Browsing by Author "Opare, J."
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Item Barriers to healthcare workers reporting adverse events following immunization in four regions of Ghana(Vaccine, 2019-11-29) Bosomprah, S.; Gidudu, J.F.; Shaum, A.; Dodoo, A.; Bonsu, G.; Amponsa-Achiano, K.; Darko, D.M.; Sabblah, G.; Opare, J.; Nyaku, M.; Owusu-Boakye, B.; Oduro, A.; Aborigo, R.; Conklin, L.; Welaga, P.; Ampadu, H.H.Despite didactic training on adverse events following immunization (AEFI) in Ghana, the reporting ratio of AEFI was 1.56 per 100,000 surviving infants in 2015, below the minimum reporting ratio of 10. We aimed to estimate the proportion of health care workers (HCWs) reporting AEFI and to identify barriers to reporting. We conducted a cross-sectional survey of HCWs in four regions in Ghana. A simple random sample of 176 health facilities was selected and up to two HCWs were randomly selected per facility. We used the Rao-Scott Chi-squared test to compare factors associated with reporting of AEFI in the last year. We used an open-ended question to identify reasons for low reporting. One supervisor from each facility, responsible for overall reporting and management of AEFI, was also interviewed. A total of 306 HCWs from 169 facilities were interviewed. Of these, 176 (57.5%) reported they had ever encountered an AEFI. Of the 120 who had encountered an AEFI in the last year, 66 (55.0%) indicated they had reported the AEFI, and 38 (31.7%) completed a reporting form. HCWs (n = 120) reported multiple barriers to reporting of AEFI; the most common barriers were fear of personal consequences (44.1%), lack of knowledge or training (25.2%), and not believing an AEFI was serious enough to report (22.2%). Discussion of AEFI during the last supervisory visit was significantly associated with reporting in the past year (OR 7.39; p < .001). Of 172 supervisors interviewed, 65 (37.8%) mentioned their facilties had ever encountered an AEFI; over 90% of facilities had reporting forms. We identified low reporting of AEFI and multiple barriers to reporting among HCWs in the four selected regions of Ghana. Discussing AEFI during supervisory visits with HCWs might improve reporting. Additionally, strategies to address fear of personal consequences as a barrier to reporting of AEFI are needed.Item Meningitis outbreak caused by vaccine-preventable bacterial pathogens — Northern Ghana, 2016(Morbidity and Mortality Weekly Report, 2017) Aku, F.Y.; Lessa, F.C.; Asiedu-Bekoe, F.; Balagumyetime, P.; Ofosu, W.; Farrar, J.; Ouattara, M.; Vuong, J.T.; Issah, K.; Opare, J.; Ohene, S.-A.; Okot, C.; Kenu, E.; Ameme, D.K.; Opare, D.What is already known about this topic? The introduction of serogroup A meningococcal conjugate vaccine (MenAfriVac) in Ghana in 2012 had a substantial impact on the periodic outbreaks of meningitis in the Northern Ghana. However, seasonal increases in bacterial meningitis continue to occur; the most prevalent etiologies are Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. What is added by this report? During December 9, 2015-February 16, 2016, a total of 432 suspected meningitis cases were reported from three regions in northern Ghana. Among 286 cerebrospinal fluid specimens tested, 133 (46.5%) were positive, including 83 (62.4%) for N. meningitidis and 44 (33.1%) for S. pneumoniae. The predominant N. meningitidis serogroup was serogroup W (99%). Based on laboratory and epidemiologic data, 135,679 doses of meningococcal polysaccharide ACW vaccine were administered to the age groups most affected, resulting in substantial reduction in the number of meningitis cases. What are the implications for public health practice? Rapid identification of the etiologic agent in meningitis outbreaks is important for informing targeted public health interventions. Building and sustaining laboratory capacity in countries where meningitis outbreaks are common will be critical in ensuring rapid and effective response to these outbreaks. © 2017, Department of Health and Human Services. All rights reserved.Item Outbreak of cholera in the East Akim Municipality of Ghana following unhygienic practices by small-scale gold miners, November 2010.(Ghana medical journal, 2012-09) Opare, J.; Ohuabunwo, C.; Afari, E.; Wurapa, F.; Sackey, S.; Der, J.; Afakye, K.; Odei, E.In October 2010 an outbreak of cholera began among a group of small-scale gold miners in the East-Akim Municipality (EAM), Eastern Region. We investigated to verify the diagnosis, identify risk factors and recommend control measures. We conducted a descriptive investigation, active case-search and an unmatched case-control study. A cholera case-patient was a person with acute watery diarrhoea, with or without vomiting in EAM from 1st October to 20(th) November, 2010. Stool from case-patients and water samples were taken for laboratory diagnosis. We performed univariate and bivariate analysis using epi-info version 3.3. Of 136 case-patients, 77 (56.6%) were males, of which 40% were miners or from miners households. Index case, a 20 yr-old male miner from Apapam village reported on October 13(th), and case-patients peaked (18.4%) 20 days later. Attack rate was 2/1000 population with no fatality. Ages ranged from 1-84 years; mean of 34±18 yrs. Age-group 20-29 yrs was mostly affected (30.1%) with Apapam village having most case-patients (19.9%). Vibrio cholera serotype ogawa was isolated from stool samples. The main water source, Birim river was polluted by small-scale miners through defecation, post-defecation baths and sand-washings. Compared to controls, case-patients were more likely to have drunk from Birim-River [OR= 6.99, 95% CI: 2.75-18]. Vibrio cholera serotype ogawa caused the EAM cholera-outbreak affecting many young adult-males. Drinking water from contaminated community-wide -River was the major risk factors. Boiling or chlorination of water was initiated based on our recommendations and this controlled the outbreak.Item Pneumococcal meningitis outbreak and associated factors in six districts of Brong Ahafo region, Ghana, 2016(BioMed Central Ltd., 2018) Letsa, T.; Noora, C.L.; Kuma, G.K.; Asiedu, E.; Kye-Duodu, G.; Afari, E.; Kuffour, O.A.; Opare, J.; Nyarko, K.M.; Ameme, D.K.; Bachan, E.G.; Issah, K.; Aseidu-Bekoe, F.; Aikins, M.Background: Meningitis, a disease of the Central Nervous System is described as inflammation of the covering of the brain and spinal cord (meninges). It is characterised by fever, severe headache, nausea, vomiting, stiff neck, photophobia, altered consciousness, convulsion/seizures and coma. In December, 2015, twelve suspected cases of meningitis were reported in Tain district in Brong Ahafo region (BAR). Subsequently, dozens of suspected cases were hospitalized in five district hospitals in BAR. We investigated to determine the magnitude, causative agent and risk factors for the disease transmission. Methods: A community-based 1:2 case-control study (with 126 individuals) was conducted form 10/12/15 to 26/4/16 in 27 districts of Brong-Ahafo Region, Ghana. We defined suspected meningitis cases as people presenting with sudden headache and fevers (Temp> 38.0 °C) in combination with one of the following signs: neck stiffness, altered consciousness, convulsions, bulging fontanelle (infants) and other meningeal signs. Controls were selected from the same neighbourhood and defined as individuals with no overt meningitis signs/symptoms. We collected CSF samples and performed serological testing using Pastorex-Meningitis-Kit and culture for bacterial isolation. Moreover, structured questionnaires were used to collect data on socio-demographics, living conditions, health status and other risk factors. We conducted univariate data analysis and logistic regressions to study disease-exposure associations using Stata 15. Results: A total of 969 suspected cases with 85 deaths (CFR = 9.0%) were recorded between December, 2015 and March, 2016. Majority, 55.9% (542/969) were females aged between 10 months-74 years (median 20 years, IQR; 14-34). Of the 969 cases, 141 were confirmed by Laboratory test with Streptococcus pneumoniae identified as the causative agent. Cases were reported in 20 districts but 6 of these districts reported cases above threshold levels. The outbreak peaked in week 6 with 178 cases. Overall attack rate (AR) was 235.0/100,000 population. District specific ARs were; Tain; 143.6/100,000, Wenchi; 110.0/100,000, Techiman; 46.6/100,000, Jaman North; 382.3/100,000 and Nkoranza South; 86.4/100,000. Female and male specific ARs were 251.3/100,000 and 214.5/100,000 respectively. Age group 10-19 years were most affected 33.8% (317/940). We identified sore throat [aOR = 5.2, 95% (CI 1.1-26.1)] and alcohol use [aOR = 9.1, 95%(CI 1.4-55.7)] as factors associated with the disease transmission. Conclusion: Meningitis outbreak due to Streptococcus pneumoniae was established in BAR. Upper respiratory tract infection and alcohol use were associated with the outbreak. Mass campaigns on healthy living habits, signs and symptoms of meningitis as well as the need for early reporting were some of the control measures instituted. Moreover, we recommend Pneumococcal vaccination in BAR to prevent future outbreaks. © 2018 The Author(s).