Browsing by Author "Sackey, S."

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Assessing Lymphatic Filariasis Data Quality in Endemic Communities in Ghana, Using the Neglected Tropical Diseases Data Quality Assessment Tool for Preventive Chemotherapy
(Public Library of Science, 2016) de Souza, D.K.; Yirenkyi, E.; Otchere, J.; Biritwum, N.K.; Ameme, D.K.; Sackey, S.; Ahorlu, C.; Wilson, M.D.
Background: The activities of the Global Programme for the Elimination of Lymphatic Filariasis have been in operation since the year 2000, with Mass Drug Administration (MDA) undertaken yearly in disease endemic communities. Information collected during MDA–such as population demographics, age, sex, drugs used and remaining, and therapeutic and geographic coverage–can be used to assess the quality of the data reported. To assist country programmes in evaluating the information reported, the WHO, in collaboration with NTD partners, including ENVISION/RTI, developed an NTD Data Quality Assessment (DQA) tool, for use by programmes. This study was undertaken to evaluate the tool and assess the quality of data reported in some endemic communities in Ghana. Methods: A cross sectional study, involving review of data registers and interview of drug distributors, disease control officers, and health information officers using the NTD DQA tool, was carried out in selected communities in three LF endemic Districts in Ghana. Data registers for service delivery points were obtained from District health office for assessment. The assessment verified reported results in comparison with recounted values for five indicators: number of tablets received, number of tablets used, number of tablets remaining, MDA coverage, and population treated. Furthermore, drug distributors, disease control officers, and health information officers (at the first data aggregation level), were interviewed, using the DQA tool, to determine the performance of the functional areas of the data management system. Findings: The results showed that over 60% of the data reported were inaccurate, and exposed the challenges and limitations of the data management system. The DQA tool is a very useful monitoring and evaluation (M&E) tool that can be used to elucidate and address data quality issues in various NTD control programmes. © 2016 de Souza et al.
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.
Determinants of low birth weight deliveries at five referral hospitals in Western Area Urban district, Sierra Leone
(Italian Journal of Pediatrics, 2021) Kargbo, D.K.; NYARKO, K.; Sackey, S.; Addo-Lartey, A.; Kenu, E.; Anto, F.
Background: Low birth weight (LBW) contributes significantly to infant and child mortality. Each year, about 20 1million deliveries are LBW with 96.5% occurring in developing countries. Whiles the incidence of LBW is reducing in other districts of Sierra Leone, it has been reported to be increasing in the Western Area Urban district. Determining the risk factors in a specific geographic area is important for identifying mothers at risk and thereby for planning and taking appropriate action. The current study sought to identify factors associated with LBW deliveries in the Western Area Urban district of Sierra Leone. Methods: A hospital-based unmatched 1:2 case-control study was conducted among mothers who delivered live singleton babies from November, 2019 to February, 2020 in five referral health facilities. Mothers were conveniently sampled and sequentially enrolled into the study after delivery. Their antenatal care cards were reviewed and a pretested questionnaire administered to the mothers. Data analysis was done using Stata 15.0 and association between maternal socio-demographic, socio-economic, obstetric and lifestyle factors and LBW assessed using bivariable and multivariable logistic regression analyses. Results: A total of 438 mothers (146 cases and 292 controls), mean age: 24.2 (±5.8) and 26.1 (±5.5) years for cases and controls respectively participated in the study. Multivariable analysis revealed that being unemployed (AoR = 2.52, 95% CI 1.16–5.49, p = 0.020), having anaemia during pregnancy (AoR = 3.88, 95% CI 1.90–7.90, p < 0.001), having less than 2 years inter-pregnancy interval (AoR = 2.53, 95% CI 1.11–5.73, p = 0.026), and smoking cigarettes during pregnancy (AoR = 4.36, 95% CI 1.94–9.80, p < 0.001) were significantly associated with having LBW babies. Conclusion: Factors associated with LBW identified were unemployment, anaemia during pregnancy, < 2 years inter-pregnancy interval and cigarette smoking during pregnancy. Health care providers should screen and sensitize mothers on the risk factors of LBW during antenatal sessions.
Determinants of low birth weight deliveries at five referral hospitals in Western Area Urban district, Sierra Leone
(Italian Journal of Pediatrics, 2021) Kargbo, D. K.; Nyarko, K.; Sackey, S.; Addo-Lartey, A.; Kenu, E.; Anto, F.
Background: Low birth weight (LBW) contributes significantly to infant and child mortality. Each year, about 20 1million deliveries are LBW with 96.5% occurring in developing countries. Whiles the incidence of LBW is reducing in other districts of Sierra Leone, it has been reported to be increasing in the Western Area Urban district. Determining the risk factors in a specific geographic area is important for identifying mothers at risk and thereby for planning and taking appropriate action. The current study sought to identify factors associated with LBW deliveries in the Western Area Urban district of Sierra Leone. Methods: A hospital-based unmatched 1:2 case-control study was conducted among mothers who delivered live singleton babies from November, 2019 to February, 2020 in five referral health facilities. Mothers were conveniently sampled and sequentially enrolled into the study after delivery. Their antenatal care cards were reviewed and a pretested questionnaire administered to the mothers. Data analysis was done using Stata 15.0 and association between maternal socio-demographic, socio-economic, obstetric and lifestyle factors and LBW assessed using bivariable and multivariable logistic regression analyses. Results: A total of 438 mothers (146 cases and 292 controls), mean age: 24.2 (±5.8) and 26.1 (±5.5) years for cases and controls respectively participated in the study. Multivariable analysis revealed that being unemployed (AoR = 2.52, 95% CI 1.16–5.49, p = 0.020), having anaemia during pregnancy (AoR = 3.88, 95% CI 1.90–7.90, p < 0.001), having less than 2 years inter-pregnancy interval (AoR = 2.53, 95% CI 1.11–5.73, p = 0.026), and smoking cigarettes during pregnancy (AoR = 4.36, 95% CI 1.94–9.80, p < 0.001) were significantly associated with having LBW babies. Conclusion: Factors associated with LBW identified were unemployment, anaemia during pregnancy, < 2 years inter-pregnancy interval and cigarette smoking during pregnancy. Health care providers should screen and sensitize mothers on the risk factors of LBW during antenatal sessions. Keywords: Low birth weight, Case-control, Referral hospitals, Western area urban, Sierra Leone
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 facilitative supervision visits in primary health care service delivery in Northern Ghana
(2013-09-24) Aikins, M.; Laar, A.; Nonvignon, J.; Sackey, S.; Ikeda, T.; Woode, G.; Nang-Beifubah, A.; Nyonator, F.
Abstract Background In Ghana’s health delivery services, facilitative supervisory visit (FSV) as a system of management is new. This paper presents the standard evaluation results of FSV, which formed an integral part of the community-based health planning services (CHPS) initiative. Methods The study was conducted in the Upper West Region of Ghana. The Project developed guidelines and tools for FSV for four different health system levels – regional, district, sub-district and community levels. Electronic data from all four levels representing quarterly results were compiled into their annual equivalents, and summarized graphically for comparison. Results The data show that all the nine districts embraced the FSV concept even though they differed markedly with regard to the degree of adherence to some set benchmarks. Three DHMTs (Wa Municipal, Lawra and Jirapa) were graded as good while the remaining six DHMTs were adjudged as fair in relation to management of supplies, transport and equipment, information, meeting, and technical support. Conclusions The data further suggest that there is much to gain both individually and institutionally from FSVs. Generally, FSVs are crucial to the delivery of primary health care services in especially rural areas.
Evaluation of facilitative supervision visits in primary health care service delivery in Northern Ghana
(BMC Health Services Research, 2013-09) Aikins, M.; Laar, A.; Nonvignon, J.; Sackey, S.; Ikeda, T.; Woode, G.; Nang-Beifubah, A.; Nyonator, F.
Background: In Ghana's health delivery services, facilitative supervisory visit (FSV) as a system of management is new. This paper presents the standard evaluation results of FSV, which formed an integral part of the community-based health planning services (CHPS) initiative. Methods. The study was conducted in the Upper West Region of Ghana. The Project developed guidelines and tools for FSV for four different health system levels - regional, district, sub-district and community levels. Electronic data from all four levels representing quarterly results were compiled into their annual equivalents, and summarized graphically for comparison. Results: The data show that all the nine districts embraced the FSV concept even though they differed markedly with regard to the degree of adherence to some set benchmarks. Three DHMTs (Wa Municipal, Lawra and Jirapa) were graded as good while the remaining six DHMTs were adjudged as fair in relation to management of supplies, transport and equipment, information, meeting, and technical support. Conclusions: The data further suggest that there is much to gain both individually and institutionally from FSVs. Generally, FSVs are crucial to the delivery of primary health care services in especially rural areas. © 2013 Aikins et al.; licensee BioMed Central Ltd.
Evaluation of the sentinel surveillance system for influenza-like illnesses in the Greater Accra region, Ghana, 2018
(PLoS ONE, 2019-03) Nuvey, F.S.; Edu-Quansah, E.P.; Kuma, G.K.; Eleeza, J.; Kenu, E.; Sackey, S.; Ameme, D.; Abakar, M.F.; Kreppel, K.; Ngandolo, R.B.; Afari, E.; Bonfoh, B.
Background Influenza-like Illness (ILI) is a medical diagnosis of possible influenza or another respiratory illness with a common set of symptoms. The deaths of four schoolchildren, during a pandemic influenza outbreak in December 2017 in Ghana, raised doubts about the ILI surveillance system’s performance. We evaluated the ILI surveillance system in the Greater Accra region, Ghana, to assess the system’s attributes and its performance on set objectives. Methods CDC guidelines were used to evaluate the data of the ILI surveillance system between 2013 and 2017. We interviewed the surveillance personnel on the system’s description and operation. Additionally, routinely entered ILI data from the National Influenza Center provided by the six sentinel sites in Accra was extracted. We sampled and reviewed 120 ILI case-investigation forms from these sites. Surveillance activities were examined on system’s performance indicators, each being scored on a scale of 1 to 3 (poorest to best performance). Results All population and age groups were under ILI surveillance over the period evaluated. Overall, 2948 suspected case-patients, including 392 (13.3%) children under-five were reported, with 219 being positive for influenza virus (Predictive value positive = 7.4%). The predominant influenza subtype was H3N2, recorded in 90 (41.1%) of positive case-patients. The system only met two out of its four objectives. None of the six sentinel sites consistently met their annual 260 suspected case-detection quota. Samples reached the laboratory on average 48 hours after collection and results were disseminated within 7 days. Of 120 case-investigation forms sampled, 91 (76.3%) were completely filled in. Conclusions The ILI surveillance system in the Greater Accra region is only partially meeting its objectives. While it is found to be sensitive, representative and timely, the data quality was sub-optimal. We recommend the determination of thresholds for alert and outbreak detection and ensuring that sentinel sites meet their weekly case-detection targets.
Factors Associated with Defaults from treatment among Tuberculosis Patients in Western Sierra Leone
(University of Ghana, 2014-07) Greene, J. J.; Sackey, S.
Background: Successful treatment of tuberculosis (TB) involves taking anti-tuberculosis drugs for at least six months. Poor adherence to treatment means patients remain infectious for a longer period, and are more likely to relapse or succumb to tuberculosis and could result in treatment failure as well as foster emergence of drug resistant tuberculosis. Sierra Leone is among countries with high tuberculosis burden globally. Objective: To identify factors associated with default from treatment among tuberculosis patients in Western Sierra Leone. Method: A case-control study was conducted between September 2012 to August 2013 in Western, Sierra Leone. The study population consisted of tuberculosis patients on treatment who default (non-compliant) and those who have completed treatment (compliant) at the Connaught Chest Clinic. A sample size of 240, 120 for compliant and 120 for non compliant. Respondents completed structured questionnaire for socio-demographic characteristics, patient related factors, socio-economic variables, healthcare system related factors, default factors, stigma and discrimination and disease and medicine related factors. Factors associated with default were analyzed using logistic regression, bivariatr and multivariate analysis. Results: Among the 120 defaulters interviewed, 34.2% (41) attributed their default to inadequate supply of medicines, 30.8% (37) to feeling better, 11.7% (14) not feeling better, 8.3% (10) lack of family support, 6.7% (8) no reason, 5% (6) stigma and discrimination and 3.3% (4) side effects . On multivariate analysis, food availability (OR=6.93,p=0.01) , patient waiting time (OR =0.09,p<0.01) , availability of medicine (OR=0.006,p<0.01),treatment should be taken until six months(OR=0.007,p<0.01),leaving with friends(OR=5.85,p<0.01) were independently associated with default. Conclusion: Non-availability of medicines, non-availability of food, long waiting times at the clinic, perception that TB treatment should be taken until six months, type of person living with the patient ,duration of stay in the current abode, disease classification ,HIV status and patients taking other medicines besides TB treatment had significant association with default from treatment among TB patients in Western Sierra Leone. Key words: Tuberculosis, Compliance, Defaulter, Western Sierra Leone
Factors associated with head injury among survivors of motorcycle crashes: a case-control study in northern Ghana
(Pan African Medical Journal, 2022) Appiah, A.B.; Akweongo, P; Sackey, S.; Morna, M.T.; Kenu, E.; Buunaaim, A.D.B.; Debrah, S.A.Y.; Ojo, T.K.; Donkor, P.; Mock, C.
Introduction: the increasing use of motorcycles in northern Ghana is associated with a high incidence of motorcycle crashes and resultant head injuries. This study sought to determine factors associated with head injuries among survivors of motorcycle crashes in northern Ghana. Methods: a prospective unmatched case-control study was conducted at the Tamale Teaching Hospital (TTH). A total of 326 cases (victims who suffered a head injury with or without other injuries) and 294 controls (persons who suffered various injuries except for head injury) from motorcycle crashes were consecutively sampled at TTH from December 15, 2019, to May 15, 2020. A semi-structured questionnaire was used to interview patients in addition to medical records review. Factors associated with head injury were examined using multivariable logistic regression at p<0.05 and a 95% confidence interval. Results: the prevalence of head injury was 53.03% among of 660 survivors of motorcycle crashes. The majority of the patients were young males aged 15-44 years. The rate of helmet use was lower in cases (12.88%) than in controls (57.82%) (p<0.001). Factors associated with head injury were not wearing helmet (AOR= 9.80, 95% CI: 6.22, 15.43), male (AOR=1.75, 95% CI: 1.07, 2.85), student (AOR=0.38, 95% CI: 0.16, 0.91), and alcohol use within 24 hours (AOR=0.17, 95% CI: 0.04, 0.70). Conclusion: non-use of helmet and male gender significantly increased the risk of head injury risk in this study. Alcohol use and being a student were associated with lower odds of head injuries. Motorcycle safety efforts in the study area should emphasize helmet promotion.
Factors Influencing Alcohol Consumption Among Adult Residents of Tema, Community One in the Greater Accra Region
(University of Ghana, 2013-07) Frimpong-Mansoh, R.P.; Sackey, S.; University of Ghana, College of Health Sciences, School of Public Health
Alcohol consumption is a long lasting widespread and varied man custom. It has become a growing challenge in many African countries of which Ghana is no exception. In spite of the numerous health and social problems associated with its use and abuse, data on alcohol consumption is insufficient and not collected consistently. This informed the inclusion of alcohol questions in the Ghana Demographic and Health Survey, 2008. This study was a cross sectional study of 412 adults aged 18 years and above that sought to determine the proportion and the factors influencing alcohol consumption in Tema Community One. Data was collected using questionnaires and was analyzed by SPSS version 20. The proportion of adults who consumed alcohol in Community One was found to be 50%, men always consumed more alcohol than women. Majority of those who consumed alcohol were within the 18-29 age group. Alcohol consumption was significantly associated with sociodemographic factors (age, sex, educational level, marital status, employment and occupation), income level but not environmental factors. Most people drink alcohol to have fun and cope with stress. They considered alcohol consumption as an adult way of life, as an appetizer or to satisfy partner(s) in bed citing peer influence and advertisement as major contributing factors. Government through the Ministry of Health should enact laws to control the sale and use of alcohol and should be keen on regulating alcohol advertisements in the media.
Improving Medical Records Filing in a Municipal Hospital in Ghana
(Ghana medical journal, 2012-09) Teviu, E.A.A.; Aikins, M.; Abdulai, T.I.; Sackey, S.; Boni, P.; Afari, E.; Wurapa, F.
Background: Medical records are kept in the interest of both the patient and clinician. Proper filing of patient’s medical records ensures easy retrieval and contributes to decreased patient waiting time at the hospital and continuity of care. This paper reports on an intervention study to address the issue of misfiling and multiple patient folders in a health facility. Design: Intervention study. Setting: Municipal Hospital, Goaso, Asunafo North District, Brong Ahafo Region, Ghana. Methods: Methods employed for data collection were records review, direct observation and tracking of folders. Interventions instituted were staff durbars, advocacy and communication, consultations, in-service trainings, procurement and monitoring. Factors contributing to issuance of multiple folders and misfiling were determined. Proportion of multiple folders was estimated. Results: Results revealed direct and indirect factors contributing to issuance of multiple patient folders and misfiling. Interventions and monitoring reduce acquisition of numerous medical folders per patient and misfiling. After the intervention, there was significant reduction in the use of multiple folders (i.e., overall 97% reduction) and a high usage of single patient medical folders (i.e., 99%). Conclusion: In conclusion, a defined medical records filing system with adequate training, logistics and regular monitoring and supervision minimises issuance of multiple folders and misfiling.
Molecular variability analysis of five new complete cacao swollen shoot virus genomic sequences
(Archives of Virology, 2005-02) Muller, E.; Sackey, S.
Cacao swollen shoot virus (CSSV), a member of the family Caulimoviridae, genus Badnavirus occurs in all the main cacao-growing areas of West Africa. We amplified, cloned and sequenced complete genomes of five new isolates, two originating from Togo and three originating from Ghana. The genome of these five newly sequenced isolates all contain the five putative open reading frames I, II, III, X and Y described for the first sequenced CSSV isolate, Agou1 originating from Togo. Their genomes have been aligned with the genome of Agou1. The nucleotide and amino acid sequence identities between isolates have been calculated and a phylogenetic analysis has been made including other pararetroviruses. Maximum nucleotide sequence variability between complete genomes of CSSV isolates was 29.4%. Geographical differentiation between isolates appears more important than differentiation between mild and severe isolates. ORF X differs greatly in size and sequence between the Togolese isolates Nyongbo2 and Agou1, and the four other isolates, its functional role is therefore clearly questionable. © Springer-Verlag 2004.
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.
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.
Raising the Political Profile of the Neglected Zoonotic Diseases: Three Complementary European Commission-Funded Projects to Streamline Research, Build Capacity and Advocate for Control
(Public Library of Science, 2015) Okello, A.L.; Beange, I.; Shaw, A.; Moriyón, I.; Gabriël, S.; Bardosh, K.; Johansen, M.V.; Saarnak, C.; Mukaratirwa, S.; Berkvens, D.; Welburn, S.C.; Gibbs, P.; de Balogh, K.; Amajoh, C.; Meslin, F.X.; Kock, R.; Kazibwe, S.W.; Ducrotoy, M.; McManus, P.; Scudamore, J.; Hattendorf, J.; Schelling, E.; Zinsstag, J.; Tanner, M.; Dorny, P.; Victor, B.; Ocholi, R.; Kazwala, R.; Ngowi, H.; Moser, I.; Tanner, M.; Correia-Neves, M.; Källenius, G.; Boué, F.; Pétavy, A.F.; Fihri, O.F.; Traoré, A.; Afonso, S.; Nicolau, Q.; Phiri, I.; Sikasunge, C.; Mwape, K.E.; Makungu, C.; Waiswa, C.; Kabasa, J.D.; Hargrove, J.; Hendrickx, G.; Bryssinckx, W.; Marcotty, T.; Bottieau, E.; Thys, S.; Madder, M.; Schelling, E.; Zinsstag, J.; Hatz, C.; Hattendorf, J.; Thrusfield, M.; Källenius, G.; Kulane, A.; Marrone, G.; Hendrickx, G.; Ducheyne, E.; de Groot, B.; Michel, A.; Venter, L.; Perridge, R.; Jenkins, A.; Rhalem, A.; Sahibi, H.; Bouslikhane, M.; Bakou, S.; Kone, P.; Waladjo, A.K.; Gbati, O.B.; Binka, F.; Clerk, C.; Sackey, S.; Afari, E.; Yebuah, N.; Gibbs, P.; de Balogh, K.; Abela-Ridder, B.; Thiermann, A.; Scudamore, J.; Simoonga, C.; Hendrickx, G.; Ducheyne, E.; de Groot, B.; Bryssinckx, W.; Marcotty, T.; Thys, S.; Schelling, E.; Zinsstag, J.
Review of Maternal Deaths Audit in Effia Nkwanta Regional Hospital in the Western Region
(University of Ghana, 2015-10) Mbiniwaya, M.; Sackey, S.; University of Ghana, College of Health Sciences, School of Public Health
Review of maternal mortality is one of the most effective methods to improve the performance of health workers and it could bring about changes to reduce maternal mortality. Ghana recorded 3,100 maternal deaths in 2013.The Western Region recorded 85 maternal deaths per 100,000 live births and Effia Nkwanta Regional Hospital recorded 24 maternal deaths out of 2,788 deliveries in 2013 giving a maternal mortality ratio of 717/ 100,000 live births. The hospital also recorded 32 maternal deaths at the end of 2014 showing an increasing trend in maternal mortality. The study was aimed at determining the factors that contributed to the 24 avoidable maternal deaths in the Effia Nkwanta Regional Hospital and to identify challenges associated with the use of maternal death audit guideline forms by health care providers. Data was collected from existing hospital record system using a data extraction sheet. Interviews were also conducted with health care workers who manage cases of maternal deaths from January to December 2013 using a questionnaire. Data was analyzed using SPSS Version 20. The descriptive variables of interest were computed and chi square test was used to ascertain whether there was a significant level of dependency between the variables of interest. A logistic regression was performed to ascertain the effect of place of residence, age of mother, parity, avoidable factors, antenatal care and education in the likelihood that the cause of death will be either direct or indirect. The logistic regression model was statistically significant for p value < 0.05. The findings of this review showed that most of the maternal deaths resulted from direct causes occurring in rural setups. From the direct causes of maternal deaths, eclampsia was the leading cause of death 9 (37.5%), followed by haemorrage 4 (16.7%), uterine rapture 3 (12.5%), unsafe abortion 2 (8.3%), and ectopic pregnancies 2 (8.3%) and 4 (16.7%) constituted indirect causes of death. Place of residence, parity, level of education and age were associated with cause of maternal deaths. The study also indicated that the main challenge in the use of maternal audit forms by health providers was due to busy work schedules. There is therefore a need to intensified Health promotion and education activities in the region and maternal audit guidelines forms should be reviewed and made simpler for health care providers.
Risk Factors for Obstetric Fistual Among Women Seeking Care in the Tamale Metropolis
(University of Ghana, 2013-07) Nuertey, B.D.; Sackey, S.
Obstetric fistula is a devastating form of maternal morbidity. It is characterized by an abnormal communication between the vagina and the lower urinary/ gastrointestinal structures or both. It is a result of injury due to pregnancy and its related complications with the resultant effect of continuous leakage of urine or faeces or both into the vagina. It remains a problem in Africa. This study sought to identify predisposing factors to obstetric fistula among women seeking care in the Tamale metropolis. In this matched case control study, cases were from the Tamale fistula center. Controls were matched on the year of delivery, region and district of index delivery. A total of 151 participants made up of 51 cases and 100 controls participated. This study identified three major factors for obstetric fistula; age below 20 years, total labour duration more than 24 hours and height 150 cm and below. It further identified four minor factors which are still birth, delivery by caesarean section, residence in a rural area and lack of formal education. Across both study groups, there is lack of adequate knowledge about obstetric fistula. Findings in this study agree with the literatures that, majority of women who suffer obstetric fistula are young, poor, illiterate, of short stature, resident in remote areas and labour more than 24 hours. Based on the associated factors, an obstetric fistula forecast score (OFFSCORE) was proposed, which is composed of three major criteria, the presence of each which is scored 2 and zero otherwise and four minor criteria each scored one and zero otherwise. A total OFFSCORE of four and above classified as high risk has a sensitivity of 90.2% and a specificity of 86.0% for predicting obstetric fistula. This study recommends immediate prophylactic urethral catheterization for high risk for obstetric fistula post-partum women.
Secondary analysis of snake bite data in the Western Region of Ghana: 2006-2010
(Ghana Medical Journal, 2016-06) Mensah, E.K.; Karikari, K.; Aikins, M.; Vanotoo, L.; Sackey, S.; Ohuabunwo, C.; Wurapa, F.; Sifah, T.K.; Afari, E.
Background: A snake bite is an injury caused by a bite from a snake, often resulting in puncture wounds, amputations and sometimes envenomation. Envenoming resulting from snake bite is a particularly important public health problem in rural areas of tropical and sub-tropical countries in Africa. This paper reports the incidence of snake bites and its associated mortality in the Western Region of Ghana. Method: The study was a descriptive cross-sectional review of 2006 - 2010 snake bite secondary data generated by the Western Regional Health Information Office in Ghana. Data was extracted from the District Health Information Management System (DHIMS) database. Data was managed and analyzed using SPSS Version 16.0. Univariate analyses were expressed as percentages and graphs. Results: The year 2009 recorded the highest incidence of Snake bites in the Western Region with Juabeso district recording the highest incidence of snake bites over the study period. Over the period about 55% of the incidence was between 50 – 100 per 100,000 population. The total number of snake bites recorded in the region for the period was 7,275, of which 52% (3,776) were males. About 60% of the patients were of the age group 15-49 years. A total of 12 reported snake bite deaths were recorded, of which 67% were men. This study recommends to the Districts Health Directorates in the Western Region to regularly organize community education on snake bite and the use of protective clothing by the farmers.