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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Now showing 1 - 10 of 39
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    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.
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    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.
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    Rural–urban and socio-demographic diferentials in perceived health state among aging population in Ghana
    (Journal of Health, Population and Nutrition, 2023) Yawson, A.E.; Boateng, R.; Adoma, P.O.
    Background The variations in health between rural and urban population have become an increasingly signifcant public health concern in developing countries including Ghana where urbanization is occurring. Whereas urbanization results in improved access to healthcare services, the concomitant negative consequences of urbanization coupled with unfavorable compositional and contextual attributes can afect the health of populations. The study sought to examine the efect of rural–urban residence and selected socio-demographic factors on perceived health state among aging population by employing a nationally representative data collected by the WHO from 2014 to 2015. Methods The data were derived from the WHO Study on Aging wave 2 released in 2019. A total of 4511 individuals, made up of 1018 adults between 18 and 49 years and 3493 respondents within the ages of 50 years and above, were involved in this study. The study examined the Spearman’s rho correlations between perceived health, rural–urban residence, age, sex, marital status, ever schooled, current work state, religion, and regional location. Subsequently, the study employed a multivariable ordinal logistic regression model to test the efect of the selected biosocial and contextual variables on perceived health state. Results The selected socio-demographic variables signifcantly correlated with health state, except for rural–urban residence. However, the predictive ability of rural–urban residence and the socio-demographic variables on perceived health state were strongly ascertained. It was observed that age, sex, rural–urban residence, and current state of work among aging populations were signifcant predictors of perceived health state as demonstrated by odds ratios and signifcant p values. The contextual factor of regional location was the most signifcant variable that increases the perceived health state of respondents in the study. Conclusions Continues engagement in work-related activities, an individual’s age within the aging continuum and regional location coupled with its environmental and ecological attributes, may signifcantly infuence the development of positive perception toward health state, which forms a vital constituent of an individual health seeking behavior.
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    Prevalence of malaria infection and the impact of mosquito bed net distribution among children aged 6–59 months in Ghana: Evidence from the Ghana demographic health and malarial indicator surveys
    (Parasite Epidemiology and Control, 2023) Tetteh, J.; Yorke, E.; Boima, V.; Yawson, A.E.
    Objective: To assess the prevalence of malaria infection and further quantify the impact of mosquito bed net distribution on malaria infection among children aged 6–59 months in Ghana. Methods: A cross-sectional study using Ghana Demographic Health (GDHS) and Malaria Indicator (GMIS) surveys (2014 GDHS, 2016 GMIS, and 2019 GMIS). The exposure and the main outcomes were mosquito bed net use (MBU) and malaria infection (MI). Relative percentage change (Δ) and prevalence ratio (PR) were estimated to assess the changes and the risk of MI by MBU respec tively. The Propensity-score matching treatment effect model was employed to estimate the average treatment effect (ATE) of MBU on MI. All analyses were performed using Stata 16.1 and p-value<0.05 was deemed significant. Results: The study involved 8781 children aged 6–59 months. MI ranged from 25.8%(22.3–29.7) in 2019 GMIS to 40.6%(37.0–44.2) in 2014 GDHS and the prevalence was significantly high among children who used mosquito bed net. The relative percentage change in MI prevalence showed a significant reduction rate and was high among non-MBU (p-value<0.05). In all, the adjusted PR of MI among children exposed to MBU was 1.21(1.08–1.35), 1.13(1.01–1.28), and 1.50(1.20–1.75) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively. The average MI among participants who slept in mosquito bed net significantly increased by 8%(0.04 to 0.12), 4%(0.003 to 0.08), and 7%(0.03 to 0.11) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively. Conclusion: Even though malaria infection prevalence among children aged 6–59 months is decreasing, the reduction rate seems not to be directly linked with mosquito bed nets distribution and/or use in Ghana. For a continued distribution of mosquito bed nets, and for Ghana to achieve her Malaria Strategic Plan (NMSP) 2021–2025, program managers should ensure effective use of the distributed nets in addition to other preventive measures and nuanced consideration of community behaviours in Ghana. The effective use and care of bed nets should be emphasized as part of the distribution.
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    Health outcomes following retirement: a comparative study of health and non-health pensioners in Ghana
    (Springer, 2021) Nuertey, B.D.; Udofia, E.A.; Yawson, A.E.; Addai, J.; Tette, E.M.A.; Calys-Tagoe, B.N.L.
    Occupation is a major determinant of health outcomes. Healthcare workers are assumed to know how to prevent diseases and live a healthy life. The aim of this study is to determine the association between working in healthcare as a pre-retirement occupation and health outcomes after retirement. Method This cross-sectional study was conducted among 4813 members of the National Pensioners Association in Ghana. Thirteen study centres were used in the study. Results A total of 403 study participants (8.4%) were healthcare workers. After retirement, healthcare workers died earlier compared to non-healthcare workers. Life-table analysis of data demonstrated that 51.9% (95% CI = 47.1–56.9) of health workers died within 5 years after retirement, compared to 35.9% (95% CI = 34.5–37.4) of non-healthcare workers within same time period. Healthcare workers had a significantly higher prevalence of obesity (34.0, 95% CI = 29.5–38.8), self-reported hypertension (54.8%, 95% CI = 49.9–59.7) and high serum total cholesterol (46.4%, 95% CI = 48.7–58.5) compared to non-health workers. Logistic regression of factors on health outcomes after retirement among healthcare workers revealed that healthcare workers were nearly twice as likely to have arthritis (AOR = 1.6, 95% CI = 1.2–2.1), hearing loss (AOR = 2.0, 95% CI = 1.2–3.1), ischaemic heart disease (AOR = 2.0, 95% CI = 1.2–3.3), and cerebrovascular accident (AOR = 2.1, 95% CI = 1.1–4.0) compared to non-healthcare workers.
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    Unmet Needs of Healthcare Services and Associated Factors among a Cohort of Ghanaian Adults: A Nationally Stratified Cross-Sectional Study Design
    (SAGE, 2021) Yamson, P.; Tetteh, J.; DeGraft-Amoah, D.; Quansah, H.; Mensah, G.; Biritwum, R.; Yawson, A.E.
    We estimated the prevalence of unmet needs of healthcare services (UNHS) and its associated factors among a cohort of older Ghanaian adults. World Health Organization (WHO) Study on Global AGEing and Adult Health for Ghana was used with a total of 4735 participants. Logistics regression analysis was performed using Stata 16 to assess associated factors. The overall UNHS was 3.7% (95% CI=2.7-4.8) and the prevalence was significantly high amongst older adults aged 60 to 69years (5.9%). Could not afford the healthcare (56.4%) was the main contender for UNHS. UNHS was influenced by; those aged 60 to 69years [OR (95% CI)=1.86 (1.19-2.91)]; no formal educational [aOR (95% CI)=4.71 (1.27-17.38)], and no NHIS [OR (95% CI)=1.78 (1.03-3.09)]. Participants needed care for joint pain (25.4%), and communicable diseases (19.1%). The inability to access healthcare was relatively higher for older adults more advanced in age, with low education, and for those without health insurance. Health system strengthening including financial protection by expanding the National Health Insurance Scheme to all Ghanaians in line with Ghana’s Universal Health Coverage Roadmap would reduce the unmet healthcare needs of older adults.
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    Social Frailty and Depression Among Older Adults in Ghana: Insights from the WHO SAGE Surveys
    (SAGE, 2021) Amegbor, P.M.; Kuuire, V.Z.; Yawson, A.E.; Rosenberg, M.W.; Sabel, C.E.
    In this study, we examine the association between social frailty and depression among older adults in Ghana over time. We employed longitudinal data analysis to examine the association between social frailty, socioeconomic status and depression using data from the WHO-SAGE survey. Our descriptive and cross-tabulation analyses show that the prevalence of depression and social frailty among older adults decreased considerably in 2014/2015 compared to 2007/2008. The finding also reveals a huge reduction in social frailty among older adults in northern Ghana–the most deprived regions in Ghana–compared to those in southern Ghana. The multivariate panel data analysis reveals that depression was significantly associated with social isolation, financial needs, and physical needs. The findings suggest an over time decline in social frailty and depression among older adults, as well as, reduction in regional dif ferences in social frailty and depression among older adults in Ghana. Keywords longitudinal analysis, financial needs, food security, social isolation, physical needs, Ghana Background Research has established links between socioeconomic status and psychosocial wellbeing (Collins & Goldman, 2008; Mar mot et al., 2008). The evidence suggests that older adults with limited social support and those of lower socioeconomic status have worse mental health; and also tend to be more susceptible to morbidities than their counterparts of higher socioeconomic status, consequently leading to early death (Allen et al., 2014; Cornwell & Waite, 2009; Ma et al., 2018; Yamada & Arai, 2018). While socioeconomic inequalities exist among all age groups, some researchers argue it is more amplified among older adults mainly due to their vulnerabilities to frailty and the pathway of life-course determinants that become exacer bated in late life (Benzeval et al., 2011; van Kippersluis et al., 2010). Older persons are thus said to be more vulnerable to social frailty than younger adults. Social frailty refers to the absence of crucial social and economic resources as well as self -management abilities vital for achieving one’s social needs and invariably negatively impact physical and psychosocial wellbeing (Bunt et al., 2017; Ma et al., 2018). Studies show that older adults living with greater social support and social assistance, including formal financial sup port from governments, have better mental health than their counterparts with less social support (Kobayashi & Steptoe, 2018; Min et al., 2016; O’Hara et al., 2016). In this context, social frailty among older adults is significantly associated with depre
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    Prevalence of pneumonia by chest x-ray, associated demographic characteristics and health risk factors among COVID-19 patients in Ghana
    (Ghana Med J, 2021) Oliver-Comme, J.A.; Puplampu, P.; Owoo, C.; Asare-Boateng, K.; Yawson, A.O.; Tetteh, J.; Calys-Tagoe, B.N.L.; Udofia, E.; Kenu, E.; Samba, A.; Yawson, A.E.; Lartey, M.
    Objective: The study was conducted to determine the prevalence of radiologically diagnosed pneumonia among COVID-19 patients and associated factors. Design, setting, and participants: A retrospective manual data extraction of 275 medical records of COVID-19 patients was conducted at two COVID-19 national treatment centres in Accra from March to May 2020. All patients had a chest x-ray done. Main outcome and analysis: The main outcome was the presence of pneumonia. Descriptive statistics and Chi-square test of independence were employed to determine the associations between independent variables and the presence of pneumonia. All analysis was performed using Stata 16, and a p-value ≤ 0.05 was deemed significant Results: The prevalence of pneumonia was 44%(95%CI) =38.2-50.0). Chi-square independent test indicated that pneumonia in the COVID-19 patients was associated with educational level, history of domestic and international travel, mass gathering in the past 14 days before diagnosis, and discharge plan (p-value< 0.05). Patients classified as secondary cases (61.5%) and those discharged as fully recovered from the health facility (61.2%) had a higher preva lence of pneumonia. In addition, COVID-19 patients with hypertension (32.1%) and asthma (5.2%) had a significantly higher prevalence of pneumonia. Conclusion: Overall, the prevalence of pneumonia was 44% and was associated with the demographic and personal characteristics of the patients. Early detection through contact tracing and community surveillance should be intensi fied to pick up more asymptomatic cases. The role of the chest x-ray for triaging patients and for clinical management of symptomatic patients remains key.
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    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.
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    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.