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6. Tracking health system performance in times of crisis using routine health data: lessons learned from a multicountry consortium

Author

Turcotte-Tremblay, Anne-Marie, Leerapan, Borwornsom, Akweongo, Patricia, Amponsah, Freddie, Aryal, Amit, Asai, Daisuke, Awoonor-Williams, John Koku, Ayele, Wondimu, Bauhoff, Sebastian, Doubova, Svetlana V., Gadeka, Dominic Dormenyo, Dulal, Mahesh, Gage, Anna, Gordon-Strachan, Georgiana, Haile-Mariam, Damen, Joseph, Jean Paul, Kaewkamjornchai, Phanuwich, Kapoor, Neena R., Gelaw, Solomon Kassahun, Kim, Min Kyung, Kruk, Margaret E., Kubota, Shogo, Margozzini, Paula, Mehata, Suresh, Mthethwa, Londiwe, Nega, Adiam, Oh, Juhwan, Park, Soo Kyung, Passi-Solar, Alvaro, Perez Cuevas, Ricardo Enrique, Reddy, Tarylee, Rittiphairoj, Thanitsara, Sapag, Jaime C., Thermidor, Roody, Tlou, Boikhutso, and Arsenault, Catherine

Published
2023
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7. Feasibility and acceptability of ACT for the community case management of malaria in urban settings in five African sites

Author

Traoré Abdoulaye, Ali Doreen, Tegegn Ayalew, Browne Edmund NL, Adongo Philip B, Konaté Amadou T, Simwaka Bertha N, Sudhakar Morankar, Agyei-Baffour Peter, Akweongo Patricia, Amuyunzu-Nyamongo Mary, Pagnoni Franco, and Barnish Guy

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background The community case management of malaria (CCMm) is now an established route for distribution of artemisinin-based combination therapy (ACT) in rural areas, but the feasibility and acceptability of the approach through community medicine distributors (CMD) in urban areas has not been explored. It is estimated that in 15 years time 50% of the African population will live in urban areas and transmission of the malaria parasite occurs in these densely populated areas. Methods Pre- and post-implementation studies were conducted in five African cities: Ghana, Burkina Faso, Ethiopia and Malawi. CMDs were trained to educate caregivers, diagnose and treat malaria cases in < 5-year olds with ACT. Household surveys, focus group discussions and in-depth interviews were used to evaluate impact. Results Qualitative findings: In all sites, interviews revealed that caregivers' knowledge of malaria signs and symptoms improved after the intervention. Preference for CMDs as preferred providers for malaria increased in all sites. Quantitative findings: 9001 children with an episode of fever were treated by 199 CMDs in the five study sites. Results from the CHWs registers show that of these, 6974 were treated with an ACT and 6933 (99%) were prescribed the correct dose for their age. Fifty-four percent of the 3,025 children for which information about the promptness of treatment was available were treated within 24 hours from the onset of symptoms. From the household survey 3700 children were identified who had an episode of fever during the preceding two weeks. 1480 (40%) of them sought treatment from a CMD and 1213 of them (82%) had received an ACT. Of these, 1123 (92.6%) were administered the ACT for the correct number of doses and days; 773 of the 1118 (69.1%) children for which information about the promptness of treatment was available were treated within 24 hours from onset of symptoms, and 768 (68.7%) were treated promptly and correctly. Conclusions The concept of CCMm in an urban environment was positive, and caregivers were generally satisfied with the services. Quality of services delivered by CMDs and adherence by caregivers are similar to those seen in rural CCMm settings. The proportion of cases seen by CMDs, however, tended to be lower than was generally seen in rural CCMm. Urban CCMm is feasible, but it struggles against other sources of established healthcare providers. Innovation is required by everyone to make it viable.

Published
2011
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8. Community response to intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in five African settings

Author

Slutsker Lawrence, Mangesho Peter, Okello George, Mwangi Rose, Akweongo Patricia, Gosling Roly, Odhiambo Frank, Adongo Philip, Mathanga Don P, Pell Christopher, Gysels Marjolein, Kremsner Peter G, Grobusch Martin P, Hamel Mary J, Newman Robert D, and Pool Robert

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background IPTi delivered through EPI has been shown to reduce the incidence of clinical malaria by 20–59%. However, new health interventions can only be effective if they are also socially and culturally acceptable. It is also crucial to ensure that attitudes to IPTi do not negatively influence attitudes to and uptake of immunization, or that people do not misunderstand IPTi as immunization against malaria and neglect other preventive measures or delay treatment seeking. Methods These issues were studied in five African countries in the context of clinical trials and implementation studies of IPTi. Mixed methods were used, including structured questionnaires (1,296), semi-structured interviews (168), in-depth interviews (748) and focus group discussions (95) with mothers, fathers, health workers, community members, opinion leaders, and traditional healers. Participant observation was also carried out in the clinics. Results IPTi was widely acceptable because it resonated with existing traditional preventive practices and a general concern about infant health and good motherhood. It also fit neatly within already widely accepted routine vaccination. Acceptance and adherence were further facilitated by the hierarchical relationship between health staff and mothers and by the fact that clinic attendance had a social function for women beyond acquiring health care. Type of drug and regimen were important, with newer drugs being seen as more effective, but potentially also more dangerous. Single dose infant formulations delivered in the clinic seem to be the most likely to be both acceptable and adhered to. There was little evidence that IPTi per se had a negative impact on attitudes to EPI or that it had any affect on EPI adherence. There was also little evidence of IPTi having a negative impact on health seeking for infants with febrile illness or existing preventive practices. Conclusion IPTi is generally acceptable across a wide range of settings in Africa and involving different drugs and regimens, though there is a strong preference for a single dose infant formulation. IPTi does not appear to have any negative effect on attitudes to EPI, and it is not interpreted as immunization against malaria.

Published
2009
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11. COVID-19 and resilience of healthcare systems in ten countries

Author

Arsenault, Catherine, Gage, Anna, Kim, Min Kyung, Kapoor, Neena R., Akweongo, Patricia, Amponsah, Freddie, Aryal, Amit, Asai, Daisuke, Awoonor-Williams, John Koku, Ayele, Wondimu, Bedregal, Paula, Doubova, Svetlana V., Dulal, Mahesh, Gadeka, Dominic Dormenyo, Gordon-Strachan, Georgiana, Mariam, Damen Haile, Hensman, Dilipkumar, Joseph, Jean Paul, Kaewkamjornchai, Phanuwich, Eshetu, Munir Kassa, Gelaw, Solomon Kassahun, Kubota, Shogo, Leerapan, Borwornsom, Margozzini, Paula, Mebratie, Anagaw Derseh, Mehata, Suresh, Moshabela, Mosa, Mthethwa, Londiwe, Nega, Adiam, Oh, Juhwan, Park, Sookyung, Passi-Solar, Álvaro, Pérez-Cuevas, Ricardo, Phengsavanh, Alongkhone, Reddy, Tarylee, Rittiphairoj, Thanitsara, Sapag, Jaime C., Thermidor, Roody, Tlou, Boikhutso, Valenzuela Guiñez, Francisco, Bauhoff, Sebastian, and Kruk, Margaret E.

Published
2022
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17. Models with time-varying predictors for meningitis in Navrongo, Ghana

Author

Hagar, Yolanda, Hayden, Mary, Forgor, Abudulai Adams, Akweongo, Patricia, Hodgson, Abraham, Wiedinmyer, Christine, and Dukic, Vanja

Subjects
Statistics - Methodology
Abstract

The "meningitis belt" is a region in sub-Saharan Africa where annual outbreaks of meningitis occur, with large epidemics observed cyclically. While we know that meningitis is heavily dependent on seasonal trends (in particular, weather), the exact pathways for contracting the disease are not fully understood and warrant further investigation. This manuscript examines meningitis trends in the context of survival analysis, quantifying underlying seasonal patterns in meningitis rates through the hazard rate for the population of Navrongo, Ghana. We compare three candidate models: the commonly used Poisson generalized linear model, the Bayesian multi-resolution hazard model, and the Poisson generalized additive model. We compare the accuracy and robustness of the models through the bias, RMSE, and the standard deviation. We provide a detailed case study of meningitis patterns for data collected in Navrongo, Ghana.

Published
2015

29. Publish and still perish? Learning to make the ‘right’ publishing choices in the Ghanaian academy

Author

Chatio, Samuel Tamti, Tindana, Paulina, Akweongo, Patricia, and Mills, David

Abstract

ABSTRACTPublication in ‘reputable’, peer-reviewed and indexed journals has become a key requirement for promotion and career advancement in African universities. There is little research into how bibliometric measures of journal reputation are shaping the publishing strategies and practices of Africa-based researchers. This study, drawing on 43 in-depth interviews, explored the publishing choices, tactics and discourses of early-career academics at two different public universities in Ghana. Most participants felt under constant pressure to publish, and more than half invoked the ‘publish or perish’ aphorism unprompted in conversation. They were also very aware that one could ‘publish andperish’ by choosing the ‘wrong’ journals, such as those not on university-approved lists or in the main global citation indexes. Some regretted the journal choices they had made at the start of their careers, and had since learnt to make every publication ‘count’. Many invoked a moral and spatial dichotomy of low-quality ‘local’ journals versus reputable ‘international’ journals. Most participants felt that more training, supervision and mentorship would help them make the ‘right’ publishing choices. In a global research economy that sustains geographical inequalities and reputational hierarchies, journals published from Africa are increasingly viewed as the ‘wrong’ choice.

Published
2024
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49. Prevalence and Classification of Misdiagnosis Among Hospitalised Patients in Five General Hospitals of Central Uganda

Author

Katongole,Simon Peter, Akweongo,Patricia, Anguyo,Robert, Kasozi,Daniel Evans, Adomah-Afari,Augustine, Katongole,Simon Peter, Akweongo,Patricia, Anguyo,Robert, Kasozi,Daniel Evans, and Adomah-Afari,Augustine

Abstract

Simon Peter Katongole,1 Patricia Akweongo,2 Robert Anguyo,3 Daniel Evans Kasozi,4 Augustine Adomah-Afari2 1Simon Peter Katongole, School of Public Health, Gudie University Project, Kampala, Uganda; 2Department of Health Policy, Planning and Management, University of Ghana, Accra, Ghana; 3Monitoring, Evaluation, Technical Assistance and Research (METRe) Group; Department of International Public Health, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK; 4The United States Agency for International Development, US Embassy Kampala, Kampala, UgandaCorrespondence: Simon Peter Katongole, Gudie University Project, P.O. Box 27450, Kampala, Uganda, Tel +256 702 830 019, Email spkatongole@gmail.comPurpose: This study sought to determine the magnitude of patients’ misdiagnosis, classify the extent to which patients were misdiagnosed, determine the major diagnostic groupings and the topmost misdiagnosed diseases 11th version of the International Classification of Diseases (ICD-11).Methods: We conducted a retrospective review of 2431 patients’ records. A patient was adjudged to have been misdiagnosed if there was a difference between the initial diagnosis and the final diagnoses which had been collectively and collaboratively agreed upon review on admission. Misdiagnosis was classified as Class I, Class II, Class III and Class IV. The Pareto analysis was used to determine the topmost misdiagnosed diseases and ICD-11 major diagnostic groupings. We established the three leading misdiagnosed diseases for each of the topmost ICD-11 major diagnostic groupings.Results: The results indicate that 9.2% (223/2341) of the inpatients were initially misdiagnosed. There were 303 conditions involved in the misdiagnosis. The majority, 70.9% (158/223) of the misdiagnosed patients were classified as Class I. The ICD-11 major diagnostic groupings accounted for at least 80% of the misdiagnosis were certain infectious or parasitic diseases (32%), diseases of the digestive system (12%), d

Published
2022

50. Using weather forecasts to help manage meningitis in the West African Sahel: integrating research, operations, and community engagement, a multinational and multidisciplinary team uses relative humidity forecasts to better manage meningitis in the Sahel

Author

Pandya, Rajul, Hodgson, Abraham, Hayden, Mary H., Akweongo, Patricia, Hopson, Thomas, Forgor, Abudulai Adams, Yoksas, Tom, Dalaba, Maxwell Ayindenaba, Dukic, Vanja, Mera, Roberto, Dumont, Arnaud, McCormack, Kristen, Anaseba, Dominic, Awine, Timothy, Boehnert, Jennifer, Nyaaba, Gertrude, Laing, Arlene, and Semazzi, Fredrick

Subjects
Meningitis -- Prevention -- Environmental aspects, Weather forecasting -- Methods -- Health aspects, Disease transmission -- Prevention -- Environmental aspects, Business, Earth sciences
Abstract

Understanding and acting on the link between weather and meningitis in the Sahel could help improve vaccine distribution and save lives. People living there know that meningitis epidemics occur in [...]

Published
2015
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