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2. Insulin therapy adherence and its associated factors among diabetic patients in a Ghanaian primary care hospital.

Author

Sefah, Israel Abebrese, Mensah, Michael, Hutton-Nyameaye, Araba Ata, Sarkodie, Emmanuel, Meyer, Johanna C., Godman, Brian, and Bangalee, Varsha

Subjects
*MEDICAL personnel, *TYPE 2 diabetes, *PATIENT compliance, *GLYCEMIC control, *INSULIN therapy
Abstract

Background: Diabetes mellitus (DM) is a global health problem. Adherence to intensive insulin therapy is necessary to achieve better glycemic control in types 1 and 2 DM. This study aimed to evaluate the extent of adherence to insulin therapy, its predictors and to identify barriers to its adherence. Method: This was a cross-sectional survey among adult (≥18 years) diabetic patients who are currently using insulin, either alone or in combination with an oral antidiabetic regimen, and seeking primary care at Kwame Nkrumah University of Science and Technology Hospital in Ghana. A total of one hundred and eight-six patients were conveniently sampled, and interviewed. Insulin adherence was determined using the Medication Adherence Reporting Scale-5. Descriptive statistics, a chi-square test of independence, and a multiple logistic regression analysis were performed using STATA version 14 (StataCorp, TX USA). Results: The majority of the patients interviewed were over 60 years (40.32%); female (61.83%); married (68.82%); and had completed secondary education (48.39%). 67.20% of the patients were adherent to insulin therapy. Adherence level was associated with age (p = 0.020), marital status (p = 0.001), employment status (p = 0.012), type of DM (p<0.001), regular follow-up (p = 0.007) and comorbidities (p = 0.002) and was only predicted by the type of DM (aOR = 14.82 C.I 1.34–163.50, p-value = 0.028). Conclusion: Adherence to insulin therapy among our study population was suboptimal, which is a concern considering the associated increased risk of complications. Adherence assessment and counselling by healthcare professionals to address barriers to poor adherence must be continually undertaken to achieve optimal glycemic control. Impact of findings on practice statements: Continuous adherence assessment and counselling must be offered to all diabetes mellitus patients on insulin therapy as part of their ambulatory care to help improve outcomes. Using the Medication Adherence Reporting Scale-5 to determine patient adherence levels is an easy-to-use and an inexpensive method; however, it should be used with caution due to the potential for misclassification. Efforts must be made to provide appropriate strategies to deal with barriers to insulin adherence at ambulatory care clinics as part of the individualized comprehensive diabetic care to reduce diabetic complications. [ABSTRACT FROM AUTHOR]

Published
2025
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3. Audit of antibiotic utilization patterns and practice for common eye infections at the ambulatory clinic of a teaching hospital in Ghana: Findings and implications.

Author

Sefah, Israel Abebrese, Quagraine, Anthony Martin, Kurdi, Amanj, Mudenda, Steward, and Godman, Brian

Subjects
*INAPPROPRIATE prescribing (Medicine), *EYE infections, *ANTIMICROBIAL stewardship, *BIVARIATE analysis, *PUBLIC health, *EYE care
Abstract

Background: Antimicrobial resistance (AMR) is a serious public health issue which is exacerbated by increased inappropriate use of antibiotics for common eye infections. This cross sectional survey was to assess the appropriate use of antibiotics for eye infections in an ambulatory clinic in Ghana and possible determinants. Method: The medical records of all patients who sought eye care between January 2022 to December 2022 and were prescribed antibiotics were extracted from the hospital's electronic database. Descriptive, bivariate and multivariate analyses were then conducted. Results: A total of 1925 patient medical records were extracted, whose median age was 40 years (IQR 26–69), and were mostly females (58.91%, n = 1134/1925). The eye condition commonly treated with antibiotics was bacteria conjunctivitis (33.51%, n = 645/1925). The most prescribed antibiotic was gentamycin (22.96%, n = 442/1925) followed by ciprofloxacin (16.78%, n = 321/1925). These were mostly topical dosage forms (82.13%, n = 1581/1925). Systemic antibiotics prescribed were mostly from the WHO 'Access' class (83.33%, n = 280/338). The appropriate choice of antibiotic prescribed was 42.44% (n = 817/1925) and this was positivity associated with age (p<0.001), number of antibiotics prescribed (p <0.001), the prescription of topical dosage forms (p <0.001), and WHO 'Access' antibiotic class (p <0.034). Conclusion: The level of appropriateness of antibiotic prescriptions for eye infections was sub-optimal. Antimicrobial stewardship programs, including prescriber education on guidelines and prescription audit to address associated factors, must now be instigated in this hospital to improve future antibiotic use and prevent the rise of AMR. [ABSTRACT FROM AUTHOR]

Published
2024
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4. An Assessment of the Current Level of Implementation of the Core Elements of Antimicrobial Stewardship Programs in Public Hospitals in Ghana.

Author

Sefah, Israel Abebrese, Chetty, Sarentha, Yamoah, Peter, Godman, Brian, and Bangalee, Varsha

Subjects
*EVALUATION of human services programs, *PUBLIC hospitals, *NATIONAL health services, *MIDDLE-income countries, *PHARMACY management, *ANTIMICROBIAL stewardship, *DRUG resistance in microorganisms, *RESPONSIBILITY, *PRIMARY health care, *DESCRIPTIVE statistics, *COMMITMENT (Psychology), *LOW-income countries
Abstract

Introduction: Antimicrobial resistance (AMR) is becoming a threat to global public health. Antimicrobial stewardship (AMS) program (ASP) is one of the 5 strategic areas in the Ghana National Action Plan to fight this menace. Assessment of the core elements of ASP in a hospital setting has been identified as a pragmatic way of identifying the barriers and facilitators for its effective implementation. Method: The World Health Organization's toolkit for assessment of the 7 core elements of ASP in hospitals in low and middle income countries was used for this situational analysis of public hospitals in 2 regions of Ghana. The core elements included leadership commitment, accountability and responsibility, pharmacy expertize, AMS actions and interventions, education and training, and periodic monitoring and surveillance. Data collected using a checklist were imported into STATA version 14 for descriptive and bivariate analyses. Results: 15 public hospitals were assessed with the toolkit. Most of them were primary health care facilities (n = 12, 80.0%), had bed capacities between 100 and 199 beds, less than 50 medical doctors (n = 12, 80.0%), less than 5 pharmacists (n = 10, 66.7%), and between 100 and 199 nurses. Performances in 4 out of the 7 core elements were most deficient and they included leadership commitment, pharmacy expertize, AMS actions (interventions) implemented, monitoring and surveillance of antibiotic use, and bacteria resistance rates. Pharmacist-led ASPs were also found to be associated with their formal training on AMS. Key barriers identified included lack of skilled human resources, lack of available time for AMS-related duties and poor laboratory infrastructure. Conclusion: There was sub-optimal performance for almost all the core elements of ASP in the public hospitals in Ghana hampered mostly by lack of skilled human and financial resources. Pharmacists must be empowered through formal training and certificate programs in infectious disease management and AMS principles and strategies to enhance their contribution toward ASPs in hospitals. The results from this study should encourage nationwide assessment of ASPs across hospital settings in Ghana to better evaluate the level of their implementation and address potential barriers to guide AMS policies and ASP strategy development toward the fight against AMR. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Current rates of purchasing of antibiotics without a prescription across sub-Saharan Africa; rationale and potential programmes to reduce inappropriate dispensing and resistance

Author

Sono, Tiyani Milta, primary, Yeika, Eugene, additional, Cook, Aislinn, additional, Kalungia, Aubrey, additional, Opanga, Sylvia A., additional, Acolatse, Joseph Elikem Efui, additional, Sefah, Israel Abebrese, additional, Jelić, Ana Golić, additional, Campbell, Stephen, additional, Lorenzetti, Giulia, additional, Ul Mustafa, Zia, additional, Marković-Peković, Vanda, additional, Kurdi, Amanj, additional, Anand Paramadhas, Bene D, additional, Rwegerera, Godfrey Mutashambara, additional, Amu, Adefolarin A, additional, Alabi, Mobolaji Eniola, additional, Wesangula, Evelyn, additional, Oluka, Margaret, additional, Khuluza, Felix, additional, Chikowe, Ibrahim, additional, Fadare, Joseph O., additional, Ogunleye, Olayinka O., additional, Kibuule, Dan, additional, Hango, Ester, additional, Schellack, Natalie, additional, Ramdas, Nishana, additional, Massele, Amos, additional, Mudenda, Steward, additional, Hoxha, Iris, additional, Moore, Catrin E., additional, Godman, Brian, additional, and Meyer, Johanna C., additional

Published
2023
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7. Antibiotic Susceptibility Surveillance in the Punjab Province of Pakistan: Findings and Implications

Author

Saleem, Zikria, primary, Haseeb, Abdul, additional, Abuhussain, Safa S. Almarzoky, additional, Moore, Catrin E., additional, Kamran, Sairah Hafeez, additional, Qamar, Muhammad Usman, additional, Azmat, Aisha, additional, Pichierri, Giuseppe, additional, Raees, Fahad, additional, Asghar, Shahzad, additional, Saeed, Amna, additional, Amir, Afreenish, additional, Hashmi, Furqan Khurshid, additional, Meyer, Johanna C., additional, Sefah, Israel Abebrese, additional, Rehman, Inaam Ur, additional, Nadeem, Muhammad Umer, additional, and Godman, Brian, additional

Published
2023
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8. Current Antibiotic Use Among Hospitals in the sub-Saharan Africa Region; Findings and Implications

Author

Siachalinga,Linda, Godman,Brian, Mwita,Julius C, Sefah,Israel Abebrese, Ogunleye,Olayinka O, Massele,Amos, Lee,Iyn-Hyang, Siachalinga,Linda, Godman,Brian, Mwita,Julius C, Sefah,Israel Abebrese, Ogunleye,Olayinka O, Massele,Amos, and Lee,Iyn-Hyang

Abstract

Linda Siachalinga,1,&ast; Brian Godman,2– 4,&ast; Julius C Mwita,5,&ast; Israel Abebrese Sefah,6,&ast; Olayinka O Ogunleye,7,8,&ast; Amos Massele,9,&ast; Iyn-Hyang Lee1,&ast; 1College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea; 2Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK; 3Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, 346, United Arab Emirates; 4Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, 02084, South Africa; 5Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana; 6Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana; 7Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, 100271, Nigeria; 8Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, 100271, Nigeria; 9Department of Clinical Pharmacology and Therapeutics, Hubert Kairuki Memorial University, Dar Es Salaam, Tanzania&ast;These authors contributed equally to this workCorrespondence: Linda Siachalinga, College of Pharmacy, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea, Tel +82 10 4112 7997, Email lindasiachalinga@yu.ac.krBackground: The rapid rise in antimicrobial resistance (AMR) globally, impacting on morbidity, mortality and costs with sub-Saharan African countries reporting the greatest burden is a concern. Instigation of antimicrobial stewardship programs (ASPs) can improve antibiotic use in hospitals and reduce AMR. Implementing ASPs requires knowledge of antibiotic utilization against agreed quality indicators with the data obtained from point prevalence surveys (PPS), hence the need to document antibiotic utilization

Published
2023

11. Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

Author

Saleem, Zikria, primary, Godman, Brian, additional, Cook, Aislinn, additional, Khan, Muhammad Arslan, additional, Campbell, Stephen M., additional, Seaton, Ronald Andrew, additional, Siachalinga, Linda, additional, Haseeb, Abdul, additional, Amir, Afreenish, additional, Kurdi, Amanj, additional, Mwita, Julius C., additional, Sefah, Israel Abebrese, additional, Opanga, Sylvia A., additional, Fadare, Joseph O., additional, Ogunleye, Olayinka O., additional, Meyer, Johanna C., additional, Massele, Amos, additional, Kibuule, Dan, additional, Kalungia, Aubrey C., additional, Shahwan, Moyad, additional, Nabayiga, Hellen, additional, Pichierri, Giuseppe, additional, and Moore, Catrin E., additional

Published
2022
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12. Key Considerations From a Health Authority Perspective When Proton Pump Inhibitors Are Used to Treat Gastroesophageal Reflux Disease (GERD) and Their Implications

Author

Meyer, Johanna C, primary, MacBride-Stewart, Sean, additional, Fadare, Joseph O, additional, Abdulrahman Jairoun, Ammar, additional, Haque, Mainul, additional, Massele, Amos, additional, Kumar, Santosh, additional, Sefah, Israel Abebrese, additional, P Skosana, Phumzile, additional, and Godman, Brian, additional

Published
2022
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15. Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals

Author

Sneddon, Jacqueline, primary, Thompson, Wendy, additional, Kpobi, Lily N. A., additional, Ade, Diana Abena, additional, Sefah, Israel Abebrese, additional, Afriyie, Daniel, additional, Goldthorpe, Joanna, additional, Turner, Rebecca, additional, Nawaz, Saher, additional, Wilson, Shona, additional, Hart, Jo, additional, and Byrne-Davis, Lucie, additional

Published
2022
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16. Tackling antimicrobial resistance across sub-Saharan Africa: current challenges and implications for the future

Author

Godman, Brian, primary, Egwuenu, Abiodun, additional, Wesangula, Evelyn, additional, Schellack, Natalie, additional, Kalungia, Aubrey Chichonyi, additional, Tiroyakgosi, Celda, additional, Kgatlwane, Joyce, additional, Mwita, Julius C., additional, Patrick, Okwen, additional, Niba, Loveline Lum, additional, Amu, Adefolarin A., additional, Oguntade, Racheal Tomilola, additional, Alabi, Mobolaji Eniola, additional, Ncube, Nondumiso B. Q., additional, Sefah, Israel Abebrese, additional, Acolatse, Joseph, additional, Incoom, Robert, additional, Guantai, Anastasia Nkatha, additional, Oluka, Margaret, additional, Opanga, Sylvia, additional, Chikowe, Ibrahim, additional, Khuluza, Felix, additional, Chiumia, Francis K., additional, Jana, Collins Edward, additional, Kalemeera, Francis, additional, Hango, Ester, additional, Fadare, Joseph, additional, Ogunleye, Olayinka O., additional, Ebruke, Bernard E., additional, Meyer, Johanna C., additional, Massele, Amos, additional, Malande, Oliver Ombeva, additional, Kibuule, Dan, additional, Kapona, Otridah, additional, Zaranyika, Trust, additional, Bwakura-Dangarembizi, Mutsa, additional, Kujinga, Tapiwanashe, additional, Saleem, Zikria, additional, Kurdi, Amanj, additional, Shahwan, Moyad, additional, Jairoun, Ammar Abdulrahman, additional, Wale, Janney, additional, and Brink, Adrian J, additional

Published
2022
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17. Evaluation of antibiotic prescribing for ambulatory patients seeking primary dental care services in a Public Hospital in Ghana

Author

Sefah, Israel Abebrese, Sneddon, Jacqui, and Godman, Brian

Subjects
RS
Abstract

Background: 1 in 10 of all antibiotic prescriptions globally are for dental conditions with 80% of them being inappropriate making it a potential source of antimicrobial resistance. The study aims to evaluate antibiotic use among ambulatory patients seeking dental care services in a Public Hospital in Ghana. Methods: A retrospective clinical audit was conducted by extracting the medical records of all patients seeking dental primary care at the ambulatory care clinic of Keta Municipal Hospital (KMH) from January 2020 to December 2020 using the hospital’s electronic database. Descriptive statistics, bivariate and multivariate analysis were performed on the data collected. Results:1433 patient medical records were extracted from the hospital electronic data within the study period. The mean age of the patients identified was 39 years with almost two thirds being female. Over 90% of them were attended to by a dental nurse. 88.6% of the patients received antibiotics and 87.5% of antibiotics prescribed were non-compliant with Ghana Standard Treatment Guidelines. Again, three-quarters of the dental conditions were managed with dual antibiotics comprising of amoxicillin and metronidazole. Antibiotic prescription was associated with the age, gender, the type of prescriber and the type of dental condition diagnosed. Conclusion: There is a high usage of antibiotics for dental conditions managed at the outpatient section of the hospital. Development of local guidelines supported by education of dental clinician especially dental nurses on empiric selection of antibiotics for common dental conditions is a suitable target for AMS team to address in KMH.

Published
2022

19. Adherence to Oral Hypoglycemic Drugs among Type 2 Diabetic Patients in a Resource-Poor Setting

Author

Sefah, Israel Abebrese, Okotah, Archibald, Afriyie, Daniel Kwame, and Amponsah, Seth Kwabena

Subjects
resource-poor setting, Adherence, type 2 diabetes mellitus, oral hypoglycemic drugs, Original Article
Abstract

Objective: Diabetes mellitus is a growing public health problem in many countries including Ghana. Adherence to drugs, especially among patients with type 2 diabetes mellitus (T2DM) is often poor is some resource-poor settings. The objective of this study was to assess adherence to oral hypoglycemic drugs and factors that affect adherence among patients with T2DM in the Volta Region of Ghana. Methods: The study was cross-sectional and conducted among 400 patients with T2DM attending diabetic clinics at 4 randomly selected hospitals in the Volta Region of Ghana between January 10 and March 30, 2015. Patients were interviewed using a structured questionnaire and other data collection tools to determine the commonest self-reported reason(s) for nonadherence. Adherence was assessed using the 8-item Morisky Medication Adherence Scale. Multivariate analysis was performed between adherence and statistically significant patient variables. Results: Adherence to oral hypoglycemic drugs among T2DM patients was 47.75%. The odds of adherence with fasting blood glucose between 1 and 6 mmol/L was approximately two-fold (adjusted odd ratio [aOR] =1.92, confidence interval [CI]: 1.11–3.32) versus the odds of having fasting blood glucose of above 10 mmol/L. The odds of adherence among patients with tertiary education was approximately three-fold (aOR = 3.01 CI: 1.44–6.269) versus patients with no formal education. The commonest self-reported reason for nonadherence was forgetfulness. Conclusion: Adherence to oral hypoglycemic drugs among T2DM patients in the current study was sub-optimal. Therefore, in such settings, management of T2DM must include strategies to identify nonadherent patients, and regular patient education and counseling.

Published
2020

20. Assessment of the quality of antimicrobial prescribing among hospitalized patients in a teaching hospital in Ghana: findings and implications

Author

Sefah, Israel Abebrese, Nyamadi, David, Kurdi, Amanj, Bugri, Amos Adapalala, Kerr, Frances, Yamoah, Peter, Pichierri, Giuseppe, and Godman, Brian

Abstract

ABSTRACTObjectiveThere is a need to assess the quality of antimicrobial prescribing in hospitals as a first step toward improving future prescribing to reduce antimicrobial resistance (AMR). This is in line with Ghana's National Action Plan.MethodsA point prevalence survey of antimicrobial use was undertaken at the adult medical, surgical, and pediatric wards of Tamale Teaching Hospital using the standardized Global Point Prevalence Survey (GPPS) tool. Key target areas include adherence to current guidelines, limiting the prescribing of ‘Watch’ antibiotics with their greater resistance potential, and limiting the prescribing of antibiotics post-operatively to prevent surgical site infections (SSIs).ResultsOut of 217 patients' medical records assessed, 155 (71.4%) patients were prescribed antimicrobials. The rates were similar among children (73.9%) and adults (70.3%). Most of the antibiotics prescribed were in the WHO ‘Watch’ group (71.0%) followed by those in the ‘Access’ group (29%). Out of the 23 cases indicated for surgical antimicrobial prophylaxis to prevent SSIs, the majority (69.6%) were given doses for more than 1 day, with none receiving a single dose. This needs addressing to reduce AMR and costs. Guideline compliance with the current Ghanaian Standard Treatment Guidelines (GSTG) for managing infections was also low (28.7%). The type of indication was the only independent predictor of guideline compliance (aOR = 0.013 CI 0.001–0.127, p-value = 0.001).ConclusionGiven current concerns with antimicrobial prescribing in this hospital, deliberate efforts must be made to improve the appropriateness of prescribing to reduce AMR via targeted antimicrobial stewardship programs.

Published
2023
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23. Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future

Author

Etando, Ayukafangha, primary, Amu, Adefolarin A., additional, Haque, Mainul, additional, Schellack, Natalie, additional, Kurdi, Amanj, additional, Alrasheedy, Alian A., additional, Timoney, Angela, additional, Mwita, Julius C., additional, Rwegerera, Godfrey Mutashambara, additional, Patrick, Okwen, additional, Niba, Loveline Lum, additional, Boahen-Boaten, Baffour Boaten, additional, Tabi, Felicity Besong, additional, Amu, Olufunke Y., additional, Acolatse, Joseph, additional, Incoom, Robert, additional, Sefah, Israel Abebrese, additional, Guantai, Anastasia Nkatha, additional, Opanga, Sylvia, additional, Chikowe, Ibrahim, additional, Khuluza, Felix, additional, Kibuule, Dan, additional, Kalemeera, Francis, additional, Hango, Ester, additional, Lates, Jennie, additional, Fadare, Joseph, additional, Ogunleye, Olayinka O., additional, Saleem, Zikria, additional, Oosthuizen, Frasia, additional, Cordier, Werner, additional, Matlala, Moliehi, additional, Meyer, Johanna C., additional, Schellack, Gustav, additional, Massele, Amos, additional, Malande, Oliver Ombeva, additional, Kalungia, Aubrey Chichonyi, additional, Sichone, James, additional, Banda, Sekelani S., additional, Zaranyika, Trust, additional, Campbell, Stephen, additional, and Godman, Brian, additional

Published
2021
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24. Practical Pharmacist-Led Interventions to Improve Antimicrobial Stewardship in Ghana, Tanzania, Uganda and Zambia

Author

Kerr, Frances, primary, Sefah, Israel Abebrese, additional, Essah, Darius Obeng, additional, Cockburn, Alison, additional, Afriyie, Daniel, additional, Mahungu, Joyce, additional, Mirfenderesky, Mariyam, additional, Ankrah, Daniel, additional, Aggor, Asiwome, additional, Barrett, Scott, additional, Brayson, Joseph, additional, Muro, Eva, additional, Benedict, Peter, additional, Santos, Reem, additional, Kanturegye, Rose, additional, Onegwa, Ronald, additional, Sekikubo, Musa, additional, Rees, Fiona, additional, Banda, David, additional, Kalungia, Aubrey Chichonyi, additional, Alutuli, Luke, additional, Chikatula, Enock, additional, and Ashiru-Oredope, Diane, additional

Published
2021
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25. Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries

Author

Godman, Brian, primary, Egwuenu, Abiodun, additional, Haque, Mainul, additional, Malande, Oliver Ombeva, additional, Schellack, Natalie, additional, Kumar, Santosh, additional, Saleem, Zikria, additional, Sneddon, Jacqueline, additional, Hoxha, Iris, additional, Islam, Salequl, additional, Mwita, Julius, additional, do Nascimento, Renata Cristina Rezende Macedo, additional, Dias Godói, Isabella Piassi, additional, Niba, Loveline Lum, additional, Amu, Adefolarin A., additional, Acolatse, Joseph, additional, Incoom, Robert, additional, Sefah, Israel Abebrese, additional, Opanga, Sylvia, additional, Kurdi, Amanj, additional, Chikowe, Ibrahim, additional, Khuluza, Felix, additional, Kibuule, Dan, additional, Ogunleye, Olayinka O., additional, Olalekan, Adesola, additional, Markovic-Pekovic, Vanda, additional, Meyer, Johanna C., additional, Alfadl, Abubakr, additional, Phuong, Thuy Nguyen Thi, additional, Kalungia, Aubrey C., additional, Campbell, Stephen, additional, Pisana, Alice, additional, Wale, Janney, additional, and Seaton, R. Andrew, additional

Published
2021
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27. Activities in Namibia to limit the impact of COVID-19 versus Europe and Iran and the implications for the future

Author

Kibuule, Dan, Nambahu, Lahya, Sefah, Israel Abebrese, Kurdi, Amanj, Phuong, Thuy Nguyen Thi, Kwon, Hye-Young, and Godman, Brian

Subjects
QR355
Abstract

Introduction and aims: Considerable differences in prevalence and mortality rates from COVID-19, with higher rates among European countries and Iran versus African and Asian countries in part due to early and extensive prevention measures. There has been considerable controversy surrounding hydroxychloroquine, with resultant misinformation increasing prices and suicides. Growing concerns also with unintended consequences of lockdown and other measures. Consequently, a need to investigate changes in utilisation and prices of relevant medicines during the pandemic in Namibia with its proactive approach to guide future decision making. Community pharmacists play a key role in this respect. Methods: Questionnaire survey among 55 pharmacists from March to end June 2020. Results: Proactivity among some pharmacists to plan for the pandemic with increased stocks. Limited increases in utilisation of antimalarials and antibiotics in Namibia versus other countries enhanced by restrictions on self-purchasing in Namibia, reflected in limited price rises and shortages. Higher use of Vitamin C/ immune boosters in Ghana and Nigeria versus Namibia reflected in higher price rises, with increased utilisation and prices of PPE across all countries. Encouragingly lower increases in herbal medicines in Namibia versus Ghana. Concerns though with unintended consequences. Conclusion: Encouraging to see continued low prevalence and mortality rates from COVID-19 in Namibia and limited increase in utilisation of antimalarials and antibiotics with prescribing restrictions. Concerns with rising rates of malaria and other infectious diseases following lockdown need addressing. Pharmacists can help plan for the future, educate the public during pandemics, help with vaccinations and general medicines management.

Published
2020

28. Prevalence and determinants of serious spontaneously reported adverse drug events among three outpatient care settings in Ghana : findings and implication

Author

Sefah, Israel Abebrese, Kordorwu, Hope Edem, Essah, Darius Obeng, Kurdi, Amanj, and Godman, Brian

Subjects
RM
Abstract

Objective Most evidence of adverse drug events (ADEs) come from hospitals as the risks associated with hospital care are higher. However, under-reporting of ADEs is a critical problem in all health care settings. This is important in Sub-Saharan African countries like Ghana with limited resources and high prevalence of both infectious and non-infectious diseases. Consequently, this study sought to determine the annual prevalence of spontaneously reported ADEs using six years reports and factors associated with the occurrence of serious ADE among outpatient care settings in Ghana to provide future guidance. Method A cross-sectional study was conducted using duplicates of Ghana Food and Drugs Authority adverse event forms retrieved from 3 outpatient care setting who had submitted their reports to the National Pharmacovigilance Centre in Ghana between 2013 and 2018. The raw data were entered into Microsoft excel and analyzed using stata version 14. Bivariate analyses were performed using Pearson chi square and all variables that were statistically significant were used for a multivariate analysis. Results Overall, 93 spontaneously reported cases of ADEs were identified during the study period. The mean age of the patients with a reported ADE was 42 ± 17 years, the annual prevalence rate was 192 reports per 1,000,000 population among our study population and the rate of serious ADE was 35.48% (95% CI: 25.83%-46.09%). Serious ADEs were associated with the type of indication for which the drug was prescribed (p=0.048), the duration of ADEs (p=0.047) and the decision to administer treatment at the reporting facility (p=0.017) and was independently predicted by duration of ADEs (aOR =7.63, 1.37-42.65) and decision to administer treatment for ADEs (aOR=20.28, 2.38-172.57). Conclusion Early reporting of ADEs at outpatient settings is essential. Patient education and awareness of potential ADE must be intensified for early identification and we will be following this up

Published
2020

30. Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications

Author

Sefah, Israel Abebrese, primary, Ogunleye, Olayinka O., additional, Essah, Darius Obeng, additional, Opanga, Sylvia A., additional, Butt, Nadia, additional, Wamaitha, Annie, additional, Guantai, Anastasia Nkatha, additional, Chikowe, Ibrahim, additional, Khuluza, Felix, additional, Kibuule, Dan, additional, Nambahu, Lahya, additional, Abubakar, Abdullahi Rabiu, additional, Sani, Ibrahim Haruna, additional, Saleem, Zikria, additional, Kalungia, Aubrey C., additional, Thi Phuong, Thuy Nguyen, additional, Haque, Mainul, additional, Islam, Salequl, additional, Kumar, Santosh, additional, Sneddon, Jacqueline, additional, Wamboga, Joshua, additional, Wale, Janney, additional, Miljković, Nenad, additional, Kurdi, Amanj, additional, Martin, Antony P., additional, and Godman, Brian, additional

Published
2021
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31. Practical Pharmacist-Led Interventions to Improve Antimicrobial Stewardship in Ghana, Tanzania, Uganda and Zambia

Author

Peter Benedict, Alison Cockburn, Scott Barrett, Diane Ashiru-Oredope, Luke Alutuli, Ronald Onegwa, Rose Kanturegye, Joseph Brayson, Eva Muro, Mariyam Mirfenderesky, Fiona Rees, Reem Santos, Asiwome Aggor, Aubrey Chichonyi Kalungia, Darius Obeng Essah, Enock Chikatula, Israel Abebrese Sefah, Musa Sekikubo, David Chimbizgani Banda, Joyce Mahungu, Daniel Ankrah, Frances Kerr, Daniel Kwame Afriyie, Sefah, Israel Abebrese [0000-0001-6963-0519], Afriyie, Daniel [0000-0001-8859-3565], Ankrah, Daniel [0000-0002-2447-1830], Muro, Eva [0000-0003-3770-9497], Kalungia, Aubrey Chichonyi [0000-0003-2554-1236], Ashiru-Oredope, Diane [0000-0001-9579-2028], Apollo - University of Cambridge Repository, Sefah [0000-0001-6963-0519], Ankrah [0000-0002-2447-1830], Muro [0000-0003-3770-9497], Kalungia [0000-0003-2554-1236], and Ashiru-Oredope [0000-0001-9579-2028]

Subjects
0301 basic medicine, 030106 microbiology, education, Psychological intervention, Pharmacist, Pharmacy, Article, 03 medical and health sciences, Pharmacy and materia medica, 0302 clinical medicine, Nursing, parasitic diseases, Outpatient clinic, Infection control, Antimicrobial stewardship, Pharmacology (medical), AMR, 030212 general & internal medicine, antimicrobial resistance, General Pharmacology, Toxicology and Pharmaceutics, health care economics and organizations, biology, business.industry, International health, CwPAMS, biology.organism_classification, RS1-441, antimicrobial stewardship, Tanzania, Business
Abstract

The World Health Organisation (WHO) and others have identified, as a priority, the need to improve antimicrobial stewardship (AMS) interventions as part of the effort to tackle antimicrobial resistance (AMR). An international health partnership model, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, was established between selected countries in Africa (Ghana, Tanzania, Zambia and Uganda) and the UK to support AMS. This was funded by UK aid under the Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET). The primary aims were to develop local AMS teams and generate antimicrobial consumption surveillance data, quality improvement initiatives, infection prevention and control (IPC) and education/training to reduce AMR. Education and training were key components in achieving this, with pharmacists taking a lead role in developing and leading AMS interventions. Pharmacist-led interventions in Ghana improved access to national antimicrobial prescribing guidelines via the CwPAMS mobile app and improved compliance with policy from 18% to 70% initially for patients with pneumonia in one outpatient clinic. Capacity development on AMS and IPC were achieved in both Tanzania and Zambia, and a train-the-trainer model on the local production of alcohol hand rub in Uganda and Zambia. The model of pharmacy health partnerships has been identified as a model with great potential to be used in other low and middle income countries (LMICs) to support tackling AMR.

Published
2021

32. The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future.

Author

Godman B, Haque M, Leong T, Allocati E, Kumar S, Islam S, Charan J, Akter F, Kurdi A, Vassalo C, Bakar MA, Rahim SA, Sultana N, Deeba F, Khan MAH, Alam ABMM, Jahan I, Kamal ZM, Hasin H, Munzur-E-Murshid, Nahar S, Haque M, Dutta S, Abhayanand JP, Kaur RJ, Rwegerera GM, do Nascimento RCRM, Dias Godói IP, Irfan M, Amu AA, Matowa P, Acolatse J, Incoom R, Sefah IA, Acharya J, Opanga S, Njeri LW, Kimonge D, Kwon HY, Bae S, Khuan KKP, Abubakar AR, Sani IH, Khan TA, Hussain S, Saleem Z, Malande OO, Piloya-Were T, Gambogi R, Hernandez Ortiz C, Alutuli L, Kalungia AC, Hoxha I, Marković-Peković V, Tubic B, Petrova G, Tachkov K, Laius O, Harsanyi A, Inotai A, Jakupi A, Henkuzens S, Garuoliene K, Gulbinovič J, Wladysiuk M, Rutkowski J, Mardare I, Fürst J, McTaggart S, MacBride-Stewart S, Pontes C, Zara C, Tagoe ET, Banzi R, Wale J, and Jakovljevic M

Subjects
Africa, Bangladesh, Brazil, Europe, Hypoglycemic Agents therapeutic use, India, Pakistan, Republic of Korea, Biosimilar Pharmaceuticals therapeutic use, Insulin, Long-Acting therapeutic use
Abstract

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers. Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders. Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries. Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production. Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities., Competing Interests: MW and JR work for HTA Consulting and MH works for Square Toiletries Limited. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Godman, Haque, Leong, Allocati, Kumar, Islam, Charan, Akter, Kurdi, Vassalo, Bakar, Rahim, Sultana, Deeba, Khan, Alam, Jahan, Kamal, Hasin, Munzur-E-Murshid, Nahar, Haque, Dutta, Abhayanand, Kaur, Rwegerera, Nascimento, Dias Godói, Irfan, Amu, Matowa, Acolatse, Incoom, Sefah, Acharya, Opanga, Njeri, Kimonge, Kwon, Bae, Khuan, Abubakar, Sani, Khan, Hussain, Saleem, Malande, Piloya-Were, Gambogi, Hernandez Ortiz, Alutuli, Kalungia, Hoxha, Marković-Peković, Tubic, Petrova, Tachkov, Laius, Harsanyi, Inotai, Jakupi, Henkuzens, Garuoliene, Gulbinovič, Wladysiuk, Rutkowski, Mardare, Fürst, McTaggart, MacBride-Stewart, Pontes, Zara, Tagoe, Banzi, Wale and Jakovljevic.)

Published
2021
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