Browsing by Author "et al."
Now showing 1 - 20 of 1088
- Results Per Page
- Sort Options
Item A comprehensive lifestyle index and its associations with DNA methylation and type 2 diabetes among Ghanaian adults: the rodam study(Clinical Epigenetics, 2024) Abidha, C. A.; Meeks, K. A. C.; Hayfron‑Benjamin, C.; et al.Background A series of modifiable lifestyle factors, such as diet quality, physical activity, alcohol intake, and smoking, may drive the rising burden of type 2 diabetes (T2DM) among sub-Saharan Africans globally. It is unclear whether epi genetic changes play a mediatory role in the associations between these lifestyle factors and T2DM. We assessed the associations between a comprehensive lifestyle index, DNA methylation and T2DM among Ghanaian adults. Methods We used whole-blood Illumina 450 k DNA methylation data from 713 Ghanaians from the Research on Obesity and Diabetes among African Migrants (RODAM) study. We constructed a comprehensive lifestyle index based on established cut-offs for diet quality, physical activity, alcohol intake, and smoking status. In the T2DM-fre discovery cohort (n=457), linear models were fatted to identify differentially methylated positions (DMPs) and diferenterally methylated regions (DMRs) associated with the lifestyle index after adjustment for age, sex, body mass index (BMI), and technical covariates. Associations between the identified DMPs and the primary outcome (T2DM), as well as secondary outcomes (fasting blood glucose (FBG) and HbA1c), were determined via logistic and linear regression models, respectively. Results In the present study population (mean age: 52±10 years; male: 42.6%), the comprehensive lifestyle index showed a significant association with one DMP annotated to an intergenic region on chromosome 7 (false discovery rate (FDR)=0.024). Others were annotated to ADCY7, SMARCE1, AHRR, LOXL2, and PTBP1 genes. One DMR was identified and annotated to the GFPT2 gene (familywise error rate (FWER) from bumphunter bootstrap=0.036). None of the DMPs showed significant associations with T2DM; directions of effect were positive for the DMP in the AHRR and inverse for all the other DMPs. Higher methylation of the ADCY7 DMP was associated with higher FBG (p=0.024); LOXL2 DMP was associated with lower FBG (p=0.023) and HbA1c (p=0.049); and PTBP1 DMP was associated with lower HbA1c (p=0.002). Conclusions In this explorative epigenome-wide association study among Ghanaians, we identified one DMP and DMR associated with a comprehensive lifestyle index not previously associated with individual lifestyle factors.Item A rare case of intusscusception in a 6-month-old baby(Radiology Case Reports 19, 2024) Fiagbedzi, E.; Arkorful, J.; Appiah, E.; et al.This case report discusses the clinical presentation, imaging findings, and successful management of a rare case of intussusception in a 6-month-old female infant referred to a regional hospital in Ghana. The patient presented with vomiting, lethargy, fever, and currant jelly stool. Differential diagnoses considered included Merkel diverticulum, volvulus, lymphadenopathy, and hypertrophic pyloric stenosis. Ultrasound imaging revealed a concentric lesion with characteristic signs of intussusception. Ileo-caeco coli intussusception was con firmed as the diagnosis. Surgical management was used for this patient. The postsurgery phase was without any complications. The patient recovered well and was discharged with a switch to oral medications. Infant intussusception is still a disease with a low morbidity rateItem Acceptability of Test and Treat with Doxycycline against Onchocerciasis in an Area of Persistent Transmission in Massangam Health District, Cameroon(PLOS, 2023) Nditanchou, R.; Boakye, D.; et al.The main onchocerciasis elimination strategy is annual Community-Directed Treatment with ivermectin (CDTi). However, as a response to persistent high infection prevalence in Massangam Health District in Cameroon, two rounds of alternative treatments including biannual CDTi, ground larviciding and test and treat with doxycycline (TTd) were implemented. This led to a significant prevalence reduction from 35.7% to 12.3% (p<0.001) as reported by Atekem and colleagues. Here we report on the acceptability of TTd component based on qualitative and quantitative data. The TTd involved microscopic examination for microfilaria in skin biopsy and those infected were offered doxycycline 100 mg daily for 35 days by community-directed distributors (CDDs). Participation level was significantly high with 54% of eligible population (age > 8, not pregnant, not breastfeeding, not severely ill,) participating in the test in each round, increasing to 83% over the two rounds. Factors associated with non-participation included mistrust, being female; being younger than 26 years; short stay in the community; and belonging to semi-nomadic sub population due to their remote and disperse settlement, discrimination, their non selection as CDD, and language and cultural barriers. Treatment coverage was high -71% in round 1 and 83% in round 2. People moving away between testing and treatment impacted treatment coverage. Some participants noted mismatch between symptoms and test result; and that ivermectin is better than doxycycline, while others favoured doxycycline. CDD worried about work burden with unmatching compensation. Overall, TTd participation was satisfactory. But can be improved through reinforcing sensitisation, reducing time between test and treatment; combining TTd and CDTi in one outing; augmenting CDDs compensation and/or weekly visit; exploring for frequently excluded populations and adapting strategies to reach them; and use of a sensitive less invasive test.Item Access to vaccination services for priority ruminant livestock diseases in Ghana: Barriers and determinants of service utilization by farmers(Preventive Veterinary Medicine, 2023) Nuvey, F.S.; Mensah, G.I.; Addo, K.K.; et al.Introduction: Livestock diseases are a major constraint to agricultural productivity, frequently causing significant livelihood losses for farmers, and negatively affecting public food safety and security. Vaccines provide an effective and profitable means for controlling most infectious livestock diseases, but remain underutilized. This study sought to assess the barriers and determinants of vaccination utilization for priority livestock diseases in Ghana. Methods: We conducted a mixed-method study involving a quantitative survey with ruminant livestock farmers (N = 350) and seven focus group discussions (FGD) involving 65 ruminant livestock farmers. The survey data were analyzed, and distribution of barriers to vaccination access described. We evaluated the determinants of vaccination utilization (any use of vaccination against contagious-bovine-pleuropneumonia (CBPP) and pestedes-petits-ruminants (PPR) in 2021) using logistic regression analyses at the 0.05 significance level. FGD transcripts were analyzed deductively. We used triangulation to achieve convergence across the different datasets and analyses. Results: The farmers kept an average (median) of 5 tropical livestock units (TLUs) of ruminant livestock (IQR=2.6–12.0) that were on average 8 kilometers (IQR=1.9–12.4) away from veterinary officers (VOs). Only 16% (56/350) of herds were vaccinated against the diseases. Most farmers (274/350) had limited knowledge on vaccines against CBPP and PPR infections, 63% (222/350) perceived low risk of these diseases to their herds. About half of farmers reported experiencing outbreaks of either disease in the study year (2021). Farmers scored on average 80.5 out of 98 (IQR=74–85) on the RS-14 resilience scale. After adjusting for farmers’ livestock rearing experience, herd size, sex, wealth status, distance to VOs, previous disease outbreaks, and perceived risk of the diseases, vaccination utilization was negatively associated with limited knowledge (aOR=0.19, 95% CI=0.08–0.43), and positively associated with personal exposure to outbreaks in the study year (aOR=5.26, 95% CI=2.01–13.7) and increasing resilience (aOR=1.13, 95%CI=1.07–1.19). FGDs revealed farmer misconceptions about vaccines, costs of vaccines, and timely access to vaccines from VOs as additional barriers. Conclusions: Acceptability, affordability, accessibility, and availability of vaccine services represent the main barriers to vaccines utilization by ruminant livestock farmers in Ghana. Given that limited knowledge regarding the value of vaccination and shortfalls in veterinary service supply are of central importance for both the demand and supply side, more collaboration between the different stakeholders in a transdisciplinary manner to effectively address the low vaccination utilization problem is needed.Item Accounting for Weather Variability in Farm Management Resource Allocation in Northern Ghana: An Integrated Modeling Approach(Sustainability, 2023) Adelesi, O.O.; Kim, Y-UK.; Adiku, S.G.K.; et al.Smallholder farmers in Northern Ghana face challenges due to weather variability and market volatility, hindering their ability to invest in sustainable intensification options. Modeling can help understand the relationships between productivity, environmental, and economical aspects, but few models have explored the effects of weather variability on crop management and resource allocation. This study introduces an integrated modeling approach to optimize resource allocation for smallholder mixed crop and livestock farming systems in Northern Ghana. The model combines a process-based crop model, farm simulation model, and annual optimization model. Crop model simulations are driven by a large ensemble of weather time series for two scenarios: good and bad weather. The model accounts for the effects of climate risks on farm management decisions, which can help in supporting investments in sustainable intensification practices, thereby bringing smallholder farmers out of poverty traps. The model was simulated for three different farm types represented in the region. The results suggest that farmers could increase their income by allocating more than 80% of their land to cash crops such as rice, groundnut, and soybeans. The optimized cropping patterns have an over 50% probability of increasing farm income, particularly under bad weather scenarios, compared with current cropping systems.Item Accounting for Weather Variability in Farm Management Resource Allocation in Northern Ghana: An Integrated Modeling Approach(Sustainability, 2023) Adelesi, O.O.; MacCarthy, D.S.; Adiku, G.K.; et al.Smallholder farmers in Northern Ghana face challenges due to weather variability and market volatility, hindering their ability to invest in sustainable intensification options. Modeling can help understand the relationships between productivity, environmental, and economic aspects, but few models have explored the effects of weather variability on crop management and resource allocation. This study introduces an integrated modeling approach to optimize resource allocation for smallholder mixed crop and livestock farming systems in Northern Ghana. The model combines a process-based crop model, farm simulation model, and annual optimization model. Crop model Simulations are driven by a large ensemble of weather time series for two scenarios: good and bad weather. The model accounts for the effects of climate risks on farm management decisions, which can help in supporting investments in sustainable intensification practices, thereby bringing smallholder farmers out of poverty traps. The model was simulated for three different farm types, represented in the region. The results suggest that farmers could increase their income by allocating more than 80% of their land to cash crops such as rice, groundnut, and soybeans. The optimized cropping patterns have an over 50% probability of increasing farm income, particularly under bad weather scenarios, compared with current cropping systems.Item Achieving carbon neutrality in Africa is possible: the impact of education, employment, and renewable energy consumption on carbon emissions(Carbon Research, 2024) Elom, C.O.; Ankrah, D.A.; Defor, E.W.; et al.This paper analysed the causal link between education, employment, renewable energy consumption and carbon emissions in Africa, where there is scant evidence. Relying on panel data obtained from the World Development Indicators for thirty-two African countries covering a period of 19 years, and fve panel rigorous regression mod els, we found that renewable energy, investment in education, school enrolment, net national income per capita, and employment had negative and signifcant efects on carbon emission, thus increasing these predictors would result in signifcant reduction in carbon emission in Africa. We identifed a bidirectional causality between carbon emissions and net national income per capita, education expenditure and renewable energy consumption, and car bon emissions and employment. Our fndings suggest that investment in education, renewable energy, and employ ment are relevant in mitigating carbon emissions in Africa. We recommend African governments to invest heavily in education, improve school enrolment, environmental education, renewable energy and employment provision to mitigate carbon emissions.Item ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) II: protocol for case based antimicrobial resistance surveillance(Wellcome Open Research, 2023) Mo, Y.; Ding, Y.; Opintan, J.; et al.Background: Antimicrobial resistance surveillance is essential for empiric antibiotic prescribing, infection prevention and control policies and to drive novel antibiotic discoveries. However, most existing surveillance systems are isolate-based without supporting patient-based clinical data and not widely implemented, especially in low- and middle-income countries (LMICs). Methods: A Clinically-Oriented Antimicrobial Resistance Surveillance Network (ACORN) II is a large-scale multicenter protocol which builds on the WHO Global Antimicrobial Resistance and Use Surveillance System to estimate syndromic and pathogen outcomes along with associated health and economic costs. ACORN-healthcare associated infection (ACORN-HAI) is an extension study which focuses on healthcare-associated bloodstream infections and ventilator-associated pneumonia. Our main aim is to implement an efficient clinically-oriented antimicrobial resistance surveillance system, which can be incorporated as part of routine workflow in hospitals in LMICs. These surveillance systems include hospitalised patients of any age with clinically compatible acute community-acquired or healthcare-associated bacterial infection syndromes, and who were prescribed parenteral antibiotics. Diagnostic stewardship activities will be implemented to optimise microbiology culture specimen collection practices. Basic patient characteristics, clinician diagnosis, empiric treatment, infection severity and risk factors for HAI are recorded on enrolment and during the 28-day follow-up. An R Shiny application can be used offline and online for merging clinical and microbiology data, and generating collated reports to inform local antibiotic stewardship and infection control policies. Discussion: ACORN II is a comprehensive antimicrobial resistance surveillance activity, which advocates pragmatic implementation and prioritises improving local diagnostic and antibiotic prescribing practices through patient-centred data collection. These data can be rapidly communicated to local physicians and infection prevention and control teams. The relative ease of data collection promotes sustainability and maximises participation and scalability. With As an example, ACORN II has the capacity to accommodate extensions to investigate further specific questions of interest.Item Actions in global nutrition initiatives to promote sustainable healthy diets(Global Food Security, 2021) Reyes, L.I.; Constantinides, S.V.; Laar, A.; et al.Multiple recent global nutrition initiatives have recommended actions to transform food systems to improve food environments and food choice. This study aimed to identify actions recommended by these initiatives and un derstand their similarities and differences. Twelve global nutrition initiatives were reviewed, collectively spanning 13 action themes and accompanying strategies. Action themes were analyzed according to primary focus on either food environments and their food system drivers or food choice. Representation of the 13 actions varied across initiatives. Some actions overlapped; others were infrequently represented. Strategies targeting food environments and their food system drivers were more frequently recommended than strategies targeting food choice for 11 of the 13 action themes. Although these global initiatives share a mission to improve nutrition through food systems and food environments, less attention has been allocated to individual food choice and sustainability.Item Activated cashew carbon-manganese oxide based electrodes for supercapacitor applications(Scientific African, 2023) Boamah, R.; Agyei-Tuffour, B.; Dodoo-Arhin, D.; Nyankson, E.; Brobbey, K.J.; et al.The current global energy challenge which affects most developing countries in particular, is of major source of concern today. The availability of less expensive techniques of storing excess generated energy is critical to the success of the renewable energy roadmaps implementation. In this study, hydrothermal and chemical leaching methods have been used to synthesize MnO2 nanoparticles using KMnO4 and MnSO4 as precursors at 140 °C and from natural local manganese ore. Activated Carbon (ACF) have also been produced from agricultural Cashew biomass waste, through a physical carbonization and KOH activation process using temperatures of 700 °C – 900 °C for periods between 1 and 2 h. The as-prepared materials have been characterized via XRD, Raman, FTIR, SEM. Electrochemical performance measurements (CV, EIS and GCD) were carried out on the prepared electrodes. The specific capacitance values obtained were in the range of 2.8 F/g - 6.5 F/g at different scan rates of 20 mV -50 mV respectively in a potential range of -0.4 to +0.4 V and -0.4 to +0.6 V for the various types of electrodesItem Actor-network analysis of community based organisations in health pandemics: evidence from the COVID-19 response in Freetown, Sierra Leone(Disasters, 2021) Frimpong, L.K.; Commodore, T.S.; Okyere, S.A.; et al.Freetown, Sierra Leone, is confronted with health risks that are compounded by rapid, unplanned urbanisation and weak capacities of local government institutions. Addressing them implies a shared responsibility between government and non-state actors. In low-income areas, the role of community-based organisations (CBOs) in combating health disasters is well-recognised. Yet, empirical evidence on how they have utilised their networks and coordinated community-level strategies in responding to the COVID-19 pandemic is scant. This paper, based on a qualitative study in two informal settlements in Freetown employs actor-network theory to understand how CBOs problematize COVID-19 as a health risk, interact with other entities, and the subsequent tensions that arise. The findings show that community vulnerabilities and past experiences of health disasters informed CBOs’ perception of COVID-19 as a communal emergency. In response, they coordinated sensitisation and mobilisation programmes by relying on a network of actors to support COVID-19 risk reduction strategies. Nonetheless, misunderstandings among them caused friction.Item An Acute And Sub-Acute Toxicological Assessment Of Reissantia Indica Plant Extract In Male Sprague-Dawley Rats: Hematological, Serum Biochemical And Histopathology(Scientific African, 2024) Amoateng, E.O.; Amoateng, P.; Ossei, P.P.S.; et al.The traditional use of medicinal plants in sub-Saharan health management lacks thorough toxicological evaluations, particularly concerning lethal dose levels. This study aims to assess the acute and sub-acute toxicity of Reissantia indica whole-plant extract (RIE) in male Sprague-Dawley rats, with a focal point on delineating its safety profile while exploring potential therapeutic applications. RIE, obtained through precise cold maceration in 70 % ethanol, underwent rigorous analysis. revealing diverse secondary metabolites, including alkaloids, flavonoids, terpenoids, and glycosides. Renowned for antioxidant, anti-inflammatory, and anticancer properties, these compounds enhance RIE’s pharmacological potential. In the acute toxicity study, RIE was orally administered at 500 and 5000 mg/kg. Sub-acute toxicity involved oral administration of the extract at various doses (5, 50 and 500 mg/kg) over 28 days, with comprehensive assessments, including hematological, biochemical, and histopathological evaluations. Results from the acute toxicity showed no mortality, suggesting a median lethal dose (LD50) exceeding 5000 mg/kg and indicating a substantial margin of safety. Sub-acute toxicity investigations spanning 28 days revealed no significant changes in body and organ weights, hematological and biochemical parameters, or histopathological signs compared to the control group. Histological examination of kidney, liver, heart, and lung sections from treated animals showed no signs of degeneration.Item Acute hyperthermia and hypoxia tolerance of two improved strains of nile tilapia (Oreochromis niloticus)(Springer, 2023) Duodu, C. P.; Obirikorang, K.A; Appiah‑Kubi, R.; et al.Abstract Tilapia production in Ghana has been hit with episodes of stress and pathogen-induced mass fsh kills which have anecdotally been linked to the culture of illegally imported Genetically Improved Farmed Tilapia (GIFT) strains of Nile tilapia, Oreochromis niloticus. This study was thus set up to comprehensively assess the stress tolerance of the GIFT strain and a native strain of Nile tilapia (the Akosombo strain) following exposures to hyperthermic and hypoxic stressors. In a series of experiments, oxygen consumption (MO2), aquatic surface respiration (ASR), thermal limits and hypoxia tolerance were assessed. The efects of these stressors on haematological parameters were also assessed. The GIFT strain was less tolerant of hypoxia and performed ASR at higher O2 levels than the Akosombo strain. Under progressive hypoxia, the GIFT strain exhibited higher gill ventilations frequencies (fV) than the Akosombo strain. The thermal tolerance trial indicated that the Akosombo strain of O. niloticus has higher thermotolerance than the GIFT strain and this was refective in the higher LT50 (45.1℃) and LTmax (48℃), compared to LT50 and LTmax of 41.5℃ and 46℃ respectively. These results imply that it is crucial to consider how the GIFT strain performs under various envi‑ ronmental conditions and changes during culture. Particularly, raising the GIFT strain of Nile tilapia in earthen ponds rich in phytoplankton and subject to protracted episodes of extreme hypoxia may have a detrimental physiological impact on its growth and welfare.Item Acute Oral Toxicological Profile of Croton membranaceus Mull. Arg. Aqueous Stem Extract, a Herbal Treatment for Benign Prostate Hyperplasia, in Male Sprague–Dawley Rats(Journal of Toxicology, 2024) Afriyie, D.K.; Ameyaw, E.O; Appiah-Opong, R.; et al.Croton membranaceus Mull. Arg. is a traditional medicinal plant frequently employed in Ghana for the treatment of benign prostatic hyperplasia and prostate cancer. The objective of this study was to determine the acute oral toxicity of the aqueous stem extract of Croton membranaceus (CMASE) in male Sprague-Dawley (S-D) rats. The acute toxicity of CMASE was evaluated using S-D rats randomly divided into four groups of five animals each. Tree groups (low dose, median dose, and high dose) of rats received single oral doses of CMASE (1000, 2500, and 5000 mg/kg body weight, respectively) using an oral gavage. Te control group was given distilled water. After 14 days of daily observations, hematological, biochemical, and histopathological analyses were conducted on the rats. From the results obtained, doses of CMASE up to 5000 mg/kg did not cause death or induce any clinical indications of toxicity during the study period. Also, the mean body weight and the hematological indices assessed were not significantly affected by the various doses of CMASE compared to the control group. However, serum uric acid and creatinine levels decreased significantly (p < 0.001) 14 days after the extract administration. Serum liver function enzyme levels, including alkaline phosphatase (ALP), alanine aminotransferases (ALT), and aspartate aminotransferases (AST), and serum proteins (total proteins and albumin) exhibited significant (p < 0.001) non-dose-dependent changes (increases and decreases) in treated groups compared to the controls. Other biochemical indices, however, did not differ significantly between the treated groups and the controls. The gross pathological and histological analysis of the heart, liver, and kidney tissues did not reveal any significant changes in histoarchitecture. The oral LD50 of CMASE in rats was greater than 5000 mg/kg, indicating that the extract was relatively safe. It must, however, be used with care as a substitute for the roots.Item Acute Oral Toxicological Profile of Croton membranaceus Mull. Arg. Aqueous Stem Extract, a Herbal Treatment for Benign Prostate Hyperplasia, in Male Sprague–Dawley Rats(Journal of Toxicology, 2024) Afriyie, D.K.; Ameyaw, E.O.; Appiah-Opong, R.; et al.Croton membranaceus Mull. Arg. is a traditional medicinal plant frequently employed in Ghana for the treatment of benign prostatic hyperplasia and prostate cancer. The objective of this study was to determine the acute oral toxicity of the aqueous stem extract of Croton membranaceus (CMASE) in male Sprague-Dawley (S-D) rats. The acute toxicity of CMASE was evaluated using S-D rats randomly divided into four groups of five animals each. Tree groups (low dose, median dose, and high dose) of rats received single oral doses of CMASE (1000, 2500, and 5000 mg/kg body weight, respectively) using an oral gavage. Te control group was given distilled water. After 14 days of daily observations, hematological, biochemical, and histopathological analyses were conducted on the rats. From the results obtained, doses of CMASE up to 5000 mg/kg did not cause death or induce any clinical indications of toxicity during the study period. Also, the mean body weight and the hematological indices assessed were not significantly affected by the various doses of CMASE compared to the control group. However, serum uric acid and creatinine levels decreased significantly (p < 0.001) 14 days after the extract administration. Serum liver function enzyme levels, including alkaline phosphatase (ALP), alanine aminotransferases (ALT), and aspartate aminotransferases (AST), and serum proteins (total proteins and albumin) exhibited significant (p < 0.001) non-dose-dependent changes (increases and decreases) in treated groups compared to the controls. Other biochemical indices, however, did not differ significantly between the treated groups and the controls. The gross pathological and histological analysis of the heart, liver, and kidney tissues did not reveal any significant changes in histoarchitecture. The oral LD50 of CMASE in rats was greater than 5000 mg/kg, indicating that the extract was relatively safe. It must, however, be used with care as a substitute for the roots.Item Adaptation to compound climate risks: A systematic global stocktake(iScience, 2023) Simpson, N.P.; Williams, P.A.; Mach, K.J.; Berrang-Ford, L.; Biesbroek, R.; Musah-Surugu, J.I.; et al.This article provides a stocktake of the adaptation literature between 2013 and 2019 to better understand how adaptation responses affect risk under the particularly challenging conditions of compound climate events. Across 39 countries, 45 response types to compound hazards display anticipatory (9%), reactive (33%), and maladaptive (41%) characteristics, as well as hard (18%) and soft (68%) limits to adaptation. Low income, food insecurity, and access to institu tional resources and finance are the most prominent of 23 vulnerabilities observed to negatively affect responses. Risk for food security, health, livelihoods, and economic outputs are commonly associated risks driving responses. Narrow geographical and sectoral foci of the literature highlight important conceptual, sectoral, and geographic areas for future research to better understand the way responses shape risk. When responses are integrated within climate risk assessment and management, there is greater potential to advance the urgency of response and safeguards for the most vulnerable.Item Addressing Africa’s outrageous neurosurgeons deficit: what could the problem be?(2023) Tenkorang, P. O.; Wireko, A. A.; Lian, D.; et al.Item Addressing the marketing and availability of unhealthy food and beverages in and around selected schools in Ghana: a community readiness appraisal(BMJ Open, 2023) Tandoh, A.; Laar, A.; Pradeilles, R.; et al.Objective This study assessed stakeholder readiness to address unhealthy food and beverage marketing and availability in/around Public Basic Schools (for children 4–15 years) in Greater Accra Region, the highly urbanized the administrative capital of Ghana. Design The community readiness model was used to conduct in-depth mixed methods interviews with stakeholders. Using predefined anchored rating statements, quantitative readiness scores ranging from 1 to 9 were generated. Thematic qualitative analysis was undertaken to understand barriers and facilitators that could influence the implementation of interventions. Setting Greater Accra Region, Ghana. Participants 18 key informants from various schools/ education/citizen sectors, which together represented the ‘school community’ of Greater Accra Region. Results The mean readiness scores indicated that the ‘school community’ was at the ‘preplanning’ stage of readiness (4.44±0.98) to address the marketing and availability of unhealthy food and beverages in and around schools. The mean readiness score for ‘leadership’ was the highest of all dimensions (5.36±1.60), corresponding to the ‘preparation’ stage. The lowest scores were found for ‘community knowledge of efforts’ (3.19±2.45) and ‘resources for efforts’ (3.64±0.87), both of which were at a ‘vague awareness’ stage. Conclusions The ‘school community’ recognized that the marketing and availability of unhealthy food and beverages was a problem. Additionally, the current leadership was actively supportive of continuing/improving efforts that create healthier children’s food environments. However, actions that aim to increase the ‘school community’s’ knowledge of existing interventions and securing resources to sustain those interventions are needed before introducing readiness-appropriate strategies.Item Adherence to antiretroviral therapy among HIV patients in Ghana: A systematic review and meta-analysis(Plos Global Public Health, 2024) Boadu, I.; Manu, A.; Abdulai, M.; et al.Maintaining a high level of adherence to antiretroviral therapy (ART) is critical to limiting rapid viral replication, drug resistance, and viral transmission. However, ART adherence remains a major challenge in HIV/AIDS treatment success. This systematic review and meta-analysis was aimed to synthesize available evidence on adherence to ART among HIV/AIDS patients in Ghana.This review followed the preferred reporting item for systematic review and meta-analysis (PRISMA) criteria. A comprehensive literature search was done using five online databases (PubMed, Google Scholar, Medline, Africa Index Medicus, and Willey Online Library) from 25th- 30th April 2023 to identify potential studies. In addition, references of related articles were manually searched to further identify relevant studies. Search records were managed in Endnote library where duplicates were removed prior to screening. Studies were eligible for inclusion if they were conducted in Ghana, designed as an observational or experimental study, and explicitly measured adherence to ART, either as a primary or secondary outcome. Studies were excluded if the proportion or prevalence of adherence to ART was not reported.A total number of 126 potential studies were identified from the literature search. Of these, 14 met the inclusion criteria and were included in the Meta-analysis. The studies involved a total number of 4,436 participants. The pooled estimate of adherence to ART was 70% (CI: 58–81%). In subgroup analysis, adolescents and young adults had a lower adherence rate (66%, CI: 46–84%) compared with adults (70%; CI: 58–81%). Publication bias was not observed among studies. The pooled estimate of optimal adherence to ART among HIV patients in Ghana was lower than is recommended (95%) to achieve viral suppression. Adherence was lower among young persons living with HIV/AIDS. To achieve the United Nation’s Sustainable development goals and the UNAIDS “95-95-95” targets, there is a need to focus on improving adherence interventions among persons living with HIV/AIDS, especially among the younger cohort.Item Adherence to antiretroviral therapy among HIV patients in Ghana: A systematic review and meta-analysis(PLOS Global Public Health, 2023) Boadu, I.; Aryeetey, R.N.O.; Abdulai, M.; et al.Maintaining a high level of adherence to antiretroviral therapy (ART) is critical to limiting rapid viral replication, drug resistance, and viral transmission. However, ART adherence remains a major challenge in HIV/AIDS treatment success. This systematic review and meta-analysis aimed at synthesizing available evidence on adherence to ART among HIV/AIDS patients in Ghana. This review followed the preferred reporting item for systematic review and meta-analysis (PRISMA) criteria. A comprehensive literature search was done using five online databases (PubMed, Google Scholar, Medline, Africa Index Medicus, and Willey Online Library) from 25th- 30th April 2023 to identify potential studies. In addition, references to related articles were manually searched to further identify relevant studies. Search records were managed in the Endnote library where duplicates were removed before screening. Studies were eligible for inclusion if they were conducted in Ghana, designed as an observational or experimental study, and explicitly measured adherence to ART, either as a primary or secondary outcome. Studies were excluded if the proportion or prevalence of adherence to ART was not reported. A total number of 126 potential studies were identified from the literature search. Of these, 14 met the inclusion criteria and were included in the Meta-analysis. The studies involved a total number of 4,436 participants. The pooled estimate of adherence to ART was 70% (CI: 58–81%). In subgroup analysis, adolescents and young adults had a lower adherence rate (66%, CI: 46–84%) compared with adults (70%; CI: 58–81%). Publication bias was not observed among studies. The pooled estimate of optimal adherence to ART among HIV patients in Ghana was lower than is recommended (�95%) to achieve viral suppression. Adherence was lower among young persons living with HIV/AIDS. To achieve the United Nation’s Sustainable development goals and the UNAIDS “95-95-95” targets, there is a need to focus on improving adherence interventions among persons living with HIV/AIDS, especially among the younger cohort.