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Treponemal infections can be blood-borne with great public health consequences. This study is aimed at comparatively describing the five-year (2013-2017) regional epidemiology of treponemal infection using pregnant women in the sentinel survey and apparently healthy blood donors as a proxy for the general population at four sentinel sites in the Volta and Oti Regions of Ghana. We analyzed retrospective data from 17,744 prospective blood donors aged 18 to 58 years and 7,817 pregnant women in a sentinel survey with ages from 15 to 49 years at Hohoe, Ho, Tongu, and Krachi West sentinel sites in the Volta and Oti Regions. Laboratory data extracted include variables such as age, gender, date of blood donation, and Treponema pallidum chromatographic immunoassay results from the blood banks of the four study sites. The five-year treponemal infection rate among the pregnant women in the sentinel survey and prospective blood donors was 0.79% and 2.38%, respectively. Site-specific infection rate for population-based/sentinel survey was 4.6%/1.1%, 2.0%/0.5%, 1.3%/1.1, and 1.2%/0.3% for Hohoe, Ho, Krachi West, and Tongu, respectively. Significant gender disparity in Treponemal infection rate exists with a male preponderance. The regional infection rate in the sentinel survey is lower compared to the general population. Therefore, the use of pregnant women as a proxy for population estimates could underestimate the burden in the study jurisdiction.

Background Adequate knowledge about COVID-19 in a population may be relevant in the fight to control its spread among the populace. Thus, the aim of this study was to assess the factors associated with real knowledge of COVID-19 among Ghanaians to promote effective dissemination of appropriate information aimed at containing the spread. Methods A cross-sectional online survey and computer assisted telephone interviews (CATI) was conducted among Ghanaians aged 18 years and above across the 260 districts of Ghana. The survey assessed the level of knowledge of COVID-19 and its associated factors and compared differences between perceived and real knowledge. One district health promotion officer per district was trained for the data collection. Participants were recruited via use of phone directories of both organized and non-organized local district groups. Phone calls were made to randomly selected phone contacts to schedule options for participation in the study. We used multivariable logistic regression to investigate the associated factors of COVID-19 knowledge among respondents. Results Of the 2,721 participants who completed the survey, the majority (99.3%) were aware of the existence of the COVID-19 outbreak, had good knowledge on infection prevention (87.0%) and rated their knowledge about COVID-19 as good (81.7%). Factors associated with COVID-19 knowledge were: age ≥56 years (aOR = 0.5; CI: 0.3–0.8; p = 0.002), tertiary education (aOR = 1.8; CI: 1.2–2.6; p = 0.003), residing in Greater Accra region (aOR = 2.0; CI: 1.1–3.6; p = 0.019), not infected with the novel coronavirus (aOR = 1.5; Cl: 1.0–2.1; p = 0.045), knowing an infected person (aOR = 3.5; CI = 1.5–7.9; p = 0.003), good practice of effective preventive measures (aOR = 1.2: Cl: 1.1–1.5: 0.008), not misinformed (aOR = 0.7; Cl: 0.5–0.9; 0.015), and perceiving spreading speed of the virus as slow (aOR = 0.7; Cl: 0.5–0.9; 0.007). Conclusion The study found good knowledge regarding COVID-19, control measures, and preventive strategies. The Ghana Health Service should continuously provide accurate information to educate the media and citizens to prevent misinformation, which is vital in stopping the spread of the COVID-19 virus.

Background. The WHO targets to end HIV/AIDS as a public health problem by 2030. The introduction of the ambitious “90-90-90” strategy to attain this target is expected to be achieved by the year 2020. However, there is lack of regional data, especially on the third “90.” This study sought to assess the rate and associated factors of viral suppression among people living with HIV (PLWH) on highly active antiretroviral therapy (HAART) at the Antiretroviral Therapy (ART) Clinic in a Ghanaian health facility.Method. The study design was a retrospective analysis of secondary data of 284 HIV registrants on HAART for at least 6 months at the ART Clinic from July 2016 to April 2019. Data on sociodemography including age, gender, marital status, education, and occupation as well as pharmacological (type of medication and duration on medication) and laboratory variable (current viral load results) were extracted from patients’ folders. Viral suppression and failure were determined using the WHO definitions (viral suppression as viral load Results. Out of the 284 HIV patients, 195 (69%) achieved viral suppression. Of the 195 who were virally suppressed, 77 (39.5%) had undetectable levels, with a similar proportion (39.5%) achieving viral load results ranging from 20 to 200 copies/ml. Moreover, 27 (13.8%) patients had viral load ranging from 201 to 500 copies/ml while 14 (7.2%) recorded viral load from 501 to 1000 copies/ml. No clear pattern in the viral suppression rate was associated with the age groups (p=0.1152). However, regular clinic attendance (used as proxy for medication adherence) (p<0.0001) and being on HAART for more than three (3) years (p=0.03) were associated with viral suppression.Conclusion. The rate of viral suppression among PLWH on HAART in the Ho municipality fell short of the WHO target. However, the study identified regular ART clinic attendance and treatment >3 years as factors associated with viral suppression.

Background Meningitis, a disease of the Central Nervous System is described as inflammation of the covering of the brain and spinal cord (meninges). It is characterised by fever, severe headache, nausea, vomiting, stiff neck, photophobia, altered consciousness, convulsion/seizures and coma. In December, 2015, twelve suspected cases of meningitis were reported in Tain district in Brong Ahafo region (BAR). Subsequently, dozens of suspected cases were hospitalized in five district hospitals in BAR. We investigated to determine the magnitude, causative agent and risk factors for the disease transmission. Methods A community-based 1:2 case-control study (with 126 individuals) was conducted form 10/12/15 to 26/4/16 in 27 districts of Brong-Ahafo Region, Ghana. We defined suspected meningitis cases as people presenting with sudden headache and fevers (Temp> 38.0 °C) in combination with one of the following signs: neck stiffness, altered consciousness, convulsions, bulging fontanelle (infants) and other meningeal signs. Controls were selected from the same neighbourhood and defined as individuals with no overt meningitis signs/symptoms. We collected CSF samples and performed serological testing using Pastorex-Meningitis-Kit and culture for bacterial isolation. Moreover, structured questionnaires were used to collect data on socio-demographics, living conditions, health status and other risk factors. We conducted univariate data analysis and logistic regressions to study disease-exposure associations using Stata 15. Results A total of 969 suspected cases with 85 deaths (CFR = 9.0%) were recorded between December, 2015 and March, 2016. Majority, 55.9% (542/969) were females aged between 10 months-74 years (median 20 years, IQR; 14-34). Of the 969 cases, 141 were confirmed by Laboratory test with Streptococcus pneumoniae identified as the causative agent. Cases were reported in 20 districts but 6 of these districts reported cases above threshold levels. The outbreak peaked in week 6 with 178 cases. Overall attack rate (AR) was 235.0/100,000 population. District specific ARs were; Tain; 143.6/100,000, Wenchi; 110.0/100,000, Techiman; 46.6/100,000, Jaman North; 382.3/100,000 and Nkoranza South; 86.4/100,000. Female and male specific ARs were 251.3/100,000 and 214.5/100,000 respectively. Age group 10-19 years were most affected 33.8% (317/940). We identified sore throat [aOR = 5.2, 95% (CI 1.1-26.1)] and alcohol use [aOR = 9.1, 95%(CI 1.4-55.7)] as factors associated with the disease transmission. Conclusion Meningitis outbreak due to Streptococcus pneumoniae was established in BAR. Upper respiratory tract infection and alcohol use were associated with the outbreak. Mass campaigns on healthy living habits, signs and symptoms of meningitis as well as the need for early reporting were some of the control measures instituted. Moreover, we recommend Pneumococcal vaccination in BAR to prevent future outbreaks. Electronic supplementary material The online version of this article (10.1186/s12889-018-5529-z) contains supplementary material, which is available to authorized users.

Abstract Background: Treponemal infection is contagious and one of the oldest blood-borne infections, with great public health consequences. This study aimed to comparatively describe the five–year (2013-2017) regional epidemiology of Treponemal infection using pregnant women in the Sentinel Survey and apparently healthy blood donors as proxy for the general population at the four sentinel sites in the Volta Region of Ghana. Method: We analysed retrospectively data from 17,744 prospective blood donors aged between 18 to 58 years and 7,805 pregnant women in a Sentinel Survey who fell within the 15 and 49 years age bracket at Hohoe, Ho, Tongu and Krachi-West sentinel sites in the Volta Region. Data extracted included age, gender, date of blood donation and Treponena pallidum chromatographic immunoassay results from the blood banks of the four study sites. Published reports of Sentinel Surveys conducted at the four sentinel sites from the years 2013-2017 were retrieved. Results: The cumulative five-year prevalence of Treponemal infections among the pregnant women in the Sentinel Survey and prospective blood donors was 0.38% and 2.38% respectively. Site-specific prevalence for population-base/Sentinel survey was 4.6%/0.4%, 2.0%/0.2%, 1.3%/0.8 and 1.2%/0.2 for Hohoe, Ho, Krachi-West and Tongu respectively. Treponemal infection rates among the younger age groups (15-24years) were 0.31% in the sentinel survey and 2.22% in the general population. Significant gender disparity in Treponemal infection exist with male preponderance. Conclusion: The regional prevalence of Treponemal infection in the Sentinel Survey is lower compared to the general population. Therefore, the use of pregnant women as proxy for population estimate could lead to underestimation of the burden in the study jurisdiction.

Background: Syphilis is contagious and one of the oldest sexually transmitted infections, with great public health consequences. This study aimed to comparatively describe the five–year (2013-2017) regional epidemiology of syphilis infection using pregnant women in the Sentinel Survey and apparently healthy blood donors as proxy for the general population at the four sentinel sites in the Volta Region of Ghana. Method: We analysed retrospectively data from 17,744 prospective blood donors aged between 18 to 58 years and 7,805 pregnant women in a Sentinel Survey who fell within the 15 and 49 years age bracket at Hohoe, Ho, Tongu and Krachi-West sentinel sites in the Volta Region. Data extracted included age, gender, date of blood donation and Treponena pallidum chromatographic immunoassay results from the blood banks of the four study sites. Published reports of Sentinel Surveys conducted at the four sentinel sites from the years 2013-2017 were retrieved. Results: The cumulative five-year prevalence of syphilis infections among the pregnant women in the Sentinel Survey and prospective blood donors was 0.38% and 2.38% respectively. Site-specific prevalence for population-base/Sentinel survey was 4.6%/0.4%, 2.0%/0.2%, 1.3%/0.8 and 1.2%/0.2 for Hohoe, Ho, Krachi-West and Tongu respectively. New Syphilis infection rate was 0.31% in the sentinel survey and 2.22% in the general population. Significant gender disparity in syphilis infection exist with male preponderance. Conclusion: The regional prevalence of syphilis infection in the Sentinel Survey is lower compared to the general population. Therefore, the use of pregnant women as proxy for population estimate could lead to underestimation of the burden in the study jurisdiction.

Introduction : more people die from tuberculosis (TB) than from any other curable infectious disease in the world. Though there have been many new interventions and investment in controlling and eradicating TB in the world particularly in Africa, TB still remains a major public health threat. In 2015, Brong Ahafo recorded a TB detection rate of 84% meaning 16% of cases went undetected. Sunyani West District recorded 37 new TB cases with 7 (19%) deaths. Each year, surveillance data on TB is recorded in the districts. In Sunyani West District however, this data is not evaluated or used in improving the system. The aim of the study was to analyse a five-year tuberculosis surveillance data in the District. Methods : we conducted secondary analysis on TB surveillance data in the Sunyani West District from 2011-2015. Data was obtained from TB registers and District health information management system (DHIMS 2) of the Sunyani West District. Variables abstracted were age group, sex, sub-district and treatment outcome and presented in tables and graphs. Results : a total of 140 patients were diagnosed with TB in Sunyani West District between 2011 and 2015, with the mean (SD) age of 41.7(18.06) years. Males were most affected (72.9%) with year 2014 recording the highest proportion (50.33%). Chiraa sub-district recorded the highest proportion (28.6%) and 45% of the total patients with TB completed treatment. Conclusion : TB infection increased in 2014 with a death rate of 7.5 per 100,000 therefore health education on prevention and benefits early treatment should be intensified in the communities especially among males and in the sub-district.

Introduction : in 2015, statistics from Ghana Health Service indicated that Brong Ahafo Region recorded 12,492 adolescent pregnancies (14.2% of pregnancies), while Sunyani West District (SWD) recorded of 431 (14.8%). This study analyzed adolescent pregnancy data in Sunyani West District from 2011 to 2015 to determine the proportion and trend of teenage pregnancy by age and sub district. Methods : descriptive data analysis was conducted on adolescent pregnancy data in the SWD from 2011 to 2015. Data were obtained from the District Health Information Management System Two (DHIMS 2) of Sunyani West District. Study population was pregnant adolescents attending ante-natal clinics and delivery service. Variables used were age, year, pregnancy, delivery and Sub-district. The data were compiled manually by tally technique and transformed into tables and charts according to the frequencies and percentages by a means of computer. Results : a total of 2,189 pregnant adolescents were recorded in Sunyani west from January 2011 to December 2015. Of these, 1013 adolescents delivered. The median age was 17 years. The 15-19 year olds were the most affected, recording 2,140 (97.36%) of 2,189. The study indicated a decrease of 19.61% (431) in ANC attendants and an increase of 22.41% (227) in deliveries for the year 2015. Chiraa sub-district recorded the highest cases; 710 (32.30%) followed by Nsoatre with 649 (29.53%), Odumasae-Kwatire with 626 (28.48%), Fiapre with 123 (6.03%) and Bofourkrom with 90 (1.16%). Conclusion : the study found a high rate of teenage pregnancy in the District among the age groups. Majority, 97.36% (2,140) of adolescent pregnancies were within the 15-19 years age cohort. Chiraa sub-district saw the most cases 32.30% (710). Sex education incorporated into school curriculum by the GES in collaboration with the GHS would help reduce the number of adolescent pregnancies in the district.

By 2003, 350,000 persons lived with HIV/AIDS in Ghana with an average drop of 15,640 over 8 years. In 2011, approximately 224,878 persons lived with HIV/AIDS, which is expected to drop to 221,884 by 2015. We think the estimated 2994 drop over 4 years is pedestrian. We attribute the lackluster performance to the haphazard HIV and AIDS, STI Policy from 2004 through 2013. We considered the Ghana HIV/AIDS and STI Policy published (NACP/GHS, 2013) “as is” to isolate the gaps in the policy, looking at the provision of judicial and legal mechanisms for testing, treatment and counseling. We also investigated the national policy on partner notification, names reporting, and expedited partner therapy, in the case of MSM and young people as provided for in the policy. Finally, we looked at issues affecting stigmatization and discrimination. The investigation consisted of the review of the Revised National HIV and AIDS, STI Policy of August 2004 through 2013. We also undertook a documentary review of publications on the topic. There are systemic problems in the policy design, which has weakened the thrust of the national control program. The policy is unsystematic and inconsistent with international best practice in combating communicable diseases. It may not maximize the number of persons who are aware of their HIV status. It may not increase the number of HIV infected persons who receive care, and may not prevent new infections. It is unlikely that by 2015 even the low 2994 drop over four years would be sustained particularly with the current rationing of ART drugs in the nation. Recommendations are made to, perhaps, inform policy.

Article published in African Journal of Microbiology Research Vol. 7(20), pp. 2213-2220, 14 May, 2013. Also available at http://www.academicjournals.org/AJMR

INTRODUCTION: hepatitis B and HIV infections are endemic in sub-Saharan Africa including Ghana. Understanding the extent of the co-infection is critical to the optimal care of persons living with HIV and AIDS (PLHIV). We determined the prevalence and risk factors of HBV co-infection in PLHIV and assessed the knowledge of health care workers (HCW) in Antiretroviral Therapy (ART) clinics regarding the co-infection. METHODS: a cross sectional study was conducted in five ART clinics to obtain data from a systematic random sample of PLHIV in the Eastern region of Ghana from March to June 2012. We used self-administered questionnaires to assess knowledge of HCW on knowledge and management of the co-infection. Descriptive statistics and logistic regression models were used for analysis at 5% significance level. RESULTS: of 320 PLHIV recruited into study, with median age of 40 years (IQR: 33-50 years), 28 tested positive for HBsAg giving an overall prevalence of 8.8%. There were significant associations between HBV infection and being an adult (p=0.004), increasing serum ALT levels (p=0.002) and partner with history of HBV infection (p=0.010). HCW obtained 84.2% (SD± 20.53; 95% CI: 89-98.1) and 53.1% (SD± 35.06; 95% CI: 13.0-88.9) in the “general knowledge” and “management practice” indexes respectively. CONCLUSION: prevalence of HBV-HIV co-infection was relatively high among PLHIV in Eastern region. Knowledge of HCW on management practices of HBV-HIV co-infection and HBV vaccination coverage among PLHIV were found to be relatively low. Regular trainings of HCW and a HBV vaccination programme targeted at PLHIV should be considered.

INTRODUCTION: cholera is a diarrhoea disease caused by the bacterium Vibrio cholera . On 13 th June 2011, there was a reported outbreak of acute watery diarrhoea at Medinya among people who eat at a mass traditional wedding ceremony in the Western Region of Ghana. We investigated to characterize the outbreak, and implement control and preventive measures. METHODS: we conducted a retrospective cohort study. We interviewed health workers, reviewed medical records, conducted environmental assessment and obtained water and stool samples for laboratory investigation. A suspected cholera-case defined as a person with acute watery diarrhoea, with or without vomiting, who ate food prepared at the mass traditional wedding in Medinya on 10th June 2011. We performed univariate and bivariate analysis. RESULTS: of the 17 case-patients, 9 (52.9%) were males. The overall attack rate was 11.18% and case fatality rate was 5.9%. The most affected age group was 6-10 years (23.53%) with median age of 20 and ranged 6 to 38 years. Time of onset of symptoms was 2.00am and peaked at 10.am on 13th June. Compared to other food served, fufu with groundnut soup was more likely to have been contaminated (RR=7.3, 95%CI: 1.8-29.3). We isolated Vibrio cholerae serotype ogawa from stool samples. We observed open defaecation and poor personal hygiene. CONCLUSION: Vibrio cholerae serotype ogawa caused a high case-fatality outbreak in Medinya. Contaminated fufu and groundnut soup were the sources. Hand washing with soap was initiated and a make shift latrine constructed following our health education and recommendations.

Background Seasonal variations greatly influence birth patterns differently from country to country. In Ghana, there is paucity of information on birth seasonal patterns. This retrospective study described the trends and seasonality of births and perinatal outcomes in Upper East Region of Ghana. Methods Births occurring in each month of the calendar years (2010–2014; inclusive) were extracted from the District Health Information Management System (DHIMS2) database of the Bolgatanga Municipal Health Directorate and exported into Microsoft Excel spread sheet and Epi Ifo for analysis. Analysis was carried out by calculating average number of births per month correcting for unequal month length using 30 days. A Chi-square test for trend was performed to check for statistical significance (p

Background The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. Methodology/Principal findings To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania. We conducted a series of field visits as well as multilocus variable tandem repeat analysis and whole-genome sequencing analysis of V. cholerae isolates throughout the study region. During this period, Ghana accounted for 52% of the reported cases in the entire study region (coastal countries from Benin to Mauritania). From 2009 to 2015, we found that one major wave of cholera outbreaks spread from Accra in 2011 northwestward to Sierra Leone and Guinea in 2012. Molecular epidemiology analysis confirmed that the 2011 Ghanaian isolates were related to those that seeded the 2012 epidemics in Guinea and Sierra Leone. Interestingly, we found that many countries deemed “cholera endemic” actually suffered very few outbreaks, with multi-year lulls. Conclusions/Significance This study provides the first cohesive vision of the dynamics of cholera epidemics in a major portion of West Africa. This epidemiological overview shows that from 2009 to 2015, at least 54% of reported cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. These findings may serve as a guide to better target cholera prevention and control efforts in the identified cholera hotspots in West Africa., Author summary We analyzed cholera epidemics from Benin to Mauritania, during 2009 to 2015, and performed a series of field visits as well as molecular epidemiology analyses of V. cholerae isolates from most recent epidemics throughout West Africa. We found that at least 54% of cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. Accra, Ghana represented the main cholera hotspot in the entire study region. Our findings indicate that the water network system in Accra may play a role in the rapid diffusion of cholera throughout the city. As observed in Accra, Conakry, and Freetown, once cholera cases arrive in overpopulated urban settings with poor sanitation, increased rainfall facilitated the contamination of unprotected water sources with human waste from cholera patients, thus promoting a rapid increase in cholera incidence. To more efficiently and effectively combat cholera in West Africa, these findings may serve as a guide to better target cholera prevention and control interventions.