Research Interests:
Malaria still represents one of the most debilitating and deadly diseases in the world. It has been suggested that malaria has different impacts on women and men due to both social and biological factors. A gender perspective is therefore... more
Malaria still represents one of the most debilitating and deadly diseases in the world. It has been suggested that malaria has different impacts on women and men due to both social and biological factors. A gender perspective is therefore important to understand how to eliminate malaria. This study aimed to investigate malaria from a gender perspective in a non-for-profit private health facility, HopeXchange Medical Centre, based in Kumasi (Ghana). A sequential mixed-methods design, comprising quantitative and qualitative methods, was used. This study found low ownership (40%) and use (19%) of insecticide-treated nets (ITNs). Most malaria cases were women (62%), who were less educated and had more external risk factors associated with infection. Our study reported a trend of preferring malaria self-medication at home, which was practiced mostly by men (43%). Our data suggest that women are more likely to be exposed to malaria infections than men, especially due to their prolonged ex...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Summary Objectives: Computers are widely used for data management in clinical trials in the developed coutries, unlike in developing countries. Dependable systems are vital for data management, and medical decision making in clinical... more
Summary Objectives: Computers are widely used for data management in clinical trials in the developed coutries, unlike in developing countries. Dependable systems are vital for data management, and medical decision making in clinical research. Monitoring and evaluation of data management is critical.In this paper we describe database structures and procedures of systems used to implement, coordinate, and sustain data management in Africa. We outline major lessons, challenges and successes achieved, and recommendations to improve medical informatics application in biomedical research in sub-Saharan Africa. Methods: A consortium of experienced research units at five sites in Africa in studying children with disease formed a new clinical trials network, Severe Malaria in African Children. In December 2000, the network introduced an observational study involving these hospital-based sites. After prototyping, relational database management systems were implemented for data entry and verification, data submission and quality assurance monitoring. Results: Between 2000 and 2005, 25,858 patients were enrolled. Failure to meet data submission deadline and data entry errors correlated positively (correlation coefficient, r = 0.82), with more errors occurring when data was submitted late. Data submission lateness correlated inversely with hospital admissions (r = –0.62). Conclusions: Developing and sustaining dependable DBMS, ongoing modifications to optimize data management is crucial for clinical studies. Monitoring and communication systems are vital in multi-center networks for good data management. Data timeliness is associated with data quality and hospital admissions.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Despite abortion being legal, complications from induced abortion are the second leading cause of maternal mortality in Ghana. The objective of this study was to understand the decision-making process associated with induced abortion in... more
Despite abortion being legal, complications from induced abortion are the second leading cause of maternal mortality in Ghana. The objective of this study was to understand the decision-making process associated with induced abortion in Ghana. Data were collected from female postabortion patients, male partners, family planning nurses and obstetricians/gynecologists at two teaching hospitals in Ghana using in-depth interviews and focus group discussions. While experiences differ for married and single women, men are involved in abortion decision making directly, through "orders" to abort, or indirectly, through denying responsibility for the pregnancy. Health care providers can be barriers to seeking safe abortions in this setting. Women who choose to terminate a pregnancy without their male partners' knowledge should have the means (both financial and social) to do so safely. Interventions with health care providers should discourage judgemental attitudes and emphasize individually focused patient care.
Research Interests:
Research Interests:
Research Interests: Communication, Interpersonal Communication, Decision Making, Contraception, Behavior, and 15 moreGhana, Developing Countries, Adolescent, Abortion, Interviews, Humans, Comparative studies, Female, Data Collection, Clinical Sciences, Adult, Ectopic Pregnancy, Logistic Models, Family Characteristics, and Induced abortion
Research Interests:
Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to... more
Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana. Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008. Patients were randomized to receive either group or individual family planning counseling. The primary outcome in this study was change in modern contraceptive method knowledge. Changes in family planning use intention before and after the intervention and intended method type were also explored. Comparisons between the two study arms suggest that randomization was successful. The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms (group-individual), adjusted for study site, was -0.21, (95% confidence interval: -0.53 to 0.12) suggesting no difference between the two arms. Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana.
Research Interests: Contraception, Family Medicine, Ghana, Developing Countries, Human Resources, and 15 moreAdolescent, Medicine, Counseling, Knowledge, Humans, Comparative studies, Organizations, Female, Family Planning, Clinical Sciences, Middle Aged, Gynecology, Adult, Clients, and Paediatrics and reproductive medicine
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
© 2011 Elsevier Ltd Dondorp AM, Fanello CI, Hendriksen ICE, et al, for the AQUAMAT group. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet 2010;... more
© 2011 Elsevier Ltd Dondorp AM, Fanello CI, Hendriksen ICE, et al, for the AQUAMAT group. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet 2010; 376: 1647–57—In this Article (Nov 13), the row in table 2 for death or sequelae at 28 days in the quinine group should have been: 316/2695 (11·7%). In table 1, the data in parentheses for coma depth are IQR. The last line of the legend for figure 3 should have read: “I 2 denotes the percentage of total variation across subgroups resulting from heterogeneity rather than chance, with the p value of significance”. The title of figure 5 should have read: “Meta-analysis of all randomised controlled trials that have compared mortality of severe malaria in patients treated with parenteral artesunate versus parenteral quinine 12–16 ”. These corrections have been made to the online version as of Jan 7, 2011.
Research Interests:
Research Interests:
Research Interests:
Background Sickle cell anemia is an inherited blood disorder that is characterized by painful vaso-occlusive crises, for which there are few treatment options. Platelets mediate intercellular adhesion and thrombosis during vaso-occlusion... more
Background Sickle cell anemia is an inherited blood disorder that is characterized by painful vaso-occlusive crises, for which there are few treatment options. Platelets mediate intercellular adhesion and thrombosis during vaso-occlusion in sickle cell anemia, which suggests a role for antiplatelet agents in modifying disease events. Methods Children and adolescents 2 through 17 years of age with sickle cell anemia were randomly assigned to receive oral prasugrel or placebo for 9 to 24 months. The primary end point was the rate of vaso-occlusive crisis, a composite of painful crisis or acute chest syndrome. The secondary end points were the rate of sickle cell-related pain and the intensity of pain, which were assessed daily with the use of pain diaries. Results A total of 341 patients underwent randomization at 51 sites in 13 countries across the Americas, Europe, Asia, and Africa. The rate of vaso-occlusive crisis events per person-year was 2.30 in the prasugrel group and 2.77 in ...
Research Interests:
Research Interests:
A subject that has received less discussion but is potentially even more important is the requirement that any drugs proven effective in the trial be made available to the host population after the trial.3 There seems to be general... more
A subject that has received less discussion but is potentially even more important is the requirement that any drugs proven effective in the trial be made available to the host population after the trial.3 There seems to be general agreement that "reasonable avail-ability" is necessary ...
Research Interests:
Research Interests: Biology, Malaria, Vietnam, Papua New Guinea, Medicine, and 12 moreBiological Sciences, Humans, Disease resistance, Genetic Association Studies, Single Nucleotide Polymorphism, Plasmodium falciparum, Logistic Models, Case Control Studies, Glucosephosphate dehydrogenase deficiency, Malaria Falciparum, Medical and Health Sciences, and ABO Blood-Group System
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Pediatrics, Africa, Malaria, Medicine, Population, and 15 moreHumans, Female, Male, Infant, Incidence, Meningitis, Plasmodium falciparum, Age Factors, Malaria Vaccine, Seizures, New England Journalof Medicine, Malaria Vaccines, Malaria Falciparum, Medical and Health Sciences, and Intention to treat analysis
Data Dictionary containing variable description and value labels
Research Interests: Immunology, Malaria, Virology, Medicine, Immune system, and 3 moreMalaria Vaccine, Immunogenicity, and Antigen
Research Interests:
Malaria remains a major global public health concern, especially in sub-Saharan Africa. The RTS,S/AS01 malaria candidate vaccine was reviewed by the European Medicines Agency and received a positive scientific opinion; WHO subsequently... more
Malaria remains a major global public health concern, especially in sub-Saharan Africa. The RTS,S/AS01 malaria candidate vaccine was reviewed by the European Medicines Agency and received a positive scientific opinion; WHO subsequently recommended pilot implementation in sub-Saharan African countries. Because malaria and HIV overlap geographically, HIV-infected children should be considered for RTS,S/AS01 vaccination. We therefore aimed to assess the safety of RTS,S/AS01 in HIV-infected children at two sites in western Kenya. We did a randomised, double-blind, controlled trial at the clinical trial sites of the Kenya Medical Research Institute (KEMRI)-Walter Reed Army Institute of research in Kisumu and the KEMRI/US Centers for Disease Control and Prevention in Siaya. Eligible participants were infants and children aged from 6 weeks to 17 months with WHO stage 1 or 2 HIV disease (documented positive by DNA PCR), whether or not they were receiving antiretroviral therapy (ART). We ran...
Research Interests:
Research Interests:
Immunization remains the most cost effective method for the control of infectious diseases. Therefore, there is a global effort to deploy new vaccines for disease control and eradication. These new vaccines must be tested in the settings... more
Immunization remains the most cost effective method for the control of infectious diseases. Therefore, there is a global effort to deploy new vaccines for disease control and eradication. These new vaccines must be tested in the settings in which they will be used. This necessity has required the conduct of many vaccine trials in Africa, where several infectious diseases with significant public health impact are prevalent. However, these areas have peculiarities and are just beginning to gain expertise in the conduct of such trials. The vaccine developers and sponsors of these trials may also not be conversant with some issues unique to the trial site. The understanding gap from both partners can result in challenges if not addressed during the planning phase of the trial. This review seeks to highlight the issues surrounding the conduct of clinical trials in resource-constrained settings and suggests some ways of circumventing them.