08) Opoku-Amankwaah, C.; Ofosu-Amaah, S.; Gyapong, J.; University of Ghana, College of Health Sciences, School of Public HealthThe Osudoku subditrict has been blamed for the persistent inability of the Dangme West District Health Authority to achieve its immunisation coverage objective. The study objective was to ascertain the accuracy of this assertion of the DHMT and then find the factors causing the alleged poor performance of the subdistrict, if confirmed by the study. Two immunisation coverage surveys using the WHO/ EPI ‘30 cluster sample’ methodology were conducted, one each in the Osudoku and Prampram subdistricts. The Prampram subdistrict is noted by the DHMT to be performing favourably in childhood immunisation. The results of the surveys showed that the Osudoku subdistrict compared favourably with the Prampram subdistrict. Notwithstanding the observed favourable performance in the study some factors were identified which could explain the apparent poor performance of the Osudoku subdistrict. These were:1. The exaggeration of the target population estimates being used by the subdistrict to calculate its childhood immunisation coverage. 2. The reduction in size of the numerator (ie. the 0 - 11 month old children) the subdistrict is supposed to immunise in a given year. 3. Poor data management (MIS) by the MCH staff. Other minor, but equally important factors identified in the coverage survey that could contribute to the apparent low EPI coverage in the Osudoku subdistrict were: 1. Missed opportunities 2. Drop - outs 3. Poor- timing for administering the vaccines.Item Clinical and serological reactions after immunization of children in Ghana, West Africa, with the Japanese acellular pertussis vaccine(Developments in Biological Standardization, 1985) Biritwum, R.B; Isomura, S.; Ofosu-Amaah, S.; Sato, Y.Item Evaluation of risk factors for advanced glaucoma in Ghanaian patients(Eye, 2005-05) Ntim-Amponsah, C.T.; Amoaku, W.M.K.; Ewusi, R.K.; Idirisuriya-Khair, R.; Nyatepe-Coo, E.; Ofosu-Amaah, S.Purpose: This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. Methods: A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases) was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. Results: Univariate analysis showed that initial IOP>31mmHg, age of > 60 years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP>31mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95% confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95% CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR 5.16, 95% CI 1.97, 13.51; P-value 0.0008) were more likely to present with advanced glaucoma than younger ones. Conclusions: Subjects with initial IOP>31 mmHg were nearly three times more likely to present with advanced glaucoma than those with IOP<32mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects. © 2005 Nature Publishing Group All rights reserved.Item An Exploratory Study into the Usefulness of the District Health Annual Report to the DHMT* in the Management of the District Health System(University of Ghana, 1995-12) Arde-Acquah, A.A.; Ofosu-Amaah, S.; Dzatse, Z.K.M.; University of Ghana, College of Health Sciences, School of Public HealthFor a developing country like Ghana, which has chosen the PHC strategy to achieve health for all by 2000 AD, the management of the district health system is understandably of vital importance. The government's support of its health policy is shown in its decentralization moves on the past few years. In 1995, not only personnel, but now, the financial administration has been brought to the district level. Health managers and teams therefore now bear the responsibility of managing the district health system. To do this successfully, information generation as well as its use in the widest sense is very essential. It is necessary to find out if this realization is present, for indeed a lot of data and information is commonly being already generated in the health system.Item Home-Visiting in the Assin District(University of Ghana, 1998-09) Antwi, P.L.; Ofosu-Amaah, S.; Pappoe, M.; University of Ghana, College of Health Sciences, School of Public HealthThis study was done in the Assin District of the Central Region of Ghana. The aim of the study was to determine the practice of home-visiting in the district. Health hazards in the home were assessed, and how these hazards were addressed by health workers during home-visiting were observed. Interviews were conducted in 4 out of the 8 sub-districts for 100 household heads, 12 Community Health Nurses and 6 Health inspectors. In addition, participant observation visits were conducted while Community Health Nurses as well as Health Inspectors were doing home-visiting. Generally, frequency of home-visiting among the nurses was found to be low. The number of days or weeks elapsing between visits ranged from 3 days to 28 weeks. Quality of service rendered in about 83% of the homes surveyed was considered to be poor. Among the Health Inspectors, home-visiting was more regular but many health hazards observed in the homes were not addressed. Health hazards identified in the home included domestic animals living in close proximity with humans, in 8 8% of homes; scattered refuse 50%, stagnant water 45%, open refuse containers 78.3%, open water storage containers 70%, and home accident hazards 75%. The health hazards that were most frequently addressed by nurses were home accident hazards (open fires) and open water storage containers. The health hazard that was sometimes addressed by Health Inspectors was open water storage containers. A gap therefore exit between what is done and what should be done by health workers, both in terms of the frequency of home visits and the health hazards addressed during such home visits. To close this gap it is recommended that: • All health workers who go on home-visiting be given in-service training on this activity and that home-visiting be included in the curriculum and job description of all health workers. • Other grass root workers who visit homes be trained to identify and address health hazards in the home.Item Is the Sub-District Concept Working? A Study of the Subdistrict Health System in the Ho District(University of Ghana, 1997) Senaya, L.K.; Ofosu-Amaah, S.; Pappoe, M.; University of Ghana,College of Health Sciences,School of Public HealthThe Primary Health Care in Ghana which started as far back as 1978 is based on the three tier structure namely the District; subdistrict and community levels. The Subdistrict level is to act as a link between the District level and the Community level. However, the subdistrict level was recognised as a weak link in translating policies into significant health impact by the Ministry of Health, (MOH). In an attempt to address these problems, subdistrict health systems were formed in the country to provide essential health services within defined catchment areas. The subdistrict concept has been operating for over three years. This study aimed at determining whether the concept is working in the Ho District. The general objectives were to verify whether the subdistrict health system is working in the Ho district and to identify factors adversely affecting the system and suggest solutions. A descriptive study was conducted using both qualitative and quantitative methods. Data was collected using a checklist, a questionnaire, an interview guide, a discussion guide and available health information in the district. The study revealed that almost all SDHTs were not functioning as a team. The support systems needed to create the enabling environment for improved health service deliver}' at the subdistrict level was weak. Consequently, the subdistrict activities were not meeting the expected outputs recommended by the subdistrict working Group of MOH. On the basis of these findings, it is recommended that the SDHTs should be reconstituted to reflect the basic composition of an SDHT. Also, SDHT should be trained after needs assessment have been done by the DHMT. It is very important that the support systems of r the SDHTs are evaluated for the necessary action to be taken to improve health service delivery. SDHTs should also play the key role of involving communities in health programmes by supporting and working closely with community structures like VHCs and IMCs.Item Pattern of road traffic injuries in Ghana: Implications for control.(2003) Afukaar, F.K.; Antwi, P.; Ofosu-Amaah, S.Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve non-mechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.Item Prevalence of children with disabilities in central region, Ghana(West African Journal of Medicine, 2001) Biritwum, R.B.; Devres, J.P.; Ofosu-Amaah, S.; Marfo, C.; Essah, E.R.A cross sectional survey was conducted in Central Region, Ghana to determine the prevalence of children with disabilities. Forty-seven (1.8%) out of a total of 2,556 children under fifteen years of age had disabilities. About a third, had difficulty with movement of which post poliomyelitis infection disability formed the majority. Twelve children (25.5%) had difficulty with hearing and speech (deaf and dumb). Three children were reported as having epilepsy and 2 others had mental retardation. There was no case of total blindness, however, two children complained of poor vision and three others had a squint. Other disabilities identified, included one child each with kyphosis (hunch back), hydrocephalus (very large head) and extensive facial scars from burns. Disability was more common among children who had not been immunized or who did not have immunization card at the time of interview. The prevalence of disability was higher among female children in the rural community and in children with no formal education. Prevalence of disability increased with age. The prevalence of disability was 14.4 per 1,000 for children (1-5) years, 16.6 per 1000 for children (6-9) years and 3.7 per 1,000 for (10-15) years age group. Younger children had better immunization status and lower disability rates. Thirty percent of the children with disability said they were experiencing discrimination especially among the female children. This study has demonstrated that there is a need to intensify the preventive efforts at reducing the problem of childhood disability and to increase public support to the disabled children by avoiding discrimination and encouraging education and training of the disabled children.Item The Prevalence of Exclusive Breastfeeding in Fosu Sub-District(University of Ghana, 2001-08) Boahen, O.; Owusu, W.B.; Ofosu-Amaah, S.; University of Ghana, College of Health Sciences, School of Public HealthStudies have shown that human milk and breastfeeding of infant provides advantages with regard to general health, growth and development for infants. Mothers who breastfeed their babies may also gain health benefits. In addition to health benefits to mothers and infants, breastfeeding provides significant social and economic benefits to nations and individuals. Researchers have found out that both mother and infant can maximise the benefits if they practice exclusive breastfeeding during the first six months of the infants’ life. Because of the importance of breastfeeding, various organizations like the World Health Organization (WHO), United Nation Childrens’ Emergency Fund (UNICEF), institutions, Non Governmental Organizations and Ministry of Health (MOH) in different countries are making efforts to promote it. In Assin District in the Central Region, the health workers have embarked on educational programs to promote the practice. Unfortunately, the prevalence of the practice in the district is not known. This makes it difficult to evaluate the impact of educational programs on breastfeeding in the district. The main objective of the study was to determine through a survey the proportion of women who practised exclusive breastfeeding in the study area. A cross sectional approach was used in the study. The inclusion criteria for the study were the mothers of children aged between 6-12 months. Midwives, Traditional Birth Attendants (TBAs) and District Nutrition Officer were also interviewed. Interview guide and pre-coded questionnaire were used to obtain information from mothers and the health providers. The study showed that the estimated prevalence of exclusive breastfeeding feeding practice in Fosu sub-district was 42.7%. Again, the study found out that, breastfeeding was universal in the communities. All the study subjects breastfed their infants during the first six months of their life. Family members such as husband, grandmothers, in-laws, parents, and neighbours influenced the breastfeeding practice during the first 6 months of infant life. Other factors like age, occupation and education also influenced the practice. Two hundred and eighty (94.9%) out of 295 mothers interviewed have heard about exclusive breastfeeding initiative. Based on the findings, the following recommendations were made: 1. Vigorous education should be embarked upon by the health providers to remove the erroneous impression about the practice of exclusive breastfeeding in the study area; 2. Education about exclusive breastfeeding should not be limited to mothers alone. They should involve grandmothers, grandfathers, and general public in breastfeeding education; 3. Health workers should constantly remind the population of the importance of exclusive breastfeeding during their outreach programs and their home visits; and 4. Various women groups should be helped to form breastfeeding promotion groups to help educate the community and to support breastfeeding mothers.Item Prevalence of glaucoma in an African population(Eye, 2004-06) Ntim-Amponsah, C.T.; Amoaku, W.M.K.; Ofosu-Amaah, S.; Ewusi, R.K.; Idirisuriya-Khair, R.; Nyatepe-Coo, E.; Adu-Darko, M.Purpose. To determine the prevalence of primary open-angle glaucoma (POAG) in a Ghanaian population aged 30 years and above and to describe any ethnic variations in glaucoma prevalence in this population. Method. A cross-sectional prevalence survey for POAG was carried out on residents of 30 years and above in the Akwapim-South district of Ghana. The principal investigator examined all glaucoma suspects and those diagnosed as glaucoma in the initial screening to determine all definite cases of POAG. All cases had intraocular pressure measurements. Glaucoma cases and suspects and some normal subjects had fundus biomicroscopy with 78 D Volk lens, and Humphrey FDT N-30 visual fields plotted. Results. A total of 1843 people aged 30 years were screened from the population. The standardized age-specific prevalence was 7.7% (30 years and above) and 8.5% (40 years and above). The best-fit trend line for prevalence/age relationship was exponential. No gender or ethnic difference in prevalence was found. Conclusions. The prevalence of POAG in this population is high and comparable to those in black populations in Barbados and St. Lucia. © 2004 Nature Publishing Group All rights reserved.Item Prevalence of refractive error and other eye diseases in schoolchildren in the Greater Accra region of Ghana(Journal of Pediatric Ophthalmology and Strabismus, 2007-09) Ntim-Amponsah, C.T.; Ofosu-Amaah, S.Purpose: To determine the prevalence of refractive error and other eye diseases in schoolchildren in the Greater Accra region of Ghana. Methods: Research assistants tested visual acuity (VA) using a Snellen chart in students randomly selected from 24 schools (ie, 8 metropolitan, 8 urban, and 8 rural). An ophthalmologist examined students with VA of 6/12 or worse in either eye and students with other eye problems. Results: Nine hundred fifty-seven students aged 6 to 22 years were screened: 67 had myopia with VA of 6/12 or worse in the better eye, 3 were unilaterally blind (2 from squint or amblyopia, 1 from a hypoplastic disk), and 4 had unilateral low vision from macular scars. Other eye diseases observed were congenital glaucoma (1), vernal conjunctivitis (2), and infective conjunctivitis (6). The prevalence of refractive error reducing vision to at least 6/12 was 7.0%. The prevalence of squint and amblyopia was 0.2%. Conclusion: The most common eye defect in the students was refractive error. Squint and amblyopia were rare.Item Serum polio antibodies in unimmunized preschool children in a rural village in Ghana: Before active immunization programme(Annals of Tropical Paediatrics, 1987) Isomura, S.; Biritwum, R.B.; Ofosu-Amaah, S.The finding of the neutralizing antibodies against poliovirus in unimmunized preschool children confirms the endemicity of the disease in the rural community. The predominant polio antibody types were types 1 and 2. In children under 4 months of age, 82% were seropositive to type 1, 91% to polio type 2 and 55% to polio type 3; evidence of maternal transplacental antibodies. There were fewer seropositives in the age group 4-9 months, 28%, 44% and 12% to the types 1, 2 and 3, respectively. However, the percentages of seropositives to all three types increased for the rest of the age groups, indicating possible contact with the wild poliovirus in early infancy. Community spread of the virus is also supported by the intrafamilial clustering of the seropositives.