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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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Item An Evaluation Of The Pattern Of Analgesics And Antibiotics Prescriptions Among Dental Practitioners In The Greater Accra Region Of Ghana(University Of Ghana, 2019-12) Bolfrey, D.A.Background: Antibiotics and analgesics are the two drugs frequently prescribed by dentist to manage patient condition therefore, their judicious use is necessary to ensure proper healthcare delivery to patient and to prevent negative effects due to wrong use of these medications. Aim of study and objectives: To investigate the pattern of prescription among dentist using recommended guidelines by WHO and the Ghana national standard treatment guidelines and other protocols. Also, to determine clinical and non-clinical factors that influences prescription practice of dentist. Methods: A cross-sectional, prospective, non-interventional quantitative study was employed to evaluate antibiotics and analgesics prescription pattern and factors that influences prescription pattern among dentist in Accra Sub metropolitan district. The study was conducted to include all dentists who were present at the four health facilities during the period of June and July 2019. Informed Consent was sought from the and study questionnaire was distributed to all participants present who agreed to participate. Data was collected using semi-structured questionnaires and a data form. Data was analyzed using STATA 15 and p-value<0.05 was considered be considered significant. Results: a total of 36 out of 48 questionnaires were returned. 19 male respondents and 17 female respondents. GDP were majority of respondents 83.33%. Amoxicillin was the most prescribed antibiotics 20 (30.30%) followed closely behind by metronidazole 17(25.76%). Antibiotics were mostly prescribed as combination (polypharmacy) that is 27 (69%) of encounters with antibiotics prescribed. Concurrently, the most preferred first line antibiotics of choice indicated by dentists were amoxicillin and metronidazole accounting for 42.19% and 25.00% of response respectively. Antibiotics were mostly prescribed after dental extractions 64.1% and to patients who reported with localized abscess 51.28%. Paracetamol was the most prescribed (65.85%) and preferred analgesics (46.05%), followed by NSAIDS. Sex of dental prescribers was determined to be statistically significant factor on patient’s knowledge on antibiotics and source of information on prescribed drugs, p<0.05. Conclusion; In this study the preferred antibiotics and most prescribed antibiotics were amoxicillin and metronidazole, and were mostly prescribed together. These medications were mostly prescribed without evidence since culture and sensitivity reports was not requested which may lead to irrational use. Sex as a factor was proven to have influence on the source of knowledge on prescribed drugs and knowledge on some prescribed antibiotics, with most female respondents not indicating scientific publication as sources of information on prescribed medication and a greater proportion exhibiting poor knowledge on some prescribed antibiotics. Number of years of practice, age of dentist, specialty, and hospital facility did not have any influence on their prescription behavior. Patient demand and pharmaceutical promotion were also proven to have minimal effect on the prescribing behavior of dentist.Item Identification And Mapping Of Risk Factors Associated With Cholera In Selected Communities In The Greater Accra Region, Ghana(University Of Ghana, 2021-09) Dongdem, A.Background Cholera is an acute diarrhoeal disease caused by the toxigenic Vibrio cholerae O1 or O139 strains. Globally, it is estimated to infect over 1.3 million people with over 21, 000 deaths annually with the most affected countries being in Africa and Asia. In Ghana, cholera has become endemic in some communities in the Greater Accra Region (GAR) with reported focal epidemics. The factors contributing to its persistence and spread in these communities are not well understood. To prevent future epidemics, it is important to identify the specific risks in these communities that may account for its persistence. This study, therefore, identified and mapped risk factors associated with cholera at the household and community levels in the GAR. Methods A community-based cross-sectional comparative study was conducted in 24 (12 each) from cholera endemic and non-endemic communities from March 2019 to March 2020. The multistage cluster sampling procedure was used in selecting households and a structured questionnaire was used to collect data from the head of households. Drinking water from selected households was sampled for water quality and the community water bodies were assessed for the presence of toxigenic strains of V. cholerae during the wet and dry seasons. A sanitation inspection guide was used to assess the sanitation conditions of the communities and GPS coordinates of the identified risk taken. Data were analysed using STATA version 14 software. Associations between the history of cholera and the independent variables were determined using Chi-square/Fisher exact test and multivariable penalized logistic regression. The differences in bacterial counts were determined using the Kruskal Wallis rank test. A p-value less than 0.05 was considered significant for the associations. Principal Component Analysis was used to categorize the household wealth index and the environmental sanitation conditions. Significantly identified risk factors were mapped with the historical cholera cases using Arc GIS. Results Results of the multivariable penalized logistic regression showed that the presence of waste dumpsites (AOR=2.96, 95% CI: 1.11-7.88, p=0.030) and big open drainage (AOR=5.78, 95% CI: 1.89-17.72, p=0.002) were predictors of cholera occurrence. Whereas cooking in a detached kitchen (AOR=0.22, 95% CI: 0.06-0.82. P=0.024), or in yard (AOR=0.42, 95% CI: 0.21-0.86, p=0.017), and the availability of public toilets in the neighbourhood (AOR=0.28, 95% CI: 0.08-0.97, p=0.046) were significantly protective against cholera. The household drinking water was mostly contaminated with faecal coliforms with counts exceeding the zero cfu/100ml standard. Klebsiella penumoniae and Escherichia coli were the dominant organisms isolated. The household stored water was more contaminated than that obtained from the direct source and the differences were significant. The contamination was generally higher in the wet season than in the dry season. No toxigenic Vibrio cholerae O1 or O139 was isolated from the household drinking water and the environmental water bodies. However, Vibrio fluvialis and Vibrio algionolyticus were isolated from the environmental water bodies. Environmental sanitation revealed 66.2% (300/453) of the endemic communities to have poor sanitation compared to the 67.5% (306/453) of the non-endemic communities with good sanitation conditions. Conclusion/Recommendation The presence of public toilets, waste dumpsites, and open drainage systems close to each other and their combined effect may account for the cholera endemicity in the endemic communities. Household drinking water contaminated with faecal coliforms is an indicator of high risk for cholera transmission. The absence of toxigenic strains of Vibrio cholerae O1 or O139 in the drinking and environmental water bodies could predict the absence of cholera occurrence. Vibrio fluvialis and Vibrio algionolyticus emerging cholera-like diarrhoea pathogens were isolated from the environmental water bodies. Poor environmental sanitation is still prevalent in the endemic communities. It is recommended that sanitation laws and the treatment of household drinking water at the point-of-used as well as siting of public toilets, waste dumpsites, and open drainages beyond 500 m from households are enforced.Item Assessing Factors Influencing Utilization of Adolescent Health Services at Kpone Health Center in the Greater Accra Region(University of Ghana, 2020-10) Biney, H.Item Factors Contributing to Antiretroviral Therapy Adherence Among Adolescents and Young Persons Living with HIV in Five Healthcare Settings in Greater Accra Region(University of Ghana, 2020-12) Lawson, F.O.Item Factors Associated with Hepatitis B Infection Among Admitted Patients at the Kaneshie Polyclinic in the Greater Accra Region of Ghana(University of Ghana, 2020-10) Jingbeja, E.Background: Hepatitis B virus infections is one of the nearly all mutual virus in the current humanity and absolute through the World Health Organization as solitary of the peak ten killers. The disease infection be creditworthy in support of roughly 1.5 million deaths globally every year, two thirds of which be dimensioned toward main hepatic carcinoma subsequent hepatitis b virus disease. On 360 million public be inveterately polluted through Hepatitis b virus. These inveterately polluted people be in upper threat of death from Hepatitis b virus-referred liver malignancy before cirrhosis near roughly 25% also larger than 4 million latest severe medical cases happen. Objectives: This work was intended to determine the burden of HBV infection and its associated risk factors among patients at the Kaneshie polyclinic. Methods: The study was conducted at the Kaneshie Polyclinic, which is government owned, providing general/specialist health services. It is located in Accra, and is NHIS accredited. A cross-sectional study with a quantitative method was used, aimed at exploring and describing the various factors influencing the Hepatitis b virus infection among patients at the Kaneshie Polyclinic. Test for the HBsAg was done in the clinic using Rapid Test™ HBsAg ELISA kits (Los Angeles-based Diagnostic Automation/Cortez Diagnostics,In). Blood samples was obtained from all the 314 admitted patients for serological test for HBsAg. Blood was obtained from each participant under aseptic procedure using lancet by simply pricking the left thumb of participants. STATA IC version 16 was used to analyze the data. Frequency and percentages were used to describe the socio-demographic characteristics, possible route factors and knowledge of participants on hepatitis B infection. Results: It was detected that, 14.4% (n=45) tested positive, 81.8% (n=256) tested negative whilst 3.8% (n=12) test results came up inconclusive. None of the admitted patients who had been vaccinated against hepatitis B were tested positive compared to the 16.3% (n=45/276) prevalence of hepatitis B infection among admitted patients who had never tested for hepatitis B. (COR: 2.54, 95% CI: 1.05-6.16, p=0.039) among admitted patients who had family history of hepatitis B infection. Conclusion: The prevalence of Hepatitis B virus infection is 14.3% with a 95% confidence interval estimate of 10.7% to 18.8% and of the patients vaccinated against hepatitis B tested positive for hepatitis B infection compared to the 16.3% among those who had not been vaccinated among admitted patients at the Kaneshie polyclinic. Recommendation: It is recommended that hepatitis B infection testing must be mandatory for all admitted Patients before discharge home.Item The Detection and Molecular Characterisation of Bacterial Symbionts of Anopheles Gambiae S.L.(University of Ghana, 2003-09) Brown, C.A.The aim of the present study was to identify and characterise bacterial symbionts in An. gambiae s.l. mosquitoes, and ultimately select one that occurs in all its life stases. Mosquito larvae and pupae samples were collected from six locations in the Greater Accra region of Ghana and some reared to adults in the laboratory. Wild adult An. gambiae mosquitoes from Navrongo and Dodowa (Ghana) and Jaribuni (Kilifi District, Kenya) and laboratory colonies of adult An. gambiae mosquitoes from Kilimanjaro (Tanzania), Suakoko (Liberia) and Kisumu (Kenya) and An. lU'abknsu (Wqcningen SU'ain) were alw studied.Item Moral Reasoning, Cost of Helping, and Human Relationships to Altruistic Orientation(University of Ghana, 1997-03) Wiafe-Akenteng, C.B.This study examined how one's level of moral reasoning, the cost of helping, and human relationships influence one's altruistic orientation. Two hundred and fourteen subjects (123 males and 91 females) aged between 16 and 22 years with an average age of 18 years from three mixed Sixth Form secondary schools in the Greater Accra Region of Ghana participated in the study. materials were the short form of Rest James (1979) Defining Issue Test (DIT) and the Self report Altruism Scale (SRAS). Results indicated significant main effects between each of the three independent variables and altruistic orientation. In addition, there were significant differences in the amount of help offered at each level of moral reasoning. at each level of cost as well as the amount of help offered to the three different victims. Furthermore, there were interaction effects of any two combinations of the three independent variables on altruistic orientation. However, there was no interaction among all the three independent variables combined. These findings suggest that all three variables influence altruistic orientation in one way or the other. It is therefore recommended that measures should be taken to improve children's level of moral reasoning: and that in situations where cost of helping is high, request for assistance must be presented in piecemeal where possible, and that education should be mounted to impress upon individuals and groups to look beyond helping only kin and/or friends so as ensure equitable treatment for all.Item Standardization of the Multidimensional Aptitude Battery (MAB) in Ghana(University of Ghana, 2002-06) Debrah, L.A.This study reports an analysts of the performance of 449 non-clinical individuals on the Multidimensiona1 Aptitude Battery (MAB). These were students ranging between the ages of sixteen (16) and thirty-four (34) years drawn from selected secondary and tertiary Institutions in the Greater Accra Region of Ghana. The purpose of undertaking this work was first to provide Ghanaian norms for the Multidimensional Aptitude Battery (MAB). Further. to Investigate the possible influence of age, and sex on each of the ten subtests of the MAB, the Verbal Scale, the Performance Scale and Full Scale. The results revealed that age and sex had an effect on performance on the MAB. Older subjects obtained significantly higher scores on Vocabulary. Comprehension, Verbal Scale and Full Scale. These are tests which relied more on experience and 8 vast store of knowledge. The findings support Cattel's theory that on tasks requiring fluid intelligence as opposed to crystallized Intelligence, older people are at an advantage. Overall, the females obtained significantly higher scores than males Males performed significantly better than females on the Spatial subtest, supporting previous findings. The observed difference between the performance of the Ghanaian and normative sample on the MAB confirm the fact that cultural issues affect psychological testing to a large extent. The general overall improvement in performance on the modified MAB and the subsequent formulation and generation of Ghanaian norms for the MAB have tremendous implications for clinical psychological practice in Ghana, and also in prediction of performance on the job and also for research in GhanaItem Assessment of Malaria Parasite Rate and System Attributes in the Sentinel Surveillance Sites in Greater Accra Region(University of Ghana, 2017-07) Mukendi, T.K.Background Malaria remains a major public health problem in the world. In Ghana, the entire population of24.2 million is at risk of malaria infection. Malaria is end emic and perennial in all parts of the country, with seasonal variations that are more pronounced in the north. From 2010 to 2015, Ghana has reduced by 45% malaria deaths. Progress in reduction of malaria prevalence has been recorded in the routine surveillance system through Health Management Information System but unfortunately that data suffers from reliability from presumed malaria. Therefore, Ghana established the sentinel surveillance system in 2013, with the aim to monitor the prevalence of malaria in the country and minimizing the proportion of cases of presumed malaria. Since this establishment the sentinel surveillance system, the indicators generated by the system show a clear progression in the control of malaria. Nevertheless, there is no evidence about how effective the system is performing. This study seeks to evaluate the performance of the malaria sentinel surveillance system, by assessing its attributes in the Greater Accra region; and also, determine the prevalence of malaria during that same period. Methods: This study was cross-sectional and used secondary quantitative data and methods to derive malaria positivity rate in sentinel sites in the Greater Accra region. Data on malaria indicators were extracted from District Health Management Team e-database for January 2014 to December 2016. The data were analyzed to show both slide and RDT malaria positivity rate, proportion of suspected malaria case, and testing rate. Based upon CDC the Centre for Disease Control, Atlanta updated guideline for evaluating Public health surveillance system, keys system attributes were assessed and described. Epi info was used to generate frequencies, proportions, and chi square test at 5% confidence level. Results: In general, the rate of malaria positivity and the proportion of suspected cases of malaria prescribed with ACTs have decreased overtime. From 2014 to 2016, this decrease ranged from 25% to 12.2% for malaria positivity and from 61.4% to 29.6% for proportion of suspected malaria cases. There was also an increase of testing rate from 81.7 to 98 % over the study period. Data quality is particularly poor in the Qbom health center sentinel surveillance site. However, overall, the internal completeness of the surveillance system was satisfactory. Data from Sentinel sites was getting more and more accurate over time, when comparing with Noguchi Memorial Institute for Medical Research data. Positive predictive value ranged from 12.0010 to 20.4 % in 2014 to 2016, declining over time while Sensitivity increased leading to the increase of number of suspected cases since 2014. Conclusion: The testing rate in the malaria surveillance sites during the study period increased, resulting in a decrease in the use of ACTs. Majority of suspected cases were tested and classified according to outcomes. Malaria positivity rate also decreased significantly in the course of these three years. The data are generally of good quality, representing very well the community in terms of place and people. The application ofT3 (Test, Treat and Track) and case definition by the system, increased the systems sensitivity to the detriment of the positive predictive value.Item Psychosocial Crises and Coping Among the Homeless in the Greater Accra Region, Ghana(University of Ghana, 2018-09) Fosu, N.B.Homelessness is a pervasive social problem that has devastating impacts on affected individuals and poses severe challenges to policymakers in developing countries. This study investigated psychosocial distress associated with homelessness and the effectiveness of coping strategies used to manage such distress. Homeless individuals aged 10 years and above in the Greater Accra region of Ghana constituted the research population. An explanatory mixed-method design comprising a crosssectional survey (study I) and a one-on-one interview (study II) was employed. A sample of 183 participants, consisting of 86 homeless (47.0%) and 97 non-homeless (53.0%) individuals with an age range of 14 – 49 years (M=24.95, SD=8.75), was drawn for the study. The non-homeless participants served as control only for the assessment of psychosocial distress associated with homelessness. The Revised UCLA Loneliness Scale, the Depression, Anxiety and Stress Scale, the Modified PTSD Symptom Scale-Self Report, the Suicidal Behaviors Questionnaire-Revised, the Somatic Symptom Scale – 8, and the Brief COPE Scale were employed as instruments for data collection in Study I. Semistructured interview guide was developed for data collection in Study II. Analyses of data in study I revealed significantly higher level of psychosocial distress among homeless participants than nonhomeless participants; greater use of adaptive coping strategies than maladaptive coping strategies among the homeless participants; and significant associations between maladaptive coping and psychosocial distress. Thematic analyses of qualitative data in Study II exposed the unique experiences of homeless individuals, their coping behaviors, and the outcomes of such coping behaviors. The findings highlight the need for timely and appropriate interventions to address the psychosocial crises facing the homeless in Ghana.