Theses

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A long essay or dissertation or thesis involving personal research, written by postgraduates of University of Ghana for a university degree.

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    Covid-19 In Patients Presenting With Malaria-Like Symptoms At Korle Bu Polyclinic, Accra
    (University Of Ghana, 2022-08) Asamoah, I.
    Malaria is one of Ghana's most frequent illnesses and the most common cause of febrile sickness. The prevalence of malaria in patients who visit the Korle Bu Polyclinic in Accra with malaria-like symptoms is around 8%. It is therefore essential to look into COVID-19's contribution to malaria-like symptoms. Most infectious diseases including COVID-19 and arboviral infections mimic malaria due to the overlapping of non-specific symptoms they both share. This study investigated COVID-19 in patients presenting with malaria-like symptoms at the Korle Bu Polyclinic, Accra. A cross-sectional study was conducted among patients presenting with malaria-like symptoms at the Korle Bu polyclinic from June to August, 2021. A total of 300 patients who qualify for Malaria Rapid Diagnostic Testing, and met the criteria for the study, were selected using simple random sampling. Two to three millilitres of whole blood, nasopharyngeal and oropharyngeal swab samples was collected for screening of Plasmodium falciparum and SARS-CoV-2 respectively. The whole blood sample was also used for COVID-19 antibody test and full blood count. Sixty out of three hundred (20%) study patients were positive for SARS-CoV-2 using Real-time PCR and twenty six out of three hundred (8.7%) tested positive using COVID-19 Rapid Antigen test. Majority were females (42/60; 70%), and participants had mean age of 28 years. Seven out of three hundred (2.3%) tested positive for Plasmodium falciparum using Malaria RDT and microscopy and eight out of three hundred (2.7%) using Nested Conventional PCR. Two coinfection of Plasmodium falciparum and SARS-CoV-2 were reported. Most of the patients came from the Ablekuma South district. Most patients with CT’s below 30 (High viral load) presented with 5 or more symptoms (p value <0.01). The most common symptom experienced by the study patients at the polyclinic was headache (95%; 57/60) followed by general body weakness and pain (78.3%;47/60), tiredness (60%; 36/60) and fever ( 51.7%; 31/60) Comorbidities reported were hypertension, diabetes, Asthma, hypertension and diabetes and none had sickle cell diseases. Most of the study patients had been previously exposure to SARS CoV-2 (113/300) and 66.7% (34/51) Astrazeneca vaccinated patients had no antibody. Due to the synergy of symptoms, screening for COVID-19 in patients presenting with malaria-like symptoms is vital for immediate diagnosis and treatment. Keywords: COVID-19, Korle Bu, Accra
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    Nutritional Status And Anaemia Prevalence, Malaria And Helminths Infestations Levels Among Children Aged 6-23 Months In Peri-Urban Communities In Accra
    (University Of Ghana, 2022-01) Datohe, D.D.
    Background and objective: The first two years of life is very critical. Children especially those under two years are vulnerable to stunting, wasting, and anaemia. However, information on these growth indices in peri-urban areas are scanty. In this study, we examined the nutritional status, anaemia prevalence, malaria and helminthes infestation levels among children aged 6 to 23 months old living in peri-urban areas in the La-Nkwantanang-Madina Metropolitan Assembly (LaNMMA) area. Methodology: The study was cross-sectional. A one-time-point data was collected which involved 268 child/ mother (key caregiver) pairs from five peri-urban communities. A semistructured questionnaire was used to interview mothers with children aged 6 to 23 months old about socio-demographic characteristics, dietary intakes and breastfeeding patterns. The weight, recumbent length and mid-upper arm circumferences (MUAC) of the children were taken using procedures specified by the World Health Organization (WHO). Five millilitres of blood samples were collected to determine haemoglobin (Hb) levels and malaria infection. Stool samples were also collected to determine helminth infestations. The anthropometric indices were converted to z-scores with the help of WHO Anthro software. The data were summarized through descriptive statistics. Crude binary logistic regression was employed to check for associations and the logistic regression model was employed to control and determine factors that predicted anaemia, wasting, stunting and underweight in lined with the objectives of the study. Results: Anaemia prevalence among the study children was 85.1% with 2% being severely anaemic. However, stunting, wasting and underweight prevalence were relatively low; 9.0%, 8.2% and 10.1% respectively. About 1.5% of the study participants were infected with malaria and no helminthic infestation was detected. Colostrum, eating or drinking something else apart from breast milk during the first three days after delivery, start month on complementary feeding, food made from vitamin A-rich dark green leafy vegetables, food made from oil, fat, or butter, red palm oil, palm nut soup/ sauce and number of times a child received solids, semisolids, or soft foods during the day/ night significantly predicted anaemia (p<0.05). Mothers who were part time workers, sex of child, initiation of breastfeeding, breastfeeding duration and households salt used predicted wasting. Conclusion: Very high anaemia prevalence was found in this study. Efforts to prevent increased anaemia prevalence especially in rural and peri-urban settings and to improve the nutritional status of young children are warranted.
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    Assessment of the Quality of Health Care Rendered to Children Under- Five with Malaria at the Princess Marie Louis Hospital, Accra
    (University of Ghana, 2017-06) Yahaya, H.
    Background: In Ghana, there have been gradual declines in malaria mortality over the years, with the institutional case fatality rate among children under five falling from 14.1% in 2000 to 0.6% in 2012 and recently 0.5% in 2015. it is contended that the amount of resources committed to malaria prevention and case management is higher than the gains made. This has raised concerns about the quality of Intervention delivered to patients with or at risk of malaria While there is increasing policy and research interest in this field, there is little attention paid to the quality of care for under-five children suffering from malaria. This study. thus, assesses the quality of care delivered to children under five with malaria at the Princess Marie Louis hospital. Methodology: A quantitative approach using cross-sectional survey design was used to examine the quality of care delivered to children under five diagnosed with malaria A computer generated random sample of 74 staff and 301 parents of children under five who were treated for malaria at the hospital were recruited for the study. The data was statistically analysed with using the Statistical Package for Social Sciences (SPSS) software version 20. Descriptive summary statistics was complemented with regression analysis preceded by Pearson's correlation analyses to draw inferences. Results: The study showed that overall, inputs availability for standard malaria case management was as high as 81.1% and highest in the area of general inputs such as staff, triaging and basic equipment including weighing scales and thermometers (88.8%) whilst anti-malaria medications was the least available (66.6%.). Also, staff compliance with the Ghana Health Service standard protocols for malaria case management was quite high (89.4%) but less than previously reported rate of 90.8%. Parental caretaker satisfaction (as proxy for patient satisfaction) was also moderate (66.1%) and lower than national average. Finally, technical quality indicators had no significant influence on patient satisfaction as pustulated in quality of care models. Conclusion: Staff adherence to standard treatment malaria case management protocols is high but appears to be declining when compared with other studies. Also, anti-malarial availability is much lower than the 98% availability of essential drugs in public health institutions as estimated by the Ghana health service. Addressing these would improve technical quality of care; they may not necessarily impact positively on subjective quality which was moderate and below reported national average. In-depth exploration for innovative and customer-oriented approaches is recommended to boost patient satisfaction.
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    Modeling the Climatic and Socio-Demographic Influence on Malaria Transmission in Accra
    (University of Ghana, 2016-12) Appiah, M.
    Climate change and variability affect the suitability of environmental conditions for malaria transmission. Although malaria transmission is place-specific, existing assessments of malaria transmission have largely focused on large-scale changes in malaria transmission and overlooked the socio-demographic factors that modulate climate and malaria nexus with the result largely indicating widespread increase in areas suitable for malaria transmission. In its recent assessment report, the Intergovernmental Panel on Climate Change (IPCC) observed the lack of models that incorporate modulating factors in malaria transmission and emphasizes the need for such models to adequately account for local level transmissions. In the context of climate change and variability, and population dynamics, the present study modelled malaria transmission over Accra, accounting not only for the climatic but actual socio-demographic factors for current and different future climatic scenarios at the macro level. The study also assessed socio-demographic and environmental factors influencing malaria incidence at the micro level. The main sources of data used include time series rainfall and temperature data for Accra (1970-2010) from the Ghana Meteorological Agency (GMeT) and census-based demographic data (1970-2010). In addition, cross-sectional household data from three selected coastal communities (James Town, Ussher Town and Agbogbloshie) in Accra were also used. To facilitate future assessment of malaria transmission, both climatic and demographic data were projected using Bergen Climate Model Version 2 and Spectrum respectively. While the VECTRI was used in analysing the climatic and demographic data, Binary Logistic Regression was employed to estimate malaria incidence and coping/adaptation strategies in the household. The results indicated increasing and temporal variability of rainfall and temperature while population also shows an increasing trend in spite of the declining population growth rate. Moreover, similar trend was observed for the future scenario (climatic and demographic factors). At the macro level, compared with the un-adjusted estimation, the population adjusted models show relatively lower malaria transmission levels presently and in the future. Annual malaria transmission shows significantly declining trend over time. There is also observed seasonal shift in the significant malaria transmission months. Results of the micro level analyses showed that socio-demographic factors significantly have far-reaching influence on malaria incidence than climatic factors. In the multiple regression analyses, experience of flooding did not have a significant influence on malaria incidence. The type of toilet facility used, malaria risk perception, the age of household head and the use of coping/adaptation measures were significant predictors of malaria incidence. Particularly, age of household head was positively related with malaria incidence. Comparatively, households that used flush toilet facility had higher risk of malaria incidence. The use of coping/adaptation measures was also significantly related with malaria incidence. The findings suggest the need to account for actual socio-demographic effects besides the climatic conditions for more accurate malaria transmission estimations to guarantee acceptable transmission levels for appropriate and effective interventions to sustain decline in malaria transmission. There is also the need to intensify and scale up the use of household coping/adaptation strategies to minimise malaria incidence. Key words: Climate, Population, Malaria, transmission, Coping/adaptation