Research Articles
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A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community
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Item Processes and challenges associated with informal electronic waste recycling at Agbogbloshie, a suburb of Accra, Ghana(Human Factors and Ergonomics Society, 2019) Acquah, A.A.; Arko-Mensah, J.; D'Souza, C.; et.alElectronic waste (e-waste) is a worldwide problem in terms of increasing production rate in the global waste stream. Its recycling is known to be associated with adverse health outcomes. The recycling site at Agbogbloshie is a major e-waste recycling hub which presents enormous health threats to the residents in this community as a result of exposure to complex mixtures of chemicals associated with the poor work methods employed. This paper describes the processes involved in e-waste recycling at Agbogbloshie and discusses some of the associated health and psychosocial challenges. Direct field observations and in-depth interviews of eight e-waste workers were conducted from November, 2017 to December, 2017. Results from a thematic analysis of the data gathered; suggest that inappropriate recycling methods, financial constraints, and the high physical demands of e-waste recycling work were associated with adverse musculoskeletal health conditions among the workers. A more systematic ergonomic study is currently being undertaken to quantify the associations between physical work exposures and worker musculoskeletal health among e-waste workers in Agbogbloshie. Further studies that focus on locally adapted ergonomic interventions for effective recycling of e-waste and reducing the health risk to workers are needed.Item Choice of household adaptation strategies to flood risk management in Accra, Ghana(City and Environment Interactions, 2019) Twerefou, D.K.; Adu-Danso, E.; Abbey, E.; Dovie, B.D.In this paper, we discuss the psychological and socio-economic factors as well as the constraints that inhibit private precautionary flood-risk mitigation measures among urban households in the Greater Accra Metropolitan Area of Ghana within the Protection Motivation framework. The results show that threat appraisal has mixed effects on the decisions by households to adopt a damage protection measure against flooding. With regards to coping appraisal, the study found that households who do not feel helpless about flooding in the neighbourhood resort to some struc tural measures such as reinforcing their house against flood damage. The study also finds that socio-economic factors have an overall positive effect on protective behaviour. Additionally, structural measures taken by the public sector to provide protection against damage from a flood are shown to complement the adoption of some specific private pro tective measures such as clearing drains and sandbagging by households. We, therefore, recommend policy choices to focus on the provision of the needed community-level flood protection infrastructure since it stimulates private flood precautionary measuresItem Changing Patterns of Disease and Mortality at the Children’s Hospital, Accra: Are Infections Rising?(PLOS ONE, 2016) Tette, E.M.A.; Nartey, E.T.; Donkor, E.S.; et al.Background The Millennium Development Goals (MDGs) have led to reductions in child mortality world wide. This has, invariably, led to the changes in the epidemiology of diseases associated with child mortality. Although facility based data do not capture all deaths, they provide an opportunity to confirm diagnoses and insight into these changes which are relevant for fur ther disease control. Objective To identify changes in the disease pattern of children who died at the Princess Marie Louise Children’s Hospital (PML) in Ghana from 2003–2013. Methods A cross sectional review of mortality data was carried out at PML. The age, sex, duration of admission and diagnosis of consecutive patients who died at the hospital between 2003 and 2013 were reviewed. This information was entered into an Access database and ana lysed using Stata 11.0 software. Results Altogether, 1314 deaths (3.6%) occurred out of a total of 37,012 admissions. The majority of the deaths, 1187 (90.3%), occurred in children under the age of 5 years. While deaths caused by malaria, malnutrition, HIV infection and diarrhoea decreased, deaths caused by pneumonia were rising. Suspected septicaemia and meningitis showed a fluctuating trend with only a modest decrease between 2012 and 2013. The ten leading causes of mortality among under-fives were malnutrition, 363 (30.6%); septicaemia, 301 (25.4%); pneumongastroenteritis/dehydration, 110 (9.3%); meningitis, 58 (4.9%); tuberculosis, 34 (2.9%) and hypoglycaemia, 27 (2.3%). For children aged 5–9 years, the leading causes of mortality were malaria, 42 (42.9%); HIV infection, 27 (27.6%); anaemia, 14 (14.3%); septicaemia, 12 (12.2%); meningitis, 10 (10.2%); malnutrition, 9 (9.2%); tuberculosis, 5 (5.1%); pneumonia, 4 (4.1%); encephalopathy, 3 (3.1%); typhoid fever, 3 (3.1%) and lymphoma, 3 (3.1%). In the adolescent age group, malaria, 8 (27.6%); anaemia, 6 (20.7%); HIV infection, 5 (17.2%); sickle cell disease, 3 (10.3%) and meningitis, 3 (10.3%) were most common. Conclusion There has been a decline in the under-five mortality at PML over the years; however, deaths caused by pneumonia appear to be rising. This highlights the need for better diagnostic ser vices, wider HIV screening and clinical audits to improve outcomes in order to achieve fur ther reductions in child mortality and maintain the gains. 218 (18.4%); HIV infection, 183 (15.4%); malaria, 155 (13.1%); anaemia, 135 (11.4%);Item Double Jeopardy: HIV-Positive Wives Caring for Their HIV- Positive Spouses in Accra(Journal of Biology, Agriculture and Healthcare, 2019-05) Tackie-Ofosu, V.; Senah, K.; Tagoe, M.; Gadegbeku, C.; Vandyke, E.Given improved medical treatment, AIDS seems no longer like a death sentence in many countries. AIDS patients live longer and are expected to be given the necessary care and support. This study explored the experiences of HIV-positive wives caring for their husbands living with AIDS. Using a qualitative method, 15 semi-structured interviews were conducted with women living with HIV/AIDS selected from the Fever Unit at the Korle-Bu Teaching Hospital in the Greater Accra Region of Ghana. The study revealed that although participants demonstrated their willingness to give quality care, care experiences were closely linked to available resources. In other words, care was perceived by all participants as being synonymous with availability of family resources. Insufficient resources (especially in terms of energy and financial resources) hindered the quality of care provided to HIV positive husbands. The challenge of insufficient financial, time, energy and other resources placed a lot of physical, health, economic and emotional burdens on participants and this affected their capacity to engage fully in daily activities. In conclusion, experiences of wives caring for their husband with AIDS influenced care practices in the home. Insufficient resources (especially in terms of energy and financial resources) hindered the quality of care HIV positive wives provided to HIV positive husbands. It resulted in a compromise of adequate and quality care not only to the sick husband but to the children as well. In the light of these findings, it was recommended that there should be sensitization or education on effective Family Resource Management; stigmatization and fear of HIV/AIDS by the Family and Consumer Sciences Outreach Program, HIV/AIDS advocates, Ghana Health, Ghana AIDS Commission and other relevant stakeholders Further research could also be conducted using a larger sample size to gain insight into the challenges of HIV positive wives when caring for their HIV positive husbands.Item The Urban Food Question in the Context of Inequality and Dietary Change: A Study of Schoolchildren in Accra(The Journal of Development Studies, 2019-06-26) Codjoe, E.; Stevano, S.; Johnston, D.Diets are changing globally, as agricultural and food systems have become globalised. Understanding how patterns of globalisation affect welfare is a key development question, but we know little about the way that the globalisation of food systems impacts different groups. This study explores food security and consumption among schoolchildren in Accra. We use a novel approach based on triangulation of primary data on food consumption and a synthesis of secondary literature on food trade, policy and urban food environment. Thus, we bridge a divide between micro-level analyses of food consumption and macro-level studies of food systems. We find that socio-economic status is a critical dimension, with poorer children more vulnerable to food insecurity and narrow dietary diversity. However, the consumption of packaged and processed foods, often sugar-rich and nutrient-poor, cuts across wealth groups. We argue that the urban food question today is defined by two intersecting phenomena: inequality and dietary change. The urban poor continue to face the fundamental challenge of adequate food access amidst a food environment that provides consumers with unhealthy and cheap food options. Therefore, food policy needs to regulate imports of cheap, unhealthy and enticing food.Item Completeness of obstetric referral letters/notes from subdistrict to district level in three rural districts in Greater Accra region of Ghana: an implementation research using mixed methods(BMJ Open, 2019-09-13) Amoakoh-Coleman, M.; Ansah, E.; Klipstein-Grobusch, K.; Arhinful, D.Objective To assess the completeness of obstetric referral letters/notes at the district level of healthcare. Design An implementation research within three districts in Greater Accra region using mixed methods. During baseline and intervention phases, referral processes for all obstetric referrals from lower level facilities seen at the district hospitals were documented including indications for referrals, availability and completeness of referral notes/forms. An assessment of before and after intervention availability and completeness of referral forms was carried out. Focus group discussions, nonparticipant observations and in-depth interviews with health workers and pregnant women were conducted for qualitative data. Setting Three (3) districts in the Greater Accra region of Ghana. Participants Pregnant women referred from lower levels of care to and seen at the district hospital, health workers within the three districts and pregnant women attending antenatal clinic in the district and their family members or spouses. Intervention An enhanced interfacility referral communication system consisting of training, provision of communication tools for facilities, formation of hospital referral teams and strengthening feedback mechanisms. Outcome Completeness of obstetric referral letters/notes. Results Proportion of obstetric referrals with referral notes improved from 27.2% to 44.3% from the baseline to intervention period. Mean completeness (95% CI) of all forms was 71.3% (64.1% to 78.5%) for the study period, improving from 70.7% (60.4% to 80.9%) to 71.9% (61.1% to 82.7%) from baseline to intervention periods. Health workers reported they do not always provide referral notes and that most referral notes are not completely filled due to various reasons. Conclusions Most obstetric referrals did not have referral notes. The few notes provided were not completely filled. Interventions such as training of health workers, regular review of referral processes and use of electronic records can help improve both the provision of and completeness of the referral notes.Item Laboratory diagnosis of typhoid fever in Accra(Ghana Medical Journal, 2000-06) Mensah, P.; Noora, R.; Welbeck, I.; Nyame, P.K.The aim of this investigation was to evaluate the most appropriate method for the diagnosis of Salmonella typhi septicaemia. This involved the culture of blood samples, Widal test and antibiotic sensitivity test. Of 50 patients suspected of having typhoid fever, blood cultures of 38 (76%) yielded no bacterial growth, while 12 (24%) produced bacterial growth. Organisms encountered included Salmonella typhi, Kblebsiella species and Staphylococcus aureus. Antibody to the 0 and H antigens was detected in 20 serum samples using the Widal test. Out of this number, 7 patients diagnosed to have S typhi infection had antibodies titres of 1/80. Convalescent sera from all diagnosed cases of S typhi showed at least a two-fold rise in titre. In addition those infected with Klebsiella sp. and Staphylococci also had low antibodies titres to 0 and H antigens. It was also discovered that 9 patienls who had no bacterial growth also had titres of <1/80 to 0 and H antigens. The S typhi isolates were all sensitive to Cefotaxime and Ofloxacin, both third line drugs so it will be prudent to keep them as such. Although one strain was resistant to Chloramphenicol, it still remains the antibiotic of choice. The widal test, like all inununological assays, cannot be positive by mere detection of antibody but based on a cut-off point. It must, therefore, be carefully interpreted and used together with blood cultures and clinical findings to safely diagnose S. typhi infections.Item Ten Years of Preoperative Autologous Blood Donation in Accra(Ghana Medical Journal, 2006-12) Ansah, J.K.; Acquaye, J.K.Background - Preoperative autologous blood donation (PABD) is utilized to circumvent the use of allogenic blood for various reasons. Objective - To describe the distribution in terms of demographic characteristic, trends in participation and result of screening test of the PABD programme of the Accra Area Blood Center from 1993-2003. Design and Setting Retrospective descriptive study of PABD in patients scheduled for a variety of elective surgical procedures. Setting- Different levels of institutional health care in Accra, Ghana. Methods Data from existing records of patients who had participated in PABD were collated and analyzed Results Five hundred and forty six (546) females and 89 males participated, with ages ranging between 14-74 years. Majority of the patients (76.7%) underwent gynaecological surgery. A total of 330 (52%) donated one unit only, and 299 (47.1%) donated two units. Majority of the patients (56.4%) had the surgery at the Korle-Bu Teaching Hospital (KBTH). Of the donations, 21 (3.3%), 1 (0.2%), 1 (0.3%) and nil were positive for HBV, HIV I & II, HCV and VDRL respectively. A total of 848 (89.4%) autologous crossmatched units were issued out. There was a steady progressive increase in participation. Conclusion Mainly adult females scheduled for gynaecological surgeries in KBTH participated, while almost equal proportions donated one or two units of blood which meets the blood needs of most elective surgeries. Therefore healthy patients going for elective surgeries in regions with limited blood supply must be encouraged to enter a PABD Programme. Further studies in this field should evaluate motivational factors for participationItem Clinic Visits and Cervical Cancer Screening in Accra(Ghana Medical Journal, 2010-06) Adanu, R.M.K.; Seffah, J.D.; Duda, R.; Darko, R.; Hill, A.; Anarfi, J.Objective: To determine the factors that increase the chances of a woman in Accra having a Pap smear and whether women who have recently visited clinics have higher chances of having had Pap smears. Design: A cross-sectional study Methods: A representative sample of women in Accra, Ghana was interviewed and the clinical and demographic factors influencing cervical cancer screening was assessed. Results: Out of 1193 women with complete data, only 25 (2.1%) had ever had a Pap smear performed though 171 (14.3%) had their last outpatient clinic visit for either a gynaecological consultation or a regular check up. Simple logistic regression showed that a high educational level, high socioeconomic status and a history over the past month of postmenopausal or intermenstrual bleeding significantly increased the odds of ever having a pap smear. Neither monthly income nor last clinic visit for a gynaecological consultation or regular check up increased the odds of having a pap smear. Multiple logistic regression showed that a high educational level and experiencing postmenopausal or intermenstrual bleeding were the most important determinants of ever having a Pap smear. Conclusion: While we wait for a national program for cervical cancer screening, there is a need for clinicians to put more individual effort into ensuring that asymptomatic women are screened for cervical cancer.Item Sexual and Reproductive Health in Accra, Ghana(Ghana Medical Journal, 2012-06) Adanu, R.M.; Seffah, J.; Anarfi, J.K.; Lince, N.; Blanchard, K.Objective: To describe sexual and reproductive health among women in Accra and explore the burden of sexual and reproductive ill health among this urban population. Design: Cross-sectional study. Methods: We analysed data from the WHSA-II (n=2814), a cross-sectional household survey on women’s health, and supplemental data from an in-depth survey (n=400), focus groups discussions (n=22) and in-depth interviews (n=20) conducted among a subsample of women which focused specifically on reproductive health issues. Results: Modern contraceptive use was uncommon. More than one third of women reported ever using abstinence; condoms, injectables and the pill were the most commonly reported modern methods ever used. The total fertility rate among this sample of women was just 2.5 births. We found a considerable burden of sexual and reproductive ill health; one in ten women reported menstrual irregularities and almost one quarter of women reported symptoms of a Sexually Transmitted Infection (STI) or Reproductive Tract Infection (RTI) in the past 6 months. Focus group results and indepth interviews reveal misperceptions about contraception side-effects and a lack of information. Conclusion: In urban Ghana, modern contraceptive use is low and a significant proportion of women experience reproductive ill health (defined here as menstrual irregularity or RTI, UTI, STI symptoms). Increased access to information, products and services about for preventive care and contraception could improve reproductive health. More research on healthy sexuality and the impact of reproductive ill health on sexual experience is needed.