Browsing by Author "Yawson, A.E."

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Aetiological agents of ear discharge: a two year review in a teaching hospital in Ghana
(Ghana medical journal, 2014-06) Appiah-Korang, L; Asare-Gyasi, S.; Yawson, A.E.; Searyoh, K
The discharging ear is a common presentation in medical practice affecting all age groups but primarily children. This study shows the current aetiological causes of ear discharge and their antibiograms, data which would guide empirical treatment of ear infections, and also form a basis for further research.METHODOLOGY: This was a retrospective review of laboratory records of all ear swabs submitted for culture over a two year period in the Korle Bu Teaching Hospital Accra, Ghana. Data was obtained on demographic characteristics of patients, clinical diagnosis, isolated organisms and antibiotic susceptibility patterns of the isolated organisms. Data was analyzed by simple descriptive statistics.RESULTS: A total of 351 ear swabs were received by the laboratory for processing over the two year period. Of these 277(78.9%) had microorganisms isolated. A significant number127 (47%) was obtained from children under five years. Pseudomonas spp was the commonly isolated organism 121(46%) followed by Staphylococcus aureus 33(12.5%) and Proteus spp 32(12.2%). Candida was the commonest isolated fungi 9 (69.2%). Susceptibility of Pseudomonas spp to commonly used ototopics (ciprofloxacin & gentamicin) was 93% and 74% respectively.CONCLUSIONS: Most cases of the discharging ear were found in children under the age of five years. The most common bacteriologic cause of the discharging ear was Pseudomonas spp followed by Staphylococcus aureus. Candida species was the commonest fungal cause of ear discharge. Ciprofloxacin and gentamicin are effective ototopic antimicrobial agents for empirical treatment of the discharging ear.
Antibiotic use in a tertiary healthcare facility in Ghana: a point prevalence survey
(Antimicrobial Resistance and Infection Control, 2018-01) Labi, A.K.; Obeng-Nkrumah, N.; Nartey, E.T.; Bjerrum, S.; Adu-Aryee, N.A.; Ofori-Adjei, Y.A.; Yawson, A.E.; Newman, M.J.
Background The global rise and spread of antibiotic resistance is limiting the usefulness of antibiotics in the prevention and treatment of infectious diseases. The use of antibiotic stewardship programs guided by local data on prescribing practices is a useful strategy to control and reduce antibiotic resistance. Our objective in this study was to determine the prevalence and indications for use of antibiotics at the Korle-Bu Teaching Hospital Accra, Ghana. Methods An antibiotic point prevalence survey was conducted among inpatients of the Korle-Bu Teaching Hospital between February and March 2016. Folders and treatment charts of patients on admission at participating departments were reviewed for antibiotics administered or scheduled to be administered on the day of the survey. Data on indication for use were also collected. Prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of survey by the total number of patients on admission. Results Of the 677 inpatients surveyed, 348 (51.4%, 95% CI, 47.6–55.2) were on treatment with antibiotics. Prevalence was highest among Paediatric surgery where 20/22 patients (90.9%, 95% CI, 70.8–98.9) were administered antibiotics and lowest among Obstetrics patients with 77/214 (36%, 95% CI, 29.5–42.8). The indications for antibiotic use were 245/611 (40.1%) for community-acquired infections, 205/611 (33.6%) for surgical prophylaxis, 129/611 (21.1%) for healthcare associated infections and 33/611 (5.4%) for medical prophylaxis. The top five antibiotics prescribed in the hospital were metronidazole 107 (17.5%), amoxicillin-clavulinic acid 82 (13.4%), ceftriaxone 17(12.1%), cefuroxime 61 (10.0%), and cloxacillin 52 (8.5%) respectively. Prevalence of meropenem and vancomycin use was 12(2%) and 1 (.2%) respectively. The majority of patients 181 (52%) were being treated with two antibiotics. Conclusion This study indicated a high prevalence of antibiotic use among inpatients at the Korle-Bu Teaching Hospital. Metronidazole was the most commonly used antibiotic; mainly for surgical prophylaxis. There is the need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital.
Cataract Surgical Uptake Among Older Adults in Ghana
(Ghana Medical Journal, 2015-06) Ackuaku-Dogbe, E.M.; Yawson, A.E.; Biritwum, R.B.
In sub-Saharan Africa, cataract surgical services are highly inadequate and surgical uptake for cataract is low. This paper describes cataract surgical uptake among older adults in Ghana. This work was based on World Health Organization's multi-country Study on global Ageing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and Department of Community Health, University of Ghana Medical School. A nationally representative sample of 5571 older adults (≥50 years) and a small sample of persons 18-49 years were interviewed. Data was obtained on uptake of cataract surgery in older adults and analyzed using descriptive measures and chi square for associations in categorical outcome measures. Overall surgical uptake was 48.9% among older adults and was slightly higher among older men (49.1%) than women (48%). Cataract surgical uptake was relatively higher in the 60-69 years group (55%), urban residents (52.6%) and those living without partners (50%). Educational and income levels of older persons did not affect cataract surgical uptake. Regional differences in cataract surgical uptake existed; was less than 60% in all ten regions (except one), and the two regions with most self-reported cataracts (Ashanti and Greater Accra) had less than 50% uptake. Intensive public education, engagement of community groups and increased access to cataract surgery at health facilities and outreach services need consideration at national/sub-national levels. Further investigations to garner equity in national eye care efforts are recommended. (PDF) Cataract Surgical Uptake Among Older Adults in Ghana. Available from: https://www.researchgate.net/publication/280626406_Cataract_Surgical_Uptake_Among_Older_Adults_in_Ghana [accessed Sep 18 2018].
Cervical cancer screening practices among women in Ghana: evidence from wave 2 of the WHO study on global AGEing and adult health
(BMC Women's Health, 2020-03-05) Aheto, J.M.K.; Calys-Tagoe, B.N.L.; Mensah, G.; Biritwum, R.B.; Yawson, A.E.
Background: Cervical cancer is the third most common cancer that affects women worldwide. It has been and remains the leading cause of cancer mortality among women in Ghana. Despite the fact that cervical cancer is preventable through early detection and treatment of precancerous lesions, anecdotal evidence from gynaecological clinics in Ghana indicates that most patients present with a late stage of the disease. This study assesses the cervical cancer screening practices among women in Ghana. Methods: Data from the World Health Organization’s (WHO) multi-country Study on AGEing and adult health (SAGE) wave 2 conducted between 2014 and 2015 in Ghana was used. We employed binary logistic regression models to analyse data on 2711 women to examine factors associated with having pelvic examination among women aged ≥18 years. Among those who had pelvic examination, we applied binary logistic regression models to analyse factors associated with receiving Pap smear test as a subgroup analysis. Results: Of the 2711 women aged 18 years or older surveyed, 225 (8.3%) had ever had a pelvic examination and only 66 (2.4%) of them reported ever having done a Pap smear test. For those who had pelvic examination, only 26.94% had Pap smear test. Ethnic group, marital status, father’s educational level and difficulty with self-care were independently associated with undergoing pelvic examination. Only age and healthcare involvement were independently associated with pelvic examination within the past 5 years to the survey. Marital status, satisfaction with healthcare and healthcare involvement were independently associated with Pap smear test. Conclusion: Even though cervical cancer is preventable through early detection of precancerous lesions using Pap smear test, the patronage of this screening test is still very low in Ghana. Factors influencing the low patronage in Ghana include the marital status of women, their level of satisfaction with healthcare as well as their level of involvement with healthcare. These may be the consequences of a weak health system and the lack of a national policy on cervical cancer screening.
Changing Patterns of the Prevalence of Helicobacter Pylori Among Patients at a Corporate Hospital in Ghana
(Ghana Medical Journal, 2015-09) Darko, R.; Yawson, A.E.; Osei, V.; Owusu-Ansah, J.; Aluze-Ele, S.
Introduction: Helicobacter pylori (H. pylori) discovered in 1982, has strongly been associated with multiple clinical disorders of the gastrointestinal tract. This study described the prevalence of H. pylori among large numbers of patients over two different time periods in Accra, Ghana. Methods: It was a retrospective records review on patients attending a quasi-government hospital in Accra, Ghana, during two time periods, 1999 and 2012. A total of 2401 records were reviewed, 1128 in first period and 1273 in second period. Biopsy was taken from the gastric antrum for Rapid Urease Test (RUT) in identifying H. Pylori. Data on patient characteristics, clinical diagnosis and findings upon endoscopy were analyzed by simple descriptive statistics. Associations between categorical outcome variables were determined by Chi square test at 95% significance level. Results: H. pylori infection was high in patients with upper gastrointestinal symptoms 69.7% (1999) and 45.2% (2012), and was even higher in patients with gastritis and duodenal ulcer. H. pylori infection however, decreased among patients over the period, 69.7% in 1999 to 45.2% in 2012. Sex differences in H. pylori infection was identified (higher among males) and young adults (21-40 years). Commonest symptom in all patients was non-ulcer dyspepsia, 86.9% in 1999 and 84.2% in 2012, while gastritis and duodenal ulcer were the commonest endoscopic finding in the two periods. Conclusion: Appropriate management guidelines in West Africa considering the high background H. pylori infection and other co-infections requiring particular antibiotic combination therapy is required.
A cis-regulatory sequence driving metabolic insecticide resistance in mosquitoes: functional characterisation and signatures of selection.
(2012-09) Wilding, C.S.; Smith, I.; Lynd, A.; Yawson, A.E.; Weetman, D.; Paine, M.J.; Donnelly, M.J.
Although cytochrome P450 (CYP450) enzymes are frequently up-regulated in mosquitoes resistant to insecticides, no regulatory motifs driving these expression differences with relevance to wild populations have been identified. Transposable elements (TEs) are often enriched upstream of those CYP450s involved in insecticide resistance, leading to the assumption that they contribute regulatory motifs that directly underlie the resistance phenotype. A partial CuRE1 (Culex Repetitive Element 1) transposable element is found directly upstream of CYP9M10, a cytochrome P450 implicated previously in larval resistance to permethrin in the ISOP450 strain of Culex quinquefasciatus, but is absent from the equivalent genomic region of a susceptible strain. Via expression of CYP9M10 in Escherichia coli we have now demonstrated time- and NADPH-dependant permethrin metabolism, prerequisites for confirmation of a role in metabolic resistance, and through qPCR shown that CYP9M10 is >20-fold over-expressed in ISOP450 compared to a susceptible strain. In a fluorescent reporter assay the region upstream of CYP9M10 from ISOP450 drove 10× expression compared to the equivalent region (lacking CuRE1) from the susceptible strain. Close correspondence with the gene expression fold-change implicates the upstream region including CuRE1 as a cis-regulatory element involved in resistance. Only a single CuRE1 bearing allele, identical to the CuRE1 bearing allele in the resistant strain, is found throughout Sub-Saharan Africa, in contrast to the diversity encountered in non-CuRE1 alleles. This suggests a single origin and subsequent spread due to selective advantage. CuRE1 is detectable using a simple diagnostic. When applied to C. quinquefasciatus larvae from Ghana we have demonstrated a significant association with permethrin resistance in multiple field sites (mean Odds Ratio = 3.86) suggesting this marker has relevance to natural populations of vector mosquitoes. However, when CuRE1 was excised from the allele used in the reporter assay through fusion PCR, expression was unaffected, indicating that the TE has no direct role in resistance and hence that CuRE1 is acting only as a marker of an as yet unidentified regulatory motif in the association analysis. This suggests that a re-evaluation of the assumption that TEs contribute regulatory motifs involved in gene expression may be necessary.
Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana
(Global Health Action, 2014) Tettey, E.; Yawson, A.E.; Tettey, Y.
Autopsies can provide a good indication of the quality of patient care, in terms of the accuracy of clinical diagnosis and the quality of treatment given. Designs: This was a cross-sectional study among clinicians at theKorle-Bu Teaching Hospital (KBTH) in 2012. Data were collected with a 69-item, self-administered, structured questionnaire. A total of 215 questionnaires were sent out and 119 clinicians responded. Data were collected on the benefits and utility of autopsies for medical practice, care of patients, and management of clinical wards. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios, and percentages). Data were analyzed using SPSS version 21. Objective: This study examined the views of clinicians regarding the utility of autopsies and their influence on clinical practice in a large teaching hospital in Ghana. Results: Overall, clinicians in KBTH agreed that autopsy reports are useful in answering clinical questions (55/119; 46.2%), confirming or verifying clinical diagnoses (54/119; 45.4%), providing information on unsuspected diagnoses (40/119; 33.6%), and for medical education (90/119; 75.6%). Overall, 70/119 (58.8%) of clinicians agreed that autopsy findings improve completeness and reliability of death certification and provide information on clinical effectiveness of treatment and patient management. However, only 23/119 (19.3%) of sampled clinicians had personal interactions with a pathologist during autopsy processes and 93/ 119 (78.2%) had not attended any autopsy demonstrations in the past 6 months. Attendance of pathologists at clinicopathological meetings of clinical departments of KBTH was minimal. Unfortunately, the use of autopsy reports for auditing clinical diagnostic performance was not seen as essential. Conclusion: Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital. © 2014 Edem Tette et al.
Data resource profile: The world health organization study on global ageing and adult health (SAGE).
(International Journal of Epidemiology, 2012-10) Kowal, P.; Chatterji, S.; Naidoo, N.; Yawson, A.E.; Fan, W.; Ridaura, R.L.; Newell, M.
Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50{thorn} years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50{thorn} and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/ sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata). © The Author 2012; all rights reserved.
Determinants of semantic and episodic memory decline among older adults in Ghana: Evidence from the WHO study on global AGEing and adult health Ghana wave 2
(Dialogues in Health, 2023) Ekem-Ferguson, G.; Tetteh, J.; Malm, K.; Yawson, A.G.; Biritwum, R.; Mensah, G.; Yawson, A.E.
Objective: Determined factors associated with semantic (SM) and episodic memory (EM) among older adults aged 50 years and older in Ghana. Methods: Data from WHO Study on Global AGEing and Adult Health (SAGE) Ghana Wave 2 was used for this study. Semantic memory (SM) and Episodic memory (EM) were the main study outcomes separately. The study employed Nested Ordinary Least Square regression analysis by sequentially adding 6 blocks of variables and comparison tests be tween the nested models. Results: The study involved 3575 adult Ghanaians aged 50 years and older with a mean ± standard deviation of 62.6 ± 18.4 years. The overall mean ± SD of EM and SM were 5.86 ± 2.51 and 11.69 ± 8.59 respectively. Overall, analysis from block 6 showed a significant variation in SM by approximately 16.9%(ΔR2 = 1.17%) where increasing age, never married (β = −1.55; 95% CI = −2.41–0.69), being resident in Greater Accra (regional disparity) (β = −3.45; 95% CI = −4.73–2.20), underweight (β = −0.81;95% CI = −1.34–0.27), and moderate self-rated health (SRH) (β = −0.98; 95% CI = −1.52–0.45) significantly decreased SM. Similarly, increasing age, separated/divorced (β = −0.22; 95% CI = −0.35–0.87), being resident in Greater Accra (β = −0.53; 95% CI = −0.80–0.26), and mod erate SRH (β = −0.20; 95% CI = −0.36–−0.04) significantly decrease EM with an overall significant variation of approximately 22.9%(ΔR2 = 2.7%). Conclusions: Increasing age, sex, marital status, regional disparity, and poor SRH significantly decreased both Semantic memory and Episodic memory. Higher educational attainment and life satisfaction significantly influenced SM and EM. These provide pointers to important socio-demographic determinants of SM and EM with implications for the im plementation of the Ghana national ageing policy 2010, ‘ageing with security and dignity’, and as a key consideration for healthy ageing towards 2030.
Determinants of Willingness To Accept Kidney Transplantation Among Chronic Kidney Disease Patients in Ghana
(BMC Nephrology, 2021) Boima, V.; Amissah-Arthur, M. B.; Yorke, E.; Dey, D.; Fiagbe, D.; Yawson, A.E.; Nonvignon, J.; Mate-Kole, C.C.;
Background: The burden of chronic kidney disease in Africa is three to four times higher compared to high- income countries and the cost of treatment is beyond the reach of most affected persons. The best treatment for end stage renal disease is kidney transplantation which is not available in most African countries. As kidney transplantation surgery is emerging in Ghana, this study assessed factors which could influence the willingness of patients with chronic kidney disease to accept it as a mode of treatment. Methods: This cross-sectional survey was carried out among patients with chronic kidney disease in Korle-Bu Teaching Hospital. A consecutive sampling method was used to recruit consenting patients. A structured questionnaire and standardized research instruments were used to obtain information on demographic, socio- economic characteristics, knowledge about transplantation, perception of transplantation, religiosity and spirituality. Logistic regression model was used to assess the determinants of willingness to accept a kidney transplant. Results: 342 CKD patients participated in the study of which 56.7% (n = 194) were male. The mean age of the participants was 50.24 ± 17.08 years. The proportion of participants who were willing to accept a kidney transplant was 67.3% (95%CI: 62.0–72.2%). The factors which influenced participants’ willingness to accept this treatment included; willingness to attend a class on kidney transplantation (p < 0.016), willingness to donate a kidney if they had the chance (p < 0.005), perception that a living person could donate a kidney (p < 0.001) and perceived improvement in quality of life after transplantation (p < 0.005). The barriers for accepting kidney transplantation were anticipated complications of transplant surgery and financial constraints. Conclusion: More than two-thirds of CKD patients were willing to accept a kidney transplant and this is influenced by multiple factors. Government health agencies must consider full or partial coverage of kidney transplantation through the existing national health insurance scheme. Further, efficient educational programmes are required to improve both patients’ and physicians’ knowledge on the importance of kidney transplantation in the management of end stage renal disease in Ghana.
Ecological Zones Rather Than Molecular Forms Predict Genetic Differentiation in the Malaria Vector Anopheles gambiae s.s. in Ghana
(Genetic 175(2): 751-761, 2007) Yawson, A.E.; Wilson, M.D.; Weetman, D.; Donnelly, M.J.
The malaria mosquito Anopheles gambiae s.s. is rapidly becoming a model for studies on the evolution of reproductive isolation. Debate has centered on the taxonomic status of two forms (denoted M and S) within the nominal taxon identified by point mutations in the X-linked rDNA region. Evidence is accumulating that there are significant barriers to gene flow between these forms, but that the barriers are not complete throughout the entire range of their distribution. We sampled populations from across Ghana and southern Burkina Faso, West Africa, from areas where the molecular forms occurred in both sympatry and allopatry. Neither Bayesian clustering methods nor FST-based analysis of microsatellite data found differentiation between the M and S molecular forms, but revealed strong differentiation among different ecological zones, irrespective of M/S status and with no detectable effect of geographical distance. Although no M/S hybrids were found in the samples, admixture analysis detected evidence of contemporary interform gene flow, arguably most pronounced in southern Ghana where forms occur sympatrically. Thus, in the sampled area of West Africa, lack of differentiation between M and S forms likely reflects substantial introgression, and ecological barriers appear to be of greater importance in restricting gene flow.
Ecological zones rather than molecular forms predict genetic differentiation in the malaria vector Anopheles gambiae s.s. in Ghana.
(2007-02) Yawson, A.E.; Weetman, D.; Wilson, M.D.; Donnelly, M.J.
The malaria mosquito Anopheles gambiae s.s. is rapidly becoming a model for studies on the evolution of reproductive isolation. Debate has centered on the taxonomic status of two forms (denoted M and S) within the nominal taxon identified by point mutations in the X-linked rDNA region. Evidence is accumulating that there are significant barriers to gene flow between these forms, but that the barriers are not complete throughout the entire range of their distribution. We sampled populations from across Ghana and southern Burkina Faso, West Africa, from areas where the molecular forms occurred in both sympatry and allopatry. Neither Bayesian clustering methods nor F(ST)-based analysis of microsatellite data found differentiation between the M and S molecular forms, but revealed strong differentiation among different ecological zones, irrespective of M/S status and with no detectable effect of geographical distance. Although no M/S hybrids were found in the samples, admixture analysis detected evidence of contemporary interform gene flow, arguably most pronounced in southern Ghana where forms occur sympatrically. Thus, in the sampled area of West Africa, lack of differentiation between M and S forms likely reflects substantial introgression, and ecological barriers appear to be of greater importance in restricting gene flow.
Edentulism and quality of life among older Ghanaian adults
(BMC Oral Health, 2015-04) Hewlett, S.A.; Yawson, A.E.; Calys-Tagoe, B.N.L.; Naidoo, N.; Martey, P.; Chatterji, S.; Kowal, P.; Mensah, G.; Minicuci, N.; Biritwum, R.B.
Background: Edentulism affects the quality of life and general health of an individual. But in ageing individuals, it has been observed to have greater impact, manifesting in functional, psychological and social limitations. With an increasing older adult population in Ghana, its burden is likely to increase. This study was thus carried out to explore the association between edentulism and quality of life among older Ghanaian adults. Methods: Secondary analysis of WHO's Study on global AGEing and adult health (SAGE) Wave 1 in Ghana was conducted using self-reported edentulism as the dependent variable. Participants included a nationally representative sample of adult's aged 50 years and older living in Ghana. Quality of life was measured using the 8 item WHOQOL measure and a single item measure which was a question "How would you rate your overall quality of life?". To assess the association between edentulism and the independent variables, a bivariate analysis was carried out. A Poisson regression model was then performed, adjusting for age, sex, income, education and the diagnosis of a chronic disease condition. A Spearman's correlation analysis was also carried out between the single and multi item measure of quality of life to assess how well they correlate. Results: Edentulism was observed to be associated with significantly lower levels of SWB among older adults using both the single-item and multiple-item measure (WHOQOL). It, however, showed no association with happiness. Among edentulous respondents, females and those with no formal education reported significantly lower quality of life. The WHOQOL correlated positively and strongly with the single-item measure. Conclusion: Edentulism may not be life threatening and yet it has been shown to have a negative effect on the quality of life of older adult Ghanaians. More emphasis may thus need to be placed on the oral health of the aging population in Ghana to avoid it. © Hewlett et al.; licensee BioMed Central.
Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization’s study on global AGEing and adult health, Wave 2
(Plos One, 2019-12-05) Tetteh, J.; Kogi, R.; Yawson, A.O.; Mensah, G.; Biritwum, R.; Yawson, A.E.
Background Functional difficulty assessment has been proven as a key factor in the health evaluation of adults. Previous studies have shown a reduction in health and functional difficulties with increasing age. This analysis was conducted to quantify the effect of poor self-rated health on functional difficulty among older adults in Ghana. Method This analysis was based on the World Health Organization Study on Global AGEing and Adult Health in Ghana for older adults 50 years and above. Fifteen standard functioning difficulty tools were extracted and used for the analysis. Three predictive models with the Coarsened Exact Matching method involving Negative Binomial, Logistics and Ordered logistic regression were performed using Stata 14. Results Overall, the prevalence of poor Self-rated health was 34.9% and that of functional difficulties among older adults in Ghana was 69.4%. Female sex, increasing age, being separated, having no religious affiliation, not currently working and being underweight were associated with and significantly influence poor Self-rated health [AOR(95%CI)p-value = 1.41(1.08– 1.83)0.011, 3.85(2.62–5.64)0.000, 1.45(1.08–1.94)0.013, 2.62(1.68–4.07)0.000, 2.4(1.85– 3.12)0.000 and 1.39(1.06–1.81)0.017 respectively]. In addition, poor Self-rated health and geographical location (rural vs. urban)significantly influence functioning difficulties among older adults in Ghana as predicted by the three models [Negative Binomial: PR(95%CI) = 1.62(1.43–1.82), Binary logistic: AOR(95%CI) = 3.67(2.79–4.81) and ordered logistic: AOR (95%CI) = 2.53(1.14–2.03)]. Conclusion Poor SRH is more pronounced among older adult females in Ghana. Some determinants of poor SRH include; age, geographical location (urban vs. rural), marital status, religion, and employment status. This provides pointers to important socio-demographic determinants with implications on the social function of older adults in line with the theme of the national aging policy of 2010, ‘ageing with security and dignity’ and ultimately in the national quest to achieve the Sustainable Development Goals by 2030.
Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization’s study on global AGEing and adult health, Wave 2
(Plos One, 2019-11-05) Tetteh, J.; Kogi, R.; Yawson, A.O.; Mensah, G.; Biritwum, R.; Yawson, A.E.
Background Functional difficulty assessment has been proven as a key factor in the health evaluation of adults. Previous studies have shown a reduction in health and functional difficulties with increasing age. This analysis was conducted to quantify the effect of poor self-rated health on functional difficulty among older adults in Ghana. Method This analysis was based on the World Health Organization Study on Global AGEing and Adult Health in Ghana for older adults 50 years and above. Fifteen standard functioning difficulty tools were extracted and used for the analysis. Three predictive models with the Coarsened Exact Matching method involving Negative Binomial, Logistics and Ordered logistic regression were performed using Stata 14. Results Overall, the prevalence of poor Self-rated health was 34.9% and that of functional difficulties among older adults in Ghana was 69.4%. Female sex, increasing age, being separated, having no religious affiliation, not currently working and being underweight were associated with and significantly influence poor Self-rated health [AOR(95%CI)p-value = 1.41(1.08– 1.83)0.011, 3.85(2.62–5.64)0.000, 1.45(1.08–1.94)0.013, 2.62(1.68–4.07)0.000, 2.4(1.85– 3.12)0.000 and 1.39(1.06–1.81)0.017 respectively]. In addition, poor Self-rated health and geographical location (rural vs. urban)significantly influence functioning difficulties among older adults in Ghana as predicted by the three models [Negative Binomial: PR(95%CI) =1.62(1.43–1.82), Binary logistic: AOR(95%CI) = 3.67(2.79–4.81) and ordered logistic: AOR (95%CI) = 2.53(1.14–2.03)]. Conclusion Poor SRH is more pronounced among older adult females in Ghana. Some determinants of poor SRH include; age, geographical location (urban vs. rural), marital status, religion, and employment status. This provides pointers to important socio-demographic determinants with implications on the social function of older adults in line with the theme of the national aging policy of 2010, ‘ageing with security and dignity’ and ultimately in the national quest to achieve the Sustainable Development Goals by 2030.
Effect of socio-economic factors in utilization of different healthcare services among older adult men and women in Ghana
(BioMed Central Ltd., 2016) Saeed, B.I.I.; Yawson, A.E.; Nguah, S.; Agyei-Baffour, P.; Emmanuel, N.; Ayesu, E.
Background: The older adult population is increasing all over the world. In sub-Saharan Africa, due to poverty and low policy coverage, older adults are not well catered for. The effect of socio-economic inequality in the use of healthcare services among older adult men and women in Ghana was investigated in this paper. Methods: The data employed in the study were drawn from Global Ageing and Adult Health survey SAGE Wave 1 Ghana and was based on the design for the World Health Survey 2003, SAGE Wave 0, Ghana. The survey was conducted in 2007-2008 and collected data on socio-economic characteristics and other variables of the 5573 individuals interviewed. Results: Using generalized logit model, the study found that health status is a very strong determinant of the type of healthcare services preferred by older adults Ghanaians. Men with higher income preferred the private health facilities, while those who completed tertiary education, those with health insurance and those who self-rated their health as very bad, bad or moderate preferred public facility. Self-employed men and those in informal employment, preferred other health facilities outside the formal public health service. Women with primary and secondary education, preferred the private health facilities. Women with health insurance, those in middle and upper class income quintiles or those with self-rated bad and moderate health status or being relatively younger preferred the public facility to other health services. Self-employed women and those in informal employment preferred traditional treatment. In Ghana, there are important socio-economic gradients in the use of some healthcare services. In both sexes, those without insurance and rural residents preferred the pharmacy and traditional treatment. Conclusion: These differences may be due to socio-economic inequities but could also indicate that the existing health facilities are not always used in an optimal way. Patient factors may be equally important as supply factors in explaining the differential use of health services. The public health systems in Ghana still have a major role in improving the health of older adults. National commitments in providing basic essential infrastructure and personnel to health centres for the citizenry is imperative. Policy readjustment of the national health insurance scheme to make it truly accessible to the aged is essential.
Effects of consumer and provider moral hazard at a municipal hospital out-patient department on Ghana's National Health Insurance Scheme.
(Ghana medical journal, 2012-12) Yawson, A.E.; Biritwum, R.B.; Nimo, P.K.
In 2003, Ghana introduced the national health insurance scheme (NHIS) to promote access to healthcare. This study determines consumer and provider factors which most influence the NHIS at a municipal health facility in Ghana. This is an analytical cross-sectional study at the Winneba Municipal Hospital (WHM) in Ghana between January-March 2010. A total of 170 insured and 175 uninsured out-patients were interviewed and information extracted from their folders using a questionnaire. Consumers were from both the urban and rural areas of the municipality. The mean number of visits by insured consumers to a health facility in previous six months was 2.48 +/- 1.007 and that for uninsured consumers was 1.18 +/- 0.387(p-value<0.001). Insured consumers visited the health facility at significantly more frequent intervals than uninsured consumers (χ(2) = 55.413, p-value< 0.001). Overall, insured consumers received more different types of medications for similar disease conditions and more laboratory tests per visit than the uninsured. In treating malaria (commonest condition seen), providers added multivitamins, haematinics, vitamin C and intramuscular injections as additional medications more for insured consumers than for uninsured consumers. Findings suggest consumer and provider moral hazard may be two critical factors affecting the NHIS in the Effutu Municipality. These have implications for the optimal functioning of the NHIS and may affect long-term sustainability of NHIS in the municipality. Further studies to quantify financial/ economic cost to NHIS arising from moral hazard, will be of immense benefit to the optimal functioning of the NHIS.
Effects of consumer and provider moral hazard at a municipal hospital outpatient department on Ghana’s National Health Insurance Scheme
(Ghana medical journal, 2012-12) Yawson, A.E.; Biritwum, R.B.; Nimo, P.K.
Background: In 2003, Ghana introduced the national health insurance scheme (NHIS) to promote access to healthcare. This study determines consumer and provider factors which most influence the NHIS at a municipal health facility in Ghana. Method: This is an analytical cross-sectional study at the Winneba Municipal Hospital (WHM) in Ghana between January-March 2010. A total of 170 insured and 175 uninsured out-patients were interviewed and information extracted from their folders using a questionnaire. Consumers were from both the urban and rural areas of the municipality. Results: The mean number of visits by insured consumers to a health facility in previous six months was 2.48 +/- 1.007 and that for uninsured consumers was 1.18 +/- 0.387(p-value<0.001). Insured consumers visited the health facility at significantly more frequent intervals than uninsured consumers (χ2 = 55.413, pvalue< 0.001). Overall, insured consumers received more different types of medications for similar disease conditions and more laboratory tests per visit than the uninsured. In treating malaria (commonest condition seen), providers added multivitamins, haematinics, vitamin C and intramuscular injections as additional medications more for insured consumers than for uninsured consumers. Conclusion: Findings suggest consumer and provider moral hazard may be two critical factors affecting the NHIS in the Effutu Municipality. These have implications for the optimal functioning of the NHIS and may affect long-term sustainability of NHIS in the municipality. Further studies to quantify financial/ economic cost to NHIS arising from moral hazard, will be of immense benefit to the optimal functioning of the NHIS.
Examining the Utilization of Social Capital by Ghanaians When Seeking Care for Chronic Diseases: A Personal Network Survey
(International Journal of Public Health, 2023) Hooley, B.; Mayeden, S.; Yawson, A.E.; et al.
Objectives: With limited social security and health protection in Ghana, intergenerational support is needed by those living with NCDs who incur recurrent costs when seeking NCD care. We measured the level of informal support received by NCD patients and identified factors that influence support provision. Methods: We surveyed 339 NCD patients from three hospitals in Ghana, who listed their social ties and answered questions about their relationship and support frequency. We analyzed the relationship between social support, demographics, and health information, characteristics of social ties and network characteristics. Results: Participants described 1,371 social ties. Nearly 60% of respondents reported difficulties in their usual work or household duties due to chronic illness, which was also the strongest predictor of support. Patients with higher wellbeing reported less social support. while older age and having co-habitant supporters were negatively associated with support, indicating caregiver burnout. Conclusion: Ghanaian NCD patients receive support from various caregivers, who may not be able to handle the increasing healthcare and social needs of an aging population. Policies should therefore enhance resource pooling and inclusiveness for elderly security.
An Exploratory Study of Market Women’s Knowledge on Infant and Young Child Feeding Practices in Ashiedu Keteke Sub-Metropolis of the Greater Accra Region Ghana
(University of Ghana, 2016-07) Onwuka, O.C.; Yawson, A.E.; University of Ghana,College of Health Sciences School of Public Health; University of Ghana,College of Health Sciences School of Public Health
Market Women’s Knowledge on Infant and Young Child Feeding Practices in Ashiedu Keteke of the Greater Accra Region, Ghana. Infant and young child feeding is an important area to improve child survival and promote healthy growth and development as recommended by the WHO/UNICEF. Malnutrition remains the leading cause of child morbidity and mortality among children under five years of age particularly in sub-Saharan Africa. Amidst the many efforts over the years to curb the malnutrition menace in Ghana, current statistics reveal that working mothers like market women resort to all forms of inappropriate feeding practices which eventually leads to malnutrition in their children. This study was therefore designed to explore market women’s knowledge on Infant and Young Child Feeding Practices in Makola market, Ashiedu Keteke, Accra. Objective: The main aim of this study is to assess the level of knowledge of market women with children 0-23 months on Infant and Young Child Feeding (IYCF) practices in Makola, Ashiedu Keteke sub-Metropolis. Methods: An exploratory cross-sectional study involving 300 mothers with children between the ages of 0-23 months consecutively enrolled in the study. The study excluded those who do not bring their children to the market. Structured questionnaire was pretested to enable modification. Findings: Only 148 (49.3%) initiated breast feeding within the first hour of delivery. In all, 121 (40.3%) introduced solid or semi-solid food to their children before 6 months. More than half 245 (81.7%) did not know responsive feeding. About 175 (58.3%) did not know the risk of not practicing the recommended IYCF and 177 (59.3%) did not wash their children’s hands before feeding them. Among the women, attending to their customers was a priority for almost half (47%) of them. Conclusion: Knowledge and practice of respondents on recommended IYCF was poor. Educational level, child’s age and market area were found to be significantly associated with respondents’ knowledge and practice levels. There is need to intensify awareness and education of recommended IYCF among mothers, especially market women and other busy mothers. Health facilities need to increase health education among mothers during antenatal and post-natal visits to ensure good health for Ghanaian children.