119 results on '"Ahorlu, Collins"'
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2. Diagnostic performance of an ultra-sensitive RDT and a conventional RDT in malaria mass testing, treatment and tracking interventions in southern Ghana
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Amoah, Linda Eva, Cheng, Ndong Ignatius, Acquah, Festus Kojo, Adu-Amankwah, Susan, Bredu, Dorcas Gyama, Mensah, Benedicta A., Anang, Sherik-fa, Abban, Bernice Cubson, Busayomi, Abena, Kwarpong, Sebastian Shine, Tey, Prosper Kofi, Cudjoe, Elizabeth, Asamoah, Alexander, Holden, Tobias McKenzie, Gerardin, Jaline, Nonvignon, Justice, and Ahorlu, Collins
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- 2024
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3. A comparative study of lymphatic filariasis-related perceptions among treated and non-treated individuals in the Ahanta West municipality of Ghana
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Ahorlu, Collins Stephen, Otchere, Joseph, Sedzro, Kojo M, Pi-Bansa, Sellase, Asemanyi-Mensah, Kofi, Opare, Joseph L, Alomatu, Bright, Long, Elizabeth F, and de Souza, Dziedzom K
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- 2022
4. Developing home cleaning intervention through community engagement to reduce infections and antimicrobial resistance in Ghanaian homes
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Tsekleves, Emmanuel, de Souza, Dziedzom, Pickup, Roger, Ahorlu, Collins, and Darby, Andy
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- 2023
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5. Low microfilaremia levels in three districts in Coastal Ghana with at least 16 years of mass drug administration and persistent transmission of lymphatic filariasis
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de Souza, Dziedzom K, Otchere, Joseph, Ahorlu, Collins S, Adu-Amankwah, Susan, Larbi, Irene A, Dumashie, Edward, McCarthy, Frances A, King, Sandra A, Otoo, Samson, Osabutey, Dickson, Osei, Joseph H N, Sedzro, Kojo M, Asiedu, Odame, Dadzie, Samuel K, Ayi, Irene, Marfo, Benjamin, Biritwum, Nana-Kwadwo, and Boakye, Daniel A
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- 2018
6. COVID-19 related perception among some community members and frontline healthcare providers for NTD control in Ghana
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Ahorlu, Collins S., Okyere, Daniel, Pi-Bansa, Sellasie, Otchere, Joseph, Marfo, Benjamin, Asemanyi-Mensah, Kofi, Opare, Joseph L., Long, Elizabeth F., and de Souza, Dziedzom K.
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- 2022
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7. Improved adherence to test, treat, and track (T3) malaria strategy among Over-the-Counter Medicine Sellers (OTCMS) through interventions implemented in selected rural communities of Fanteakwa North district, Ghana
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Soniran, Olajoju Temidayo, Mensah, Benedicta Ayiedu, Cheng, Ndong Ignatius, Abuaku, Benjamin, and Ahorlu, Collins Stephen
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- 2022
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8. Modelling the cost of engage & treat and test & treat strategies towards the elimination of lymphatic filariasis in Ghana.
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Adams, Nathaniel N. K., Ahorlu, Collins S., de Souza, Dziedzom K., and Aikins, Moses
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MEDICAL care costs , *FILARIASIS , *NEGLECTED diseases , *RUBELLA - Abstract
Background: Despite several years of LF-MDA implementation, Ghana still has some districts with mf prevalence >1%, partly due to poor treatment coverage levels resulting from non-participation in MDA. To address the challenges, we implemented an Engage & Treat (E&T) and Test & Treat (T&T) strategies for individuals who miss or refuse MDA respectively, in a hotspot district, enabling us to reach many of those who seldom, or never, take part in MDA. This financial cost study was undertaken to analyse data on the LF-MDA, E&T and T&T implementation in 2021 and the financial cost to inform the rollout of the E&T and T&T as mop-up strategies in future LF-MDAs. Methods: This costing study analysed cost data from the 2021 LF-MDA implementation activities carried out by the Neglected Tropical Diseases (NTD) programme of the Ghana Health Service and the SENTINEL study, carried out in Ahanta West district for the two interventions (i.e., E&T and T&T). The 2021 Ghana Population and Housing Census data was used to estimate the LF-MDA-eligible population. The financial cost per person treated was estimated and these costs were applied to the projected population to obtain the financial cost for subsequent years. Results: Implementing MDA mop-up strategies either through the E&T or T&T to improve coverage comes at an additional cost to the elimination goals. For example, in 2024 the projected cost per person treated by the routine LF-MDA is estimated at US$0.83. The cost using the integrated LF-MDA and the E&T, T&T led by the NTD programme or T&T integrated into the health system was estimated at US$1.62, US$2.88, and US$2.33, respectively, for the same year. Despite the increased cost, the proposed combined LF-MDA and mop-up strategies will have a higher estimated population treated for 2024 (i.e., 1,392,211) compared to the routine LF-MDA approach (i.e., 988,470) for the same year. Conclusion: Combining LF-MDA with E&T/T&T mop-up strategies, despite their high costs, may provide NTD Programmes with the options of improving treatment coverage and reaching the LF elimination target sooner, given that the routine LF-MDA alone approach has been implemented for many years with some districts yet to reach the elimination targets. Author summary: In Ghana, despite many years of efforts to eliminate lymphatic filariasis (LF) through mass drug administration (MDA), some districts still have a prevalence of infection above the threshold required to eliminate the disease as a public health problem. This is partly because not everyone in these districts is participating in the MDA program. To tackle this challenge, new strategies called Engage & Treat (E&T) and Test & Treat (T&T) were implemented in a hotspot district. These strategies focus on reaching individuals who either miss or refuse MDA, ensuring that even those who rarely or never participate are covered. A financial cost study was undertaken to analyze the data from LF-MDA, E&T, and T&T implementations in 2021 to understand the financial implications for future LF-MDA efforts. The study looked at the cost data from LF-MDA activities conducted by the Neglected Tropical Diseases (NTD) program of the Ghana Health Service and the SENTINEL study in the Ahanta West district for the E&T and T&T interventions. Population data from the 2021 Ghana Population and Housing Census were used to estimate the LF-MDA-eligible population in the country. The study found that implementing these strategies, either through E&T or T&T, to improve coverage comes with an additional cost to the LF elimination goals. For example, in 2024, the projected cost per person treated by the routine LF-MDA alone is estimated at US$0.83. However, when combining LF-MDA with E&T or T&T, the costs increase to US$1.62, US$2.88, and US$2.33, respectively, for the same year. Despite the higher costs, the combined LF-MDA and mop-up strategies are estimated to treat a larger population in 2024 (1,392,211) compared to the routine LF-MDA approach (988,470) for the same year. In summary, although the combined LF-MDA and mop-up strategies have higher costs, they may offer NTD Programs the option to improve treatment coverage and achieve the LF elimination target sooner. This is particularly important as the routine LF-MDA alone approach has been in place for many years, with some districts still facing challenges in reaching elimination targets. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Factors impacting test-based management of suspected malaria among caregivers of febrile children and private medicine retailers within rural communities of Fanteakwa North District, Ghana
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Soniran, Olajoju Temidayo, Abuaku, Benjamin, Anang, Abraham, Opoku-Afriyie, Patricia, and Ahorlu, Collins
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- 2021
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10. Guiding placement of health facilities using multiple malaria criteria and an interactive tool
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Toh, Kok Ben, Millar, Justin, Psychas, Paul, Abuaku, Benjamin, Ahorlu, Collins, Oppong, Samuel, Koram, Kwadwo, and Valle, Denis
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- 2021
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11. Evaluating interventions to improve test, treat, and track (T3) malaria strategy among over-the-counter medicine sellers (OTCMS) in some rural communities of Fanteakwa North district, Ghana: study protocol for a cluster randomized controlled trial
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Soniran, Olajoju Temidayo, Abuaku, Benjamin, and Ahorlu, Collins Stephen
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- 2020
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12. Understanding the gap between access and use: a qualitative study on barriers and facilitators to insecticide-treated net use in Ghana
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Ahorlu, Collins Stephen, Adongo, Philip, Koenker, Hannah, Zigirumugabe, Sixte, Sika-Bright, Solomon, Koka, Eric, Tabong, Philip Teg-Nefaah, Piccinini, Danielle, Segbaya, Sylvester, Olapeju, Bolanle, and Monroe, April
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- 2019
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13. Prevalence of asymptomatic malaria parasitaemia following mass testing and treatment in Pakro sub-district of Ghana
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Ndong, Ignatius Cheng, Okyere, Daniel, Enos, Juliana Yartey, Mensah, Benedicta A., Nyarko, Alexander, Abuaku, Benjamin, Amambua-Ngwa, Alfred, Merle, Corinne Simone C., Koram, Kwadwo Ansah, and Ahorlu, Collins Stephen
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- 2019
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14. Potential factors influencing lymphatic filariasis transmission in “hotspot” and “control” areas in Ghana: the importance of vectors
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Pi-Bansa, Sellase, Osei, Joseph Harold Nyarko, Frempong, Kwadwo Kyeremeh, Elhassan, Elizabeth, Akuoko, Osei Kweku, Agyemang, David, Ahorlu, Collins, Appawu, Maxwell Alexander, Koudou, Benjamin Guibehi, Wilson, Michael David, de Souza, Dziedzom Komi, Dadzie, Samuel Kweku, Utzinger, Jürg, and Boakye, Daniel Adjei
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- 2019
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15. Improving access to lymphatic filariasis MMDP services through an enhanced evidence-based, cascaded training model for health worker capacity strengthening in Ghana: an evaluation study.
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Ahorlu, Collins Stephen, Atinbire, Solomon Abotiba, Sedzro, Kojo Mensah, Alomatu, Bright, de Souza, Dziedzom K., Asamenyi-Mensah, Kofi, Opare, Joseph, Saunderson, Paul, and Weiland, Stefanie
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- 2023
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16. Challenges and perceptions of implementing mass testing, treatment and tracking in malaria control: a qualitative study in Pakro sub-district of Ghana
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Ndong, Ignatius Cheng, Okyere, Daniel, Enos, Juliana Yartey, Amambua-Ngwa, Alfred, Merle, Corinne Simone C., Nyarko, Alexander, Koram, Kwadwo Ansah, and Ahorlu, Collins Stephan
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- 2019
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17. Characterizing local-scale heterogeneity of malaria risk: a case study in Bunkpurugu-Yunyoo district in northern Ghana
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Amratia, Punam, Psychas, Paul, Abuaku, Benjamin, Ahorlu, Collins, Millar, Justin, Oppong, Samuel, Koram, Kwadwo, and Valle, Denis
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- 2019
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18. The use of social media among adolescents in Dar es Salaam and Mtwara, Tanzania
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Pfeiffer, Constanze, Kleeb, Matthis, Mbelwa, Alice, and Ahorlu, Collins
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- 2014
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19. Impact of indoor residual spraying on malaria parasitaemia in the Bunkpurugu-Yunyoo District in northern Ghana
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Abuaku, Benjamin, Ahorlu, Collins, Psychas, Paul, Ricks, Philip, Oppong, Samuel, Mensah, Sedzro, Sackey, William, and Koram, Kwadwo A
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- 2018
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20. Detecting local risk factors for residual malaria in northern Ghana using Bayesian model averaging
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Millar, Justin, Psychas, Paul, Abuaku, Benjamin, Ahorlu, Collins, Amratia, Punam, Koram, Kwadwo, Oppong, Samuel, and Valle, Denis
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- 2018
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21. Community engagement: The key to tackling Antimicrobial Resistance (AMR) across a One Health context?
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Mitchell, Jessica, Cooke, Paul, Ahorlu, Collins, Arjyal, Abriti, Baral, Sushil, Carter, Laura, Dasgupta, Rajib, Fieroze, Fariza, Fonseca-Braga, Mariana, Huque, Rumana, Lewycka, Sonia, Kalpana, Pachillu, Saxena, Deepak, Tomley, Fiona, Tsekleves, Emmanuel, Vu Thi Quynh, Gioa, and King, Rebecca
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ANTIMICROBIAL stewardship ,MIDDLE-income countries ,COMMUNITY health services ,LOW-income countries ,RESEARCH funding ,THEMATIC analysis ,DRUG resistance in microorganisms ,HEALTH promotion - Abstract
Antimicrobial resistance (AMR) is a One Health problem underpinned by complex drivers and behaviours. This is particularly so in low – and middle-income countries (LMICs), where social and systemic factors fuel (mis)use and drive AMR. Behavioural change around antimicrobial use could safeguard both existing and future treatments. However, changing behaviour necessitates engaging with people to understand their experiences. This publication describes a knowledge-exchange cluster of six LMIC-based projects who co-designed and answered a series of research questions around the usage of Community Engagement (CE) within AMR. Findings suggest that CE can facilitate AMR behaviour change, specifically in LMICs, because it is a contextualised approach which supports communities to develop locally meaningful solutions. However, current CE interventions focus on human aspects, and demand-side drivers, of AMR. Our cluster suggests that broader attention should be paid to AMR as a One Health issue. The popularity of mixed methods approaches within existing CE for AMR interventions suggests there is interdisciplinary interest in the uptake of CE. Unfortunately, the specificity and context-dependency of CE can make it difficult to evaluate and scale. Nevertheless, we suggest that in synthesising learnings from CE, we can develop a collective understanding of its scope to tackle AMR across contexts. [ABSTRACT FROM AUTHOR]
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- 2022
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22. The impact of COVID-19 on implementation of mass testing, treatment and tracking of malaria in rural communities in Ghana: A qualitative study.
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Cheng, Ndong Ignatius, Tabong, Philip Teg-Nefaah, Netongo, Palmer Masumbe, Mensah, Benedicta Ayiedu, Chu, Chuo Ennestine, Yaw, Effah-Baafi, Enos, Juliana Yartey, Malm, Keziah, and Ahorlu, Collins Stephen
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MALARIA ,COMMUNITIES ,HEALTH facilities ,COVID-19 ,PUBLIC health ,TRAINING of volunteers ,RURAL women - Abstract
Background: Mass test, treat and track (MTTT) of malaria is ongoing in the Pakro sub district of Ghana. In the delivery of MTTT of malaria, community health volunteers are trained to routinely provide this service through a door-to-door strategy. Following the report of the first cases of COVID-19 in Ghana, we conducted this study to explore the effects of the pandemic on the implementation of the MTTT of malaria intervention. Methods: Using qualitative methodology, we conducted ten focus groups discussions (FGDs) in eight communities: eight with community members (N = 49); one with health workers (N = 6), and one with MTTT of malaria volunteers. In addition, two in-depth interviews (IDI) were conducted, one with health worker and another with a health manager. All interviews were recorded, translated into English during transcription and analysed using QSR NVivo 12. Thematic content analysis was used in this study. Results: The findings of the study showed an increase in the number of people reporting with complications of malaria in health facilities in the study communities during the COVID-19 period. Some participants were of the view that COVID-19 rumours and misinformation could largely be responsible for the low coverage and uptake of the MTTT of malaria intervention. To sustain the uptake of the MTTT intervention, community engagement strategies were employed to identify and respond to these rumours. Also, incentive schemes were introduced to encourage parents and children to participate in the MTTT intervention during this period of COVID-19. Conclusion: Findings suggest that the COVID-19 pandemic has adversely affected the provision and uptake of malaria prevention and treatment services, especially the MTTT of malaria being implemented at the community level. These observations underscore the need to find innovative ways to address the challenges encountered in providing essential services during public health emergencies. [ABSTRACT FROM AUTHOR]
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- 2022
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23. The Effect of Mass Testing, Treatment and Tracking on the Prevalence of Febrile Illness in Children under 15 in Ghana.
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Ahorlu, Collins Stephen, Ndong, Ignatius Cheng, Okyere, Daniel, Mensah, Benedicta A., Chu, Chuo Ennestine, Enos, Juliana Y., and Abuaku, Benjamin
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MALARIA ,ABDOMINAL pain - Abstract
Background: Malaria remains a serious threat to children under 15 years of age in sub-Sahara Africa. Mass testing, treatment and tracking (MTTT) of malaria has been reported to reduce parasite load significantly. However, the impact of MTTT on the prevalence of febrile illnesses in children under 15 is not yet clear. This study explores the impact of MTTT complemented by prompt home-based management of malaria on febrile illnesses and their treatment in children under 15 years old. Methods: A cohort of 460 children under 15 years were recruited from the Pakro subdistrict in Ghana during a community-wide implementation of a quarterly MTTT intervention. The MTTT implementation involved testing all household members for malaria using RDTs, and positive cases were treated with Artemisinin-based combination therapy (ACT). Febrile illnesses among this cohort in the two weeks prior to the prevalence survey at baseline and endline were recorded to constitute date for analysis. Results: The prevalence of febrile illnesses, such chills, convulsion, fever, diarrhoea, headache, vomit, cough/rashes or stomachache, etc., were recorded). Asymptomatic parasitaemia prevalence at baseline was 53.3%, which dropped to 44.1% at evaluation. An overall decrease in the parasitaemia prevalence of 33.0% (OR = 0.67, CI = 0.50, 0.89) was observed at evaluation compared to baseline after adjusting for age, ITN use and temperature. A 67% decrease in severe anaemia cases (Hb < 7) was observed at evaluation. Conclusion: Our findings suggest that implementing MTTT complemented by home-based timely management of malaria does not only reduce febrile illnesses and for that matter malaria prevalence, but could also reduce severe anaemia in children under 15 years old. [ABSTRACT FROM AUTHOR]
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- 2022
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24. Finding and eliminating the reservoirs: Engage and treat, and test and treat strategies for lymphatic filariasis programs to overcome endgame challenges.
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de Souza, Dziedzom K., Otchere, Joseph, Sumboh, Jeffrey G., Asiedu, Odame, Opare, Joseph, Asemanyi-Mensah, Kofi, Boakye, Daniel A., Gass, Katherine M., Long, Elizabeth F., and Ahorlu, Collins S.
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- 2022
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25. Socio-cultural determinants of treatment delay for childhood malaria in southern Ghana
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Ahorlu, Collins K., Koram, Kwadwo A., Ahorlu, Cynthia, de Savigny, Don, and Weiss, Mitchell G.
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- 2006
26. Enhancing Buruli ulcer control in Ghana through social interventions: a case study from the Obom sub-district
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Ahorlu Collins K, Koka Eric, Yeboah-Manu Dorothy, Lamptey Isaac, and Ampadu Edwin
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Buruli ulcer ,Social intervention ,Early case detection ,Transportation ,Breakfast ,Social support and antibiotic treatment ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Buruli ulcer is considered a re-emerging disease in West Africa where it has suffered neglect over the years, though children below the age of 16 years are the worst affected in most endemic regions. Due to delayed health seeking, the disease leads to disabilities resulting from amputation and loss of vital organs like the eye leading to school dropout and other social and economic consequences for the affected family. Early treatment with antibiotics is effective; however, this involves daily oral and intramuscular injection at distant health facilities for 56 days making it a challenge among poor rural folks living on daily subsistence work. The mode of transmission of Buruli ulcer is not known and there is no effective preventive vaccine for Buruli ulcer. Thus the only effective control tool is early case detection and treatment to reduce morbidity and associated disabilities that occurs as a result of late treatment. It is therefore essential to implement interventions that remove impediments that limit early case detection; access to early effective treatment and this paper reports one such effort where the feasibility of social interventions to enhance Buruli ulcer control was assessed. Methods This was a qualitative study using in-depth interviews to generate information to ascertain the benefit or otherwise of the intervention implemented. Clinical records of patients to generate data to determine the feasibility and effectiveness of social interventions in the fight against Buruli ulcer was examined. In all, 56 in-depth interviews (28 at baseline and 28 at evaluation) were conducted for this report. Results At full implementation, treatment default and dropout reduced significantly from 58.8% and 52.9% at baseline to 1.5% and 1.5% respectively. The number of early case detection went up significantly. Affected families were happy with social interventions such as provision of transportation and breakfast to patients on daily basis. Families were happy with the outpatient services provided under the intervention where no patient was admitted into the hospital. Conclusion The study showed that with a little more investment in early case detection, diagnosis and treatment, coupled with free transportation and breakfast for patients, most of the cases could be treated effectively with the available antibiotics to avoid disability and complications from the disease.
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- 2013
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27. Two-year evaluation of Intermittent Preventive Treatment for Children (IPTc) combined with timely home treatment for malaria control in Ghana
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Seake-Kwawu Atsu, Koram Kwadwo A, Ahorlu Collins K, and Weiss Mitchell G
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Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. Intermittent preventive treatment for children (IPTc) combined with timely treatment of malaria related febrile illness at home to reduce parasite prevalence and malaria morbidity in children aged between six and 60 months in a coastal community in Ghana. This paper reports persistence of reduced parasitaemia two years into the intervention. The baseline and year-one-evaluation findings were published earlier. Objective The main objective in the second year was to demonstrate whether the two interventions would further reduce parasite prevalence and malaria-related febrile illness in the study population. Methods This was an intervention study designed to compare baseline and evaluation findings without a control group. The study combined home-based delivery of intermittent preventive treatment for children (IPTc) aged 6 - 60 months and home treatment of suspected febrile malaria-related illness within 24 hours. All children aged 6 - 60 months received home-based delivery of intermittent preventive treatment using amodiaquine + artesunate, delivered at home by community assistants every four months (6 times in 24 months). Malaria parasite prevalence surveys were conducted before the first and after the third and sixth IPTc to the children. The evaluation surveys were done four months after the third and sixth IPTc was given. Results Parasite prevalence which reduced from 25% to 3.0% at year-one evaluation had reduced further from 3% to 1% at year-two-evaluation. At baseline, 13.8% of the children were febrile (axilary temperature of ≥37.5°C) compared to 2.2% at year-one-evaluation while 2.1% were febrile at year-two-evaluation. Conclusion The year-two-evaluation result indicates that IPTc given three times in a year (every four months) combined with timely treatment of febrile malaria illness, is effective to reduce malaria parasite prevalence in children aged 6 to 60 months in the study community. This must give hope to malaria control programme managers in sub-Saharan Africa where the burden of the disease is most debilitating.
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- 2011
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28. Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control
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Seakey Atsu K, Koram Kwadwo A, Ahorlu Collins K, and Weiss Mitchell G
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Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Whiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC) and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana. Methods The study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months). Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC. Results Parasite prevalence was reduced from 25% to 3% (p < 0.00, Mann-Whitney) one year after the inception of the two interventions. At baseline, 13.8% of the children were febrile (axillary temperature greater than or equal to 37.5 degree Celsius) compared to 2.2% at evaluation (post IPTC3 combined with timely home management of fever) (p < 0.00, Mann-Whitney). Conclusion The evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.
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- 2009
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29. Malaria-related beliefs and behaviour in southern Ghana: implications for treatment, prevention and control
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Ahorlu, Collins K., Dunyo, Samuel K., Afari, Edwin A., Koram, Kwadwo A., and Nkrumah, Francis K.
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- 1997
30. Consequences of hydrocele and the benefits of hydrocelectomy: a qualitative study in lymphatic filariasis endemic communities on the coast of Ghana
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Ahorlu, Collins K., Dunyo, Samuel K., Asamoah, Godfred, and Simonsen, Paul E.
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- 2001
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31. Assessment of antimalarial drug resistant markers in asymptomatic Plasmodium falciparum infections after 4 years of indoor residual spraying in Northern Ghana.
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Myers-Hansen, James L., Abuaku, Benjamin, Oyebola, Muyiwa K., Mensah, Benedicta A., Ahorlu, Collins, Wilson, Michael D., Awandare, Gordon, Koram, Kwadwo A., Ngwa, Alfred Amambua, and Ghansah, Anita
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PLASMODIUM falciparum ,GENETIC mutation ,YEAR ,MALARIA ,SINGLE nucleotide polymorphisms ,POLYMERASE chain reaction ,DRUG resistance - Abstract
Background: Drug resistance remains a concern for malaria control and elimination. The effect of interventions on its prevalence needs to be monitored to pre-empt further selection. We assessed the prevalence of Plasmodium falciparum gene mutations associated with resistance to the antimalarial drugs: sulfadoxine-pyrimethamine (SP), chloroquine (CQ) and artemisinin combination therapy (ACTs) after the scale-up of a vector control activity that reduced transmission. Methods: A total of 400 P. falciparum isolates from children under five years were genotyped for seventeen single nucleotide polymorphisms (SNPs) in pfcrt, pfmdr1, pfdhfr, pfdhps and pfk13 genes using polymerase chain reaction (PCR) and high resolution melting (HRM) analysis. These included 80 isolates, each randomly selected from cross-sectional surveys of asymptomatic infections across 2010 (baseline), 2011, 2012, 2013 (midline: post-IRS) and 2014 (endline: post-IRS) during the peak transmission season, when IRS intervention was rolled out in Bunkpurugu Yunyoo (BY) District, Ghana. The proportions of isolates with drug resistant alleles were assessed over this period. Results: There were significant decreases in the prevalence of pfdhfr- I
51 R59 N108 haplotype from 2010 to 2014, while the decline in pfdhfr/pfdhps- I51 R59 N108 G437 during the same period was not significant. The prevalence of lumefantrine (LM), mefloquine (MQ) and amodiaquine (AQ) resistance-associated haplotypes pfmdr1-N86 F184 D1246 and pfmdr1-Y86 Y184 Y1246 showed decreasing trends (z = -2.86, P = 0.004 and z = -2.71, P = 0.007, respectively). Each of pfcrt-T76 and pfmdr1-Y86 mutant alleles also showed a declining trend in the asymptomatic reservoir, after the IRS rollout in 2014 (z = -2.87, P = 0.004 and z = -2.65, P = 0.008, respectively). Similarly, Pyrimethamine resistance mediating polymorphisms pfdhfr-N108, pfdhfr-I51 and pfdhfr-R59 also declined (z = -2.03, P = 0.042, z = -3.54, P<0.001 and z = -4.63, P<0.001, respectively), but not the sulphadoxine resistance mediating pfdhps-G437 and pfdhps-F436 (z = -0.36, P = 0.715 and z = 0.41, P = 0.684, respectively). No mutant pfk13-Y580 were detected during the study period. Conclusion: The study demonstrated declining trends in the prevalence of drug resistant mutations in asymptomatic P. falciparum infections following transmission reduction after an enhanced IRS intervention in Northern Ghana. [ABSTRACT FROM AUTHOR]- Published
- 2020
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32. Community concepts of malaria-related illness with and without convulsions in southern Ghana
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Ahorlu Cynthia, Koram Kwadwo A, Ahorlu Collins K, de Savigny Don, and Weiss Mitchell G
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Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Malaria, both with or without convulsions, is a serious hardship for people living in endemic areas, especially in sub-Saharan Africa. Community references to malaria, however, may encompass other conditions, which was collectively designated malaria-related illness (MRI). Inasmuch as the presence or absence of convulsions reportedly affects timely help-seeking for malaria, a local comparison of these conditions is needed to inform malaria control. Methods Vignette-based EMIC interviews (insider-perspective interviews) for MRI with convulsions (convulsion positive, MRI-CP) and without convulsions (convulsion negative, MRI-CN) were developed to study relevant features of MRI-related experience, meaning and behaviour in two rural communities in Ghana. These semi-structured interviews elicited both qualitative narrative and categorical codes for quantitative analysis. Interviews with 201 respondents were conducted. Results The conditions depicted in the vignettes were well recognized by respondents and named with various local terms. Both presentations were considered serious, but MRI-CP was more frequently regarded potentially fatal than MRI-CN. More than 90.0% of respondents in both groups acknowledged the need to seek outside help. However, significantly more respondents advised appropriate help-seeking within 24 (p = 0.01) and 48 (p = 0.01) hours for MRI-CP. Over 50.0% of respondents responding to questions about MRI-CP identified MRI-CN as a cause of convulsions. Conclusion Local comparison of MRI-CP and MRI-CN based on vignettes found a similar profile of reported categories of perceived causes, patterns of distress, help-seeking and preventive measures for both presentations. This differs from previous findings in sub-Saharan Africa, which assert communities regard the two conditions to be unrelated. The perceived relationships should be acknowledged in formulating strategies to control malaria through timely help-seeking and treatment to reduce childhood mortality.
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- 2005
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33. Review of MDA registers for Lymphatic Filariasis: Findings, and potential uses in addressing the endgame elimination challenges.
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de Souza, Dziedzom K., Gass, Katherine, Otchere, Joseph, Htet, Ye Min, Asiedu, Odame, Marfo, Benjamin, Biritwum, Nana-Kwadwo, Boakye, Daniel A., and Ahorlu, Collins S.
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FILARIASIS ,STREET addresses ,DRUG administration ,RECORDS ,TRACHOMA ,ADVERSE health care events - Abstract
Background: Lymphatic filariasis (LF) is endemic in Ghana, and the country has implemented the GPELF strategy since 2000 with significant progress made in the control of the disease. However, after several years of mass drug administration (MDA) implementation, there is persistent transmission in 17 of the 98 endemic districts in the country. Current approaches to surveillance are clearly unable to target untreated individuals and new strategies are required to address the endgame challenges to enhance LF elimination as a public health problem in endemic countries. Community registers are used during MDAs to enumerate community members, their age, gender, house numbers, and records of their participation in MDAs. These MDA registers represent an untapped opportunity to identify and characterize non-compliance and inform appropriate programmatic actions. In this study, we analyzed the data presented in the registers to assess the coverage and individuals' compliance in MDA. Methods: The information in the MDA registers were assessed to verify the reported coverages obtained from the district. The community registers were obtained from the district health offices and the data from each individual record was entered into a database. A simple questionnaire was used to cross-check the participation of study participants in the 2017 MDA. The questionnaire solicited data on: participation in the 2017 MDA, reasons for not taking part in the MDA, adverse events experienced, what was done for the adverse events, and willingness to participate in subsequent MDAs. Results: We found that 40.1% of the population in the registers missed at least one MDA in 3 years (2016–2018) and the majority of them were between 10–30 years of age. The results of the questionnaire assessment indicated that 13.8% of the respondents did not receive treatment in 2017 for various reasons, the most prominent among them being "absence/travel" (37.1%). Data in the registers were used to verify the treatment coverage for the years 2017 and 2018, and reviewed against the reported coverage obtained from the district. Significant differences between the reported and verified coverages were only observed in four communities. However, the assessment also revealed that the reported coverage was only accurate in 33.3% of cases. Conclusions: The MDA registers allow for the identification of eligible individuals who were not reached during any MDA round. Thus, the MDA registers could be utilized at the community and programme levels to identify missing and untreated individuals, appropriately address their non-compliance to MDA, and thereby improve MDA coverage in each implementation unit and monitor the progress towards elimination of LF. The challenges observed through the review of the registers also offer opportunities to improve the training given to the community drug distributors. Author summary: Elephantiasis is a disease that is common in Ghana. Since the year 2000 the country has implemented a control programme aimed at eliminating the disease as a public health problem, through the yearly treatment of entire communities in districts where the disease is found. Achievements have been made, and treatment has stopped in many districts; however, some districts have received many years of treatment without successfully reducing the infections below the targeted levels. Many individuals go untreated every year, as can be observed from the low reported treatment coverage after MDA. This untreated population may explain why some districts have failed to achieve the criteria for stopping treatment. Fortunately, the treatments are recorded in community registers, which contain the details of all community members, as well as their treatment participation. These registers can therefore be used to identify people who have not received treatment and design appropriate interventions to reach them. Through these registers, we were able to identify and characterize individuals who were not treated between 2016 and 2018 in 10 communities. We found that 4 out of 10 people missed at least one treatment between 2016 and 2018, and the majority of them were 10–30 years of age. Using the information from the registers we were also able to verify the proportion of people who took part in the treatments in 2017 and 2018, and compared this to what was reported. This comparison revealed that the reporting was only accurate in 33% of cases. A questionnaire was also used to cross-check the participation of study participants in the 2017 MDA, with results indicating that 13.8% of the respondents did not receive treatment for various reasons, the most prominent among them being "absence/travel" (37.1%). Although these registers are seldom used by the Lymphatic Filariasis Control Programme for anything other than recording and reporting treatment information, this study shows that the registers provide an opportunity to identify individuals who have not received treatment, develop a plan to appropriately address their reasons for not taking part in the treatments, target these untreated individuals to improve the overall proportion of people taking part in MDA, and assess the accuracy of reported coverage information. These activities will allow the programme to better monitor the progress towards, and ultimately achieve, elimination of lymphatic filariasis as a public health problem. [ABSTRACT FROM AUTHOR]
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- 2020
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34. Lymphatic filariasis related perceptions and practices on the coast of Ghana: implications for prevention and control
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Ahorlu, Collins K., Dunyo, Samuel K., Koram, Kwadwo A., Nkrumah, Francis K., Aagaard-Hansen, Jens, and Simonsen, Paul E.
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- 1999
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35. Combining design research with microbiology to tackle drug-resistant infections in different home environments in Ghana: Challenging the boundaries of design thinking.
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Tsekleves, Emmanuel, Darby, Andy, Ahorlu, Collins, De Souza, Dziedzom, Pickup, Roger, and Boakye, Daniel
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DESIGN research ,DESIGN thinking ,HOME environment ,MICROBIOLOGY ,SUSTAINABLE urban development - Published
- 2019
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36. Implementing active community-based surveillance-response system for Buruli ulcer early case detection and management in Ghana.
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Ahorlu, Collins S. K., Okyere, Daniel, and Ampadu, Edwin
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BURULI ulcer , *MYCOBACTERIUM , *EPIDEMIOLOGY , *POLYMERASE chain reaction , *PUBLIC health surveillance - Abstract
Background: Buruli Ulcer (BU) is one of the most neglected debilitating tropical diseases caused by Mycobacterium ulcerans, which causes considerable morbidity and disability. Building on earlier findings that community-based interventions could enhance case detection and reduce treatment dropout and defaulter rates, we established an active surveillance-response system in an endemic sub-district in the Ga West municipality of Ghana to enhance early case detection, diagnosis and treatment to reduce or eliminate severe ulcers and its related disabilities. Methods: We established surveillance response system, implemented in collaboration with the sub-district disease control officers, selected clinical staff and trained community-based volunteers. The active community-based surveillance- response system was implemented for 12 months. Also, pre and post intervention surveys were conducted to document any change in perceptions on BU in the study population over the period. The baseline and endline surveys were conducted in August 2016 and August 2017 respectively. Results: On average, each person was seen 11 times in 12 months. In all 75 skin lesions were detected during surveillance rounds, out of which 17 were suspected to be BU and 12 out of the 17 were confirmed as BU using Polymerase chain reaction (PCR). Out of the 12, five, three and four were categories I, II and III lesions respectively. Physical examination was done on 94% of the people seen during the surveillance rounds. Knowledge on BU has also increased in the communities at the end of the study. Conclusion: The findings from this study have demonstrated that it is possible to establish surveillance-response system for BU and by extension, other neglected tropical diseases to enhance control and elimination efforts through the use of community-based volunteers. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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37. Twelve-month longitudinal parasitological assessment of lymphatic filariasis-positive individuals: impact of a biannual treatment with ivermectin and albendazole.
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Kanamitie, John N., Ahorlu, Collins S., Otchere, Joseph, Aboagye‐Antwi, Fred, Kwansa‐Bentum, Bethel, Boakye, Daniel A., Biritwum, Nana‐Kwadwo, Wilson, Michael D., and Souza, Dziedzom K.
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DRUG administration , *FILARIASIS , *IVERMECTIN , *PARASITOLOGY , *BLOOD testing , *ANIMALS , *ANTHELMINTICS , *ANTIGENS , *ELEPHANTIASIS , *LONGITUDINAL method , *NEMATODES , *MACROLIDE antibiotics , *GOVERNMENT programs , *DISEASE prevalence , *PHARMACODYNAMICS , *PREVENTION , *THERAPEUTICS - Abstract
Objective: Mass drug administration (MDA) for the control of lymphatic filariasis (LF), in Ghana, started in the year 2000. While this had great success in many implementation units, there remain areas with persistent transmission, after more than 10 years of treatment. A closer examination of the parasite populations could help understand the reasons for persistent infections and formulate appropriate strategies to control LF in these areas of persistent transmission.Materials and Methods: In a longitudinal study, we assessed the prevalence of microfilaraemia (mf) in two communities with 12 years of MDA in Ghana. In baseline surveys 6 months after the National MDA in 2014, 370 consenting individuals were tested for antigenaemia using immunochromatographic test (ICT) cards and had their mf count determined through night blood surveys. 48 ICT positives, of whom, 17 were positive for mf, were treated with 400 μg/kg ivermectin + 400 mg albendazole and subsequently followed for parasitological assessment at 3-month intervals for 1 year. This overlapped with the National MDA in 2015.Results: There was a 68% parasite clearance 3 months after treatment. The pre-treatment mf count differed significantly from the post-treatment mf counts at 3 months (P = 0.0023), 6 months (P = 0.0051), 9 months (P = 0.0113) and 12 months (P = 0.0008).Conclusion: In these settings with persistent LF transmission, twice-yearly treatment may help accelerate LF elimination. Further large-scale evaluations are required to ascertain these findings. [ABSTRACT FROM AUTHOR]- Published
- 2017
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38. Community-based trial of annual versus biannual single-dose ivermectin plus albendazole against Wuchereria bancrofti infection in human and mosquito populations: study protocol for a cluster randomised controlled trial.
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de Souza, Dziedzom K., Ahorlu, Collins S., Adu-Amankwah, Susan, Otchere, Joseph, Mensah, Sedzro K., Larbi, Irene A., Mensah, George E., Biritwum, Nana-Kwadwo, and Boakye, Daniel A.
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- *
TREATMENT of filariasis , *IVERMECTIN , *ALBENDAZOLE , *FILARIASIS prevention , *DISEASE prevalence , *RANDOMIZED controlled trials - Abstract
Background: The Global Programme for the Elimination of Lymphatic Filariasis (GPELF) has been in operation since the year 2000, with the aim of eliminating the disease by the year 2020, following five to six rounds of effective annual mass drug administration (MDA). The treatment regimen is ivermectin (IVM) in combination with diethylcarbamazine (DEC) or albendazole (ALB). In Ghana, MDA has been undertaken since 2001. While the disease has been eliminated in many areas, transmission has persisted in some implementation units that had experienced 15 or more rounds of MDA. Thus, new intervention strategies could eliminate residual infection in areas of persistent transmission and speed up the lymphatic filariasis (LF)-elimination process. This study, therefore, seeks to test the hypothesis that biannual treatment of LF-endemic communities will accelerate the interruption of LF in areas of persistent transmission.Methods: A cluster randomised trial will be implemented in LF-endemic communities in Ghana. The interventions will be yearly or twice-yearly MDA delivered to entire endemic communities. Allocation to study group will be by clusters identified using the prevalence of LF. Clusters will be randomised to one of two groups: receiving either (1) annual treatment with IVM + ALB or (2) annual MDA with IVM + ALB, followed by an additional MDA 6 months later. The primary outcome measure is the prevalence of LF infection, assessed by four cross-sectional surveys. Entomological assessments will also be undertaken to evaluate the transmission intensity of the disease in the study clusters. Costs and cost-effectiveness will be evaluated. Among a random subsample of participants, microfilaria prevalence will be assessed longitudinally. A nested process evaluation, using semi-structured interviews, focus group discussions and a stakeholder analysis, will investigate the community acceptability, feasibility and scale-up of each delivery system.Discussion: It is expected that this study will add to the existing evidence on the need for alternative intervention strategies for the elimination of LF in Ghana and in other African countries that are facing similar challenges or are at the beginning of their LF-elimination programmes.Trial Registration: ClinicalTrials.gov, ID: NCT03036059 . Registered on 26 January 2017. Pan African Clinical Trials Registry, ID: PACTR201702002012425 . Registered on 23 February 2017. [ABSTRACT FROM AUTHOR]- Published
- 2017
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39. Willingness to pay for small solar powered bed net fans: results of a Becker–DeGroot–Marschak auction in Ghana.
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Yukich, Joshua O., Briët, Olivier J. T., Ahorlu, Collins K., Nardini, Peter, and Keating, Joseph
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WILLINGNESS to pay ,FANS (Machinery) ,MOSQUITO nets ,VECTOR control ,MALARIA prevention ,AUCTIONS - Abstract
Background and methods: Long-lasting insecticidal nets (LLINs) are one of the main interventions recommended by the World Health Organization for malaria vector control. LLINs are ineffective if they are not being used. Subsequent to the completion of a cluster randomized cross over trial conducted in rural Greater Accra where participants were provided with the 'Bɔkɔɔ System'—a set of solar powered net fan and light consoles with a solar panel and battery—or alternative household water filters, all trial participants were invited to participate in a Becker–DeGroot–Marschak auction to determine the mean willingness to pay (WTP) for the fan and light consoles and to estimate the demand curve for the units. Results, discussion and conclusions: Results demonstraed a mean WTP of approximately 55 Cedis (~13 USD). Demand results suggested that at a price which would support full manufacturing cost recovery, a majority of households in the area would be willing to purchase at least one such unit. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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40. Understanding resilience of female adolescents towards teenage pregnancy: a cross-sectional survey in Dar es Salaam, Tanzania.
- Author
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Pfeiffer, Constanze, Ahorlu, Collins K., Alba, Sandra, and Obrist, Brigit
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PSYCHOLOGICAL adaptation , *CLUSTER analysis (Statistics) , *CONFIDENCE intervals , *PSYCHOLOGICAL resilience , *HUMAN sexuality , *TEENAGE pregnancy , *CROSS-sectional method , *ODDS ratio - Abstract
Background: In Tanzania, teenage pregnancy rates are still high despite the efforts being made to reduce them. Not enough is known about how adolescents experience and cope with sexuality and teenage pregnancy. Over the past few decades, most studies have focused on vulnerability and risk among youth. The concept of 'reproductive resilience' is a new way of looking at teenage pregnancy. It shifts the perspective from a deficit-based to a strength-based approach. The study presented here aimed to identify factors that could contribute to strengthening the reproductive resilience of girls in Dar es Salaam, Tanzania. Methods: Using a cross-sectional cluster sampling approach, 750 female adolescents aged 15-19 years were interviewed about how they mobilize resources to avoid or deal with teenage pregnancy. The main focus of the study was to examine how social capital (relations with significant others), economic capital (command over economic resources), cultural capital (personal dispositions and habits), and symbolic capital (recognition and prestige) contribute to the development of adolescent competencies for avoiding or dealing with teenage pregnancy and childbirth. Results: A cumulative competence scale was developed to assess reproductive resilience. The cumulative score was computed based on 10 competence indicators that refer to the re- and pro-active mobilization of resources. About half of the women who had never been pregnant fell into the category, 'high competence' (50.9%), meaning they could get the information and support needed to avoid pregnancies. Among pregnant women and young mothers, most were categorized as 'high competence' (70.5%) and stated that they know how to avoid or deal with health problems that might affect them or their babies, and could get the information and support required to do so. Cultural capital, in particular, contributed to the competence of never-pregnant girls [OR = 1.80, 95% CI = 1.06 to 3.07, p = 0.029], pregnant adolescents and young mothers [OR = 3.33, 95% CI = 1.15 to 9.60, p = 0.026]. Conclusions: The reproductive resilience framework provides new insights into the reproductive health realities of adolescent girls from a strength-based perspective. While acknowledging that teenage pregnancy has serious negative implications for many female adolescents, the findings presented here highlight the importance of considering girls' capacities to prevent or deal with teenage pregnancy. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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41. SOCIAL CAPITAL AND ADOLESCENT GIRLS' RESILIENCE TO TEENAGE PREGNANCY IN BEGORO, GHANA.
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Gyan, Sylvia Esther, Ahorlu, Collins, Dzorgbo, Dan-Bright S., and Fayorsey, Clara K.
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- *
TEENAGE pregnancy , *SOCIAL capital , *PSYCHOLOGICAL resilience , *CLUSTER sampling , *STAKEHOLDERS , *HEALTH attitudes , *PARENTS , *HUMAN sexuality , *TEENAGERS' conduct of life , *SOCIOECONOMIC factors - Abstract
This study focuses on how older adolescent girls access and utilize social capital to develop resilience against teenage pregnancy in Begoro, Ghana. A survey of 419 non-pregnant girls aged 15–19 years, selected using a multi-stage cluster sampling technique, was conducted in 2012. Qualitative data were gathered through in-depth interviews with ten girls purposively selected from the survey respondents. Parents, relatives, teachers and religious groups were found to be important sources of social capital for the non-pregnant girls in developing resilience against teenage pregnancy. In addition, resilient girls tended to rely on multiple sources of social capital. It is recommended that stakeholders and policymakers in Ghana ensure that these significant sources of social capital in adolescent girls’ sexual experience are equipped with the right information to help girls decrease the risk of teenage pregnancy. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
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42. The effect of small solar powered 'Bͻkͻͻ' net fans on mosquito net use: results from a randomized controlled cross-over trial in southern Ghana.
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Briët, Olivier J. T., Yukich, Joshua O., Pfeiffer, Constanze, Miller, William, Jaeger, Mulako S., Khanna, Nitin, Oppong, Samuel, Nardini, Peter, Ahorlu, Collins K., and Keating, Joseph
- Subjects
SOLAR energy ,MOSQUITO nets ,MALARIA ,MALARIA transmission ,HAWTHORNE effect ,ENDEMIC diseases - Abstract
Background: Long-lasting insecticidal nets (LLINs) are ineffective malaria transmission prevention tools if they are unused. Discomfort due to heat is the most commonly reported reason for not using nets, but this problem is largely unaddressed. With increasing rural electrification and the dropping price of solar power, fans could improve comfort inside nets and be affordable to populations in malaria endemic areas. Here, results are presented from a pilot randomized controlled cross-over study testing the effect of fans on LLIN use. Methods: Eighty-three households from two rural communities in Greater Accra, Ghana, randomized into three groups, participated in a 10-month cross-over trial. After a screening survey to identify eligible households, all households received new LLINs. Bͻkͻͻ net fan systems (one fan per member) were given to households in Group 1 and water filters were given to households in Group 2. At mid-point, Group 1 and 2 crossed over interventions. Households in Group 1 and 2 participated in fortnightly surveys on households' practices related to nets, fans and water filters, while households in Group 3 were surveyed only at screening, mid-point and study end. Entomological and weather data were collected throughout the study. Analysis took both 'per protocol' (PP) and 'intention to treat' (ITT) approaches. The mid- and end-point survey data from Group 1 and 2 were analysed using Firth logistic regressions. Fortnightly survey data from all groups were analysed using logistic regressions with random effects. Results: Provision of fans to households appeared to increase net use in this study. Although the increase in net use explained by fans was not significant in the primary analyses (ITT odds ratio 3.24, p > 0.01; PP odds ratio = 1.17, p > 0.01), it was significant in secondary PP analysis (odds ratio = 1.95, p < 0.01). Net use was high at screening and even higher after provision of new LLINs and with follow up. Fan use was 90–100% depending on the fortnightly visit. Conclusions: This pilot study could not provide definitive evidence that fans increase net use. A larger study with additional statistical power is needed to assess this association across communities with diverse environmental and socio-demographic characteristics. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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43. Perceptions on the effect of small electric fans on comfort inside bed nets in southern Ghana: a qualitative study.
- Author
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Jaeger, Mulako S., Briët, Olivier J. T., Keating, Joseph, Ahorlu, Collins K., Yukich, Joshua O., Oppong, Samuel, Nardini, Peter, and Pfeiffer, Constanze
- Subjects
FANS (Machinery) ,MOSQUITO nets ,MALARIA transmission ,SOLAR energy ,RURAL geography - Abstract
Background: Long-lasting insecticidal nets (LLINs) are known to be highly effective in reducing malaria transmission, morbidity and mortality. However, among those owning an LLIN, use rates are often suboptimal. A reported barrier to bed net use is discomfort due to heat. This qualitative study was part of a larger evaluation conducted in communities without electricity in rural Ghana to assess whether 0.8 W solar powered net fans can increase net use. Methods: Twenty-three key informant interviews with household heads in the study communities in Shai-Osudoku District, southern Ghana, were conducted from July to August 2015. The purpose of the interviews was to obtain insight into perceptions of participants about the net fan system in relation to LLIN use. Results: While all study participants reported using LLINs, with mosquito nuisance prevention as the prime motivation, heat was also mentioned as a key barrier to net use. Respondents appreciated the net fans because they improved comfort inside bed nets. The LED light on the fan stand became the main source of light at night and positively influenced the perception of the intervention as a whole. Conclusion: The general acceptance of the net fan system by the study participants highlights the potential of the intervention to improve comfort inside mosquito nets. This, therefore, has a potential to increase bed net use in areas with low access to electricity. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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44. Molecular epidemiology of Mycobacterium africanum in Ghana.
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Asante-Poku, Adwoa, Darko Otchere, Isaac, Osei-Wusu, Stephen, Sarpong, Esther, Baddoo, Akosua, Forson, Audrey, Laryea, Clement, Borrell, Sonia, Bonsu, Frank, Hattendorf, Jan, Ahorlu, Collins, Koram, Kwadwo A., Gagneux, Sebastien, Yeboah-Manu, Dorothy, and Otchere, Isaac Darko
- Subjects
MYCOBACTERIUM ,PHYLOGENY ,TUBERCULOSIS ,PATHOGENIC microorganisms ,PUBLIC health - Abstract
Background: Mycobacterium africanum comprises two phylogenetic lineages within the M. tuberculosis complex (MTBC) and is an important cause of human tuberculosis (TB) in West Africa. The reasons for this geographic restriction of M. africanum remain unclear. Here, we performed a prospective study to explore associations between the characteristics of TB patients and the MTBC lineages circulating in Ghana.Method: We genotyped 1,211 MTBC isolates recovered from pulmonary TB patients recruited between 2012 and 2014 using single nucleotide polymorphism typing and spoligotyping. Associations between patient and pathogen variables were assessed using univariate and multivariate logistic regression.Results: Of the 1,211 MTBC isolates analysed, 71.9 % (871) belonged to Lineage 4; 12.6 % (152) to Lineage 5 (also known as M. africanum West-Africa 1), 9.2 % (112) to Lineage 6 (also known as M. africanum West-Africa 2) and 0.6 % (7) to Mycobacterium bovis. Univariate analysis revealed that Lineage 6 strains were less likely to be isoniazid resistant compared to other strains (odds ratio = 0.25, 95 % confidence interval (CI): 0.05-0.77, P < 0.01). Multivariate analysis showed that Lineage 5 was significantly more common in patients from the Ewe ethnic group (adjusted odds ratio (adjOR): 2.79; 95 % CI: 1.47-5.29, P < 0.001) and Lineage 6 more likely to be found among HIV-co-infected TB patients (adjOR = 2.2; 95 % confidence interval (CI: 1.32-3.7, P < 0.001).Conclusion: Our findings confirm the importance of M. africanum in Ghana and highlight the need to differentiate between Lineage 5 and Lineage 6, as these lineages differ in associated patient variables. [ABSTRACT FROM AUTHOR]- Published
- 2016
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45. Cultural Understanding of Wounds, Buruli Ulcers and Their Management at the Obom Sub-district of the Ga South Municipality of the Greater Accra Region of Ghana.
- Author
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Koka, Eric, Yeboah-Manu, Dorothy, Okyere, Daniel, Adongo, Philip Baba, and Ahorlu, Collins K.
- Subjects
BURULI ulcer ,BACTERIAL diseases ,ULCERS ,PEPTIC ulcer ,MEDICAL personnel - Abstract
Background: This study was conducted with the aim to understand some of the cultural belief systems in the management of wounds and patients practices that could contaminate wounds at the Obom sub-district of the Ga South Municipality of Ghana. Methods: This was an ethnographic study using in-depth interviews, Focus Group Discussions and participant observation techniques for data collection. Observations were done on Buruli ulcer patients to document how they integrate local and modern wound management practices in the day-to-day handling of their wounds. Content analysis was done after the data were subjected to thematic coding and representative narratives selected for presentation. Results: It was usually believed that wounds were caused by charms or spirits and, therefore, required the attention of a native healer. In instances where some patients’ wounds were dressed in the hospital by clinicians whose condition/age/sex contradict the belief of the patient, the affected often redress the wounds later at home. Some of the materials often used for such wound dressing include urine and concoctions made of charcoal and gunpowder with the belief of driving out evil spirits from the wounds. Conclusion: Clinicians must therefore be aware of these cultural beliefs and take them into consideration when managing Buruli ulcer wounds to prevent redressing at home after clinical treatment. This may go a long way to reduce secondary infections that have been observed in Buruli ulcer wounds. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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46. Assessing Lymphatic Filariasis Data Quality in Endemic Communities in Ghana, Using the Neglected Tropical Diseases Data Quality Assessment Tool for Preventive Chemotherapy.
- Author
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de Souza, Dziedzom K., Yirenkyi, Eric, Otchere, Joseph, Biritwum, Nana-Kwadwo, Ameme, Donne K., Sackey, Samuel, Ahorlu, Collins, and Wilson, Michael D.
- Subjects
FILARIASIS ,DATA quality ,CANCER chemotherapy ,DISEASE prevalence ,PUBLIC health - Abstract
Background: The activities of the Global Programme for the Elimination of Lymphatic Filariasis have been in operation since the year 2000, with Mass Drug Administration (MDA) undertaken yearly in disease endemic communities. Information collected during MDA–such as population demographics, age, sex, drugs used and remaining, and therapeutic and geographic coverage–can be used to assess the quality of the data reported. To assist country programmes in evaluating the information reported, the WHO, in collaboration with NTD partners, including ENVISION/RTI, developed an NTD Data Quality Assessment (DQA) tool, for use by programmes. This study was undertaken to evaluate the tool and assess the quality of data reported in some endemic communities in Ghana. Methods: A cross sectional study, involving review of data registers and interview of drug distributors, disease control officers, and health information officers using the NTD DQA tool, was carried out in selected communities in three LF endemic Districts in Ghana. Data registers for service delivery points were obtained from District health office for assessment. The assessment verified reported results in comparison with recounted values for five indicators: number of tablets received, number of tablets used, number of tablets remaining, MDA coverage, and population treated. Furthermore, drug distributors, disease control officers, and health information officers (at the first data aggregation level), were interviewed, using the DQA tool, to determine the performance of the functional areas of the data management system. Findings: The results showed that over 60% of the data reported were inaccurate, and exposed the challenges and limitations of the data management system. The DQA tool is a very useful monitoring and evaluation (M&E) tool that can be used to elucidate and address data quality issues in various NTD control programmes. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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47. Socio-cultural and economic factors influencing adolescents' resilience against the threat of teenage pregnancy: a cross-sectional survey in Accra, Ghana.
- Author
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Ahorlu, Collins K., Pfeiffer, Constanze, and Obrist, Brigit
- Subjects
- *
CHI-squared test , *COMMUNICATION , *CONCEPTUAL structures , *CONFIDENCE intervals , *CULTURE , *INTERVIEWING , *MULTIVARIATE analysis , *PARENT-child relationships , *QUESTIONNAIRES , *PSYCHOLOGICAL resilience , *STATISTICAL sampling , *SEX education , *SURVEYS , *TEENAGE pregnancy , *LOGISTIC regression analysis , *SOCIAL capital , *SOCIAL support , *SOCIOECONOMIC factors , *CROSS-sectional method , *DATA analysis software , *DESCRIPTIVE statistics , *ODDS ratio - Abstract
Background: Adolescent pregnancy exposes female adolescents to medical, social and economic risks. In Ghana, adolescent mothers are more likely to experience complications during pregnancy and delivery as compared to older mothers. This study examined the competencies of adolescent girls to either proactively prevent teenage pregnancy or reactively cope effectively with it. Methods: A cross-sectional survey approach was used to interview 820 adolescent girls aged 15-19 years in Accra, Ghana. The main focus of the study was to examine how social capital (various kinds of valued relations with significant others), economic capital (command over economic resources, mainly cash and assets), cultural capital (personal dispositions and habits; knowledge and tradition stored in material forms and institutionalized) and symbolic capital (honour, recognition and prestige) contribute to the development of competencies of adolescents to deal with the threat of teenage pregnancy and childbirth. Results: Out of 820 adolescents interviewed, 128 (16 %) were pregnant or mothers. Adolescents in both groups (62 % never pregnant girls and 68 % pregnant/young mothers) have access to social support, especially from their parents. Parents are taking the place of aunts and grandmothers in providing sexual education to their adolescent girls due to changing social structures where extended families no longer reside together in most cases. More (79 %) pregnant girls and young mothers compared to never pregnant girls (38 %) have access to economic support (P = <0.001). Access to social, economic and cultural capitals was associated with high competence to either prevent or deal with pregnancy among adolescent girls. Conclusion: Findings showed that adolescent girls, especially those that get pregnant should not be viewed as weak and vulnerable because many of them have developed competencies to cope with pregnancy and childbirth effectively. Thus, focusing on developing the competencies of girls to access social, economic and cultural capitals may be an effective way of tackling the threat of teenage pregnancy than focusing only on their vulnerability and associated risks. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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48. Transmission indices and microfilariae prevalence in human population prior to mass drug administration with ivermectin and albendazole in the Gomoa District of Ghana.
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Aboagye-Antwi, Fred, Kwansa-Bentum, Bethel, Dadzie, Samuel K., Ahorlu, Collins K., Appawu, Maxwell A., Gyapong, John, Wilson, Michael David, and Boakye, Daniel Adjei
- Subjects
DRUG administration ,IVERMECTIN ,ALBENDAZOLE ,FILARIASIS ,COMMUNITY involvement ,CULEX - Abstract
Background: The Lymphatic Filariasis Elimination Programme in Ghana involves annual mass drug administration (MDA) of ivermectin and albendazole to persons living in endemic areas. This is repeated annually for 4-6 years to span across the reproductive lifespan of adult worms. In order to stimulate participation of community members in the MDA programme, this study was carried out to understand local views on transmission, management and prevention of the disease. The study also presents baseline transmission indices and microfilariae prevalence in the human population in eight endemic communities of coastal Ghana prior to the MDA. Methods: A descriptive survey was carried out to explore perceptions on causes, treatment and prevention of lymphatic filariasis. Perceptions on community participation in disease control programmes were also assessed. After participants were selected by cluster sampling and 100 μl of blood sampled from each individual and examined for mf microfilariae. A similar volume of blood was used to determine the presence of circulating filarial antigen. Mosquitoes were collected simultaneously at all sites by human landing catches for 4 days per month over a six-month period. All Anopheles mosquitoes were dissected and examined for the larval stages of the parasite following which molecular identification of both vector and parasite was done. Results: Eight hundred and four persons were interviewed, of which 284 (32.9 %; CI 31.1-34.5) acknowledged elephantiasis and hydrocoele as health related issues in the communities. Thirty-three people (3.8 %; CI 2.1-5.5) thought sleeping under bed net could help prevent elephantiasis. Microfilariae prevalence was 4.6 % (43/941) whiles 8.7 % (75/861) were positive for circulating filarial antigen. A total of 17,784 mosquitoes were collected, majority (55.8 %) of which were Anopheles followed by Culex species (40 %). Monthly biting rates ranged between 311 and 6116 bites/person for all the eight communities together. Annual transmission potential values for An. gambiae s.s. and An. funestus were 311.35 and 153.50 respectively. Conclusion: Even though the highest mf density among inhabitants was recorded in a community that had the lowest Anopheles density with Culex species constituting 95 % of all mosquitoes collected, Anopheles gambiae s.s. and An. funestus remained the main vectors. [ABSTRACT FROM AUTHOR]
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- 2015
- Full Text
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49. Impact of Cowpea-Based Food Containing Fish Meal Served With Vitamin C-Rich Drink on Iron Stores and Hemoglobin Concentrations in Ghanaian Schoolchildren in a Malaria Endemic Area.
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Egbi, Godfred, Ayi, Irene, Saalia, Firibu Kwesi, Zotor, Francis, Adom, Theodosia, Harrison, Eric, Ahorlu, Collins K., Asiedu, Matilda Steiner, and Steiner-Asiedu, Matilda
- Abstract
Background: Nutritional anemia is a public health problem among Ghanaian schoolchildren. There is need to employ dietary modification strategies to solve this problem through school and household feeding programs.Objective: To evaluate the effectiveness of cowpea-based food containing fish meal served with vitamin C-rich drink to improve iron stores and hemoglobin concentrations in Ghanaian schoolchildren.Methods: The study involved cross-sectional baseline and nutrition intervention phases. There were 150 participants of age 6 to 12 years. They were randomly assigned to 3 groups, fish meal -vitamin C (n = 50), vitamin C (n = 50), and control (n = 50), and given different cowpea-based diets for a 6-month period. Height and weight measurements were done according to the standard procedures, dietary data were obtained by 24-hour recall and food frequency questionnaire, hemoglobin concentrations were determined by Hemocue Hemoglobinometer, and serum ferritin and complement-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay. Participants' blood samples were examined for malaria parasitemia and stools for helminthes using Giemsa stain and Kato-Katz techniques, respectively.Results: Mean ferritin concentration was not significantly different among groups. End line mean or change in hemoglobin concentrations between fish meal-vitamin C group (128.4 ± 7.2/8.3 ± 10.6 g/L) and control (123.1 ± 6.6/4.2 ± 10.4 g/L) were different, P < .05. Change in prevalence of anemia in fish meal-vitamin C group (19.5%) was different compared to those of vitamin C group (9.3%) and the control (12.2%). Levels of malaria parasitemia and high CRP among study participants at baseline and end line were 58% and 80% then 55% and 79%, respectively. Level of hookworm infestation was 13%.Conclusion: Cowpea-based food containing 3% fish meal and served with vitamin C-rich drink improved hemoglobin concentration and minimized the prevalence of anemia among the study participants. [ABSTRACT FROM AUTHOR]- Published
- 2015
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50. Sero-Epidemiology as a Tool to Screen Populations for Exposure to Mycobacterium ulcerans.
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Yeboah-Manu, Dorothy, Röltgen, Katharina, Opare, William, Asan-Ampah, Kobina, Quenin-Fosu, Kwabena, Asante-Poku, Adwoa, Ampadu, Edwin, Fyfe, Janet, Koram, Kwadwo, Ahorlu, Collins, and Pluschke, Gerd
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BURULI ulcer ,HEAT shock proteins ,MYCOBACTERIUM ,ANTIBODY formation ,ANTIBODY titer ,ENVIRONMENTAL sampling - Abstract
Background: Previous analyses of sera from a limited number of Ghanaian Buruli ulcer (BU) patients, their household contacts, individuals living in BU non-endemic regions as well as European controls have indicated that antibody responses to the M. ulcerans 18 kDa small heat shock protein (shsp) reflect exposure to this pathogen. Here, we have investigated to what extent inhabitants of regions in Ghana regarded as non-endemic for BU develop anti-18 kDa shsp antibody titers. Methodology/Principal Findings: For this purpose we determined anti-18 kDa shsp IgG titers in sera collected from healthy inhabitants of the BU endemic Densu River Valley and the Volta Region, which was so far regarded as BU non-endemic. Significantly more sera from the Densu River Valley contained anti-18 kDa shsp IgG (32% versus 12%, respectively). However, some sera from the Volta Region also showed high titers. When interviewing these sero-responders, it was revealed that the person with the highest titer had a chronic wound, which was clinically diagnosed and laboratory reconfirmed as active BU. After identification of this BU index case, further BU cases were clinically diagnosed by the Volta Region local health authorities and laboratory reconfirmed. Interestingly, there was neither a difference in sero-prevalence nor in IS2404 PCR positivity of environmental samples between BU endemic and non-endemic communities located in the Densu River Valley. Conclusions: These data indicate that the intensity of exposure to M. ulcerans in endemic and non-endemic communities along the Densu River is comparable and that currently unknown host and/or pathogen factors may determine how frequently exposure is leading to clinical disease. While even high serum titers of anti-18 kDa shsp IgG do not indicate active disease, sero-epidemiological studies can be used to identify new BU endemic areas. Author Summary: Sero-epidemiological analyses revealed that a higher proportion of sera from individuals living in the Buruli ulcer (BU) endemic Densu River Valley of Ghana contain Mycobacterium ulcerans 18 kDa small heat shock protein (shsp)-specific IgG than sera from inhabitants of the Volta Region, which was regarded so far as BU non-endemic. However, follow-up studies in the Volta Region showed that the individual with the highest anti-18 kDa shsp-specific serum IgG titer of all participants from the Volta Region had a BU lesion. Identification of more BU patients in the Volta Region by subsequent active case search demonstrated that sero-epidemiology can help identify low endemicity areas. Endemic and non-endemic communities along the Densu River Valley differed neither in sero-prevalence nor in positivity of environmental samples in PCR targeting M. ulcerans genomic and plasmid DNA sequences. A lower risk of developing M. ulcerans disease in the non-endemic communities may either be related to host factors or a lower virulence of local M. ulcerans strains. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
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