Introduction: schistosomiasis is a neglected parasitic infection caused by nematode worms. It aff... more Introduction: schistosomiasis is a neglected parasitic infection caused by nematode worms. It affects approximately 200 million people globally. Prevalence in Ghana is 23.3%, mostly affecting school children. On November 28th 2018, the Disease Surveillance Department received reports of increase in occurrence of bloody urine among students of a basic school in the Volta Region. We investigated to identify the agent and source, to determine the magnitude, risk factors and to implement control measures. Methods: we conducted a case-control study. A suspected case was any student of the school, who has bloody urine with or without: dysuria, itching of the skin, frequent urination or lower abdominal pain from September 2018 to November 2018. A confirmed case was one with laboratory isolation of Schistosoma ova in appropriate urine sample. We identified cases from the school and hospital records. We collected socio-demographic, clinical and exposure data from cases and controls. Descriptive and inferential analysis were performed to estimate odds ratios at 95% confidence intervals (CI) to determine associations. Results: of 880 students, 112 suspected cases were identified (attack rate = 12.7%). Mean age of suspected cases was 14-years (standard deviation = ±3.5). Confirmed cases were 76.8%(86/112). Males had twice odds of becoming cases (cOR = 2.3, 95% CI = 1.35-3.96). Fishing (cOR = 7.29, 95% CI = 4.08-13.04) and swimming (aOR = 44.63, 95% CI = 4.73-420.86) were factors significantly associated with infection. Students with previous history of bloody urine had greater odds of being cases (aOR = 47.9, 95% CI = 4.19-546.55). Conclusion: Schistosoma haematobium was isolated in this outbreak. Fishing and swimming were risky water-related activities. WASH education and mass drug administration with Praziquantel were control measures.
Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical featur... more Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical features are still evolving, new tests are being developed with inherent challenges regarding interpretation of tests results. There is generally, a gap in knowledge on the virus globally as the pandemic evolves and in Ghana, there is dearth of information and documentation on the clinical characteristics of the virus. With these in mind, we set out to profile the initial cohort of COVID-19 patients who recovered in Ghana. Methods: We reviewed clinical records of all confirmed cases of COVID-19 who had recovered from the two main treatment centres in Accra, Ghana. Descriptive data analysis was employed and presented in simple and relational tables. Independent t-test and ANOVA were used to determine differences in the mean age of the sexes and the number of days taken for the first and second retesting to be done per selected patient characteristics. Results: Of the 146 records reviewed, 54% w...
Coronaviruses are RNA viruses that cause respiratory, hepatic and neurological diseases in domest... more Coronaviruses are RNA viruses that cause respiratory, hepatic and neurological diseases in domestic and wild animals, and humans. Among humans, six species of coronavirus have been identified to cause disease. Among these, Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV) are of zoonotic origin and have been known to cause severe acute respiratory syndrome outbreaks among humans.
Introduction: Malaria is endemic in Ghana, accounting for about 40% of all OPD diagnosis. Data on... more Introduction: Malaria is endemic in Ghana, accounting for about 40% of all OPD diagnosis. Data on malaria is routinely collected as part of the IDSR monthly reporting forms. Sunyani municipality recorded 56,540 malaria cases in 2016 with about 35% of the cases occurring in children under five years of age. We analyzed malaria surveillance data to identify the distribution of malaria cases by person, place and time and determine the timeliness and completeness of malaria report submission in the municipality.Methods: We analyzed malaria surveillance data in Sunyani municipality reported between 2015 and 2019 from the District Health Management Information System II. We calculated morbidity and mortality rates of cases by person and estimated proportion of cases by sub-districts. We performed trend analysis and calculated disease threshold levels. We presented the findings using tables and figures.Results: Of 639,361 malaria cases suspected, 93.5% (597,512/639,361) were tested, of whi...
This study reviewed the design and deployment of relational geodatabase on mobile GIS application... more This study reviewed the design and deployment of relational geodatabase on mobile GIS application, using collector for ArcGIS and survey 123 for ArcGIS platforms for COVID-19 contact tracing in Ghana during the lockdown. The study assessed whether cases spread by physical neighborhood contacts, defined by a 2km buffer of initial known 60 cases location. The application was deployed on the android tablet, which was used by field workers. Application Post-deployment review shows that from 30th March to 4th April 2020, 828 samples were collected with 34 confirmed cases, of which 61% occurred outside the 2km buffer. From 1-30 April 2020, 8,748 individuals with 16,087 contacts were tested within the physical neighbourhoods, 2.4% turned positive. Similarly, 7,501 individuals with 17,071 contacts were tested outside the physical neighbourhoods with 4.3% positives. Results suggest that more infections occurred outside the case’s physical neighbourhoods possibly due to; (1) existence of unk...
Introduction in the absence of a vaccine and definitive treatment, non-pharmacological measures o... more Introduction in the absence of a vaccine and definitive treatment, non-pharmacological measures of physical distancing, regular hand hygiene and wearing of face covering remain the mainstays of mitigating coronavirus disease 2019 (COVID-19). In Ghana, these measures are mandatory in public places and underpin COVID-19 infection prevention and control (IPC). We assessed adherence and appropriate performance of these measures among patrons of community convenience shops in selected hotspots. Methods we conducted a non-intrusive observation of patrons of convenience shops in COVID-19 burden hotspots. We observed patrons as they entered and exited the shops and collected data on their gender, adherence and appropriate use of face covering and hand hygiene facilities. Data were analyzed descriptively and inferentially to determine factors associated with adherence to IPC guidelines. Results of 800 patrons observed from eight community shops, 481 (60.1%) were males. Of these, 653 (81.6%) wore face covering and 98 (12.3%) performed hand hygiene; with 92 (11.5%) adhering to both measures. Patrons who wore face mask appropriately were 578; comprising 299 (92.3%) of patrons who wore face mask before entering the shops. Of 89 patrons who washed their hands, appropriate handwashing was recorded among nine (10.1%). Compared to inappropriate handwashing, appropriate handwashing was negatively associated with adherence to IPC guidelines [aOR=0.1 (95% CI=0.01-0.59)]. Conclusion adherence to and appropriate performance of IPC measures of handwashing and use of face covering in the selected shops was low. There is the need to complement availability of IPC measures with intensification of risk communication messaging targeted at ensuring their appropriate use.
Objective: To assess the progress made towards the actualization of the 80% reduction in incident... more Objective: To assess the progress made towards the actualization of the 80% reduction in incident cases, monitor trends and to assess the quality of GWM TB surveillance data from 2012 to 2016.Design: The study was descriptive secondary data analysisData Source: Tuberculosis cases recorded in the District Health Information Management Systems (DHIMS) and municipal TB registers. The Municipal TB Coordinator was interviewed for clarification on the data. A TB patient was defined as one who coughed persistently for two weeks or more.Main outcome measure: Trend of TB cases in Ga West MunicipalityResults: A total of 441 TB cases were registered of which 68.9% were smear positive. Males were (67%). Age group 35-44 years were the most affected (28.6%). The incidence rose from 21.5 (2012) to 41.6 (2015). The 2016 incidence was 40.7 (± 5.63) per 100,000 population. This is significantly different from the current national incidence of 156 (p < 0.05). Data was 95% complete. Discrepancies ex...
Background: We evaluated the Viral haemorrhagic fever (VHF) surveillance system from 2011 to 2015... more Background: We evaluated the Viral haemorrhagic fever (VHF) surveillance system from 2011 to 2015 in the Bawku Municipality, Upper East region, Ghana to determine whether the goals of the surveillance system are being met and to assess the performance of the system attributes.Design: Descriptive secondary data analysis.Setting: Bawku MunicipalityData Source: Review VHF surveillance records, interviewed community-based surveillance volunteers (CBSVs) and reviewed vital events registers. We also assessed the system attributes by reviewing records and interviewing key stakeholders involved in VHF surveillance system with focus on Ebola using checklist and semi structured questionnaire developed based on the Centers for Disease Control and Prevention (CDC) guidelines.Main outcome measure: System attributes of the VHF surveillance systemResults: Population under surveillance was 105,849. The system required detail information about suspected cases. However, it had a simple and clear stan...
Background: We reviewed malaria morbidity data to assess compliance to malaria T3 strategy in Bos... more Background: We reviewed malaria morbidity data to assess compliance to malaria T3 strategy in Bosomtwi District, Ashanti Region, Ghana.Design: The study was descriptive secondary data analysisSetting: Bosomtwi DistrictData source: District Health Information Management Systems (DHIMS2)Main outcome: Proportion of recorded cases tested, proportion of tested cases treated and proportion of cases trackedResults: Data for suspected and tested malaria cases was complete for only 3 years (2014-2016). Malaria testing reduced from 84.4% in 2015 to 76.8% in 2016 (national average 77.3%; regional average 70%). The proportion of untested but treated malaria cases declined from 46.3% in 2015 to 4.9% in 2016. Proportion of confirmed malaria cases put on antimalarial drugs was highest in 2016 at 63.9%. Pramso sub-district although home to largest facility in the district, under prescribed antimalarial drugs. Reports generated on malaria showed information on only confirmed suspected cases, under f...
BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygien... more BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygienic slaughter and sale points. Consumption of meat contaminated with antibiotic resistantE. coliis associated with grave health care consequences. The aim of this study was to determine the microbial quality of raw meat, the antimicrobial susceptibility and Extended Spectrum Beta Lactamase (ESBL) production inE. coliisolates from raw meat.ResultsTotal Plate Counts exceeded the acceptable limit of 5.0 log CFU/ cm2in 60.5% (124/205) of raw meat samples. Total Coliform Counts in 70.7% (145/205) of samples were in excess of the acceptable limit of 2.5 log CFU/cm2.E. coliwas detected in about half of raw meat samples (48%), ranging from 9.5–79.0% among the slaughter sites. Isolates were susceptible to meropenem (100%), ceftriaxone (99%), cefotaxime (98%), chloramphenicol (97%), gentamycin (97%), ciprofloxacin (92%) and amikacin (92%), but resistant to ampicillin (57%), tetracycline (45%), sulf...
Pan African Medical Journal Conference Proceedings, 2018
Introduction : childhood pneumonia remains a major health problem especially in developing countr... more Introduction : childhood pneumonia remains a major health problem especially in developing countries with an annual death toll of 473,000 in Africa and 6,450 in Ghana. The pneumonia surveillance system in Ghana is a facility-based system, requiring health facilities to routinely submit monthly summaries to the national database. We described the trend and distribution of pneumonia in children under five years over a five-year period in Tema Metropolis. Methods : we reviewed 2012-2016 surveillance dataset, laboratory registers and medical cause of death certificates. A case of pneumonia is clinically diagnosed by fever and fast breathing with characteristic x-ray changes and confirmed by microbiological testing. We assessed reporting completeness, calculated annual incidence and mortality rates, and performed descriptive analysis. We identified outbreaks by displaying case frequencies against C2 thresholds. Results : from 2012 through 2016, there were 3337 cases and 54 deaths (CFR = 1.6%) reported by 24% (13/55) of facilities which even reported infrequently. Females accounted for 48% (1625/3337) of reported cases. There were higher rates observed in infants (mean incidence = 21/1000 12) than 1-4-year group (mean incidence=8/1000 2.8). Between the period of review, the highest incidence (15/1000) was recorded in 2012 and the lowest (5/1000) in 2016, with a mean incidence of 10.8/1000 (SD = 4). Incidence peaked in June-July and October-November. The highest mortality rate (104/100,000) was recorded in 2015 by one sub-district which also persistently recorded highest incidence rates. Two outbreaks occurred during the five-year period. Conclusion : generally, there was a decline in childhood pneumonia incidence and mortality over the study period in the district. The data is however interpreted with caution as erratic facility reporting may distort the real trend. Following our recommendations, community-based health education on pneumonia by health workers has been intensified, specifically targeting mothers of infants, and data providers have been sensitized on frequent reporting.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : rabies is a zoonotic disease caused by the rabies virus. Domestic dogs are the mos... more Introduction : rabies is a zoonotic disease caused by the rabies virus. Domestic dogs are the most common reservoirs of the virus. Dog bites are responsible for over 95% of human rabies deaths. Rabies has the highest case-fatality rate of all infectious diseases of humans. About 95% of rabies cases are reported in Asia and Africa. In Ghana, rabies cases and deaths are under-reported. Hence, the true burden of the disease is usually underestimated. We analyzed data in Eastern Region of Ghana to characterize the trend of dog bites and human rabies and identify discrepancies in data for reporting cases. Methods : we analyzed recorded dog bites and human rabies cases from 2011 to 2015 in the Eastern Region. Data were collected from DHIMS, Regional Disease Control Unit and Regional Veterinary Unit. The results were expressed in frequencies, percentages and incidences. We used Stata version 13 for data analysis. Results : a total of 4821 dog bites/suspected rabies cases were recorded from 2011 to 2015. Children 5 to 9 years old were most affected. Males were more affected (51.2%) than females. Kwahu West District recorded the highest incidence of cases (625/100,000). Eighteen deaths from human rabies were recorded from 2011-2015. New Juaben Municipality recorded the highest number of deaths (6 deaths). Majority of rabies deaths (73%) occurred in urban areas. Eighty-two percent of those who died from rabies did not receive post exposure prophylaxis (PEP) also the vaccination status of the rest were unknown. The number of cases recorded for New Juaben Municipality at the Regional Health Directorate was 5.5 times that recorded at the veterinary unit for the same period. Conclusion : the burden of dog bites and human rabies is a public health problem in the Eastern Region and Ghana as a whole. The data underline the need for improved availability and timely administration of PEP in the treatment of dog bite victims. There is also the need for improved collaborative effort and effective communication between the various units within the health system of Ghana.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : urinary schistosomiasis is a parasitic Neglected Tropical Disease caused by blood ... more Introduction : urinary schistosomiasis is a parasitic Neglected Tropical Disease caused by blood flukes called Schistosoma haematobium and characterized by terminal hematuria.School-aged children get infested through habits such as swimming and fishing in infested water bodies. Schistosomiasis is endemic in Ghana. On September 28, 2016, La Madina Nkwantanang Municipality (LaMNM) reported clusters of suspected schistosomiasis in a basic school. We investigated to determine the extent and risk factors of the outbreak and implement control and preventive measures. Methods : we screened all pupils with a questionnaire followed by testing urine of those with a history of hematuria. We conducted 14 case control study to determine the risk factors for schistosomiasis. A case of urinary schistosomiasis was any pupil from the affected school with Schistosoma ova identified in the urine. We interviewed case patients and their controls to obtain data on socio-demographic characteristics and their social play habits. We conducted an environmental assessment. Descriptive and inferential data analyses were done. Risk factors were assessed using adjusted odds ratio (AOR) and their corresponding 95% confidence intervals. Results : of 753 students, 81 case-patients were identified (attack rate 10.8%). Sex specific attack rates were 17.0% (68/401) for males and 3.7% (13/352) for females. Median age of case-patients was 13 years (IQR 11-14 years). Compared to controls, case-patients were more likely to be males [AOR=5.8 (CI=3.04; 11.96)]. After controlling for possible confounders, swimming in Silver land pond [AOR=9.0, 95%CI (2.18-33.55)] and swimming in Quotam pond [AOR=3.2, 95%CI (1.10-9.41)] were independent risk factors for contracting schistosomiasis. Conclusion : urinary schistosomiasis outbreak mainly affecting males occurred in LaMNM. Swimming in infested ponds was the major risk factor. Following our investigation, health education, mollusciciding and clearing of weeds in ponds, and preventive chemotherapy using Praziquantel were carried out.
Pan African Medical Journal Conference Proceedings, 2018
introduction : cerebrospinal meningitis is an inflammation of the meninges around the brain and s... more introduction : cerebrospinal meningitis is an inflammation of the meninges around the brain and spinal cord, characterized by sudden onset headache, fever, neck stiffness and sensitivity to light. The most common form of meningitis is bacterial which includes Neisseria meningitides, Haemophilus influenza, and Streptococcus pneumonia . Epidemics occur annually between late November and June in the African belt and constitutes a major health threat. Beginning 2017, Ghana reported 69 suspected cases with 9 deaths in Ashanti and Upper West Region. By the 8 th epidemiological of 2017, Jirapa District in the Upper West Region reported 41 suspected cases of meningitis with six deaths. We investigated to verify the diagnosis, identify risk factors and implement control measures. Methods : we conducted a descriptive study. A case-patient was anybody living in Jirapa and its environs and reporting with or without fever of acute onset and with one or more of the following signs; neck stiffness, poor sucking (in infants), bulging fontanelles (in infants), altered consciousness, irritability, seizures, and other meningeal signs. We reviewed medical records, conducted active case search and contact tracing. We interviewed case-patients and contacts and conducted an environmental search. We reviewed laboratory records for CSF examinations. We analyzed data by person, place and time. Results : of 61 case-patients, 32 (53.3%) were female. The case fatality was 6/61 (9.8%). Median age was 16.5 years (interquartile range: 1-86 years). Most affected age group were below 10 years. Conclusion : streptococci pneumonia was responsible for the upsurge in cases. Children were mostly affected.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : measles, although a vaccine preventable disease, poses a threat to the lives of ma... more Introduction : measles, although a vaccine preventable disease, poses a threat to the lives of many children worldwide. In 2015, measles death toll of 134,200 was recorded globally with 95 percent of these deaths occurring in developing countries. In Ghana, measles is one of the diseases earmarked for elimination in the Integrated Disease Surveillance Response strategy. The measles surveillance system seeks to monitor trends, detect outbreaks and report timely. We evaluated the Ga West Municipality measles surveillance system to determine its effectiveness, usefulness and to assess its attributes.
Introduction: schistosomiasis is a neglected parasitic infection caused by nematode worms. It aff... more Introduction: schistosomiasis is a neglected parasitic infection caused by nematode worms. It affects approximately 200 million people globally. Prevalence in Ghana is 23.3%, mostly affecting school children. On November 28th 2018, the Disease Surveillance Department received reports of increase in occurrence of bloody urine among students of a basic school in the Volta Region. We investigated to identify the agent and source, to determine the magnitude, risk factors and to implement control measures. Methods: we conducted a case-control study. A suspected case was any student of the school, who has bloody urine with or without: dysuria, itching of the skin, frequent urination or lower abdominal pain from September 2018 to November 2018. A confirmed case was one with laboratory isolation of Schistosoma ova in appropriate urine sample. We identified cases from the school and hospital records. We collected socio-demographic, clinical and exposure data from cases and controls. Descriptive and inferential analysis were performed to estimate odds ratios at 95% confidence intervals (CI) to determine associations. Results: of 880 students, 112 suspected cases were identified (attack rate = 12.7%). Mean age of suspected cases was 14-years (standard deviation = ±3.5). Confirmed cases were 76.8%(86/112). Males had twice odds of becoming cases (cOR = 2.3, 95% CI = 1.35-3.96). Fishing (cOR = 7.29, 95% CI = 4.08-13.04) and swimming (aOR = 44.63, 95% CI = 4.73-420.86) were factors significantly associated with infection. Students with previous history of bloody urine had greater odds of being cases (aOR = 47.9, 95% CI = 4.19-546.55). Conclusion: Schistosoma haematobium was isolated in this outbreak. Fishing and swimming were risky water-related activities. WASH education and mass drug administration with Praziquantel were control measures.
Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical featur... more Introduction COVID-19 is a new disease, knowledge on the mode of transmission and clinical features are still evolving, new tests are being developed with inherent challenges regarding interpretation of tests results. There is generally, a gap in knowledge on the virus globally as the pandemic evolves and in Ghana, there is dearth of information and documentation on the clinical characteristics of the virus. With these in mind, we set out to profile the initial cohort of COVID-19 patients who recovered in Ghana. Methods: We reviewed clinical records of all confirmed cases of COVID-19 who had recovered from the two main treatment centres in Accra, Ghana. Descriptive data analysis was employed and presented in simple and relational tables. Independent t-test and ANOVA were used to determine differences in the mean age of the sexes and the number of days taken for the first and second retesting to be done per selected patient characteristics. Results: Of the 146 records reviewed, 54% w...
Coronaviruses are RNA viruses that cause respiratory, hepatic and neurological diseases in domest... more Coronaviruses are RNA viruses that cause respiratory, hepatic and neurological diseases in domestic and wild animals, and humans. Among humans, six species of coronavirus have been identified to cause disease. Among these, Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV) are of zoonotic origin and have been known to cause severe acute respiratory syndrome outbreaks among humans.
Introduction: Malaria is endemic in Ghana, accounting for about 40% of all OPD diagnosis. Data on... more Introduction: Malaria is endemic in Ghana, accounting for about 40% of all OPD diagnosis. Data on malaria is routinely collected as part of the IDSR monthly reporting forms. Sunyani municipality recorded 56,540 malaria cases in 2016 with about 35% of the cases occurring in children under five years of age. We analyzed malaria surveillance data to identify the distribution of malaria cases by person, place and time and determine the timeliness and completeness of malaria report submission in the municipality.Methods: We analyzed malaria surveillance data in Sunyani municipality reported between 2015 and 2019 from the District Health Management Information System II. We calculated morbidity and mortality rates of cases by person and estimated proportion of cases by sub-districts. We performed trend analysis and calculated disease threshold levels. We presented the findings using tables and figures.Results: Of 639,361 malaria cases suspected, 93.5% (597,512/639,361) were tested, of whi...
This study reviewed the design and deployment of relational geodatabase on mobile GIS application... more This study reviewed the design and deployment of relational geodatabase on mobile GIS application, using collector for ArcGIS and survey 123 for ArcGIS platforms for COVID-19 contact tracing in Ghana during the lockdown. The study assessed whether cases spread by physical neighborhood contacts, defined by a 2km buffer of initial known 60 cases location. The application was deployed on the android tablet, which was used by field workers. Application Post-deployment review shows that from 30th March to 4th April 2020, 828 samples were collected with 34 confirmed cases, of which 61% occurred outside the 2km buffer. From 1-30 April 2020, 8,748 individuals with 16,087 contacts were tested within the physical neighbourhoods, 2.4% turned positive. Similarly, 7,501 individuals with 17,071 contacts were tested outside the physical neighbourhoods with 4.3% positives. Results suggest that more infections occurred outside the case’s physical neighbourhoods possibly due to; (1) existence of unk...
Introduction in the absence of a vaccine and definitive treatment, non-pharmacological measures o... more Introduction in the absence of a vaccine and definitive treatment, non-pharmacological measures of physical distancing, regular hand hygiene and wearing of face covering remain the mainstays of mitigating coronavirus disease 2019 (COVID-19). In Ghana, these measures are mandatory in public places and underpin COVID-19 infection prevention and control (IPC). We assessed adherence and appropriate performance of these measures among patrons of community convenience shops in selected hotspots. Methods we conducted a non-intrusive observation of patrons of convenience shops in COVID-19 burden hotspots. We observed patrons as they entered and exited the shops and collected data on their gender, adherence and appropriate use of face covering and hand hygiene facilities. Data were analyzed descriptively and inferentially to determine factors associated with adherence to IPC guidelines. Results of 800 patrons observed from eight community shops, 481 (60.1%) were males. Of these, 653 (81.6%) wore face covering and 98 (12.3%) performed hand hygiene; with 92 (11.5%) adhering to both measures. Patrons who wore face mask appropriately were 578; comprising 299 (92.3%) of patrons who wore face mask before entering the shops. Of 89 patrons who washed their hands, appropriate handwashing was recorded among nine (10.1%). Compared to inappropriate handwashing, appropriate handwashing was negatively associated with adherence to IPC guidelines [aOR=0.1 (95% CI=0.01-0.59)]. Conclusion adherence to and appropriate performance of IPC measures of handwashing and use of face covering in the selected shops was low. There is the need to complement availability of IPC measures with intensification of risk communication messaging targeted at ensuring their appropriate use.
Objective: To assess the progress made towards the actualization of the 80% reduction in incident... more Objective: To assess the progress made towards the actualization of the 80% reduction in incident cases, monitor trends and to assess the quality of GWM TB surveillance data from 2012 to 2016.Design: The study was descriptive secondary data analysisData Source: Tuberculosis cases recorded in the District Health Information Management Systems (DHIMS) and municipal TB registers. The Municipal TB Coordinator was interviewed for clarification on the data. A TB patient was defined as one who coughed persistently for two weeks or more.Main outcome measure: Trend of TB cases in Ga West MunicipalityResults: A total of 441 TB cases were registered of which 68.9% were smear positive. Males were (67%). Age group 35-44 years were the most affected (28.6%). The incidence rose from 21.5 (2012) to 41.6 (2015). The 2016 incidence was 40.7 (± 5.63) per 100,000 population. This is significantly different from the current national incidence of 156 (p < 0.05). Data was 95% complete. Discrepancies ex...
Background: We evaluated the Viral haemorrhagic fever (VHF) surveillance system from 2011 to 2015... more Background: We evaluated the Viral haemorrhagic fever (VHF) surveillance system from 2011 to 2015 in the Bawku Municipality, Upper East region, Ghana to determine whether the goals of the surveillance system are being met and to assess the performance of the system attributes.Design: Descriptive secondary data analysis.Setting: Bawku MunicipalityData Source: Review VHF surveillance records, interviewed community-based surveillance volunteers (CBSVs) and reviewed vital events registers. We also assessed the system attributes by reviewing records and interviewing key stakeholders involved in VHF surveillance system with focus on Ebola using checklist and semi structured questionnaire developed based on the Centers for Disease Control and Prevention (CDC) guidelines.Main outcome measure: System attributes of the VHF surveillance systemResults: Population under surveillance was 105,849. The system required detail information about suspected cases. However, it had a simple and clear stan...
Background: We reviewed malaria morbidity data to assess compliance to malaria T3 strategy in Bos... more Background: We reviewed malaria morbidity data to assess compliance to malaria T3 strategy in Bosomtwi District, Ashanti Region, Ghana.Design: The study was descriptive secondary data analysisSetting: Bosomtwi DistrictData source: District Health Information Management Systems (DHIMS2)Main outcome: Proportion of recorded cases tested, proportion of tested cases treated and proportion of cases trackedResults: Data for suspected and tested malaria cases was complete for only 3 years (2014-2016). Malaria testing reduced from 84.4% in 2015 to 76.8% in 2016 (national average 77.3%; regional average 70%). The proportion of untested but treated malaria cases declined from 46.3% in 2015 to 4.9% in 2016. Proportion of confirmed malaria cases put on antimalarial drugs was highest in 2016 at 63.9%. Pramso sub-district although home to largest facility in the district, under prescribed antimalarial drugs. Reports generated on malaria showed information on only confirmed suspected cases, under f...
BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygien... more BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygienic slaughter and sale points. Consumption of meat contaminated with antibiotic resistantE. coliis associated with grave health care consequences. The aim of this study was to determine the microbial quality of raw meat, the antimicrobial susceptibility and Extended Spectrum Beta Lactamase (ESBL) production inE. coliisolates from raw meat.ResultsTotal Plate Counts exceeded the acceptable limit of 5.0 log CFU/ cm2in 60.5% (124/205) of raw meat samples. Total Coliform Counts in 70.7% (145/205) of samples were in excess of the acceptable limit of 2.5 log CFU/cm2.E. coliwas detected in about half of raw meat samples (48%), ranging from 9.5–79.0% among the slaughter sites. Isolates were susceptible to meropenem (100%), ceftriaxone (99%), cefotaxime (98%), chloramphenicol (97%), gentamycin (97%), ciprofloxacin (92%) and amikacin (92%), but resistant to ampicillin (57%), tetracycline (45%), sulf...
Pan African Medical Journal Conference Proceedings, 2018
Introduction : childhood pneumonia remains a major health problem especially in developing countr... more Introduction : childhood pneumonia remains a major health problem especially in developing countries with an annual death toll of 473,000 in Africa and 6,450 in Ghana. The pneumonia surveillance system in Ghana is a facility-based system, requiring health facilities to routinely submit monthly summaries to the national database. We described the trend and distribution of pneumonia in children under five years over a five-year period in Tema Metropolis. Methods : we reviewed 2012-2016 surveillance dataset, laboratory registers and medical cause of death certificates. A case of pneumonia is clinically diagnosed by fever and fast breathing with characteristic x-ray changes and confirmed by microbiological testing. We assessed reporting completeness, calculated annual incidence and mortality rates, and performed descriptive analysis. We identified outbreaks by displaying case frequencies against C2 thresholds. Results : from 2012 through 2016, there were 3337 cases and 54 deaths (CFR = 1.6%) reported by 24% (13/55) of facilities which even reported infrequently. Females accounted for 48% (1625/3337) of reported cases. There were higher rates observed in infants (mean incidence = 21/1000 12) than 1-4-year group (mean incidence=8/1000 2.8). Between the period of review, the highest incidence (15/1000) was recorded in 2012 and the lowest (5/1000) in 2016, with a mean incidence of 10.8/1000 (SD = 4). Incidence peaked in June-July and October-November. The highest mortality rate (104/100,000) was recorded in 2015 by one sub-district which also persistently recorded highest incidence rates. Two outbreaks occurred during the five-year period. Conclusion : generally, there was a decline in childhood pneumonia incidence and mortality over the study period in the district. The data is however interpreted with caution as erratic facility reporting may distort the real trend. Following our recommendations, community-based health education on pneumonia by health workers has been intensified, specifically targeting mothers of infants, and data providers have been sensitized on frequent reporting.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : rabies is a zoonotic disease caused by the rabies virus. Domestic dogs are the mos... more Introduction : rabies is a zoonotic disease caused by the rabies virus. Domestic dogs are the most common reservoirs of the virus. Dog bites are responsible for over 95% of human rabies deaths. Rabies has the highest case-fatality rate of all infectious diseases of humans. About 95% of rabies cases are reported in Asia and Africa. In Ghana, rabies cases and deaths are under-reported. Hence, the true burden of the disease is usually underestimated. We analyzed data in Eastern Region of Ghana to characterize the trend of dog bites and human rabies and identify discrepancies in data for reporting cases. Methods : we analyzed recorded dog bites and human rabies cases from 2011 to 2015 in the Eastern Region. Data were collected from DHIMS, Regional Disease Control Unit and Regional Veterinary Unit. The results were expressed in frequencies, percentages and incidences. We used Stata version 13 for data analysis. Results : a total of 4821 dog bites/suspected rabies cases were recorded from 2011 to 2015. Children 5 to 9 years old were most affected. Males were more affected (51.2%) than females. Kwahu West District recorded the highest incidence of cases (625/100,000). Eighteen deaths from human rabies were recorded from 2011-2015. New Juaben Municipality recorded the highest number of deaths (6 deaths). Majority of rabies deaths (73%) occurred in urban areas. Eighty-two percent of those who died from rabies did not receive post exposure prophylaxis (PEP) also the vaccination status of the rest were unknown. The number of cases recorded for New Juaben Municipality at the Regional Health Directorate was 5.5 times that recorded at the veterinary unit for the same period. Conclusion : the burden of dog bites and human rabies is a public health problem in the Eastern Region and Ghana as a whole. The data underline the need for improved availability and timely administration of PEP in the treatment of dog bite victims. There is also the need for improved collaborative effort and effective communication between the various units within the health system of Ghana.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : urinary schistosomiasis is a parasitic Neglected Tropical Disease caused by blood ... more Introduction : urinary schistosomiasis is a parasitic Neglected Tropical Disease caused by blood flukes called Schistosoma haematobium and characterized by terminal hematuria.School-aged children get infested through habits such as swimming and fishing in infested water bodies. Schistosomiasis is endemic in Ghana. On September 28, 2016, La Madina Nkwantanang Municipality (LaMNM) reported clusters of suspected schistosomiasis in a basic school. We investigated to determine the extent and risk factors of the outbreak and implement control and preventive measures. Methods : we screened all pupils with a questionnaire followed by testing urine of those with a history of hematuria. We conducted 14 case control study to determine the risk factors for schistosomiasis. A case of urinary schistosomiasis was any pupil from the affected school with Schistosoma ova identified in the urine. We interviewed case patients and their controls to obtain data on socio-demographic characteristics and their social play habits. We conducted an environmental assessment. Descriptive and inferential data analyses were done. Risk factors were assessed using adjusted odds ratio (AOR) and their corresponding 95% confidence intervals. Results : of 753 students, 81 case-patients were identified (attack rate 10.8%). Sex specific attack rates were 17.0% (68/401) for males and 3.7% (13/352) for females. Median age of case-patients was 13 years (IQR 11-14 years). Compared to controls, case-patients were more likely to be males [AOR=5.8 (CI=3.04; 11.96)]. After controlling for possible confounders, swimming in Silver land pond [AOR=9.0, 95%CI (2.18-33.55)] and swimming in Quotam pond [AOR=3.2, 95%CI (1.10-9.41)] were independent risk factors for contracting schistosomiasis. Conclusion : urinary schistosomiasis outbreak mainly affecting males occurred in LaMNM. Swimming in infested ponds was the major risk factor. Following our investigation, health education, mollusciciding and clearing of weeds in ponds, and preventive chemotherapy using Praziquantel were carried out.
Pan African Medical Journal Conference Proceedings, 2018
introduction : cerebrospinal meningitis is an inflammation of the meninges around the brain and s... more introduction : cerebrospinal meningitis is an inflammation of the meninges around the brain and spinal cord, characterized by sudden onset headache, fever, neck stiffness and sensitivity to light. The most common form of meningitis is bacterial which includes Neisseria meningitides, Haemophilus influenza, and Streptococcus pneumonia . Epidemics occur annually between late November and June in the African belt and constitutes a major health threat. Beginning 2017, Ghana reported 69 suspected cases with 9 deaths in Ashanti and Upper West Region. By the 8 th epidemiological of 2017, Jirapa District in the Upper West Region reported 41 suspected cases of meningitis with six deaths. We investigated to verify the diagnosis, identify risk factors and implement control measures. Methods : we conducted a descriptive study. A case-patient was anybody living in Jirapa and its environs and reporting with or without fever of acute onset and with one or more of the following signs; neck stiffness, poor sucking (in infants), bulging fontanelles (in infants), altered consciousness, irritability, seizures, and other meningeal signs. We reviewed medical records, conducted active case search and contact tracing. We interviewed case-patients and contacts and conducted an environmental search. We reviewed laboratory records for CSF examinations. We analyzed data by person, place and time. Results : of 61 case-patients, 32 (53.3%) were female. The case fatality was 6/61 (9.8%). Median age was 16.5 years (interquartile range: 1-86 years). Most affected age group were below 10 years. Conclusion : streptococci pneumonia was responsible for the upsurge in cases. Children were mostly affected.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : measles, although a vaccine preventable disease, poses a threat to the lives of ma... more Introduction : measles, although a vaccine preventable disease, poses a threat to the lives of many children worldwide. In 2015, measles death toll of 134,200 was recorded globally with 95 percent of these deaths occurring in developing countries. In Ghana, measles is one of the diseases earmarked for elimination in the Integrated Disease Surveillance Response strategy. The measles surveillance system seeks to monitor trends, detect outbreaks and report timely. We evaluated the Ga West Municipality measles surveillance system to determine its effectiveness, usefulness and to assess its attributes.
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Papers by Ernest Kenu