Fifth Ghana FELTP Scientific Conference and 15th Anniversary Celebration Conference Proceedings

Ghana Field Epidemiology and Laboratory Training Programme^1,&

 

¹Ghana Field Epidemiology and Laboratory Training Programme

 

 

^&Corresponding author
Delia Bandoh, Ghana Field Epidemiology and Laboratory Training Programme.

 

 

 

 

 

 

Godwin Faigo^1,&, Samuel Dapaa², Magdalene Akos Odikro², Samuel Sackey ²

¹Veterinary Services Directorate, Mamprugu-Moagduri District, North East Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, Accra Ghana

^& Corresponding author: Godwin Faigo, Veterinary Services Directorate, Mamprugu-Moagduri District, North East Region, Ghana

 

Email: godwinfaigo72@gmail.com

Background: Animal anthrax is a World Organization for Animal Health listed and reportable zoonotic disease that is more prevalent in developing countries like Ghana. About 1.1. billion livestock in the world are at risk of the disease, and hence there is a need to assess the performance of the disease's surveillance system to aid in informed decisions. We evaluated the animal anthrax surveillance system in Mamprugu-Moagduri district to determine whether the system is meeting its objectives and to assess the usefulness and attributes of the system.

 

Methods:A cross-sectional design was used with updated Center for Disease Control and Prevention guidelines for Surveillance System Evaluation for the period 2015 - 2021. A semi structured questionnaire was designed and used to interview key stakeholders. Group discussions were held with farmers in randomly selected communities. Veterinary reporting forms, laboratory diagnosis and vaccination records were reviewed. Quantitative data were analysed using summary descriptive statistics while qualitative data were analysed using thematic analysis. Results were presented in tables and charts.

 

Results: The system prompted vaccination campaigns and health education. The system detected 210 suspected cases in 2019 of which 28 died. Samples were sent to the testing laboratory within 12 hours same day for all suspected cases. All the reporting officers knew the exact reporting channels with filling of VF1 taking about ten minutes The system is both hard and soft copy based and are used to collect data on other schedule diseases for reporting. One out of the four zones in the district report to the system. Out of 23 report forms reviewed, about 91.3% (21/23) were accurately and completely filled. The system adequately monitored the trend of a suspected outbreak and provided timely appropriate measures when one outbreak was detected. There was vaccination in 2019 which saw 894 sheep, 136 goats, and 155 cattle vaccinated.

 

Conclusion: The anthrax surveillance system was useful and partially meeting its objectives. It was sensitive, flexible, timely, acceptable, and representative. Simplicity and data quality were fairly good. Stability and PVP were poor.

 

Keywords: anthrax, surveillance, evaluation, zoonotic, outbreak, vaccination

 

 

Isaac Jakalia^1,2,&, George Akowuah², Joseph Asamoah Frimpong², Magdalene Akos Odikro², Ernest Kenu²

¹Food and Drugs Authority, Upper West Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, Accra, Ghana

^&Corresponding author: Isaac Jakalia, Food and Drugs Authority, Upper West Region|Ghana Field Epidemiology and Laboratory Training Programme, Accra, Ghana

 

Email: Isaac.jakalia@fda.gov.gh

Background: Sulphadoxine Pyrimethamine (SP) and Amodiaquine (AQ) used in Seasonal Malaria Chemoprevention (SMC) are not without Adverse Drug reactions (ADRs). Safety monitoring of public health programs such as SMC is pivotal in ensuring safety of medicines. The recommendation of WHO for a fully functional PV system is to detect about 200 to 250 reports per one million population per year. We determined the pattern and trend of SMC ADRs in the Upper West Region from 2018 to 2021.

 

Methods: A descriptive secondary data analysis was conducted. We created a line list and extract data from all completed ADR reports submitted to the regional office of FDA. We also extracted data on causality assessment from the feedback received from the Technical Advisory Committee on drugs. Variables used included reporting district, suspected product, symptoms of reaction, classification of ADR, outcome of ADR, drugs used for management. The data was analyzed into frequency, proportions, and rate. Results were reported in tables and graphs.

 

Results: A total of 930 SMC ADR were submitted to the Upper West regional Office of FDA. The highest ADRs were submitted by Nurses 59.4% (552/930). Daffiama Bussie Issa had a reporting rate of 52.7 reports per 1,000,000 population. Most of the ADRs 51.90% (437/842) were classified as probably. Fever 24% (403/1,669) was the most common symptom reported.

 

Conclusion: The surveillance data analysis did not detect any untoward ADRs during the analysis. The reporting rates within the districts were however not up to the WHO recommendation for reporting ADRs. Its therefore recommended that, the Regional Offices of FDA and GHS collaborates to educate health staff on the need to monitor and report ADRs during SMC.

 

Keywords: Seasonal Malaria Chemoprevention, Adverse Drug Reaction, Pharmacovigilance

 

 

Ishmael Kunateh Alhassan^1,2,&, George Akowuah², Joseph Asamoah Frimpong², Ernest Kenu²

¹Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), Accra, ²Wa Municipal Hospital, Ghana Health Service, Wa

^&Corresponding Author: Ishmael K. Alhassan, Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)

 

Email: ishmael0089@gmail.com

Background: Public health surveillance is not only the collection of data but also the analysis of data and communication of findings to relevant stakeholders for appropriate action. In the Upper West Region, Novel Coronavirus (COVID-19) surveillance data are collected periodically but are not analysed. We analysed the COVID-19 surveillance data to estimate the burden, describe the distribution of cases and describe the trend of COVID-19 cases in the Upper West Region.

 

Methods: A descriptive secondary data analysis was done using all confirmed cases recorded in the Upper West Regional COVID-19 line list from 2020 to 2021. Age and sex distribution were reported, case fatality rates (CFR) and incidence rates were reported by districts and an epidemiological curve was constructed. Analyses were done using Epi Info 7 and Microsoft Excel 2016. Maps were developed with QGIS v3.24. Results were presented as tables, graphs and maps.

 

Results: Out of 2,375 suspected cases, 27.9% (663/2,375) cases were positive with 24 confirmed cases resulting in death (CFR; 3.62%). Incidence rate was 37.2 per 100,000 per year. Most confirmed cases (90 vs 573) and deaths (3 vs 21) were recorded in 2021. Among the confirmed cases, 56.4 % (374/663) were males, 53.4% (354/663) were within 21 – 40 years. Wa Municipal recorded the highest incidence (73 per 100,000 per year) and mortalities (14/24). The epidemic curve showed a propagated outbreak.

 

Conclusions: COVID-19 incidence rate in the Upper West Region increased over the time period with increasing CFR. Cases were predominantly males and majority were between 21 to 40 years. Wa Municipal recorded the highest burden. Strict adherence to COVID-19 protocols and mass vaccination should be enforced by Regional Health Management Team to reduce the spread.

 

Keywords: COVID-19, Secondary data, Analysis, Incidence rate, Case Fatality Rate, Upper West Region, Ghana

 

 

Joseph Yaw Jerela^1,2,&, Rita Agyekumwah Asante Kusi¹, Timothy Letsa², Senanu Kwesi Djokoto²

¹Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), ²Regional Health Directorate, Ghana Health Service, Volta Region

^&Corresponding Author: Joseph Y. Jerela, Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)

 

Email: jerelayawka@gmail.com

Background: Globally, about 10 million people got infected with Tuberculosis (TB) with 1.2 million deaths recorded in 2019. Ghana's TB incidence in 2019 was 48 per 100,000. Regular analysis of TB surveillance data is needed to monitor the progress of interventions. We performed a descriptive analysis on TB surveillance data in the Volta Region of Ghana.

 

Methods: A secondary data analysis was used to analyze the TB surveillance data in the Volta Region from 2016 to 2020. Age, sex, HIV status, district, treatment outcome and mortality were collated from TB report forms (TB07 and TB08) in DHIMS2. We analyzed data as frequencies and proportions and presented as graphs and map.

 

Results: The overall TB case notification rate for the period was 4,502 (42%) of 10,829 people screened. The highest case notification rate, 944 (53%) of 1,781 was recorded in 2016 and lowest, 810 (42%) of 1,928 cases in 2020. Of the 4,502 positive cases, males accounted for 2,866 (64%) with age group 35-44 years accounting 770 (17%). Keta Municipality had the highest average TB case notification rate of 689 (69%) of 999 and the least, 1 (0.64%) of 156 in Anloga. The overall TB treatment success rate was 3,647 (81%) of 4,502 cases. Highest treatment success rate of 799 (87%) of 920 was achieved in 2017 with the lowest, 682 (75%) of 913 in 2018. The TB mortality rate for the period was 553 (12%) of 4,502 with 2018 recording the highest 121 (13%) of 913 cases.

 

Conclusion: Tuberculosis case notification rate in the Volta Region was low. Tuberculosis cases were highest among males and age group 35-44 years. Keta Municipality had the highest TB case notification rate. Tuberculosis treatment success rate was achieved in 2017 and the region's TB mortality rate was high. Community sensitization and counselling by TB focal persons will increase case detection and improve treatment outcomes.

 

Key words: Tuberculosis, Surveillance, Data, Analysis, Volta Region, Ghana.

 

 

Jiah Jiato Juah ^1,&, Rita Agyekumwah Asante Kusi^1,2, Magdalene Akos Odikro², Samuel Oko Sackey²

¹Food and Drug Authority, Bolgatanga, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme

^&Corresponding Author: Jiah J. Juah, Food and Drug Authority, Bolgatanga, Ghana

 

Email: jiah.juah@fda.gov.gh

Background: The Food and Drugs (FDA) Authority registers food products through Good Manufacturing Practice (GMP) inspections and product quality and safety evaluations. Nonadherence to food safety practices may result in foodborne diseases and ban in food trade. Despite continuous data collection in the product functionality software, data has not been analyzed in the Upper East Region (UER), hence the analysis of the Food Registration Surveillance data was conducted to determine the trends and distribution of registered food products.

 

Methods: Secondary data analysis was employed in analyzing data retrieved from the food surveillance database in the region from 2018 to 2021. Food type, date of application and location was collated and analysed as frequencies, proportions and presented as tables and graphs. QGIS was used to generate a map depicting the distribution of registered food industries within the region.

 

Results: The highest, 20 (29.0%) of 69 food product registered was observed in 2021 and lowest, 15 (22%) in both 2018 and 2019. Of the total 35 registered food industries in the UER, cottage industry formed the majority, 14 (40%) with the large-scale industry being the least 3 (8%). Bolga Municipal had the highest, 35 (50.7%) of the 69 registered food products while Bongo, Builsa South and North, Nabdam, Pusiga and Tempane recorded <5 products. Groundnut paste was the highest, 23 (33.3%) of 69 food types, whereas Burkina fresh yoghurt was lowest 10 (14.5%).

 

Conclusion: There was increase in food product registration from 2018 to 2021 in the UER. The Cottage Industry formed majority of food manufacturers industry. Bolgatanga Municipal had the highest number of registered food products with Groundnut paste being the major food product in the region. FDA Regional officers should intensify market surveillance activities, to ensure all food products produced are registered in the Upper East Region.

 

Keywords: Food Registration, Upper East Region, Surveillance, System

 

 

Judith Naa Deide Okine^1,2,&, George Akowuah², Joseph Asamoah Frimpong², Ernest Kenu²

¹Shama District Health Directorate, Shama District, ²Ghana Field Epidemiology and Laboratory Training Programme

^&Corresponding Author: Judith Naa Deide Okine, Shama District Health Directorate, Shama District

 

Email: judithnaadeedeokine@gmail.com

Background: HIV/AIDS has killed nearly 36.3 million people worldwide so far. WHO estimated that about 680,000 people will have died from HIV-related causes whilst 84% of HIV-positive people will have known their by 2020. The HIV surveillance system seek to rapidly detect HIV in the population, monitor the trend, providing data for estimation and projection of HIV prevalence in the district. This evaluation set out to assess whether HIV surveillance system in Shama District is meeting its objectives, assess its attributes and usefulness.

 

Method: A descriptive cross-sectional study was used. A review of HIV/AIDS surveillance records from 2017 to 2021 was conducted. Midwives, prescribers, JSI staff, data managers, Health Information Officer, Public Health Nurse, Surveillance Officer and HIV focal person were interviewed using a semi-structured questionnaire. Data analysis was carried out using Microsoft Excel. Qualitative responses were summarized into themes. Results were presented in text, tables, and charts.

 

Results: A total of 33,599 suspected HIV cases were tested over the period, 716 (2%) were positive. Of this, 95% (583/716) were put on treatment. Case definitions and job aides were available at various work stations for easy reference. Participation among private facilities was not encouraging. The system is integrated with Tuberculosis and Syphilis surveillance systems. Completeness of reports was 100% (336/336). Overall timeliness rate was 99.1% (333/336). Facility case reports were from only 2 out of 5 sub districts.

 

Conclusion: The surveillance system was useful and partially meeting its objectives. It was simple, flexible, stable, fairly acceptable and sensitive with a low PVP. Timeliness and data quality needs improvement. There should be capacity building on data management and reporting for service provides in health facilities.

 

Keywords: HIV, surveillance, evaluation, Ghana

 

 

Kingsley Atuahene Ampratwum^1,&, Akosua Gyimah Omari-Sasu¹, Enyonam Kwawukume³, Darius Agyei², Martha Danso², Joseph Amoateng¹, Jerry Adu-Amankwaa³, Hephzibah Okyere-Mensah³, Gladys Abban², Linda Agyarko Poku²

¹Kumasi Metropolitan Health Directorate, ²Manhyia District Hospital, ³Ghana College of Physicians and Surgeons

^&Corresponding Author: Kingsley A. Ampratwum, >Kumasi Metropolitan Health Directorate

 

Email: kingsley.ampratwum@yahoo.com

Introduction: Food poisoning, happens when a person or a group of persons consume food that may be contaminated with microbes, their toxins, or chemical. Most cases are accidental and may arise from contamination of ingredients, overdose of additives, or contamination of utensils. Globally, 600 million cases and 420,000 deaths are reported annually. In Ghana, 1914 cases were reported between 2013 and 2021, with 36 deaths. We investigated a case of food poisoning among students of a Girls SHS in the Kumasi Metropolis to estimate the burden, identify the cause and implement control measures.

 

Methods: Medical records were reviewed. Active case search was conducted in classes. Our outbreak Case Definition was ‘Any person who developed diarrhoea and or abdominal pains from March 5-8, 2022 within the school’. An unmatched case-control study (119 cases, 347 controls) was conducted after descriptive epidemiology, to test for association between the suspected exposure and the outcome. Confidentiality was ensured by excluding the name of the school. Results were presented as tables and charts

 

Results: A total of 119 boarders, out of 982 (attack rate 12.1%) were affected, and 18 were hospitalised. The mean age was 17.4 (range 15-20, SD±0.92). Onset of index case was March 5, 2022. Symptoms included Abdominal pains (84/119), Diarrhoea (95/119) without mortality. A total 109 (91.6%) cases ate Rice and stew, 6 (5%) ate tea and bread, 7(5.8%) ate banku and groundnut soup, 4 (3.3%) ate rice balls and 1(0.8%) ate porridge prior to incident. Odds ratio was 9.9 for consumption of rice-and-stew. Students and food-vendors were educated on food hygiene

 

Conclusion: A point source outbreak was concluded. The odds ratio indicated very strong association between consumption of the rice-and-stew and the outbreak. We recommend screening for food-vendors and education on food hygiene.

 

Keywords: Food poisoning, Senior High School, Kumasi

 

 

Owusu Kwabena^{1, 2,&}, George Akowuah², Magdalene Akos Odikro², Joseph Asamoah Frimpong², Samuel Sackey²

¹Ghana Health Service, Wa West District Health Directorate, ²Ghana Field Epidemiology and Laboratory Training Programme, Accra

^&Corresponding Author: Owusu Kwabena, Ghana Health Service, Wa West District Health Directorate

 

Email: okwabena7@gmail.com

Introduction: Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord causes the swelling. In 2020, 381 meningitis cases were reported in 3 districts of Upper West Region with attack rate of 44.1/100, 000 population and case fatality rate of 13.1%. The danger meningitis poses to human life and development implores the need to analyze surveillance data to inform public health action. We determined the epidemiologic distribution of meningitis in the Upper West Region.

 

Methods: The study adapted descriptive cross-sectional study design using secondary data on meningitis surveillance from the Upper West Regional Health Directorate for the period of 2017 to 2021. Descriptive analysis were performed by person place and time. Freqeuncies and proportions were calculated. Graduated maps were used to display the distribution of cases by districts. Case fatality and incidence rate were calculated using populations of the region. Results were presented in figures and tables.

 

Results: The region suspected 1,061 cases across all districts over the five-year period. Of this, 189 were confirmed with a case fatality rate of 43.4% (82/189). High incidence and fatalities were recorded in Nandom 54(96/100,000, Jirapa 47 (44/100,000, and Nadowli-Kaleo 47 (63/100,000) Cases were predominantly 1 to 19 years, 67.2% (127/189) and males 51.3% (97/189). Fatalities were more common among males, 67.2% (51/82) and children under five years, 26.8% (22/82). Case fatality rate was highest, 41.2% (56/136), in 2020.

 

Conclusion: The region recorded her highest number of cases in 2020, cases increased between November and March. Nandom Municipal recorded the highest case fatality rate. Males and young people below 20 years were most affected. Regular mass vaccination and health education on meningitis should be intensified across all communities in the Upper West Region.

 

Keywords: Meningitis, surveillance, fatality, incidence, Upper West Region, Ghana

 

 

Kwadwo Boakye^1,&, Rita Asante Kusi², Samuel Oko Sackey², Ernest Kenu²

¹Veterinary Service Directorate, Effutu, ²Ghana Field Epidemiology and Laboratory Training Programme

^&Corresponding Author: Kwadwo Boakye, Veterinary Service Directorate, Effutu

 

Email: Kaybee.kwadwo2@gmail.com

Introduction: Avian influenza (AI) is a highly contagious viral disease affecting several species of birds. The zoonotic and socio-economic threats of AI raise serious concerns regarding the sustainability of an already weakened poultry industry in Ghana. We evaluated the AI surveillance system in the Central region to assess the system's attributes, its usefulness and also whether it is meeting its objectives.

 

Methods: A cross-sectional survey was conducted in evaluating the AI surveillance in the Central region from 2017 to 2021. Based on the US Center for Disease Control updated guidelines for evaluating public health surveillance system, a semi-structured questionnaire was designed for record reviews, observations and interviews. Data collected was analyzed using Microsoft excel, 2016 to generate mean and frequencies. Attributes including simplicity, flexibility, representativeness, acceptability, data quality, stability, timeliness, sensitivity and predictive positive value were evaluated.

 

Results: In total, 50 stakeholders were interviewed. Between 2017 and 2021, 21 (55.3%) of 38 suspected samples screened for AI in the Central Region were positive. About 25 (83.3%) of 30 veterinary workers indicated the system accommodates surveillance of other enzootic poultry diseases, while 29 (96.7%) knew the case definition and found reporting format as easy. Most, 46 (92%) of 50 respondents reported AI cases. Monthly report from 13 (59.5%) of 22 districts was complete. Laboratory results also took 24 to 72hours with 21 (91.3%) of 23 suspected AI cases confirmed as true positives.

 

Conclusion: The AI surveillance system in Central Region was meeting its objectives and useful in case detection. The system was simple, flexible, representative, with fair acceptability, data quality, stability, timeliness of reporting. Sensitivity and Predictive Positive value were good. The Head, Regional VSD should train veterinary staff on the principles and importance of disease reporting to be done in improving data quality and representativeness of surveillance reports.

 

Key words: Avian Influenza, Surveillance, Central Region

 

 

Longstone Ohene Spio^1,&, Rita Asante^1,2, Magdalene Akos Odikro², Joseph Asamoah Frimpong²

¹Food and Drugs Authority, Central Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)

^&Corresponding Author: Longstone O. Spio, Food and Drugs Authority, Central Region, Ghana

 

Email: longstone.spio@fda.gov.gh

Background: In Ghana, the FDA ensures vaccine safety and efficacy after market approval through safety monitoring of drugs including the AEFI surveillance system to minimize vaccine associated adverse effect on the health of individuals and entire population. To ensure the sustainability of the Central Region's contribution to the national target for AEFI reports, we evaluated the AEFI surveillance system to determine if its objectives were being met, assess its attributes and usefulness.

 

Methods: We used a cross-sectional design to evaluate the AEFI surveillance system from January 2017 to December 2021. Semi-structured questionnaire was used in collecting quantitative and qualitative data via interviews, observations and records review. Microsoft excel, 2016 was used to analyse data into frequencies, proportions and results presented as text, table and charts.

 

Results: Majority, 21 (58.3%) of the 36 stakeholders interviewed were females. The reporting rate of AEFI surveillance system was 3.4/100,000 population. About 268 (56.8%) of the 472 reported cases were females with median age of all cases being 38 (3-80) years. Of the 22 districts in the region, 19 (86%) were represented in the AEFI reports. Awutu Senya East recorded the highest 136 (28.8%) of 472 cases. Average of 33 days reporting time from the day of onset was observed. AEFI form modification and the inception of Med Safety and Safety Watch online System was done. Since 2017, generated data on AEFI surveillance system has led to training of health workers by FDA and EPI.

 

Conclusion: The surveillance system was partially meeting its objectives. The system was flexible, representative, acceptable, stable and sensitive but not simple. Data quality and timeliness was poor. The system was useful in making decisions to promote public health. We recommend increase in public sensitization and staff training of tools used for AEFI reporting and data management.

 

Keywords: Adverse Event Following Immunization, Evaluate, Surveillance, System

 

 

Louis Jean Piu^1,&, Simon Adjei², Rita Asante Kusi², Samuel Oko Sackey²

¹Ghana Health Service, ²Ghana Field Epidemiology and Laboratory Training Programme

^&Corresponding Author: Louis J. Piu, Ghana Health Service

 

Email: eaglejean07@gmail.com

Background: Globally, about 2.5 million new cases and 236,000 meningitis fatalities are recorded annually. In Ghana, over 3,000 cases and 400 meningitis deaths are recorded yearly with Upper East Region recording 352 cases. Data generated on meningitis must be analysed, interpreted and disseminated to relevant stakeholders to make informed decision in reducing meningitis morbidity and mortality. We sought to descriptively analyse meningitis data for Upper East Region of Ghana for 2017 to 2021.

 

Methods: Secondary data on meningitis surveillance for the Upper East Region from 2017 to 2021 was analysed. Data on age, sex, district of residence and date of onset of symptoms were extracted from meningitis line list for the region and frequencies, proportions, and case fatality rates determined. Microsoft excel 365 and QGIS 3.24.2 was used for analysis and results presented as charts, maps and tables.

 

Results: About 672 suspected Meningitis cases were reported from 2017 to 2021 with 132 (19.6%) cases being positive and a Case Fatality Rate of (29) 21.9% among 132 cases. A total of 132 cases were confirmed in 12 (80%) of the 15 districts in the region with Bawku Municipal recording 37 (28.0%) cases. Males were mostly 398 (53.8%) affected with 543 (80.8%) cases among persons below 35 years. The 5-years overall attack rate was 2.1 per 100,000 populations among 6,339,277 with 2017 recording the highest 5.7 and lowest, 0.3 in 2021.

 

Conclusion: Cerebrospinal meningitis in the Upper East Region affected mostly persons in the youthful age with a high Case fatality Rate. All districts confirmed cases except Builsa South, Binduri and Bolgatanga East Districts. We recommend that the Director of health services organize health education and promotion activities as well as routine and mass vaccination exercises to keep cases at the lowest level.

 

Keywords: Meningitis, Surveillance, Upper East Region

 

 

Lamin Manjang^1,&, Razak Gyesi Issahaku¹, Mary Bobb¹, Louisa Cassell¹, Thelma Aphour¹, Isaac Baffoe-Nyarko¹, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon

^&Corresponding Author: Lamin F. Manjang, Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon

 

Email: manjangsambouwally@gmail.com

Background: Unsafe waste handling practices among tricycle waste collectors remain a public health challenge in Ghana. Previous evidence reported compliance level of Personal Protective Equipment (PPE) use at 36% in Accra. An estimated 43.7% to 63.9% of occupational injuries occur among solid waste collectors in Sub-Saharan Africa, including Ghana. Yet, the factors influencing adopting safe waste handling practices in Accra remained unclear. We assessed compliance and factors influencing PPE use among tricycle waste collectors in Achimota, Accra.

 

Methods: This study was a cross-sectional study. A semi-structured questionnaire and observational checklist were used to collect data on April 30, 2022, through face-to-face interviews and observation techniques. A sample size of 112 participants was estimated. The relationship between PPE use and several factors, such as educational and training status, PPE availability, length of service, age, previous injury exposure, and daily income, was examined using Pearson's Chi-square test. The level of significance was determined using an alpha level of 0.05. Descriptive statistics were performed for the continuous variables and reported using tables and graphs.

 

Results: One hundred and fourteen respondents were studied. The mean age and length of experience were 33.6 (sd. 9.5) and 3.5 (sd. 1.9), respectively. Level of PPE use was 37% (42/114). About 71% (81/114) were previously exposed to occupational injury. Moreover, education level [OR = 0.14 (95% CI: 0.055 – 0.342)] and possession of PPEs [OR = 3.7 (95% CI: 1.830 – 7.653)] were significantly associated with non-compliance of PPE use.

 

Conclusions: PPEs use among tricycle solid waste collectors low. Higher levels of education and availability of PPEs promoted PPE use. We recommend further studies and appropriate interventions towards unsafe waste handling practices.

 

Keywords: Solid waste, PPE use, tricycle, waste collectors, Achimota, Ghana

 

 

Akua Oduraa Nuamah^1,&, Yaw Karikari Asamoah², Sally Quartey², Delia Akosua Bandoh¹, Donne Ameme¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon, ²Madina Polyclinic Rawlings Circle, Ghana Health Service, ³Tema Metro Health Directorate, Ghana Health Service

^&Corresponding Author: Akua Oduraa Nuamah, Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon

 

Email: akuaod.nuamah@gmail.com

Background: Globally, an estimated 2.5 million newborns died in 2018, constituting about 7,000 newborn deaths every day. Global mortality estimates are primarily reliant on data from developing nations, which account for majority of newborn deaths. Sub-Saharan Africa accounts for approximately 41% of global neonatal deaths. Ghana's neonatal mortality rate was 22.9 deaths per 1,000 live births in 2020. We describe trends and causes of neonatal mortality to provide evidence that could be useful in the design and implementation of interventions to reduce neonatal mortality in Ghana. p class='ParagraphSeparator'> 

Method: We performed secondary data analysis on neonatal mortality data from 2016 to 2020 in a Ghanaian secondary health facility within the Tema Metropolis. Data were extracted from the District Health Information Management System (DHIMS II) and mortality registers. Variables collected were sex, age, date of admission, date of death, and cause of death. We analysed neonatal mortality data descriptively and presented results as frequencies, proportions, and graphs.

 

Results: Neonatal mortality rate in the health facility was 27.4 deaths per 1000 live births (833/30,447). The highest rate being of 38.5 deaths/1000 live births (201/5,226) was recorded in 2020, with the least NMR 2.4 deaths/1000 live births (15/6238) recorded in 2016. Out of 833 neonatal deaths, 69.9% (583/833) were early neonatal deaths. Between 2016 and 2020, neonatal deaths were high in males, at 57.8% (482/833). Preterm (29.5%), asphyxia (21.0%), respiratory distress syndrome (16.5%), septicaemia (8.2%), and jaundice (4.6%) were the top five causes of early neonatal deaths. Brought-in-dead accounted for most late neonatal deaths, 47.0% (67/140).

 

Conclusion: Neonatal mortality in health facilities is still high. The top causes of neonatal deaths are preventable. Majority deaths occurred in babies born within health facilities, presenting an opportunity to reduce mortality by improving the quality of care provided during perinatal, intra-natal and postnatal care.

 

Keywords: Surveillance, Neonates, Neonatal mortality, Tema, Ghana

 

 

Robert Nuoh^1,2,& , Hilarius Abiwu¹, Gyasi Razak^1,2, Francis Atiagbor^1,2, Daniel Appiah², Joseph Asamoah Frimpong^1,2, Ernest Kenu^1,2

¹Northern Regional Health Directorate, Ghana Health Service, Tamale, ²Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon

^&Corresponding Author: Robert Nuoh, Northern Regional Health Directorate, Ghana Health Service, Tamale

 

Email: nuohrobert@yahoo.com

Background: A switch from tOPV to bOPV in Ghana in 2016 led to the emergence of Vaccine derived poliovirus type 2 in under-immunised populations. The Northern Region recorded two confirmed events of cVDPV2 from environmental samples. From Koblimahgu and Nyanshegu on April 19, 2022. We investigated the outbreak to identify human cases, determine geographical spread, assess the immunisation system, determine the risk of spread and implement control measures.

 

Methods: Investigations were carried out in Tamale and Saganrigu Municipalities of the Northern Region of Ghana between 2nd and 10th May 2022. World Health Organization (WHO) integrated health facility supportive supervision checklist, WHO community vaccination coverage survey checklist, and semi-structured questionnaire were used to assess risk and immunisation. We visited health facilities and communities, surveyed 172 children for vaccination status and collected stool samples from 70 healthy children and 21 environmental samples for testing.

 

Results: Polio Vaccination Coverage for 2021 are as follows, Sagnarigu, OPV1(67.7%), OPV 2(70.2%), OPV3(70.3%), IPV (72%), Tamale Metro, OPV1(152%), OPV2 (140.2%) OPV3 (137.3%), IPV (138%,). Out of 172 children surveyed for vaccination coverage in the community, 154 (89.5%) were fully immunised for age,12 (7%) were partially immunised, and 6 (3.5%) were never immunised. In all, (17/21) environmental samples and (3/78) healthy children were positive for CVDPV2 – making a total of about 115.6% (473585/409, 549) of eligible children in the Region vaccinated with nOPV to control spread.

 

Conclusion: An outbreak of CVDPV2 occurred in Tamale spread among x subdistricts. A key challenge for estimating coverage was wrong population estimates in some subdistricts. However, low vaccination coverage, attrition of community health nurses, and accurate` estimates of actual populations are critical areas that must be addressed as part of polio eradication efforts and health planning in the Region.

 

Keywords: Outbreak, Circulating, Vaccine-Derived, Polio-virus, Ghana

 

 

Shahadu Shembla Sayibu^1,&, Sarja Jarjusey¹, Robert Ossom¹, Ebenezer Nana Wireko¹, Francis Mendy¹, Richard Wodah-Seme², Charles Lwanga Noora¹, Basil Benduri Kaburi¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon, Accra, ²Upper West Regional Health Directorate, Ghana Health Service, Wa

^&Corresponding Author: Shahadu Shembla Sayibu, Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon, Accra

 

Email: drshembla@yahoo.co.uk

Background: Food hygiene refers to the practices of handling, preparing, serving, and storing food to promote safety and reduce the risk of foodborne illnesses. Although the Municipal health directorate of the University of Ghana has instituted measures to improve food hygiene practices medical records from students' clinics indicate foodborne illnesses as common. We assessed food hygiene practices and sanitary conditions among food vendors of the University of Ghana.

 

Methods: We surveyed vendors at the two markets over one day. We observed the adherence and use of food protection gears such as, aprons, headcovers, and food covers. We also assessed the hygiene of the immediate environment and obtained sociodemographic details: age, sex, level of education, and length of time in the food vending. A narrative descriptive analysis and summary statistics of data was done.

 

Results: We observed a total 59 food vendors and interviewed 58 of them. About 53% (31/59) wore headgear, and 15% (9/59) covered food when waiting for customers. About 88% (52/59) did not wear gloves, and handled both food and money with the same hand. The markets had no running water for handwashing. About 60% (6/10) of food stands had an assistant collecting money while vendors served food. Of the 58 we interviewed, about 78% (45/58) 45 (78%) had primary or secondary education. About 32% (18/52) had less than one year of food vending experience, and 18% (10/56) had more than 10 years' experience.

 

Conclusion: Food hygiene practices at the university common markets are not optimum with the poorest practices being wearing food safety gears and handling of food. We recommended regular refresher talks to be organised by the municipal health directorate on food hygiene; handwashing facilities, mandatory wearing of gloves and headgear while serving food by the end of 2022.

 

Keywords: Food hygiene, food vendors, food safety gears, market, University of Ghana

 

 

Stephen Ofori Nyarko^1,2,&, Eunice Baiden Laryea², Deborah Pratt¹, Esinam Agbosu¹, Charles Lwanga², Magdalene Odikro², Joseph Asamoah Frimpong², Samuel Sackey², Ernest Kenu², Joseph Humphrey Kofi Bonney¹

¹University of Ghana, Noguchi Memorial Institute for Medical Research, Legon, ²Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon

^&Corresponding Author: Stephen Ofori Nyarko, University of Ghana, Noguchi Memorial Institute for Medical Research, Legon

 

Email: snyarko16@gmail.com

Background: The World Health Organization (WHO) estimates that one-third to half of the world's population is at risk of getting infected with chikungunya and common in tropical areas, parts of Africa, South America and Asia. Although Ghana is prone to these vector-borne diseases, but there is limited data on dengue and chikungunya infection in Ghana. This analysis aimed to determine the seroprevalence, factors associated with these infections and their seasonality pattern.

 

Method: Secondary data analysis of dengue and chikungunya infections in Ghana was conducted. Data was obtained electronically from the virology department of Noguchi Memorial Institute for Medical Research. The institute processed samples collected at sentinel sites located in seven different regions. Period of analysis was from 2016 to mid-2018. To estimate seroprevalence, proportion of participants that were reactive to IgM/IgG for dengue and chikungunya was determined. Bivariate analysis was conducted to determine factors associated with these infections, and trend analysis was performed to determine the seasonality of infections.

 

Results: A total of 1,105 participants' entries were analysed. The mean age (years) recorded was 33±16, and 64% (693/1105) of female. The seroprevalence of 62% (681/1105) for dengue and 41% (424/1053) for chikungunya. The odds of being infected with dengue were higher among residents of Greater Accra (OR=1.87, 95%CI [1.43-2.46]) and Northern regions (OR=4.62, 95%CI [2.00-10.63]) than in the Ashanti Region. There was no distinct seasonal pattern, as infections occurred all year round.

 

Conclusion: The seroprevalence of dengue and chikungunya was estimated to be high. Residents of Greater Accra and the Northern Region had an increased odds of being infected with both viruses. Observed seasonal pattern absence can be partially attributed to insufficient data. We recommended the two diseases to be incorporated into the malaria program for differential diagnosis because of higher seropositivity.

 

Keywords: dengue, chikungunya, seroprevalence, infection, seropositivity, Ghana

 

 

Adu Boahen Gyekye^1,&, George Khumalo Kuma², Enoch Anto Opoku¹, Charles Lwanga Noora¹

¹Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon, ²Bono Region Health Directorate, Ghana Health Service, Sunyani

^&Corresponding Author: Adu Boahen Gyekye, Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Legon

 

Email: kwamekye2@yahoo.com

Background: Buruli ulcer (BU) has a low mortality rate. However, it can result in ulcers causing functional disabilities in affected individuals if poorly managed or untreated. Data show that Asante-Akim North had had 38 cases/100,000 in 2018. According to a municipal health performance review, the BU surveillance system has not been evaluated since 2015. We evaluated the BU surveillance system to determine if it is meeting its objectives, and to assess its attributes and usefulness.

 

Methods: We adapted Center for Disease Control (CDC) guidelines for evaluating public health surveillance systems (2001). Surveillance data from 2016-2020 from District Health Information Management System-2 (DHIMS-2) were extracted and reviewed. Key stakeholders were interviewed using a structured questionnaire on system description and attributes and direct observations with a checklist. Surveillance data sets were analysed using frequencies and proportions and presented in graphs and tables.

 

Results: The surveillance system detected 1973 suspected cases at the national level, 250 at regional level, and 115 at the district level. The ratio of pre-ulcerative to ulcerative was 1: 0.6 at the district level, 1:11 at the regional level, and 1:2 at district level. The predominant age group affected was >15 years (53.9%), and the national PCR non-confirmation rate was 26.9%. The timeliness of reporting was 12.5%. All sub-districts reported suspected cases. About 52.2% (60/115) were males, and the most affected age group were those older than 15 years 53.9% (62/115). BU-01 case form completion rate 80-85%, and positive predictive value was 95.65%.

 

Conclusion: The system is meeting its objectives partly, with good attributes and usefulness. We recommend the DHMT organise refresher training for staff on surveillance activities. Also, NBUCP should resource and enhance the capacity of all regional laboratories with PCR testing, particularly in endemic regions to reduce disease burden.

 

Keywords: Buruli ulcer, PCR, Surveillance System, Evaluation, Ghana

 

 

Daniel Tetteh Agudey^1,&, Gifty Amugi¹, Dennis Laryea², Gyimah-Mireku¹, Ebenezer, Kofi Mensah¹, Samuel Oko Sackey³, Abigail Birago Ofosuhene³, Joseph Frimpong³, Dennis Jubin¹, Clement Tettey¹, Daniel Bomfeh¹, Yaw Ofori Yeboah¹

¹Western Regional Health Directorate, Ghana Health Service, Takoradi, ²National Surveillance Department, Accra, ³Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon

^&Corresponding Author: Daniel Tetteh Agudey, Western Regional Health Directorate, Ghana Health Service, Takoradi

 

Email: danielagudey@gmail.com

Background: Viral Haemorrhagic Fevers (VHFs) are a group of diseases caused by several distinct families of viruses, such as Ebola, Marburg, and Lassa and affects the body's vascular system leading to significant internal bleeding and multiple organ failures. Though most VHFs have case fatality rate of about 50%, there are neither cures nor vaccines. The increase of zoonotic epidemic-prone illnesses in Ghana and the Sub-Saharan Africa necessitates continued enhancement of the surveillance system to build resilience. We conducted a field simulation exercise to assess the readiness and capacities of Western Region to respond to VHFs outbreaks.

 

Methods: Tarkwa Nsuaem Municipality and Apinto Government Hospitals in the Tarkwa Nsuaem Municipality hosted the field simulation exercise on June 28, 2022. There was a pre-media engagement with journalists, and six persons simulated the field exercise. Three different scenarios depicting Ebola Virus Disease, Yellow Fever, and Lassa Fever were played out in both hospitals. Staff and Rapid Response Teams in both hospitals were blinded to the exercise. We collected data on surveillance, laboratory, and case management capacities, protocols, and procedures. We performed a descriptive analysis.

 

Results: Key strengths observed were an opportunity for peer mentoring, general awareness of VHFs among healthcare workers and functional reporting channels for public health emergencies from the facility to the regional level. Infection Prevention and Control (IPC) protocols, Triaging at the Out-Patient Department and Knowledge of Communicable Diseases were not poor.

 

Conclusion: The response preparedness of facilities was sub-optimal and could not respond to cases of VHFs if detected. Strengthening surveillance, triaging, and knowledge of infectious diseases will improve preparation and rapid response. Based on our recommendations, the two health facilities suspected three VHFs which tested negative.

 

Keywords: VHFs, Field Simulation Exercise, Infection Prevention Control, Tarkwa Nsueam Municipality

 

 

Eben Godsway Dzodanu^1,&, Rufai Tanko¹, Ernest Kenu¹, Edmond Ekow Kaitoo²

¹Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon, ²New Juaben South Municipal Health Directorate – Ghana Health Service, Juaben

^&Corresponding Author: Eben Godsway Dzodanu, Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon

 

Email:ebendzodanu@gmail.com

Background: Mental illness refers to all diagnosable mental disorders. They are characterised by sustained, abnormal alterations in thinking, mood, or behaviour associated with distress and impaired functioning. Mental illness is distant first in the global burden of disease in terms of years lived with disabilities, with estimates of the global burden of mental illnesses accounting for 32.4% of years lived with disability. It remains a low priority for African countries. Mental health data informs policy. Hence, we analysed the mental health surveillance data in the New Juaben South municipality to determine the distribution and trend of mental health illnesses.

 

Methods: Municipal-level mental health data from January 2016 to December 2020 was extracted from District Health Information Management System II, cleaned and analysed in Excel 2019. We performed descriptive analysis person and place. We performed trend analysis and presented the results using tables and figures.

 

Results: A total of 1870 mental health cases were reported from 2016 – 2020. Schizophrenia was the most reported mental health condition (518/1870, 27.7%), and the least common were behavioural and personality disorders each making 0.1 % (2/1870) of cases. The incidence of mental illnesses was higher among females (54.4%). Highest proportion of disorders (729/1870, 38.9%) was recorded among the 20 – 34 age group. The reported mental health disease pattern was irregular, but a peak was observed in 2020. Koforidua 2 sub-municipalilty recorded the highest proportion (1499/1870, 80.2%), while Agavenya, Densuano, and Zongo sub-municipalities did not record any case of mental illness for the period.

 

Conclusion: Females in general, and those aged between 20-34 years appear to be disproportionately affected by mental health disorders. There is no established pattern of geographical distribution of mental health cases. Community mental health activities should be strengthened, and mental health interventions should prioritise females.

 

Keywords: Mental Illness, Surveillance data, New Juaben South, Ghana

 

 

Grace Adjoa Ocansey^1,2,&, Godfred Konnyebal¹, Donne Ameme¹, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon, ²Ghana Health Service

^&Corresponding Author: Grace Adjoa Ocansey, Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon

 

Email: graceadjoas@gmail.com

Background: HIV/AIDS remains a public health threat. Globally, 37.7 million persons are living with HIV/AIDS; 4.9 million of thee in Sub-Saharan Africa. In Ghana, HIV prevalence was 1.7% in 2020. Heterosexual intercourse and mother-to-child transmission (MTCT) accounts for most new HIV cases in the country. We evaluated the HIV/AIDS surveillance system to assess its usefulness and attributes and determine whether it meeting its objectives.

 

Methods: We evaluated the HIV/AIDS surveillance system in Kpone-Katamanso Municipality using CDC Updated Guidelines for Evaluating Public Health Surveillance Systems. We engaged stakeholders in HIV/AIDS surveillance from the community to the national level through in-depth interviews, observation and semi-structured questionnaires. Additionally, we reviewed reporting forms, registers, summary sheets and electronic data in DHIMS2, e-tracker from 2017-2021. Data were entered into MS Excel, exported into Epi Info 7.2.5, analysed by deriving frequencies and means and presented as tables and graphs.

 

Results: Out of 37 stakeholders engaged, 56.8% (21/37) were females, and 89.2% (33/37) had tertiary education. The HIV/AIDS surveillance data were used to determine trends, estimate morbidity/mortality and improve clinical practice. From 2017 to 2021, there were a total of 26,544 HIV tests, 7.3% (1,947) of which were positive. About 33.3% (211/633) of positive cases were linked to care in 2020, and 86.1% (310/360) in 2021. Also, 90.3% (168/186) of those eligible were on Tuberculosis Preventive Therapy in 2021. The system adapts to variations in funding sources and new health events but with low reporting from private hospitals. About 86.5% of stakeholders were involved in HIV activities five days a week.

 

Conclusion: The HIV/AIDS surveillance system is functional and meets its objectives. It's fairly simple, flexible and acceptable but has low representativeness. The Municipal Health Directorate should involve private health centres actively involved in HIV/AIDS activities.

 

Keywords: HIV/AIDS, Surveillance, Evaluation, Kpone-Katamanso Municipality, Ghana

 

 

Michael Awenkanab Avarade^1,2,3,&, George Akowuah^1,3, Pascal Mwine ^1,2,3, Maasoayel Christopher^1,2 Kwabena Owusu^1,2 Ishmael Kunateh Alhassan^1,2, Ziyadah Suleman Gbene^1,2, Isaac Mwinebuobo Jakalia^1,2, Sidik Yakubu^1,2, Magdalene Odikro¹, Charles Lwanga Noora^1,2,3 Donne Kofi Ameme^1,2,3 Ernest Kenu^1,2

¹Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon, ²Department of Epidemiology and Disease Control, University of Ghana, Legon, ³Ghana Health Service, Accra

^&Corresponding Author: Michael Awenkanab Avarade, Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon

 

Email:avaradem@yahoo.com

Introduction: Yellow fever is a disease of public health concern, especially in the Sub-Saharan Region, with a high case fatality rate above 50%. It is transmitted from animals to humans (sylvatic cycle) or humans to humans (urban cycle). In February 2022, a Yellow fever (YF) case was suspected in Ducie, in the Wa East District of the Upper West Region. We investigated the outbreak to determine its magnitude, source, risk factors, and to put in the appropriate control measures to stop it.

 

Methods: We reviewed medical records, conducted active community case search, environmental assessment, vaccination coverage assessment, and risk communication. We evaluated the YF surveillance system in the district from January 1 2015, to June 18 2022.

 

Results: A single case was reported in the district on June 23rd, 2022. District attack rate of 1.1 per 100,000 population. The case was a 10-year-old girl resident of the Ducie community in the Bulenga Sub-district. She was of Chakale ethnicity. The vaccination status of the patient was unknown. The case patient is alive and doing well. Four (4) of the 167 records reviewed met our case definition but were not detected by the YF surveillance system. Out of 36 participants interviewed, 56% (20/36) were aware of YF, and 30.6% (11/36) had knowledge of the signs and symptoms. The YF surveillance system detected 87 suspected YF cases and two outbreaks.

 

Conclusion: The outbreak involved a single case. We found low awareness and knowledge of YF among residents and healthcare workers. The YF surveillance system was sensitive, timely and representative, but has of low data quality.

 

Keywords: Yellow fever, outbreak investigation, surveillance system, evaluation, Wa East District

 

 

Christian Owusu-Nyantakyi^1,3,&, Holy Alomatu¹, Rita Dede Lomotey², Felicia Amoa Owusu³, Delia Benewaa Bandoh¹, Magdalene Odikro¹, Donne Ameme¹

¹Ghana Field Epidemiology and Training Program, University of Ghana, Legon, ²Upper-West Akim Health Directorate, Wa, ³University of Ghana, Noguchi Memorial Institute for Medical Research, Legon

^&Corresponding Author: Christian Owusu-Nyantakyi, Ghana Field Epidemiology and Training Program, University of Ghana, Legon

 

Email: owusu4677@gmail.com

Background: Yaws is a neglected tropical disease caused by Treponema pallidum pertenue, with 75% of cases occurring before age 15. The burden of Yaws cases reduced significantly in the early 1950s. However, the disease has re-emerged worldwide, and Ghana remains a significant transmission focus in Africa. The Yaws surveillance data was analysed to determine the prevalence and factors associated with the disease.

 

Methods: Secondary data analysis was conducted on the Yaws surveillance data obtained from the Upper-West Akyim district between 2018 – 2021. Data on suspected and confirmed Yaws cases were extracted from DHIMS 2 and district line lists and cleaned. Descriptive statistics were performed. We calculated means and standard deviation for continuous variables, and proportions for categorical variables. Chi-square test and logistic regression were used to determine the significance and strength of the association between variables and Yaws infection with 95% confidence level.

 

Results: A total of 966 suspected were analysed with a positivity rate of 20% [95%CI: 17.6–22.6]. The mean age of suspected and confirmed cases was 10.06 ± 0.14 [95%CI: 9.78–10.34], majority of whom were males (58.13%, n=561). Majority of the positive cases presented with papilloma (91.7%, n=177). The odds of Yaws infection among suspected cases was 1.62 [95%CI: 1.14–2.29] times higher in children between 11-15 years compared to those between 5-10 years. Males had a 0.53 [95%CI: 0.37–0.75] times reduced odds of Yaws infection compared to females. The odds of Yaws infection were 1.59 [95%CI: 1.01–2.49] times higher among people living in Okurase sub-district compared to those in the Adaeiso sub-district.

 

Conclusion: The high prevalence of Yaws in the Upper-West Akim district highlights the need for continuous surveillance and public education to create awareness. We recommended mass treatment with Azithromycin within the district to prevent further transmission of the infection.

 

Keywords: Yaws, Treponema pallidum pertenue, Surveillance data, Azithromycin, Upper-West Akim

 

 

Samuel Kwasi Apedo^1,&, Mary Akua Ampomah¹

¹University of Health and Allied Sciences, Fred N. Binka School of Public Health, Hohoe, Ghana

^&Corresponding Author: Samuel Kwasi Apedo, University of Health and Allied Sciences, Fred N. Binka School of Public Health, Hohoe, Ghana

 

Email:skapedo18@gmail.com

Background: Sickle cell disease (SCD) is the most common inherited blood disorder in the world, and it is increasingly recognized as a neglected chronic disease. Every year, SCD affects 2% of Ghana's 882,490 new-borns, with a 16.7% prevalence rate in Ho. Cost-effective interventions to reduce morbidity and mortality are underutilized in Ghana, increasing hospitalizations for disease patients. As a result, the goal of this research was to determine nurses' knowledge, attitude, beliefs, and stigma regarding sickle cell disease in the Hohoe municipality.

 

Methods: A quantitative cross-sectional study was carried out to assess SCD knowledge, attitude, health-related beliefs, and stigma. Nurses were selected from the Volta Regional Hospital, health centres, and CHPS facilities in the Hohoe municipality. Data was gathered using close-ended questions. Descriptive and inferential statistics such as frequencies and percentages, as well as logistic regression, were used to assess the predictors of the outcome variables.

 

Results: Among the 212 nurses enrolled, 63 (29.7%) work in a hospital, 114 (53.8%) are between the ages of 20 and 29, 157 (74.1%) are females, and 188 (88.7%) hold a diploma. More than half of the nurses, 119 (56.1%), were knowledgeable about SCD, with 147 (69.3%) having a positive attitude toward their patients. During treatment sessions, nurses at a CHPS health facility were 74% less likely to have a positive attitude toward their patients (aOR=0.26, 95% CI: 0.09-0.77). Nurses working in a health center with diagnostic equipment were 4 times more likely to be knowledgeable about their patients' conditions (aOR=3.69, 95% CI: 1.11-12.34).

 

Conclusion: Nurses in the Hohoe municipality had a good understanding of the disease and were willing to take on responsibility for disease patients. Prompt refresher training from SCD stakeholders is required to improve patient outcomes and reduce increased hospitalization.

 

Keywords: Sickle Cell Disease, Knowledge, Attitude, Beliefs, Stigma, Nurses, Hohoe Municipality

 

 

Martha Kotey^1,&, Samuel Dapaa¹, Joseph Asamoah Frimpong¹, Magdalene Akos Odikro¹, Samuel Oko Sackey¹, Ernest Kenu¹

¹Ghana Field Epidemiology & Laboratory Training Programme (GFELTP), Legon, Accra – Ghana

^&Corresponding Author: Martha Kotey, Ghana Field Epidemiology & Laboratory Training Programme (GFELTP), Legon, Accra – Ghana

 

Email:koteymarthaarkaa@gmail.com

Background: The WHO recommends that countries integrate COVID-19 into their existing influenza-like illness and severe acute respiratory infection (ILI/SARI) surveillance systems, to harness the strengths of both influenza and COVID-19 surveillance systems to the benefit of each other. Ghana integrated the systems in 2021. We evaluated the system to determine whether it was meeting its objectives, assess the system attributes and establish its usefulness.

 

Methods: The Centers for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems was adapted. We reviewed surveillance data and procedures from March 2021 to February 2022 and interviewed key stakeholders. We performed thematic analysis on qualitative information and summary descriptive statistics on quantitative data using Microsoft Excel 365. Results were presented using tables, charts, graphs, and proportions.

 

Results: In all, 877 cases of COVID-19 and 329 cases of influenza were recorded from all 29 sentinel sites. ILI/SARI case-based form was modified seamlessly to include COVID-19. Majority of case-based forms reviewed, 93.5% (43/46) were filled completely. All respondents 100% (20/20) were willing to participate in the surveillance system. About 69% (20/29) of the sites submitted samples for the period. Positive predictive value for influenza in ILI/SARI was 10.3% (421/4090) and that for COVID-19 in ILI/SARI was 21.4% (877/4,090). Twenty-seven of the reviewed case-based forms were from Greater Accra and 100% (27/27) of the samples reached the NIC within 48 hours. However, for the remaining 19 forms, sample transportation ranged from 1–2 weeks to reach the National Influenzas Centre (NIC).

 

Conclusion: The integrated ILI/SARI and COVID-19 surveillance system was useful and meeting its objectives. It was complex, acceptable, stable, flexible, and sensitive. It had good data quality but low PPV, fairly timely and representative. The GHS and NIC should establish sentinel sites in the six newly created regions to improve representativeness of data.

 

Keywords: Influenza, COVID-19, ILI, SARI, Evaluation, Ghana

 

 

Aba Sam Essel^1,&, Rita Asante Kusi¹ Magdalene Akos Odikro¹, Joseph Asamoah Frimpong¹, Samuel Sackey¹

¹Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)

^&Corresponding Author: Aba Sam Essel, Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)

 

Email:sabessel12@gmail.com

Introduction: Hypertension is when the systolic and diastolic blood pressures exceed 139mmHg and 89mmHg respectively. It is the leading modifiable risk factor for cardiovascular disease, with an annual death of 7.5 million globally. In Ghana, hypertension is reported monthly, with one of every three individuals suffering from the condition. A descriptive epidemiological analysis of the Greater Accra regional hypertension data was conducted to determine the trends and distribution of hypertension.

 

Methods: Secondary data analysis was conducted using hypertension surveillance data extracted from the District Health Information Management System II (DHIMS2) from 2017 to 2021. Quantum Geographic Information System (QGIS) was used to describe the spatial distribution of cases in the Greater Accra region. Data was summarized as frequencies, proportions, percentages and presented in tables and graphs using Microsoft Excel 2016.

 

Results: Hypertension cases increased from 118,552 (18.8%) among 632,092 in 2018 to 136,947 (21.7%) in 2019 with a sharp decline to 125,743 (19.9%) in 2021. The year 2020 recorded the highest, 139,511 (22.1%) cases over the five-year period. The average prevalence of hypertension cases for the period was 25.5/1,000 population. Majority, 413,829 (65.5%) cases were recorded among females. The highest, 163,087 (25.8%) cases were identified among the population aged 50-59 years. Ashaiman and La Dade-Kotopon municipalities had the highest cumulative cases of hypertension in the Greater Accra region, representing 103,785 (16.4%) and 61,335 (9.7%) respectively. Ada East district had the lowest 992 (0.3%) of the 632,092 cumulative cases.

 

Conclusion: Cases of hypertension declined in the year 2021. Females were most affected with ages 50-59 of both sexes being susceptible to disease. Ashaiman municipality recorded the highest number of hypertensive cases. The regional director of health services should ensure that public health control and monitoring activities are intensified by all stakeholders involved in hypertension surveillance in health facilities.

 

Keywords: Hypertension, Surveillance, Greater Accra

 

 

Jennifer Nai-Dowetin^1,&, George Akowuah¹, Magdalene Akos Odikro¹, Joseph Asamoah Frimpong¹, Samuel Sackey¹

¹Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana

^&Corresponding Author: Jennifer Nai-Dowetin, Ghana Field Epidemiology and Laboratory Training Programme (GFELTP)

 

Email: naidowetin@gmail.com

Introduction: As of February 2022, over 56,900 confirmed cases and over 1,400 deaths of COVID-19 had been confirmed in Ghana since the novel coronavirus disease (COVID-19) was declared a pandemic on March 11, 2020. Cases continue to increase and studies on the disease burden is quite limited in Ghana. We sought to establish the burden, distribution and trend of COVID-19 in Ayawaso West municipality to inform policy direction.

 

Methods: A secondary data analysis was performed using COVID-19 surveillance data obtained from the Ayawaso West municipality line list from 2020 - 2021. Microsoft Excel 365 was used in data abstraction and cleaning. The age/sex, geographical and monthly distributions of cases were expressed as frequencies, proportions and rates using Epi info 7. Results were presented in tables and graphs.

 

Results: A total of 8,502 cases were recorded from the year 2020 to 2021. The incidence rate over the period was 238 cases per 100,000 population with a case fatality rate of 0.53% (45/8,502). Higher proportion of cases were among age group 25 to 44 years old. Most cases reported were males 54.9% (4,667/8,502). Trends revealed high incidence of cases in the 1st and 2nd quarters of the year with peaks following festive seasons. More than two-thirds (76.8%) of cases were inhabitants of the Ayawaso West Municipality.

 

Conclusion:. Incidence of COVID-19 in Ayawaso West municipality is high. Cases were mostly among the working class and were males. The trend of cases tends to increase after festive occasions. About one-third of cases were residents of other districts. We recommend that continuous adherence to COVID-19 protocols, active contact tracing and mandatory vaccination should be introduced to control the pandemic.

 

Key words: Coronavirus, SARS-CoV-2, epidemiology, Ayawaso West, Ghana

 

 

Melvin Tamba Foday, Jr^1,2,3,&, Maame Amo-Addae³, Peter Adewuyi³, Himiede Wede Sesay³, Jimmy Lawubah¹, Elijah Quansah³, Obafemi Joseph Babalola³, Thomas Nagbe²

¹Grand Kru County Health Team, ²National Public Health Institute of Liberia, Congo Town, Liberia, ³Liberia Field Epidemiology Training Program, Congo Town, Liberia

^&Corresponding Author: Melvin Tamba Foday, Jr, Grand Kru County Health Team

 

Email: fodayjr.m859@gmail.com

Background: Globally, 830 women die from pregnancy and childbirth daily. The maternal mortality ratio (MMR) in Liberia is 1072/100,000 live births. The causes and contributing factors for county-specific MMR are unknown. Maternal death is a priority event in Liberia which requires immediate reporting. This study analyzed the trend and causes of maternal mortality in Grand Kru County.

 

Methods: A retrospective data review was conducted on maternal mortality records in Grand Kru. Grand Kru County is located in the south-east of Liberia with five (5) health districts and twenty-three (23) health facilities. Grand Kru has an estimated population of 77,468 inhabitants. Microsoft word 2013 was used to prepare the data generated. We used Excel 2013 to clean and analyze the data. Descriptive analysis was done using proportions and ratios.

 

Results: The total of 27 cases of maternal deaths were recorded from 2017 to 2021 with median age of 28 years (range 12-47). The most affected age group was 20-39 years 20 (74%). During the five years period, 2020 accounted for the highest number of maternal death, 9 cases (33.3%). Cases of maternal death were reported by the five (5) health districts during this period with Barclayville accounting for the highest 12 (44.4%) followed by Trehn District 7 (25.9%) and Jroah District 5 (18.5). Out of the total cases, 18 (66.6) occurred in the communities. The leading causes of deaths were Postpartum Hemorrhage (PPH) 12 (44.4), Anemia 4 (14.8%), Ruptured Uterus 3 (11.1%) and Eclampsia 3 (11.1%).

 

Conclusion: The MMR of Grand Kru is higher than expected with post-partum hemorrhage being the leading cause of deaths. The causes of maternal deaths in Grand Kru are potentially preventable. Early identification of hig- risk pregnancies during ANC and timely intervention are recommended.

 

Key words: Liberia, Maternal Mortality, Hemorrhage, Postpartum, Eclampsia

 

 

Trokon Teekonblah Roberts^1,&, Chukwuma David Umeokonkwo²

¹Liberia Field Epidemiology Training Program, ²Africa Field Epidemiology Training Network

^&Corresponding Author: Trokon Teekonblah Roberts, Liberia Field Epidemiology Training Program

 

Email: troberts2384@gmail.com

Background: Liberia announced her first confirmed case of COVID-19 on the 16th of March 2020. The outbreak affected all counties with Montserrado County the capital city being the epi center. A suspected case of COVID-19 was reported at the St. Francis Hospital Rivercess county on July 5, 2020. We described the outbreak of the COVID-19 at St. Francis Hospital.

 

Method: We conducted an outbreak investigation at St. Francis Hospital, the only referral hospital in Rivercess County that provides free health care services including treatment and care center for COVID-19 to the citizens of the county. Demographic, epidemiological and clinical information for the confirmed and suspected cases were generated using the COVID-19 line list for Rivercess County.

 

Results: There were two separate outbreaks of COVID-19 at the St. Francis Hospital between July 5, 2020, and September 1, 2021. The first outbreak (July 5 to September 1, 2020) had five confirmed cases with one death. Ten cases, including one death were reported during the second outbreak (June - July, 2021). All the contacts were followed up and tested negative for COVID-19. Females accounted for 47% (7/15). Most (80%, 12/15) of the cases had history of recent travel, 60% (9/15) were voluntarily tested and the case fatality rate was 13.3%. The mean age of cases was 42 (±15.8) years. There was no spread of COVID-19 among the health workers.

 

Conclusion: Effective contact tracing, adherence to SOPs and IPC measures, adequate health education and promotion by facility management help to limit the spread among health workers and community.

 

Key words: Rivercess County, COVID-19, Outbreak

 

 

Isaac Baffoe-Nyarko^1,&, Chris Tamal¹, Charles Lwanga Noora¹, Donne Ameme¹, Dennis Odai Laryea², Paulina Clara Appiah², Dawuda Lubabatu², Albert Owusu², Magdalene Akos Odikro¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, ²Ghana Health Service

^&Corresponding Author: Isaac Baffoe-Nyarko, Ghana Field Epidemiology and Laboratory Training Program, ²Ghana Health Service

 

Email: isaac.baffoe-nyarko@ghs.gov.gh

Background: Yellow fever is endemic in at least 27 countries in Africa, with annual estimated deaths of 29,000 to 60,000. It is of public health concern in Ghana, with a mortality rate of 2,200/per 100,000 population. The 2021 outbreak warranted the evaluation of the yellow fever surveillance system to ascertain its usefulness and whether it met set objectives and attributes.

 

Methods: Mixed methods approaches were used to obtain responses from informants. We used CDC surveillance system evaluation guidelines to develop structured questionnaires, interview guides, and observation checklists for data collection. We collected and reviewed data for the period 2018 to 2022. We developed and used a scoring rubric to score attributes based on key indicators. Attributes that scored less than 50 were ranked as “poor/low”, 50-70, “fair”, and above 80, “good”. Data were analysed as frequencies and proportions and presented in tables, charts, and maps.

 

Results: Ten (10) health facilities' focal persons were interviewed. Participants demonstrated high knowledge and awareness, with 9(90%), 8(80%), and 8(80%) mentioning yellow decolourisation of the eye, and fever as the major signs of yellow fever. Between 2018 and 2022, 32 suspected cases of yellow fever were recorded. with 10(31.3%) in 2021. In 2021, with 10 (31.3%) of these suspected cases, reporting timeliness of 91.3%, data completeness of 95.4%, and PPV of 10%, the system detected an outbreak. About 20(90.9%) cases detected between 2020 and 2022 have been entered onto SORMAS with 83.7% data completeness. Data completion on the case base forms was 83.7%.

 

Conclusion: The system meets its objective of detecting cases. It is sensitive, has a high PPV. The timeliness and data quality of the system were fair. It helps provide evidence for public health intervention. We reviewed case definition with staff and assisted them in conducting record reviews.

 

Keywords: Yellow fever, surveillance system evaluation, surveillance data, outbreak, Kintampo South, Ghana

 

 

Forster Amponsah-Manu^1,2,&, Abigail Brago Ofosuhene¹, lhassan Abdul-Nasir¹, Yaw Karikari Asamoah¹, Gerald Osei-Poku¹, Caesar Nyadedzor³, Isaac Opoku¹, Chris Tamal¹, Gifty Amugi⁴, Ernest Kenu¹, Franklin Asiedu-Bekoe⁴

¹ Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon, Accra, Ghana, ² Eastern Regional Hospital, Koforidua, Eastern Region, ³ Ghana Poison Control Centre, Occupational and Environmental Health Unit, Public Health Division, Ghana Health Service, ⁴ Ghana Health Service

^&Corresponding Author: Forster Amponsah-Manu, Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Legon, Accra, Ghana

 

Email: foster_amponsah@yahoo.com

Background: On January 20, 2022, a collision between a motorbike and a truck carrying mining explosives occurred at Appiatse, a community along the Bogoso-Ayanfuri highway in the Prestea Huni Valley district, Western Region, Ghana. It caused an explosion, displacing the entire community, causing injuries, structural damages and deaths within a 500 m radius. We investigated the incident as a chemical event to identify the type of explosives involved, determine the magnitude of the problem, conduct an environmental risk assessment, and establish a syndromic surveillance system.

 

Methods: Semi-structured questionnaires, key informant interview guides, checklists, and risk assessment tools were used to obtain data on the nature of casualties, disaster management employed, environmental exposure risk assessment and chemical exposure risk assessment. We performed descriptive data analysis and presented results in tables and charts.

 

Results: Ammonium nitrate fuel oil was identified as the chemical explosive substance on board the truck. Approximately 140 buildings collapsed within a 150-meter shockwave radius. A total of 122 injured persons were listed from five health facilities, median age 27 years (0.25 – 81). About 45.1% (55/122) sustained secondary injuries. A total of 77 households with 488 members were affected. The median household size was 6 persons (range: 1 – 17), the median age of household members was 17 years (1 month - 80 years), 18% (c/d) of household members were below five years, and 53.3% (e/f) were female. A syndromic surveillance system with data capture and collection tools was developed and implemented.

 

Conclusion: An explosion of ammonium nitrate fuel oil in Appiatse resulted in loss of lives and property. We provided immediate healthcare assistance to some of the injured victims. We recommend periodic evaluation of the syndromic surveillance system implemented.

 

Keywords: Ammonium nitrate, explosion, chemical disaster, Appiatse, Ghana

 

 

Philip Allan Kommey^1,3,&, Phoebe Balagumyetime^1,2, Charles Lwanga Noora¹, Donne Ameme¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, ²Ghana Health Service, District Health Directorate, Nadowli-Kaleo, Upper West Region, ³Christian Health Association of Ghana, Seventh Day Adventist Hospital, Naming, Ashanti Region

^&Corresponding Author: Philip A. Kommey, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana

 

Email: doctorbest123@gmail.com

Background: Tuberculosis (TB) causes high morbidity and mortality worldwide, with an estimated 10 million new cases in 2017. In Ghana, it remains a public health concern. Surveillance is one critical strategy for TB control. However, the TB surveillance system in the Nadowli-Kaleo district has not been evaluated. Hence, we evaluated the system over a five-year period to determine whether it was achieving its objectives, and to assess its attributes.

 

Method: We used a cross-sectional design for the evaluation. We extracted and reviewed data from reporting forms and District Health Information Management System 2 (DHIMS 2) from 2017 to 2021. A semi-structured questionnaire was used to interview stakeholders in the district about case detection and clinical outcomes. We evaluated the system attributes using the CDC's updated public health system evaluation guidelines. Attributes were graded as good, fair, or poor. Summary descriptive statistics were performed on quantitative data, and the results were presented in tables and graphs.

 

Results: The TB surveillance system in the district was functional and operated at all levels for timely detection of cases, accurate diagnosis, and case management. A suspected TB case was confirmed each day on average. The registration of confirmed cases was immediate, and treatment started right away. In 2021, the district detected 59 of 229 TB cases (26% case detection rate). The predictive value positive was 5.8% (33/3,464) in 2017 and 9.4% (59/3,464) in 2021. In the district, there was only one diagnostic center. The participation of faith-based facilities in TB surveillance activities was low (1/4).

 

Conclusions: The tuberculosis surveillance system in the Nadowli-Kaleo District is well structured but partially meets its objectives. The system is timely, stable, acceptable to most stakeholders, and useful at all levels. It has no significant data quality issues. Faith-based health facilities in the district should be well incorporated into TB surveillance.

 

Keywords: Tuberculosis, Surveillance system, Evaluation, Nadowli-Kaleo, Ghana

 

 

Benedict Adzogble^1,&, Richael Odarkor Mills², Seth Baffoe¹, Charles Lwanga Noora¹, Donne Ameme¹, Ernest Kenu¹, Selorm Kutsoati³

¹University of Ghana, ²University of Cape Coast Department of Biomedical Sciences, ³Ghana Health Service

^&Corresponding Author: Benedict Adzogble, University of Ghana

 

Email: badzogble@ug.edu.gh

Background: Poliomyelitis is an infectious disease caused by poliovirus, affecting children under fifteen. Over the past five years, the acute flaccid paralysis (AFP) surveillance system in the Ga East Municipality failed to meet the national non-polio acute flaccid paralysis (NPAFP) detection rate of 3 cases per 100,000 population in persons under 15 years old. We evaluated the AFP surveillance system to assess its attributes and identify operational gaps.

 

Methods: A retrospective AFP surveillance system evaluation was conducted in Ga East Municipality from 2017 to 2021. We collected data through in-depth interviews using questionnaire based on the updated CDC guidelines for surveillance system evaluation. We reviewed AFP notification forms and consulting room registers using a checklist to assess data completeness. Some of the indicators assessed were (NPAFP) detection rate, and stool adequacy. We performed a descriptive analysis of data, including summary statistics.

 

Results: Twenty-two (22) healthcare workers were interviewed; nurses constituted 50% (11/22), and 18.2% (4/22) were medical officer. Knowledge of the AFP surveillance system was (72.7%) among nurses and 28.6% among prescribers. About 86.4% (19/22) of respondents reported that the time spent on AFP activities was adequate. The sensitivity and NPAFP detection rate were below 80% throughout the period of evaluation. Stool adequacy was 100% throughout the evaluation period. Data quality and completeness was excellent as all investigation forms were filled. The 60-day follow-up was done and documented.

 

Conclusion: The AFP surveillance system in Ga East Municipality was timely, with good data completeness on the notification forms and excellent stool adequacy. However, the AFP surveillance system is not sensitive, with a low NPAFP detection rate.

 

Keywords: Acute flaccid paralysis, Polio, Surveillance System, Evaluation, Ga East Municipality

 

 

Doris Aboagyewaa Edu-Quansah^1,&, Anthony Baffour-Appiah¹, Nana Ama Adjabeng², Joyce Boatemaa Yeboah², Isaac Boateng Bempong², Dennis Odae Laryea², Ivy Asantewaa Asante³, Stephen Ofori Nyarko³, Joseph Asamoah Frimpong¹, Delia Akosua Bandoh¹, Elijah Paa Edu-Quansah⁴, Donne Ameme¹, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, ²Ghana Health Service, ³Noguchi Memorial Institute for Medical Research, ⁴African Field Epidemiology Network

^&Corresponding Author: Doris Aboagyewaa Edu-Quansah, Ghana Field Epidemiology and Laboratory Training Program

 

Email: dorisduke23@gmail.com

Background: Influenza-like Illness (ILI) causes morbidity in Ghana. Records of ILI outbreaks in recent times and the COVID-19 pandemic disrupted surveillance activities raising concerns on the optimal operation of ILI surveillance system. We evaluated the ILI surveillance system of Okai Koi North to assess whether the surveillance system was meeting its objectives and assess its system attributes and usefulness.

 

Method: We adapted the CDC Updated guidelines for evaluating public health surveillance systems for this evaluation at Okai Koi North District. We extracted and reviewed ILI 2018-2021 morbidity data from District Health Information Management System (DHIMS-2), FluNet, and health facility registers. We observed surveillance activities and interviewed key informants using an observational checklist and semi-structured questionnaire. Data were analysed for frequencies and proportions, and results were presented in charts and tables.

 

Results: Of the 525 suspected samples reported from the district's sentinel site via FluNet from 2018-2021, 58 (11%) of 525 were influenza positive with PVP 11%. Six (46%) of 13 staff did not know the expected weekly number to be sampled. The system detects cases all year-round which led to the detection of three outbreaks over the evaluation period. Nine (70%) of 13 staff indicated that the ILI surveillance system served as the backbone for case identification during the COVID-19 pandemic. Data completeness was 89% among sampled forms and data from the district and National Influenza Center (NIC). Nine (64%) of 13 staff confirmed no budget allocation for system operation. Averagely, it takes about 48 hours for samples to arrive at the laboratory and seven days to receive feedback on results.

 

Conclusion: The system is useful and sensitive and partially meets its objectives. The system though complex, is flexible, representative, timely in most activities and has excellent data quality. We urge the NIC to establish thresholds and include the case location as a variable in their line list facilitate geospatial prediction and transmission modelling.

 

Keywords: Surveillance System, Evaluation, Influenza-like illness, Sentinel sites, Ghana

 

 

Stephen Bekoe Nyarko^1,&, Isaiah Agorinya¹

¹Fred Binka School of public health, University of Health and Allied Sciences

^&Corresponding Author: Stephen Bekoe Nyarko, Fred Binka School of public health, University of Health and Allied Sciences

 

Email: stephenyarko33@gmail.com

Background: In Africa, studies have reported low utilization of modern contraceptive among women in their reproductive age. Studies have also shown that adolescent girls in Ghana face a number of challenges accessing reproductive/sexual health services. This study therefore sought to examine the preference, barriers and factors that influence the use of modern contraceptive by teenagers aged 15-19 in Ghana.

 

Methods: The data used for the analysis were obtained from the Ghana Demographic and Health Survey conducted in 2014 with a sample size of 2,082. The outcome variable for this study was modern contraceptive among teenage girls aged 15-19 and the independent variables were sociodemographic and reproductive factors which consist of; education, marital status, wealth index, ethnicity, husbands desire for fewer children and decision making for contraceptive use, Crude odds ratios and adjusted odds ratios with 95% confidence intervals as well as the p- value were estimated using binary logistic regression.

 

Results: Between the age group of 15-19 one third (33.78%) of respondents preferred the use of condoms as a modern contraceptive. Aside that, desire to become pregnant (21.4%), wanted more effective method (21.4%), Side effects/ health concerns (21.4%) and other fertility related reasons (21.4%) were cited as the barriers according to age group (15-19) for discontinuation. The socio demographic factors were put into a multiple logistic regression analysis, the findings showed that education, marital status, ethnicity, and wealth index, emerged as the independent predictors of modern contraceptive which are the factors that influence the use of modern contraceptive in Ghana.

 

Conclusion: This study examined the preferences, the barriers and factors that influence the use of modern contraceptive among teenage girls between the ages of 15-19. Family planning services such as the use of modern contraceptive must be increased in order to increase young women's access to and usage in Ghana.

 

Keywords: Contraceptive, adolescents

 

 

Stephen Nti^1,2,&, Safiatu Tarl Abdullai¹, Emmanuel Gyasi², Magdalene Odikro¹, Edwin Afari¹

¹Ghana Field Epidemiology and Laboratory Training Program, ²Ghana Health Service

^&Corresponding Author: Stephen Nti, Ghana Field Epidemiology and Laboratory Training Program

 

Email:ntis383@gmail.com

Background: Data for Surveillance systems play a major role in managing public health threats. One key requirement for good surveillance data is timeliness. Late reporting of surveillance data is a term used to describe facility's inability to submit a surveillance data within an expected time. The consequences of late submission of data lead to poor decision making and delay of interventions when there is a public health problem. Private hospitals in Upper Denkyira West District constantly submit reports late. We analyzed the situation to identify the root and critical causes to this problem.

 

Methods: A team of ten involving the District Director, Administrators, Nurses, Physician Assistants, Records staff, surveillance officers from the health directorate, two private and two public hospitals met to brainstorm to identify contributory factors to the problem. These factors were grouped under root causes and labelled as T (totally) P (partially) N (Not) to indicate our levels of control over them. We presented results using a fish bone diagram.

 

Results: A total of 16 factors were identified and grouped under four root causes as materials, human resource, administrative and surveillance. About 37.5% (6/16) were totally under our control; 56.3% (9/16) were partially under our control and 6.2% (1/16) inadequate supervision of facility surveillance by facility managers, was not under our control. The critical cause was inadequate supervision of facilities by district officers which was totally under our control to improve.

 

Conclusion: The critical cause to late submission of surveillance reports by private facilities was inadequate supervision by district officers. Root causes were administrative, materials, surveillance and human resource. The district health directorate has intensified regular supportive supervision and monitoring to all facilities in the district.

 

Keywords: Late submission, report, surveillance, supervision, Upper Denkyira West

 

 

Mawuli Gohoho^1,2,&, Isaac Annobil² , Samuel Adolf Bosoka^1,3, Timothy Agbo^1,2, Mark Ati², Florence Kwami² , Prosper Davor^1,2, Gabriel Ofori², Bennet Dakedzah², Alec Liyal Njonaa²

¹Ghana Field Epidemiology and Laboratory Training Programme, Legon, Accra, Ghana, ²Jasikan Municipal Health Directorate, Ghana Health Service, Jasikan, Ghana, ³Volta Regional Health Directorate, Ghana Health Service, Ho, Volta Region, Ghana

^&Corresponding Author: Mawuli Gohoho, Ghana Field Epidemiology and Laboratory Training Programme, Legon, Accra, Ghana

 

Email: mawulikgohoho@gmail.com

Background: Seasonal malaria chemoprevention (SMC) is a WHO-recommended community-based intervention for children aged 3-59 months resident in areas of high malaria transmission to prevent malaria during the rainy season. The Jasikan Municipality achieved >80% registration coverage and >95% dosing coverage of each of the four rounds of SMC implemented in 2021. We therefore estimated the malaria morbidity averted among children under 5 years following the SMC implementation in the Municipality.

 

Methods: A quasi-experimental design was employed in comparing changes in malaria morbidity during the high transmission period (August–November) between SMC intervention period (SMCp) of 2021 and non-SMC intervention period (nSMCp) of 2020. Out-patient and in-patient malaria morbidity data among children under 5 years were extracted from the District Health Information Management System (DHIMS2). We estimated the risk, risk ratio and prevented fraction for the population using chi-squared test. P-values <0.05 were considered statistically significant.

 

Results: The risk of uncomplicated malaria estimated in the SMCp and nSMCp were 36.0% (839/2330) and 72.0% (1598/2220) respectively. The risk of severe malaria in the SMCp and nSMCp were 36.6% (63/172) and 69.1% (172/249) respectively. Also, the risk of uncomplicated malaria (0.50, 95% CI {0.47 – 0.53}) and severe malaria (0.53, 95% CI {0.43 – 0.66}) were significantly reduced in the SMCp compared to nSMCp. Further, we estimated that 25.6% of uncomplicated malaria and 19.2% of severe malaria could have been prevented among the children under 5 in the nSMCp if there was an SMC implementation.

 

Conclusion: SMC implementation contributed to averting both uncomplicated and severe malaria cases among children under 5 years. This evidence on the effectiveness of SMC, using routine data, supports the need to sustain its implementation in the Municipality.

 

Keywords: Preventive Fraction, Seasonal Malaria Chemoprevention, Malaria Morbidity, Jasikan Municipality, Ghana

 

 

Clement Avoka^1,2,&, Susana Adofo Boateng^1,2, Magdalene Odikro,¹, Francis Arizie², Gifty Sunu², David Kwame Tsotorvor³, Gideon Kwakye³, Kate Gyimah Asante⁴

¹Ghana Field Epidemiology and Laboratory Training Program - Frontline Training, SPH University of Ghana, Accra, Ghana, ²Akyemansa District Health Directorate, Ghana Health Service, Akyem Ofoase, Ghana, ³Eastern Regional Health Directorate, Ghana Health Service, Koforidua, Ghana, ⁴Food and Drug Authority, Eastern Region, Koforidua, Ghana

^&Corresponding author: Clement Avoka, Ghana Field Epidemiology and Laboratory Training Programme, Legon, Accra, Ghana

 

Email: ndeogo2@yahoo.com

Background: Medical events occurring after immunization that result in hospitalization or death can be classified as severe Adverse Events Following Immunization (AEFI), whether the event has any causal relationship to getting the immunization or not. It is important to investigate serious AEFIs well to enable the determination of causality and contribute to building public confidence in the immunization programme. After receiving an immunization, a child was reported dead the next day in Kwame Donkor, a community in Akyemansa. We investigated this reported AEFI to assess the relationship between the vaccination and this reported AEFI.

 

Methods: We reviewed the Maternal and Child Health Record Book, the vaccine temperature monitoring chart, and documentation in the immunization register at the Kofi Nimo CHPS to establish adequate documentation and assess whether a good cold chain system of vaccines was maintained. We used the AEFI reporting form, and the case investigation form to collect the child's bio-data and details of vaccines given and interviewed the mother and some key stakeholders.

 

Results: The child was 6 weeks old and had received the first doses of Pentavalent, rotavax, and oral polio vaccines on Friday, 27th May 2022, and developed fever 30 minutes afterward. The mother confirmed the child died at around the wee hours of the night when she slept off leaving him on her chest. The parents failed to seek timely medical care resulting in the child's death. The child was buried immediately according to Islamic tradition. We found the nurses had adequate understanding of AEFIs but not the community, documentation, and good cold chain system of vaccines was maintained.

 

Conclusion: Delay in seeking appropriate health care after receiving AEFI started could have resulted in the death of the child. Inability to conduct an autopsy limited the investigations. Community health durbar was organized to educate the community on immunization, and AEFIs.

 

Keywords: Adverse Events Following Immunization (AEFI), Immunization, Eastern Region, Ghana

 

 

Theophilus Opata Akwetey^1,&, Safiatu Tarl Abdullai¹, Tanko Rufai²

¹Ghana Field Epidemiology and Laboratory Training Program, Legon, Accra, Ghana, ²Ghana Health Service, Accra, Ghana

^&Corresponding author: Theophilus Opata Akwetey, Ghana Field Epidemiology and Laboratory Training Program, Legon, Accra

 

Email: mulamontana1@gmail.com

Background: Clinical decisions depend on timely laboratory result reporting. Timeliness is expressed in turnaround time and serves as quality improvement tool to assess effectiveness and efficiency of laboratories. It is important to know the turnaround time of each test in the Laboratory. At the Koforidua Polyclinic Laboratory, blood film for malaria parasites test was used as benchmark for turnaround time. The average turnaround time in Koforidua Polyclinic laboratory is 30 - 60 minutes. It was observed, total processing time takes 1 - 2 hours resulting in delays in diagnosis, treatment and managements of patients. Some patients become frustrated and leave to seek services elsewhere affecting attendance and revenue generation. We analyzed the problem to determine the root and key causes.

 

Methods: Four laboratory staff, two service personnel one nurse and the investigator brainstormed using the ‘but why’ approach to identify factors that contributed to delayed turnaround time of laboratory results. Factors identified were grouped under broad categories (root causes) and assigned levels of control as totally under control, partially under control and not under control. We selected one factor as the key cause. The results presented using fishbone diagram.

 

Results: Four major root causes were identified as Staff, Equipment and Reagent, Patient and Healthcare system. Under these four major root causes' were 17 contributory factors out of which 11.8% (2/17) including miscommunication and staff attitude were totally under our control. About 41.2% (7/17) including low staff strength and shortage of reagent were partially under our control and 47.1% (7/17) including workload and high patient attendance were not under our control.

 

Conclusion: Identified key cause was ‘low staff strength’ which was addressed after a recommendation was made to the Polyclinic. Koforidua Polyclinic laboratory's turnaround time has improved due to the public health action taken which has had a positive impact on clinical operations and increased revenue.

 

Keywords: Turnaround, Time, Laboratory, Koforidua, Polyclinic

 

 

Emmanuel Okoampah^1,&, Joan Davids Shine² Joseph Payne²

¹University for Development Studies, Faculty of Biosciences, Department of Biochemistry and Molecular Biology, Tamale, Ghana, ²University for Development Studies, Faculty of Biosciences, Department Biotechnology, Tamale, Ghana

^&Corresponding author: Emmanuel Okoampah, University for Development Studies, Faculty of Biosciences, Department of Biochemistry and Molecular Biology, Tamale, Ghana

 

Email: eokoampah@uds.edu.gh

Background:An alarming increase in microbial resistance has resulted from the uneven bio-distribution of antibiotics to disease sites, sparking a number of public health debates. The consequences of antibiotic resistance impede UN Sustainable Goal 3, which seeks to promote good health and well-being. As a result, new antibiotics must be developed or existing antibiotics' efficacy must be improved. Nanoparticles (NPs) have emerged as promising in the pharmaceutical industry, prompting several studies into their potential as drug delivery agents.

 

Methods: We investigated the drug release potential and antimicrobial activity of Parkia biglobosa-mediated gold nanoparticles functionalized with a polyethylene glycol (PEG) and a standard drug (lincomycin). Three nanodrug composites were created: PD (PEG conjugated on lincomycin), PN (PEG conjugated on AuNPs), and PND (PEG and lincomycin on AuNPs). The as-synthesized AuNPs and the formulated nanodrug composites were characterized using UV-Vis spectrophotometry, TEM, FTIR, XRD, and EDS.

 

Results: The results revealed that the optimal released capacity for all nanodrug composites was within 9 minutes, PND had the highest release capacity of 23 mg/ml, followed by PD and PN with 12 mg/ml and 4.8 mg/ml, respectively. For the antimicrobial study, PND inhibited Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, and Escherichia coli with zones of inhibition of 43.25 mm, 20.25 mm, 33.0 mm, and 28.00 mm respectively. For PD, Pseudomonas aeruginosa, Enterococcus faecalis, Staphlococcus aureus, and Escherichia coli, the zones of inhibition were 41.75 mm, 19 mm, 30.75 mm, and 23.5 mm respectively. PND and PD both inhibited Candida albicans with zones of inhibition of 50.31 mm and 49.34 mm respectively. Interestingly, PN exhibited no antimicrobial activity against microbes or fungi, which we attribute to the no inclusion of lincomycin in their formulation.

 

Conclusion: The combined drug release potential and microbial growth inhibition of the as- synthesized NPs drugs provides a new generation technology to improve disease treatment capacity of pharmaceutical drugs.

 

Keywords: Gold nanoparticles, antibiotics, drug release, microbes, polymer

 

 

Mohamed Abdirahman Omar^1,& , Mohamed Mohamud Fuje¹ Tahlil Abdi Afrah³, Yasin Ahmed Nur⁴, Ahmed Yusuf Guled³, Fartun Sharif Mohamed⁵

¹Department of Research and Disease Surveillance Department, Banadir Hospital, Bandir, Somalia, ²Deparment of Tropical and Infectious Disease, Benadir University School of Postgraduate Studies, Bandir, Somalia, ³Deparment of Public Health, Benadir University School of Postgraduate Studies, Bandir, Somalia, ⁴Deparment of Internal Medicine, Benadir University School of Postgraduate Studies, Bandar, Somalia

^&Corresponding author: Mohamed A. Omar, Department of Research and Disease Surveillance Department, Banadir Hospital, Bandir, Somalia

 

Email: drmcqalbi@gmail.com

Background: Measles is a leading vaccine preventable childhood disease, which has been designated for elimination by the World Health Organization. Measles records an estimated 10 million cases and 164, 000 deaths worldwide each year. Measles is a frequent but worrisome pediatric problem, with its associated childhood morbidity and mortality especially in areas with low socio-economic status and poor pediatric health services such as Somalia, where currently there are limited reliable statistics data on the prevalence of Measles among children under 15 years. There is no documented evidence of a study evaluating the prevalence of children with measles in Somalia. This study assessed the prevalence of Measles in children under 15 years among patients of the Banadir Hospital

 

Methods: The study was a retrospective cross-sectional among children under 15 years who were registered in the Banadir Hospital in Mogadishu in Somalia from January 2019 to July 31, 2022 for medical care. A consecutive sampling including all children under 15 years who were registered in the study period were included in this study.

 

Results: A total of 219,959 patients were admitted in the Hospital for various diseases. Of these, 5,519 cases were admitted as Measles cases (2.5%) and were treated. Of the 5,519 measles cases, 1,241 cases were sampled for laboratory confirmation and 1,181 (95%) cases were confirmed as Measles, with positive for IgM. The age groups among the confirmed cases were 84% between 0 and <5 years, 16% were between 5-14 years. In regard to Measles Vaccination Status (Vaccine Dose), 97% (1145/1181) of children were 0 Dose, 2.6% (307) of them were one. For Measles Complications, 46.4% (548/1181) had Severe Pneumonia, 21.6% had (255/1181) Severe Acute Malnutrition (SAM).

 

Conclusion: Our study found high prevalence of measles. This could be due to poor vaccination coverage among population in the Banadir Region, Mogadishu-Somalia.study found high prevalence of measles which could be due to poor vaccination coverage among population in the Banadir Region, Mogadishu-Somalia. Routine Immunization and cold chain system should also be improved.

 

Keywords: Measles Prevalence, Banadir Hospital

 

 

Patrick Avevor^1,2,&, Emma Delali Forley¹, Dennis Jubin¹,Solomon Asante Sefa¹, Selassie Kofitse¹, Saibu Adama Sawadigo¹, Samuel Twum Andoh¹, Judith Okine¹, Longstone Ohene Spio³, Ephraim Foanor Kwadzodeh⁴, Banaan Ahmed⁵, Emmanuel Kwasi³, Emelia Dadzie⁵, Degboe Martin⁴, Jennifer Nai Dowetin⁶, Kwadwo Boakye⁵ Gloria Odame Asiedu³, Okyere Derrick⁴, Samuel Dapaa⁶, Rita Asante⁶, George Akowuah⁶, Magdalene Akos Odikro⁶, Joseph Asamoah Frimpong⁶, Samuel Oko Sackey⁶, Ernest Kenu⁶

¹ World Health Organisation, Accra, Ghana, ² Ghana Health Service, Accra, Ghana,³Food and Drugs Authority, Accra, Ghana ⁴Environmental Health Department, Accra Ghana, ⁵Veterinary Services Department, Accra, Ghana, ⁶Ghana Field Epidemiology and Laboratory Training Program, Legon, Accra, Ghana

^&Corresponding author:Patrick Avevor, World Health Organisation, Accra, Ghana

 

Email: patavevor@yahoo.com

Background: Globally, non-communicable diseases (NCDs) claim the lives of over 41 million people annually. Amongst COVID-19 cases, increased severity and death have been linked with NCDs in developed countries. Ghana experienced a relatively lower burden of COVID-19 therefore disease severity is under explored. We determined the association between NCDs and COVID-19 severity among patients in the Central, Western, and Western North regions of Ghana.

 

Methods: We conducted a descriptive cross-sectional study using facility-based data on confirmed COVID-19 cases from April to October 2022. Data were sourced from the regional and district COVID-19 composite line lists, SORMAS and patient folders at designated treatment centers. Patient's demographic information, NCDs, hospitalization and death status were extracted into an excel sheet and cleaned. Epi Info 7 was used to summarize the data into frequencies and proportions. Multivariate logistic regression was performed to determine predictors of COVID-19 hospitalizations or deaths at 95% confidence interval.

 

Results: A total of 3,234 confirmed COVID-19 cases were recorded with median age 33 (range:0-112) years. Males were 50.5% (1,641/3,180) of the cases. Majority of cases, 28.6% (920/3222) were aged 30 to 39 years and 55.6% (1,799/3,234) resided in Western Region. Of 2,739 cases with data on their NCDs status, 12% (320/2739) had NCDs. About 36.8% (1,188/3,222) of the cases were hospitalized and 5% (158/3,222) died. Having hypertension (AOR=1.90, 95%CI 1.29-2.81) and other CVDs (AOR=5.71, 95%CI 2.94-11.09) were associated with hospitalization. Being hospitalized (AOR=8.68, 95%CI 4.64-16.23), having hypertension (AOR=3.02, 95%CI 1.89-4.84) and other CVDs (AOR=2.29, 95%CI 1.04-5.05) were associated with increased odds of deaths.

 

Conclusion: From the three regions one-tenth of COVID-19 cases had NCDs. Approximately a third of the cases were hospitalized and one out of 20 died. Hypertension and other CVDs were associated with COVID-19 severity. COVID-19 preventive interventions and COVID-19 case management resources should prioritize persons with NCDs.

 

Keywords: COVID-19, NCDs, severity, hospitalization, deaths, Ghana

 

 

Suleman Gbene Ziyadah^1,&, Adam Anas¹, Jiah Juah⁴, Dramani Fuseini Mahama⁵, Gyetuah Asumadu¹, Simon Effah Adjei¹ Godwin Faigo¹, Abubakari Yussif⁴, Felix Oduro¹, Yakubu Sidik⁵, Isaac Jakalia⁴, Louis Jean Piu¹ Fatawu Yussif Akomnaba⁵, Ishmael Alhassan Kunateh¹, Kwabena Owusu¹, Aba Sam Essel³, Martha Arkaa Kotey², Samuel Dapaa³, George Akowuah³, Rita Asante³, Magdalene Odikro³, Joseph Asamoah Frimpong³, Samuel Oko Sackey³, Ernest Kenu³

¹Veterinary Services Department, Accra, Ghana, ²Ghana Health Service, Accra, Ghana, ³Ghana Field Epidemiology and Laboratory Training Program, Accra, Ghana, ⁴Food and Drugs Authority, Accra, Ghana, ⁵Environmental Health Department, Accra, Ghana

^&Corresponding author: Suleman Gbene Ziyadah, Veterinary Services Department, Accra, Ghana

 

Email: ziyadahgbene@gmail.com

Background: Avian influenza (AI), caused by Influenza A virus, mainly affects birds. Ghana recorded its first case in 2007 and has subsequently recorded various sporadic outbreaks. The most recent outbreak in the Upper East Region in February 2022, affected over 2,000 birds. This study assessed the knowledge, practices and perception on AI among poultry farmers in the Upper East, Upper West, and North-East regions of Ghana.

 

Methods: A descriptive cross-sectional study was conducted in the Upper East, Upper West, and North East Regions from August to September, 2022. A structured questionnaire and observation checklist were used to collect data on demographics, knowledge, practices and perceptions on AI. Data were summarized as frequencies, proportions and percentages. For knowledge, a score of ≥50% was classified as good. Practice was good if the score was ≥60%.

 

Results: Of 131 respondents, 77.1% (101/131) were males, 56.5% (74/131) attained tertiary education and 53% (69/131) had less than five years of experience. About 45.8% (60/131) of farmers perceived that Personal Protective Equipment (PPEs) are not worn due to inability to afford and 36.6% (48/131) did not feel it was important to change clothes when entering the farm. Farmers did not believe that AI can affect humans therefore, 90.1% (118/131) use sick birds as meat. About 42% (55/131) did not think it was important to wash hands and 47.3% (62/131) do not practice isolation of sick birds due to lack of space. Overall, 10.7% (14/131) had good knowledge and 63.4% (83/131) adhered to good practices on AI.

 

Conclusion: Farmers had poor knowledge of AI but high adherence to good practices. High cost of PPEs and farm equipment influenced wrong perceptions on good poultry farm practices. The Veterinary Service Directorate should intensify education of poultry farmers on Avian Influenza for sustainability of good practices and correct wrong perceptions.

 

Keywords: Avian Influenza, Poultry farmers, Perception, Knowledge, Practices, Ghana

 

 

Emma Delali Forley^1,&, Anthony Baffour Appiah¹, Rita Agyekumwah Asante Kusi¹, Selassie Kennedy Kofitse¹, Derrick Okyere¹, Longstone Ohene-Spio¹, Kwadwo Boakye¹, Michael Awenkanab Avarade¹, Jennifer Nai-Dowetin¹, Enoch Koomson², Godfeed Kwabena Sarpong²

¹Ghana Field Epidemiology and Laboratory Training Program, Legon, Accra, Ghana, ²Central Regional Health Directorate, Ghana Health Service, Cape Coast, Ghana

^&Corresponding author: Emma Delali Forley, Ghana Field Epidemiology and Laboratory Training Program, Legon, Accra, Ghana

 

Email: emforley@gmail.com

Background: On July 29, 2022, a 60-year-old male reported to Saltpond Municipal Hospital unconscious with acute rashes on the face and hands as well as generalized body weakness and loss of appetite. Laboratory investigation confirmed his skin swab positive of monkeypox infection. We investigated to describe the epidemiology of the outbreak while implementing prevention and control measures.

 

Methods: We conducted a descriptive study. An active case search, interviews and contact listing was conducted in 200 households. A case was defined as unexplained acute skin rash, mucosal lesions, or lymphadenopathy in Mfantseman Municipality from July – August 2022. Stakeholder engagement, environmental and behavioural risk assessment were conducted. Data was summarized as frequency and proportions.

 

Results: We identified 13 suspected cases (53.9% males) of which 3 were confirmed with one death. Median age was 25 years (range 7-60 years). All 52 contacts were asymptomatic and tested negative. Of 9,580 records reviewed at the facility level, 234 (2.4%) had rashes and other symptoms with seven (3.0%) records meeting the case definition for monkeypox. Cases were isolated and managed on supportive treatment (Calamine, cetirizine, and analgesics), INO2 and IVF 10% Dextrose for those with sepsis with bilateral pneumonia, vesicular disease, and malaria. Presence of rodents travel history, and intercommunity trading, overcrowding and poor sanitary facilities were potential sources of the outbreak. Safe burial was conducted for the deceased.

 

Conclusion: Our investigation confirmed an outbreak of monkeypox. Behaviourial and environmental factors such as presence of rodents, travelling history and intercommunity trading were potential sources of the outbreak. Overcrowding, poor sanitation and poor adherence to infection prevention and control (IPC) were possible contributing factors. We supported the Municipal Health Management Team to conduct community sensitization on potential risk factors which contributed to the control of the outbreak.

 

Keywords: Monkeypox, Mfantseman Municipality, Ghana

 

 

Solomon Asante-Sefa^1,&, George Akowuah², Magdalene Akos Odikro², Joseph Asamoah Frimong², Ernest Kenu²

¹Sekondi Public Health Laboratory, Ghana Health Service, Western Region, Ghana, ²Ghana Field Epidemiology and Laboratory Program, UG-SPH, Accra, Ghana

^&Corresponding author: Solomon Asante-Sefa, Sekondi Public Health Laboratory, Ghana Health Service, Western Region, Ghana

 

Email: sefajnr@gmail.com

Background: Globally, most bacterial infections have become difficult to treat in recent times due to the development of resistance to available drugs. The highest burden of Anti-microbial resistance occurs in Western sub-Saharan Africa, where 27 deaths per 100,000 are attributable to resistant pathogens. Testing for the likelihood of treatment success with an antibiotic is vital. We analysed laboratory data from a zonal public health laboratory to identify bacteria that are frequently implicated in infections and to establish their susceptibility to antibiotics.

 

Methods: A secondary data analysis was carried out on microbiology test records generated from 2017 to 2021 in the Western region. Variables extracted included age, sex, specimen type, collection date, pathogen isolated, and antimicrobial susceptibility test outcomes. We summarized the bacterial pathogens according to their species and calculated the proportion of each species that was resistance to antibiotics tested. The results were presented in tables and charts.

 

Results: During the period 7,753 microbiology tests were performed out of which 1,221 (16%) were positive for bacterial pathogens. The most frequently isolated bacteria were Gram-negatives, including E. coli (37%), Klebsiella sp. (12%) and Citrobacter sp. (12%). Overall, majority of these pathogens showed resistance to first line antibiotics such as tetracycline (93%), trimethoprim-sulfamethoxazole (83%), amoxicillin clavulanic acid (71%), ciprofloxacin (56%) and cefotaxime (54%). Meropenem (6%) and amikacin (17%) recorded the least levels of antibiotic resistance.

 

Conclusion: Majority of the bacterial infections in the Western region were caused by E. coli, Klebsiella sp. and Citrobacter sp. The organisms showed increased likelihood of treatment failure with most drugs recommended for treating infections they cause. The Ghana Health Service should monitor resistant pathogens and regularly review the standard treatment guidelines.

 

Keywords: Antimicrobial resistance, bacterial infections, antibiotics, Ghana

 

 

Degboe Martin^1,2,&, George Akowuah², Joseph Asamoah Frimpong², Samuel Sackey²

¹Sekondi-Takoradi Metropolitan Assembly, Western Region, Ghana, ²Ghana Field Epidemiology and Laboratory Programme, Legon, Accra, Ghana

^&Corresponding author: Degboe Martin, Sekondi-Takoradi Metropolitan Assembly, Western Region, Ghana

 

Email: martindegboe71@gmail.com

Background: Globally, 1 in 10 persons suffer from illness due to consumption of contaminated foods. Foodborne diseases are a major cause of morbidity and mortality. In Ghana, medical screening of food handlers is a pre-requisite for licensing food handlers but information on the systems performance is sparse. We evaluated the food hygiene surveillance system in Sekondi-Takoradi to determine if it is useful and meeting its objectives as well as to describe the system's attributes.

 

Methods: Descriptive cross-sectional study was used to evaluate the system following the CDC updated guidelines for evaluating public health surveillance systems. A semi structured questionnaire was used to collect both qualitative and quantitative data from the key stakeholders of the surveillance system. Surveillance data was reviewed for the period 2018 to 2021. Qualitative data was analyzed using content analysis. Descriptive analysis was performed on the abstracted data using Microsoft Excel 2016. Results were presented in text, tables, and graphs.

 

Results: Over the period, 98.2% (6,432/6,552) of the estimated food vendor population were screened. Females formed the majority 95.5% (6148/6432). Of the number screened, 1.4% (92/6432) were deemed unfit. About 85% (17/20) of stakeholders knew the case definition and how the system operates. Data completeness was 92.8% (13/14) in registers at the Environmental Health offices within the three sub-metros and in the laboratory registers. The system was paper-based with inadequate logistics for its operations. The system lacked an appropriate means of transport.

 

Conclusion: The food hygiene surveillance in Sekondi-Takoradi metropolis is meeting its objectives and certifying food handlers to handle food in the metropolis. The system was found to be simple, flexible, acceptable, sensitive and timely with good data quality but poor in representativeness and stability. Environmental Health Officers should be supported with dedicated means of transport for system operations by the Metropolitan Assembly.

 

Keywords: Food hygiene, food vendor, surveillance, evaluation, Ghana

 

 

Franklin Duncan Sylvester Adjato¹, Sadat Ibrahim¹, Derrick Atandaa Aboyinga¹, Erasmus John Awlime¹, George Ayitey¹, Kwaku Appiagyei¹, Abena Ansomaa Debrah Wiafe¹, David Abass¹, Mark Azure¹, Yussif Yakubu¹, Jonathan Laari¹, Gideon Kye-Duodu¹, Anthony Dongdem¹, Gregory Amenuvegbe¹ Joyce Der^1,&

¹Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Hohoe, Volta Region, Ghana

^&Corresponding author: Franklin Duncan Sylvester Adjato, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Volta Region, Ghana

 

Email: jdberkumwine@uhas.edu.gh

Background: Globally, 1.3 million people lose their lives annually as a result of road traffic accidents. Motorcycle traffic is on the rise on roads with an associated increase in road traffic accidents resulting in severe injuries and mortality. According to the Ghana National Road Safety Authority, motorcycle accidents account for 4% of all road traffic accidents in Ghana, yearly. Hohoe recorded increase in cases of road traffic accidents by 47.80% from 2019 to 2020. Hence, this study assessed the adherence of motorcycle riders to road safety protocols in Hohoe township.

 

Methods: This study was an observational cross-sectional which conveniently sampled 371 motorcycle riders in Hohoe township. Quantitative data were collected electronically using an observational checklist and analysed with Stata version 16.0. A 95% confidence interval and a p-value of 0.05 were used to determine statistical significance for descriptive and inferential analyses. Tricycles were excluded from the study.

 

Results: Findings from this study showed that 73.32% (272/371) of riders observed wore a crash helmet. The proportion of pillion riders in a helmet was 2.70% (10/371), and 17.52% (65/371) riders were not in any protective gear. Overall compliance with road safety regulations was 43.40% (161/371). Comparing pillion riders in helmet and those not in helmet, riders were more likely to comply with road traffic regulations in the former than latter [AOR: 5.48, 95% CI: 1.14–26.00, p = 0.034].

 

Conclusion: The use of crash helmet among motorcycle riders was high but compliance with road traffic regulations was poor. National Road Safety Commission and Motor Transport and Traffic Division of Ghana Police Service should embark on intensive education of motorcycle riders in Hohoe township on the importance of adherence to road traffic regulations to prevent deaths and mitigate the severity of motorcycle-related injuries.

 

Keywords: Adherence, Motorcycle riders, Road Safety Protocols, Hohoe, Injuries

 

 

Dennis Jubin^1,2,&, George Akowuah², Magdalene Akos Odikro², Joseph Asamoah Frimpong², Ernest Kenu²

¹ Ghana Health Service, Takoradi, Western Region, Ghana 2 Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra

^&Corresponding author: Dennis Jubin, Ghana Health Service, Takoradi, Western Region, Ghana

 

Email: dennisjubin82@yahoo.com

Background: One of the key strategies for polio eradication is acute flaccid paralysis (AFP) surveillance among children below 15 years. Ghana recorded sporadic outbreaks of polio in 2019 and 2020. Periodic evaluation of surveillance system strengthens the system for effective performance. We evaluated the AFP surveillance system in Sekondi-Takoradi Metropolis to determine whether it is meeting its objectives, and to assess the system attributes and usefulness.

 

Methods: Descriptive cross-sectional design was used to evaluate the AFP surveillance system in Sekondi Takoradi Metro. Routine AFP database, monthly and weekly IDSR data from 2017-2021 were reviewed in addition to observations and interviews. Evaluation checklist was developed with the help of CDC updated guidelines for surveillance system evaluation. MS Excel was used to summarize data into frequencies, proportions and rates. System achievement was compared with the WHO targets. Results were presented in tables and figures.

 

Results: Thirty-four surveillance staff were interviewed. A total of 28 AFP cases were recorded between 2017 and 2021. One was positive for cVDPV2. About 86% (24/28) of cases were investigated within 14 days of onset of paralysis. Annualized non-polio AFP rate was below 2/100,000 of children below 15 years. Case definition was easy to use and apply (34/34). Introduction of mobile data collection apps and modification of forms did not affect system operations. Sample collection process and transportation to the laboratory involved multiple steps with inadequate funds. Surveillance activities were limited to a few trained staff. About 82% (23/28) of reviewed forms were correctly filled.

 

Conclusion: The AFP surveillance system was partially meeting its objectives. It is complex, flexible, acceptable, timely, representative, and fairly sensitive. Data quality was good but stability was poor. It was useful in detecting polio outbreaks. Training of all staff involved in surveillance operations will help improve the system.

 

Keywords: AFP, surveillance, polio, evaluation, Sekondi Takoradi, Ghana

 

 

Patrick Avevor^1,&, Samuel Dapaa², Samuel Oko Sackey² Ernest Kenu²

¹World Health Organization Country Office for Ghana, Accra, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, Legon, Accra, Ghana

^&Corresponding author: Patric Avevor, World Health Organization Country Office for Ghana

 

Email: patavevor@yahoo.com

Background: Measles is a highly infectious viral disease responsible for over 140,000 mortalities annually. Actions towards reducing measles mortality include measles surveillance and vaccination. Public health surveillance systems require periodic evaluation, however, this has not been done for measles in the Ketu South Municipality in the last five years. This evaluation assessed the usefulness and attributes of the measles surveillance system as well as the extent to which it is achieving its objectives.

 

Methods: A descriptive cross-sectional evaluation of the measles surveillance system in the Ketu South Municipality, Volta Region was conducted. Stakeholders were interviewed using a semi-structured questionnaire. Surveillance records were reviewed from 2017 to 2021. The updated US Centres for Disease Control and Prevention guidelines on surveillance system evaluation was adapted to assess the attributes of the system. Frequencies and proportions were computed in Microsoft Excel and qualitative data analyzed in themes. Results were presented in tables and graphs.

 

Results: A total of 152 measles cases were suspected with one (0.7%) confirmed in Ketu South Municipality over the period. Measles surveillance was population-based, integrated into other disease surveillance systems and was the basis for planning measles SIA. Specimen collection rate was 100% but laboratory processes were cumbersome, causing delayed feedback and dissatisfaction among health workers. Completeness of measles line list at municipal and regional levels was 100%. The municipality maintained an updated electronic line list of all cases detected.

 

Conclusions: The measles surveillance system in the Ketu South Municipality was useful and achieving its objectives. The system was flexible, sensitive, representative and of satisfactory data quality and predictive value positive. It was however complex, unstable, unacceptable and untimely. Improving laboratory turnaround times through sustained logistical support for testing sites and the implementation of electronic data management systems will improve the performance of the measles surveillance system.

 

Keywords: Measles, Surveillance system evaluation, Ketu South, Ghana

 

 

Ephraim Foanor Kwadzodeh^1,2,&, Samuel Dapaa², Samuel Oko Sackey²

¹Environmental Health and Sanitation Directorate, Aowin Municipal Assembly, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Ephraim Foanor Kwadzodeh, Environmental Health and Sanitation Directorate, Aowin Municipal Assembly, Ghana

 

Email: ephraim.foanor@gmail.com

Introduction: In Ghana, about 65,000 mortalities associated with food-borne diseases are recorded yearly. The food hygiene surveillance system medically screens food handlers to ensure safety of their food for public consumption. We evaluated the food hygiene surveillance system in Aowin municipality to determine their usefulness and whether the system is achieving its objectives as well as assessing its attributes.

 

Methods: A descriptive cross-sectional design was used to evaluate the system from 2019 to 2021. Key stakeholders were interviewed using questionnaire based on the CDC updated guidelines for evaluating public health surveillance systems. Observation and records reviews were used to collect data on the performance of the system. Quantitative data were summarized as frequencies and proportions. Qualitative data were summarized using direct content analysis. Results were presented in table, texts and graph.

 

Results: Of 15 stakeholders engaged, 53.3% (8/15) were Environmental Health Officers, 33.3% (5/15) Food Handlers and 13.3% (2/15) Laboratory Technicians. Of 1,293 food handlers screened over the period, 93% (1,203) were certified. About 93.3% (14/15) knew the case definition. Forms completion rate was 85% (17/20). Four out of the five zonal councils were involved in the screenings. The system captured and tested 314, 369 and 610 food handlers in 2019, 2020, and 2021 respectively. The PVPs in 2019, 2020 and 2021 respectively were 10.19%, 5.42% and 6.23%. Typhoid fever and hepatitis B cases detected were referred for treatment. Screening records were not properly stored.

 

Conclusion: The system was partially useful and meeting its objectives. The system was found to be simple, flexible, representative, stable and sensitive with good PVPs. Data quality and acceptability were fairly good with poor timeliness. The Municipal Environmental Health Officer should facilitate capacity building of personnel on data management and review the type of tests conducted. Laboratory Technicians should keep records of screenings.

 

Keywords: Food Hygiene, Surveillance, Evaluation, Aowin Municipality-Enchi, Ghana

 

 

Rapheal Gyan Asamoah^1,2,&, Priscilla Asante²

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Ghana, ²Okere District Health Directorate, Dawu, Ghana, ³Community Health Nurses Training School, Ministry of Health, Akim Oda, Ghana

^&Corresponding author: Rapheal Gyan Asamoah, Ghana Field Epidemiology and Laboratory Training Program, Legon, Accra, Ghana

 

Email: lordmotion9@gmail.com

Background:. In Sub-Saharan Africa, only 64% of deliveries are attended by a trained birth attendant, compared to 99% in Europe and North America. Non-skilled birth delivery is associated with undesirable outcomes such as maternal and perinatal mortality. We examined the studies on the barriers to skilled birth delivery uptake and offered suggestions to improve them.

 

Methods: The literature search was done using Biomed Central (BMC), ScienceDirect, PubMed, and Google Scholar between 2011 and 2021. The search returned 97 references and 16 articles were selected for review after screening. The study used the Preferred Reporting Items for Systematic reviews and Meta-analyses to examine factors affecting skilled birth delivery uptake in Sub-Saharan Africa.

 

Results: Skilled birth delivery was found to be facilitated by ANC attendance in 3 (43%) of 7 of the studies. In 3 (43%) of 7 of the research, free maternity care or health insurance was mentioned as facilitators. In 2 (28%) of 7 of the research, owning or watching a TV at least once per week was considered a facilitator. About 5 (56%) of 9 studies identified poor staff attitudes, whereas 3 (33%) of 9 highlighted low education levels of women as barriers. Long travel hours/costs to health services were cited as barriers by 2 (22%) of 9.

 

Conclusion: Some facilitators to skill birth delivery were free maternal care, owning a national health insurance card as well as attending antenatal care. Owning a TV or watching a TV once a week was also seen as a facilitator of skilled birth delivery. Poor staff attitudes toward women and lower educational levels of women were seen as barriers to skilled birth delivery. Continuous education on benefits of skilled birth delivery is key amidst sensitization of skilled birth attendants on developing good working relationship with clients.

 

Keyword: Skilled Birth Delivery, Sub-Saharan Africa, Barriers, Facilitators

 

 

Ziyadah Gbene Suleman^1,2,&, George Akowuah¹, Joseph Asamoah Frimpong² Samuel Oko Sackey², Ernest Kenu²

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Ghana, ² Veterinary Services Department (VSD), Upper West Region, Ghana

^&Corresponding author: Ziyadah Gbene Suleman, Veterinary Services Department (VSD), Upper West Region, Ghana

 

Email: ziyadahgbene@gmail.com

Background: Pneumonia is the most common respiratory infection in domestic animals, with bacteria, viruses, parasites, or a combination of all of them as aetiologic agents. Animal pneumonia is common in developing countries resulting in significant losses to the livestock sector. Despite its regular occurrence among livestock in the region, analysis on data generated on the disease is rare. This study sought to determine the distribution of animal pneumonia cases in livestock in the Upper West Region by livestock species, place and time.

 

Methods: Secondary data on animal pneumonia was compiled from veterinary monthly reports in the Upper West Region from 2017 to 2021. Study population included livestock detected with animal pneumonia within the period. Data was analyzed by livestock species, districts and time using descriptive epidemiology. Microsoft Excel 2016 and QGIS V.3.24 were used for analysis. Results were presented as text tables, and figures.

 

Results: Of 7,120 animal pneumonia cases recorded over the period, majority, 3,484 (49%) occurred among sheep whilst the least 128 (2%) occurred in donkeys. For the other species in the study, cattle recorded 1,138 (16%), goats 2216 (31%) and pigs 154 (2%). Incidence of the disease ranged from 16/100,000/year in Lawra District to 2,293/100,000/year, in Daffiama-Busie-Issa district. Most affected species was sheep with incidence of 1,580/100,000/year whilst pigs recorded the lowest with incidence of 129/100,000/year. Cases were more frequent during the rainy seasons for all years.

 

Conclusion: Animal pneumonia is on the rise in the Upper West Region. Sheep were more susceptible to the disease with the Daffiama-Bussie-Issa district being most affected. Animal pneumonia was more predominant in the rainy seasons. Regular analysis of animal pneumonia data should be conducted to determine the burden of the disease and implement control measures.

 

Key words: Animal pneumonia, incidence, livestock, Upper West Region

 

 

Abubakari Yussif ^1,&, Samuel Dapaa², Magdalene Akos Odikro² Samuel Sackey²

¹Food and Drugs Authority, Accra, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Abubakari Yussif, Food and Drugs Authority, Ghana

 

Email: abubakariy62@yahoo.com

Introduction: The World Health Organization defines Adverse drug reactions (ADRs) as any undesired toxic effect during the clinical use of a drug. In 2020, the incidence of serious ADRs was 6.7% and that of fatal ADRs was 0.3% in the United States making ADRs one of the leading causes of death among hospitalized patients. Data collated by the Food and Drugs Authority in Northern Ghana on Adverse drug reactions has not been analyzed from 2017 to 2019. We analyzed this data to establish distribution by sex, age, districts, monthly, yearly trend and treatment type.

 

Method: Secondary data analysis of ADR surveillance data in Northern Ghana, from 2017 to 2019 was carried out. Data was extracted from the Food and Drugs Authority's ADR database in Northern Ghana. This was analyzed into frequencies, proportions and rates. Results were presented in text, tables and charts.

 

Results: A total of 241 ADRs were reported from 2017 to 2019 with one death with CFR of 0.4% (1/241). Females represented 52.9% (127/240). The median age of the cases was 37years with a range of 0-91 years. ADRs peaked in November, September and July for 2017, 2018 and 2019 respectively. Sulfadoxine-pyrimethamine plus amodiaquine-Co/Sulfadoxin recorded the highest ADR, with Amoxicillin Clavulanate recording the least ADR among medications.

 

Conclusion: Adverse Drug Reactions in Northern Ghana affected people of all ages with more females affected from 2017 to 2019. There was an increase in ADRs reporting from 2017 to 2019 with Sulfadoxine-pyrimethamine plus amodiaquine-Co/Sulfadoxin recording the highest ADR. ADRs line list should be clearly completed by health workers to capture clinics and hospital names. Public education should be intensified to encourage ADR reporting.

 

Keywords: Adverse Drug Reaction, Sulfadoxine-pyrimethamine plus amodiaquine-Co/Sulfadoxin, Amoxicillin Clavulanate

 

 

Banaan Ahmed^1,2,&, Samuel Dapaa², Samuel Oko Sackey², Joseph Asmaoah Frimpong ²

¹Veterinary Services Directorate, Ministry of Food and Agriculture, Bibiani Municipal, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Banaan Ahmed, Veterinary Services Directorate, Ministry of Food and Agriculture, Bibiani Municipal

 

Email: ahmedbanaan8@gmail.com

Background:Rabies is a global health problem, affecting almost 59,000 people worldwide. Rabies is prevented by human and animal vaccinations. We analyzed dog bites and animal rabies surveillance data to establish the burden of dog bites and animal rabies and characterize the disease by person, place, and time in Bibiani Anhwiaso Bekwai Municipality.

 

Methods: This was a secondary data analysis of dog bites and canine rabies in Bibiani Anhwiaso Bekwai Municipality (BABMA) from 2017 to 2021. Records of animal rabies and dog bites cases were reviewed from veterinary clinics and hospitals in Bibiani Anhwiaso Bekwai Municipality. Frequencies and proportions were generated. The results were presented in the form of tables and figures.

 

Results: A total of 407 dog bites and 7 cases of animal rabies were reported from Bibiani hospital and from veterinary clinics respectively. The highest 25.1% (102/407) dog bites were reported in 2018 with more 54% (220/407) males affected. Children were less affected 37.6% (153/407) and the urban areas had majority of dog bites 70% (285/407). For animal rabies, the year 2018 recorded the highest number 42.9% (3/7) and males were majority 57% (4/7). About 14.3% (1/7) of the human cases got two doses of prophylaxis vaccination.

 

Conclusion: Dog bites and animal rabies are a burden in BABMA. Males and adults age 18 and above were more affected by dog bites. Most of the dog bites cases were within the urban municipal area. The veterinary services should intensify public education regarding dog bites and animal rabies throughout the year.

 

Keywords:Canine rabies, Dog bite, Data analysis Bibiani Anhwiaso Bekwai, Ghana

 

 

Derrick Okyere^1,&, Rita Agyekumwah Asante Kusi², Joseph Asamoah Frimpong², Samuel Oko Sackey²

¹Central Regional Coordinating Council, Cape Coast, ²Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Derrick Okyere, Central Regional Coordinating Council, Cape Coast, Ghana

 

Email: Okyere.k.derrick36@gmail.com

Introduction: The Community Led Total Sanitation (CLTS) surveillance system in the Central Region aims at eradicating Open Defecation (OD) while improving household latrine ownership. Consequences that OD poses to public health include child mortality and morbidity. We evaluated the surveillance system in Assin South District to determine if system's objectives are being met, assess system's attributes and usefulness.

 

Methods: A descriptive cross-sectional design was used to evaluate the CLTS surveillance system from 2017–2021 in Assin South District, using the CDC updated guidelines for evaluating public health surveillance systems. We interviewed key stakeholders, reviewed records and made operational observations. Data was analyzed by performing summary descriptive statistics on quantitative data and direct content analysis on qualitative data. Results were presented in texts, graphs and table.

 

Results: A total of 15 stakeholders comprising 12 (80%) females were interviewed. Following triggering of 133 communities in 2014-2016, 132 open defecation (OD) communities were identified. About 26 (19.70%) of the 132 OD communities were declared Open Defecation Free (ODF) communities between 2017-2021. The system easily integrated BaSiS, a database for storage of data. Though no report was submitted to the region in 2020, and 2021 reports submitted to the district level were timely with 85.7% (12/14) reports complete. It took >1year to declare a community ODF. Lack of vehicles, internet and funds also made the system unstable. About 248 latrines were constructed with majority 115 (46.4%) constructed in 2017.

 

Conclusion: The CLTS surveillance system in the Assin South partly met its objectives. It was simple, flexible, sensitive, representative with poor acceptability, data quality, timeliness and stability. The system was useful in improving sanitation practices to promote public health. We recommend the District Interagency Coordinating Committee on Sanitation to facilitate the process of declaring communities ODF to improve public confidence.

 

Keywords: Community-Led Total Sanitation, Household, latrines, Open Defecation, Defecation Free

 

 

Emelia Dadzie^1,2,&, George Akowuah ², Magdalene Akos Odikro², Samuel Oko Sackey², Ernest Kenu²

¹ Veterinary Services Department, Ahanta West, Ghana, ² Ghana Field Epidemiology Training and Laboratory Program, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Emelia Dadzie, Veterinary Services Department, Ahanta West, Ghana

 

Email:dadzieemily06@gmail.com

Background: Rabies is a highly fatal disease that is endemic in Ghana. In the past five to ten years, the surveillance system for dog bites and rabies has not been evaluated in the Ahanta West Municipal. We evaluated the dog bites and rabies surveillance system to determine whether it is meeting its objectives, assess its attributes and determine its usefulness.

 

Method: A descriptive cross-sectional study was conducted in Ahanta West Municipal. Key stakeholders were interviewed. A structured questionnaire based on the Updated CDC guidelines for evaluating surveillance system was used for data collection using face-to-face interviews. Surveillance records were reviewed. Major qualitative findings were narrated and summarized using content analysis to supplement the quantitative findings. The quantitative findings were analyzed into frequencies, percentages and rates using Microsoft Excel 2016. Results were presented as text, and charts.

 

Results: From 2017-2021, 735 and 150 dog bite cases were recorded in humans and animals respectively. Rabid dogs involved in the biting incidence were 6.5% (12/186) and zero in humans. Standard reporting forms were used for reporting at all levels. Completeness of Veterinary Form 1 was 75.9% (22/29). Case definition was easy to apply. Only 4 out of 21 health facilities that recorded dog bite cases reported to the Veterinary Service for investigation. Data analysis and feedback dissemination was not regular. Data in the system was used to inform mass vaccination of dogs.

 

Conclusion: The surveillance system partially met its objectives. The system was simple, sensitive, representative and useful. Data quality and acceptability needs improvement for the system to function effectively. Regular data analysis, feedback dissemination built on one health concept must be put in place in order to improve the system.

 

Keywords: Dog bite, rabies, surveillance, one health, Ahanta West Municipal

 

 

Emmanuel Kwasi^1,&, George Akowuah², Joseph Asamoah Frimpong², Ernest Kenu²

¹Food and Drugs Authority, Accra, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Emmanuel Kwasi, Food and Drugs Authority, Accra, Ghana

 

Email: emmanuel.kwasi@fda.gov.gh

Background: Food product registration is the review of food manufacturing processes, assessment of food safety and quality in accordance with Food and Drugs Authority's regulation. Currently, most food products in the Ghanaian markets are from the informal sector. The increasing share of informal sector players in the food industry with inadequate knowledge on standards and current specifications lowers the quality of good food safety practices. The surveillance data on food product registrations was analyzed to describe categories of registered food products, trend of food product registrations and establish level of compliance among food manufacturers in the Western zone of the FDA.

 

Methods: Records on food products registration from 2017-2021 were reviewed. Data was sourced from food manufacturers' dataset and paper files at the Western Regional Office of FDA. Electronic and paper data were extracted into predesigned excel template. Data was imported to Epi Info 7 and ArcGIS for analysis. Data was summarized into frequencies, percentages and presented as tables, charts, and map.

 

Results: Over the period, 439 food products applications were received by the FDA. Among the categories of food products, water recorded highest applications 62.4% (274/439). Majority of the applications were from Sekondi Takoradi Metropolis, 54.7% (240/439) with Sefwi Akontombra and Nzema East recording the lowest, 0.2% (1/439) each. Applications increased consistently in all years from 21 (2017) to 171 (2021). Valid food registrations were 54.9% (241/439). Nearly a third of unsuccessful applications were due to incomplete application forms, 28.6% (56/196).

 

Conclusions: Food product applications in Western zone of the FDA increased from 2017-2021. Applications were predominantly for water products and from Sekondi Takoradi Metropolis. About half of the applications were compliant and successful. FDA should increase the frequency of field visit to distant districts to improve registrations and compliance.

 

Keywords: Food, registration, compliance, trend, Ghana

 

 

Fuseini Mahama Dramani^1,&, Samuel Dapaa², Samuel Oko Sackey², Joseph Asamoah Frimpong²

¹Department of Environmental Health and Sanitation, Yunyoo- Nasuan District Assembly, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Fuseini Mahama Dramani, Department of Environmental Health and Sanitation, Yunyoo- Nasuan District Assembly, Ghana

 

Email:fuzzydfm1@gmail.com

Background:Open Defecation (OD) practices have been a major sanitation problem in Ghana. It is commonly practiced in rural and peri-urban areas where sanitation infrastructures and services are not available. Cholera and malaria among others are sanitation related diseases related to OD which pose severe threat to human survival. This study established latrine coverage, proportion of latrines with handwashing facilities, trend and burden of open defecation in the East Mamprusi Municipality.

 

Methods: This was a secondary data analysis of open defecation (OD) data in the East Mamprusi Municipality from 2015 to 2018. Data was extracted from the environmental health unit Community Led Total Sanitation database. Duplicates, missing and incomplete data were cleaned using Microsoft excel. Data was descriptively summarized as frequencies and proportions. Results were presented in tables and graphs.

 

Results: A total of 9,321 houses were in all the zonal councils with 27.4% (2,552) having constructed latrines. Nalerigu zonal council had 9.9 % (930/9,321) of households with latrines. Sakogu zonal council recorded 3.2% (300/9,321) of latrines constructed. Across the zonal councils, Nalerigu had the least proportion with hand washing facility 12.8% (119/930) while in Sakogu all 100% (300/300) improved latrines had hand washing facilities with 9 latrines each having an extra handwashing facility. The year 2017 recorded highest 28.7% (959/3,347) of households with latrines constructed out of those triggered. About 62.5% (100/160) of the communities defecate in the open.

 

Conclusion: Majority of the latrines constructed were found in the Nalerigu zonal council with few communities certified and declared as open defecation free. There was increasing trend in the proportion of handwashing facilities. The municipal assembly together with the environmental health and sanitation unit should continuously assess community to improve on sanitation towards the creation of sustainable communities.

 

Keywords: Open defecation, Data analysis, East Mamprusi, North East, Ghana

 

 

Amara Stevens Ngegbai^1,&, Kwaku Adjei-Manu², Desmond Maada Kangbai³, Culbert Nuolabong¹, Charles Lwanga Noora¹

¹Ghana Field Epidemiology and Training Program, School of Public Health, University of Ghana, Legon, Ghana, ²Ghana Health Service, Accra, Ghana, ³Ministry of Health and Sanitation, Freetwon, Sierra Leone

^&Corresponding author: Amara Stevens Ngegbai, Ghana Field Epidemiology and Training Program, School of Public Health, University of Ghana, Legon, Ghana

 

Email: drnas88@gmail.com

Background: Ghana's maternal mortality ratio has improved since the 1990s but remains high, especially in rural areas. This necessitates concerted measures if Ghana is to meet its 2030 sustainable development goal of 70 /100,000 live births. Ghana adopted the Maternal Death Surveillance and Response (MDSR) in 2014 to help prevent avoidable maternal deaths. This study assessed whether maternal death surveillance in Sunyani Municipality is useful and meets its objectives.

 

Methods: The evaluation approach was both quantitative and qualitative. The checklists and interviewer guides were adapted from Ghana's IDSR 3rd Edition and the CDC updated guidelines for evaluating public health surveillance systems. The data reviewed was from January 2017 to December 2021. Stakeholders in the surveillance system were interviewed, and summary statistics and content analysis were done.

 

Results: Thirty-seven respondents were interviewed from eleven facilities, 32.4% (12/37) of whom were midwives, and median age was 30 years (interquartile range: 34-23 yrs.). About 75.7% (28/37) could explain how surveillance data has been used to prevent avoidable maternal deaths. Notification forms were easy to understand for 85% (17/20) of respondents. However, 86.5% (32/37) could not correctly recall the maternal death case definition. About 94.6% (35/37) were willing to notify and be involved in audits. Also, 80% (5/25) of forms reviewed were reported within 24 hours, and 88% (22/25) were investigated within seven days. Only 68% (17/25) of the forms reviewed were filled out correctly, and no line list was found at most facilities. No maternal death was reported in the community.

 

Conclusions: The system was meeting most of its objectives. It was useful and simple but with poor knowledge of the case definition. The system was somehow acceptable, flexible, and stable. Data quality was, however, poor and was only partially representative. Health workers should be trained in maternal death surveillance and support data management.

 

Keywords: Maternal Death, Surveillance system, Evaluation, Sunyani Municipal, Ghana

 

 

Bakalilu Kijera^1,&, Danny Kalala Mukandila¹, Amara Stevens Ngegbai^1,, Doris Aboagyewaa Edu-Quansah¹, Seth Baffoe¹, Donne Ameme¹, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

^&Corresponding author: Bakalilu Kijera, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

 

Email:bkkijera@gmail.com

Background: Hand hygiene practices among students and staff in a public health training institution is expected to be optimum. Students and staff can serve as role models in their respective work settings, homes, and communities. This study aimed to assess the knowledge, attitude, and practice of hand hygiene among students and staff of the School of Public Health at the University of Ghana, Legon.

 

Methods: This study was a cross-sectional study. An observational checklist was used to observe whether students and staff washed their hands upon entrance to the School of Public Health on April 29, 2022. Self-administered questionnaires were used to assess their knowledge, attitude, and hand hygiene practice. The study used simple random and systematic sampling techniques to select 145 study participants. Cochrane's formula for the finite population was used to calculate the study's sample size. We used a two-point Likert scale to rank knowledge, attitude, and practice as good or poor.

 

Results: Of 145 respondents, four (3.0%) washed their hands with soap and water or hand sanitiser upon entry. More females washed their hands (4.3%) compared to males (1.3%) (1.03-5.32)). Less than half of the respondents, 50 (47.2%), had good knowledge. Forty (37.7%) had good hand hygiene practices, and 79 (75%) respondents had good attitudes towards hand hygiene.

 

Conclusion: The knowledge and practice of hand hygiene of students and staff in the School of Public Health were low. The hand hygiene stations within the school were not used by staff or students. We designed posters with information about hand hygiene and put them up in key locations across the campus of the School of Public Health.

 

Keywords: Hand hygiene practices, Students, Staff, School of Public Health, University of Ghana

 

 

Bakalilu Kijera^1,&, Donne Ameme¹, Charles Lwanga Noora¹, Abdul Nasir Alhasan², Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana, ²Ghana Health Services, Accra, Ghana

^&Corresponding author: Bakalilu Kijera, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Ghana

 

Email: bkkijera@gmail.com

Background: Ghana reported the last native wild poliovirus that causes poliomyelitis in 1999. However, Ghana experienced another outbreak when a case each was imported into the country in 2003 and 2004. However, the decade-long polio-free status ended in 2019, following the detection of circulatory vaccine derived polio virus type 2 (cVDPV2) through environmental health surveillance (EHS). This evaluation describes the usefulness and attributes of an acute flaccid paralysis surveillance system and whether the system meets its objectives.

 

Methods: A descriptive evaluation of the AFP surveillance system from January 2017 to December 2021 was conducted in Ho Municipality, Volta Region. Interviews of health workers and key stakeholders, observations, records review, and administration of semi-structured questionnaires were made. The Centres for Disease Control and Prevention Updated guidelines for evaluating public health surveillance systems were used as a reference for developing a checklist. The quantitative data was analysed using percentages and frequencies, while qualitative data were audio recorded and later transcribed and descriptive narrative analysis performed.

 

Results: A total of 10 AFP cases were reported between January 2017 to December 2021. Six of theses (28.57%) were detected based on actions taken on AFP surveillance data. The district recorded 1.11/100,000 and 1.09/100,000 ≤ 15 populations of non-polio AFP rates in 2018 and 2019, respectively. One (10.0%) of the specimens reached the reference laboratory within 72 hours, and overall data completeness of 68.04%. Three (30.0%) cases were followed for up to 60 days from the onset of the paralysis.

 

Conclusion:The AFP surveillance system in Ho municipality is partially meeting its objectives. It is complex, partially stable, sensitive, acceptable, representative, and poor in data quality and timeliness. Overall, the system is useful and flexible. The District Health Management Team should ensure specimens are sent to the reference laboratory within 72 hours after the case investigation.

 

Keywords: Acute Flaccid Paralysis, Surveillance system, Evaluation, Ho Municipality, Ghana

 

 

Danny Mukandila Kalala^1,&, Holy Alomatu¹, Winfred Ofosu², Paul Twene², Christabel Ayepah¹, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health University of Ghana, Accra, Ghana, ²Eastern Region Health Directorate, Ghana Health Service, Koforidua, Ghana

^&Corresponding Author: Danny Mukandila Kalala, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health University of Ghana, Accra, Ghana

 

Email: dkalalam@gmail.com

Background: Seasonal influenza is an acute respiratory infection with the potential to cause large outbreaks leading to hospitalisation and loss of economic productivity, even though most cases recover within a week without treatment. On May 13, 2022, influenza A/ H3N2 outbreak was declared among students of boarding schools in Akwapim District in the Eastern Region of Ghana. We investigated the outbreak to describe its magnitude and identify risk factors.

 

Methods: From the dataset, 362 blood samples of suspected cases were collected from four affected schools, and only 126 were tested. We interviewed positive cases using semi-structured questionnaires; standard environmental assessment checklists were used to assess possible risk factors. We extracted additional outbreak data from the district health directorate records. We constructed an epicurve and performed a descriptive analysis including summary statistics.

 

Results: Out of the samples tested about 38% (48/126) cases were confirmed positive. The mean age of confirmed cases was 16.8 ± 2.2 years, females represented 97.92%, and cough represented 75% of symptoms. The overall attack rate was 0.6%, with the highest attack rate of 0.8% in Adonten Senoir High School. The outbreak had a point source in each school with transmissions increasing from 3rd – 23rd May 2022. A history of an interschool game competition was reported; congestion and gathering were suggested factors to the outbreak's spread within schools.

 

Conclusion: A low-magnitude influenza A/ H3N2 outbreak was successfully detected and controlled in boarding schools. Female students were the most affected; congestion and gathering were possible risk factors for the spread. We recommended decongestion of classrooms, dining rooms, and dormitories.

 

Keywords: Influenza A/H3N2, outbreak, boarding school, Ghana

 

 

Forster Amponsah-Manu^1,2,&, Ijeoma Aja¹, Ebenezer Temitokpe Arkorful¹, Edwin Kwesi Tinkorang¹, Edmund Atta Asante¹ Ransford Aduah¹, Muhyideen Alhassan Bashir¹, Arko Akoto-Ampaw¹, George Akowuah², Dora Dadzie²

¹Eastern Regional Hospital, Koforidua, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program, School of Public Health University of Ghana, Accra, Ghana

^&Corresponding author: Forster Amponsah-Manu, Eastern Regional Hospital, Koforidua, Ghana

 

Email: foster_amponsah@yahoo.com

Background: Peptic ulcers are focal defects in the gastric or duodenal mucosa that extend into the submucosa or are more profound. The prevalence of peptic ulcer disease among patients with dyspepsia in Africa ranges from 12 to 25%. The common complications of peptic ulcer disease are bleeding, perforation, and obstruction, with perforated peptic ulcer having mortality rates of up to 30%. However, there is limited investigation on the epidemiology of perforated peptic ulcer disease in the Eastern Region of Ghana. We described the trends and characteristics of perforated peptic ulcer (PPU) at the Eastern Regional Hospital, Koforidua.

 

Methods: We conducted a retrospective review of surgical records of clients presenting with PPU at the Eastern Regional Hospital, Koforidua from January 2016 to December 2021. Data related to patient's demographics, diagnosis, site of perforation, length of stay, and outcome of surgery were analysed descriptively with summary statistics. Results were expressed in proportions and frequencies.

 

Results: A total of 222 PPU cases with 42 related deaths (CFR of 18.8%) were recorded over the period. Majority, 83.3% (185/222), were males. About 58.5% (130/222) were 45 to 74 years, with a mean age of 52. Farmers were 43.7% (97/222) and artisans were 15.3% (34/222). Less than half (107/222, 48.2%) had health insurance. Mean length of hospital stay was 8 (±4) days. About, 32% (71/222) of patients, resided in New Juaben Municipality. The least number of cases (29/222) were recorded in 2019; whiles most cases were recorded in September (12.6%) and October (12.2%). About 70% (155/222) of cases had duodenal perforations, with 45% (100/222) having no history of non-steroidal anti-inflammatory drug use.

 

Conclusions: Mortality was high among persons presenting with PPU at Eastern Regional Hospital from 2016 through 2021. Males, the middle aged, residents of New Juaben, artisans and farmers were more affected. Interventions for early initiation of peptic ulcer disease (PUD) treatment and health education on PUD and PPU prevention should be implemented.

 

Keywords: peptic ulcer, perforation, bleeding, Eastern Regional Hospital, Ghana

 

 

Francisca Happy Ametorwodufia^1,2,&, Joyce Der², Donne Ameme¹, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Programme, School of Public Health, University of Ghana, Accra, Ghana, ²Ghana Health Service, Weija-Gbawe Municipal Health Directorate, Weija, Ghana, ³ University of Allied Health Sciences, School of Public Health, Hohoe, Ghana

^&Corresponding author: Francisca Happy Ametorwodufia, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health University of Ghana, Accra, Ghana

 

Email: franca.ameth@yahoo.com

Introduction: Globally, the incidence of paralytic polio linked to wild polio virus (WPV) from 1988 to 2018 has reduced by about 99% worldwide, according to the WHO. In Ghana, the last indigenous wild poliovirus was detected in 1999, followed by two polio outbreaks in 2003 and 2008 caused by importation from neighboring countries. In recent times, Ghana has recorded several outbreaks due to circulating vaccine-derived polio (cVDP) hence the need to periodically evaluate the AFP surveillance system. We evaluated the AFP surveillance system to determine whether the system is meeting it objectives, usefulness and assess system attributes.

 

Methods: We adapted the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. Key stakeholders were interviewed using semi-structured questionnaire at different reporting levels. Additionally, we extracted and reviewed a five-year (2017-2021) Dhims2 data on AFP surveillance to assess system performance. Data obtained was analyzed to produce summaries, frequencies, and proportion.

 

Results: Of the 12 respondents engaged at different levels, five (42%) had received training on AFP surveillance, eight (67%) had adequate knowledge on AFP surveillance and are involved in AFP case detection, reporting and investigation. All 8 key respondents indicated that case definition, case-based investigation form was simple, fairly flexible and could easily accommodate changes. A total of 89 AFP cases were reported from 2017 to 2021. The non-polio AFP rate ranged from 2.7/100,000 -11.9/100,000 under-fifteen population. All cases had a stool adequacy above the WHO minimum standard of 80% except for 2021, follow up at 60days was above 80%, feedback on result and final classification not documented at all sub-metros. All stakeholders perceived the system to be useful, however, only 6/12 had used the surveillance for action locally. Timeliness and completeness of data in the metro was consistently above 80% for 2017 to 2021.

 

Conclusion: The AFP surveillance system in Accra Metro partly met its objectives. The system was useful at detecting AFP cases and data from the system triggers response actions locally. It is fairly representative, timely, flexible, acceptable, sensitive and stable though IGF-driven with minimal external support. It is threatened by lack of laboratory feedback, periodic training for staff and support for 60 days follow-up and transportation of samples to designated laboratory.

 

Key words: Acute Flaccid Paralysis, poliomyelitis, surveillance, Accra Metro, Greater Accra

 

 

Garcondoe Burgess Gbelee, Jr^1,2,3,& , Yaw Karikari Asamoah1,4, Elijah Edu-Quansah⁴, Charles Lwanga Noora¹, Chrysanthus Kubio⁴, Ernest Kenu⁵

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana, ²Liberia Field Epidemiology Training Program, Congo Town, Liberia, ³National Public Health Reference Laboratory, Acrra, Ghana, ⁴Ghana Health Service, Accra, Ghana, ⁵African Field Epidemiology Network, Monrovia, Liberia

^&Corresponding author: Burgess Gbelee, Jr., Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana

 

Email: gburgessg55@gmail.com

Introduction:Yellow fever (YF) is an acute viral hemorrhagic disease transmitted by Aedes aegypti, with a fatality rate of 15-50%. Ghana and 26 African countries are classified as the highest area for yellow fever. Surveillance system evaluation is a key instrument to know whether the system is meeting its objectives. Laboratory turnaround around time helps in decision-making. We evaluated the yellow fever surveillance system in West Gonja to determine its usefulness, assess its attributes, and calculate the turnaround time of results.

 

Methods: We adopted the US-Center for Disease Control and Prevention updated guideline for surveillance system evaluation to collect qualitative and quantitative data. We interviewed the system's key stakeholders using a semi-structured questionnaire and direct observation. Yellow fever data between 2017 and 2021 were extracted from DHMIS2. Data were analysed using Epi-info version 7.2, and results were presented in frequencies and proportions.

 

Results: One hundred fifty-nine suspected cases were detected with a positivity of 33.3% (53/159) and a case fatality rate of 17.0% (9/53) between 2017-2019. Twenty-eight key informants were interviewed. Of these, 64.3% (18/28) and 100% (28/28) said the system was stable and simple, respectively. On average, it took symptomatic patients 5–6 days to report to the nearest health centre. Of the samples with results, 98.3% (118/120) were tested within seven days, and the time it takes from the transportation of samples to feedback of results is in the median, interquartile range of 13 (11–18) days. It took an average of 15 days for the district to receive sample feedback.

 

Conclusion: High positive predictive value and case fatality rates were reported. Although the system is simple but partially stable, the timeliness of feedback is poor. We recommend that Ghana Health Services ensure timely feedback on patient reports. Data analysed were used for decision-making by stakeholders.

 

Keywords: Yellow fever, turnaround time, Ghana

 

 

Eben Godsway Dzodanu^1,&, Rufai Tanko¹, Ernest Kenu¹, Brainard Ayisi-Asare²

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana, ²Kwaebibirem Municipal Health Directorate, Ghana Health Service, Ghana

^&Corresponding author: Eben Godsway Dzodanu, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana

 

Email: ebendzodanu@gmail.com

Introduction: Onchocerciasis is a neglected tropical disease caused by Onchocerca volvulus. It is highly debilitating and can result in permanent blindness. The global burden of the disease estimated in 2017 was 20.9 million, with 4.7 million people at risk of contracting the disease in Ghana. Onchocerciasis is earmarked for elimination in Ghana; hence we evaluated its surveillance system in the Kwaebibirem municipality to determine its usefulness, whether the system was meeting its objectives and assessed its attributes.

 

Methods: We extracted and reviewed data from monthly Integrated Disease Surveillance Response (IDSR) reporting forms, District Health Management Information System (DHIMS) II and laboratory register covering 2015–2020. We interviewed stakeholders using a semi?structured questionnaire for information on their awareness and involvement in the system, case detection, and reporting and observed using a checklist. We assessed the system attributes by adopting the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health systems (2006). Participants' responses to questions on surveillance activities were presented as frequencies and proportions in tables and graphs.

 

Results: Of 13 suspected onchocerciasis cases recorded in the Kwaebibirem municipality over the six years, none was confirmed positive. Transmission assessment survey in 2017 yielded no positive cases. Of the 20 health staff interviewed, 90% (18/20) knew the case definition, and 100% said the system was simple and acceptable. No blank response was found on any of the fifty IDSR forms sampled. There were major discrepancies in data in DHIMS II, IDSR forms and laboratory register. The system was heavily dependent on donor funding, and the average timeliness of reporting was 88%.

 

Conclusion: The onchocerciasis surveillance system was useful and partially met its objectives. There is a need to improve data validation in DHIMS 2, and the laboratory should be involved in surveillance.

 

Keywords: Onchocerciasis, Kwaebibirem, Surveillance system, Evaluation, Elimination, Ghana

 

 

Iddrisu Musah^1,2,3,&, Abdul Gafaru Mohammed^1,2, Donne Ameme^1,2, Adam Zakaria^1,2

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana, ²University of Ghana, School of Public Health, Accra, Ghana, ³Tamale Teaching Hospital, Northern Region, Ghana

^&Corresponding author: Iddrisu Musah, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana

 

Email: miburner@yahoo.com

Background:In 2019, there were 229 million malaria cases and 409,000 malaria-related deaths. The WHO African region carried a disproportionately high share of the global malaria burden, with approximately 94% of all malaria cases and deaths. Despite the several malaria control measures being practised in the Tamale Metropolis, malaria has been the third outpatient disease in the metropolis. This study was conducted to describe malaria morbidity in the Tamale Metropolis of the Northern Region by person, place and time from 2015 to 2021.

 

Methods: We conducted a cross-sectional study with retrospective analysis of malaria surveillance data from 2015 to 2021 in the Tamale Metropolis. The study was conducted from January – March 2022. Using data extraction sheets, we extracted malaria surveillance data from the DHIMS 2 and district records. We estimated morbidity and mortality rates and proportions from the extracted data using STATA version 15.0.

 

Results: Over the study period, 460,146 cases of malaria were suspected, and 58.63% (269,774) were tested for malaria using microscopy and RDTs. Of the 269,774 cases tested, 29.02% (78,285) were confirmed positive. Over the period, the malaria testing rate and positivity rate increased by over 47% and 1.5%, respectively. In terms of place distribution of malaria cases, the highest number of cases over the period was recorded in the Tamale central sub-district (42,440). Nyohini sub-district registered the least number of cases over the period. The highest case count was recorded in 2021, and the least was seen in 2015.

 

Conclusion: The study revealed an increase in the malaria testing rate, the majority of cases confirmed were from the Tamale central sub-district. The study further revealed an increasing trend of confirmed cases from 2018 – 2021. The majority of the cases recorded were among females. We organised sensitisation programs to educate the public in the district.

 

Keywords: Malaria, Data Analysis, Tamale, Surveillance, Northern Region

 

 

Jacob Nignan Nabei^1,&, Gideon Oteng Korankye², Charles Lwanga Noora¹

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, ²Zebilla Hospital, Ghana Health Service, Zebilla

^&Corresponding Author: Jacob Nignan Nabei, Ghana Field Epidemiology and Laboratory Training Program

 

Email: nabeijake3@yahoo.com

Background: Meningitis is an inflammation of the membranes covering the brain and spinal cord. Globally, over 1.2 million cases of bacterial meningitis are estimated to occur annually, accounting for 2-30% mortality rates, with significant epidemics occurring in the meningitis belt of Africa. Despite all efforts made in its diagnosis and treatment, mortality rates are still high in Ghana. Data showed that about 20 confirmed cases with 15 deaths were recorded in Saboba District between 2010 and 2015. We evaluated the system over five years in Saboba District to determine if it was achieving its objectives and assessed its attributes.

 

Methods: We used semi-structured questionnaires on the system operation to interview health workers. To determine case trends, we extracted and reviewed meningitis records from 2016-2020. Center for Disease Control and Prevention (CDC) Updated Guidelines for Evaluating Surveillance Systems was used to assess meningitis surveillance system attributes. Frequencies and relative frequency of data were generated using Microsoft excel.

 

Results: Twenty-nine cases were suspected, and 6 cases were confirmed, given a positivity rate of 20.6%. Cases among 11-20 years accounted for the highest; 13 (44.8%). Males constituted more cases; 16 (55.2%). The dominant strain of meningitis in circulation is Streptococcus pneumoniae (83.3%). Reporting rate in the district is 93.1%. The system was fairly useful and very flexible, but sensitivity was poor.

 

Conclusion: The meningitis surveillance system in Saboba District fairly meets its objectives and is quite helpful. However, clinician's low index of suspicion, delays in getting feedback from the Zonal Public Health Reference Laboratory (ZPHRL) and low motivation of community-based surveillance volunteers (CBSVs) rendered its sensitivity and timeliness poor. Therefore, following our recommendations, plans were started by the district director to organise a meningitis refresher training for clinicians.

 

Keywords: Meningitis, Surveillance, Evaluation, DHIMS-2, Saboba, Ghana

 

 

Linda Adjapong^1,5,&, Abdul Gafaru Mohammed¹, Patience Ami Mamattah⁵, Donne Ameme¹, George Asumah Adu^{1, 4}, Ernest Kenu^1,2

¹Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, ²Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana, ³Disease Surveillance Department, Ghana Health Service, Accra, Ghana ⁴National Malaria Control Programme, NMCP, Accra, Ghana, ⁵Ashaiman Municipal Health Directorate, Ghana Health Service, Accra, Ghana

^&Corresponding Author: Linda Adjapong, Ghana Field Epidemiology and Laboratory Training Programme

 

Email: akualinda28@yahoo.com

Background: Malaria remains endemic in Ghana accounting for about 21% of all morbidities among pregnant women and children under five. Malaria data is routinely collected through the IDSR strategy. Of the 19,292 malaria cases recorded in Ashaiman in 2020, 11.1% occurred among pregnant women. We analyzed pregnancy surveillance data to determine the distribution of malaria in pregnancy by person, place and time, assessed malaria intervention programs and malaria report submission in Ashaiman municipality.

 

Methods: We analyzed pregnancy surveillance data reported between 2017 and 2021 from the District Health Information Management System II. We performed trend analysis, calculated thresholds and morbidity rates by person and estimated proportion of cases by sub municipals. We determined proportion of morbidities attributable to malaria, uptake of malaria interventions and malaria report submission. We presented results in tables and figures.

 

Results: Of 20,627 pregnant women suspected of malaria, 87.7% (18,084/20,627) were tested with 11.8% (2,136/18,084) confirmed. The age group 20-34 years accounted for 56.5% (1207/2136) of all cases. Tsinai-agber recorded the highest (1640 per 1000) cases whilst the least (13/1000) was in Blakpatsona. Majority of malaria cases were recorded in February and May. About 52.0% (2,999/5793) of all morbidities reported by pregnant women was due to malaria. Of ANC registrants, IPTp3+ coverage was highest 66.5% (7512/11292) in Mansteman and lowest in Amui Jor 36.3% (263/725) whilst ITN was highest in Amui Jor 92.8% (673/725) and lowest in Blakpatsona 69.1% (215/311). Completeness and timeliness of reporting for Gbemi, Amui Jor and Blakpatsona were below the WHO target of 80% with Amui Jor reporting as low as 38% and 37% respectively.

 

Conclusion: Malaria was the highest reported morbidity among pregnant women with most cases occurring among the ages 20-34 years. Most of the cases were recorded in Tsinai-agber sub municipal. IPTp 3+ coverage was below national target in all sub municipals. The municipal had data entry challenges. The Ashaiman Municipal Health Directorate should ensure monthly data entry and validation at all levels.

 

Key words: Surveillance, Malaria in pregnancy, Ashaiman municipal, Ghana

 

 

Lucia Bawo^1,&, Lily Blebo², Ernest Kenu ¹

¹Ghana Field Epidemiology Training Program, ²National Public Health Institute of Liberia

^&Corresponding author: Lucia Bawo, Ghana Field Epidemiology Training Program

 

Email: lucia.m.bawo@gmail.com

Background: Ebola Virus Disease (EVD) is a global health problem whose epidemic in past times devastated the west coast of Africa. To strengthen the preparedness of the EVD surveillance system and per the requirements of the surveillance cycle, we evaluated the EVD surveillance system in the Ho Municipality to assess if the system is meeting its objectives and to assess the attributes and usefulness of the system.

 

Methods: We evaluated the EVD (VHF) surveillance system using the Centre for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems. Both qualitative and quantitative data collection processes were used. We reviewed surveillance records, case reporting forms, and surveillance data tools and interviewed key informants using a structured questionnaire on the EVD system's operations and attributes.

 

Results: The EVD surveillance system in the Ho municipality provided timely information weekly and monthly. All health facilities reported on time and provided complete reports. Case report forms and case definition was complex, users however expressed a willingness to participate and continue surveillance activities. Data collection tools were not available at the various health facilities under evaluation. Data are being consolidated into the District Health Information Management System-2 (DHIMS-2). The evaluation showed a stable EVD surveillance system due to its integration with other systems.

 

Conclusion: Though the timeliness and completeness of reports have shown excellent improvements over time, the EVD surveillance system in the Ho municipality is not meeting its objectives. The system was partially representative, acceptable, and stable but also complex. We recommend more technical and logistical support be provided to the peripheral level by the municipal directorate.

 

Keywords: Ebola Virus Disease; Volta Region; Surveillance; evaluation; Ho Municipality

 

 

Martin Safo Osei^1,&, Abdul Gafaru Mohammed¹, Gyekye Adu Boahene¹, Osei-Antwi Reuben², Delia Bandoh¹, Sackey Samuel Oko³

¹Ghana Field Epidemiology and Laboratory Training Programme, ²Ghana Health Service Asante Akim South, Juaso, ³School of Public Health, University of Ghana, Legon

^&Corresponding Author: Martin Safo Osei, Ghana Field Epidemiology and Laboratory Training Programme

 

Email: awoshekamso@yahoo.com

Background: In Ghana, malaria is a major cause of hospital attendance, contributing to about 30% of OPD, 27.3% of inpatients and 7.2% of deaths. According to the Asante Akim South Health Directorate 2020 annual report, malaria continued to be the leading cause of outpatient visits. As a result, malaria surveillance data were analysed to determine the distribution of malaria morbidity and mortality by person, place and time in Asante Akim Municipality.

 

Methods: We conducted a secondary data analysis of malaria surveillance data from 2016 – 2020 in the Asante Akim South municipality. We obtained data using a data extraction tool from the District Health Information Management system (DHIMS 2). The variables extracted included; cases suspected, cases tested, and cases treated by age, sex, time and place of residence. We computed rates and proportions using Microsoft Excel 2019.

 

Results: A total of 287343 malaria cases were suspected over the five years. Out of the total, 90.0% (258853/287343) were tested, with 68% (175307/258853) confirmed positive. From 2018 to 2020, the positivity rate saw a marginal rise from 91.4% (55842/258853) to 96.9% (60365/25885). The majority of the cases, 56.0% (98172/175307), were among females, Children under five years accounted for 23.4% (41022/175307) of all the confirmed cases. The Ofoase sub-municipal accounted for 25.6% (44879/175307) of the confirmed cases. Over the period, the proportion of confirmed malaria cases declined from 68.6% (26344/38408) in 2016 to 67.1% (43181/60365) in 2020.

 

Conclusion: There is a high testing rate for malaria in the municipality coupled with an increasing positivity rate. Females and children under five years accounted for the most confirmed cases in the municipality. The Ofoase sub-municipal accounted for the majority of the recorded cases in the municipality. The Municipal health directorate should sensitise the public to use distributed insecticide-treated mosquito nets.

 

Keywords: Malaria, Surveillance, Data Analysis, Asante Akim South Municipal

 

 

Mary Bobb^1,&, Irene Amedzro², Charles Lwanga Noora², Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana, ²Ghana Health Service, Accra, Ghana

^&Corresponding author: Mary Bobb, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana

 

Email: bobbmary31@gmail.com

Introduction: Globally meningitis morbidities and mortalities remain a major public health concern with over 1.2 million cases reported each year. Despite the implementation of the MenAfrica vaccine in routine immunization programs, countries that fall within the meningitis belt continue to experience outbreaks. The meningitis surveillance system in Sunyani municipality was evaluated to determine whether the system was useful, meeting its objectives, and its attributes performance.

 

Methods: We interviewed key stakeholders involved in the surveillance system using a questionnaire developed from CDC 2001 guidelines for Evaluating Surveillance Systems to assess the system's operation, usefulness, and attributes. Data reported in District Health Information Management System and case-based forms were reviewed from 2017 to 2021. Qualitative data were analyzed based on content and quantitative data was presented as frequencies and proportions.

 

Results: About 87% (20/23) of the staff understood the purpose and objectives of the surveillance system. A total of 84 suspected cases were reported and 18 were laboratory confirmed. A higher proportion (46/84, 55%,) of suspected cases were males, with ages ranging from 3 days to 66 years. The system was sensitive to detecting cases with a positive predictive value of 69.4%(18/26). The surveillance system is integrated with other systems but complex as suspected cases from sub-district health facilities were referred to municipal or regional hospitals. About 70.5%(36/51) of case-based forms were incompletely filled. The timeliness of weekly and monthly IDSR reports was 75% (9/12). Data from the surveillance system informed epidemic preparedness and response plan in the municipality.

 

Conclusion: The meningitis surveillance system in the Sunyani municipality was found to be sensitive, representative, flexible and useful. However, stability and acceptability were fair due to logistic constraints. The District Health Director needs to advocate for Physician Assistants at sub-district health facilities to be trained on cerebrospinal fluid sample collection.

 

Keywords: Meningitis, Case-based, Surveillance, Evaluation, Sunyani Municipality

 

 

Michael Awenkanab Avarade^1,2,3,&, Abdul Gafaru Mohammed^1,3, Gideon Kyei-Duodu⁴, Magdalene Odikro¹, Charles Lwanga Noora^1,2,3, Donne Kofi Ameme^1,2,3, Ernest Kenu^1,2

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana, ²Department of Epidemiology and Disease Control, University of Ghana, Accra, Ghana, ³Ghana Health Service, Accra, Ghana, ⁴University of Health and Allied Sciences, Hohoe, Ghana

^&Corresponding author:Michael Awenkanab Avarade, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana

 

Email: avaradem@yahoo.com

Background: On October 31, 2021, and November 9, 2021, the Bole and Sawla-Tuna-Kalba (STK) District Health Directorates, respectively, were notified of suspected Yellow fever (YF) cases in health facilities within their districts. We investigated the outbreak to determine its magnitude and source, to determine the environmental and behavioural risk factors, and to implement prevention and control measures.

 

Methods: We conducted active case searches, interviewed cases and contacts, assessed the knowledge and awareness of residents on YF in the affected communities and collected samples of suspected cases from 25^th to 29^th November 2021. We conducted an unmatched case-control study to determine risk factors and used multivariate logistic regression to evaluate risk factors associated with the YF outbreak.

 

Seven (63.6%) were males. The median age was 22 years (range: 12 - 53). Two (18.2%) were of Fulani ethnicity, and 3 (27.3%) were farmers. The case fatality rate was 54.5% (6/11). Case fatality was higher among children aged ?17 (2/3, 66.7%). In STK, 11 cases were reported as of November 26, 2021, with a district attack rate of 0.8 per 10,000 population. Seven (63.6%) were males. The median age was 13 years (range: 2 - 28). One (9.1%) case was of Fulani ethnicity, and 5/11 (45.5%) were farmers. The vaccination status of all the cases was unknown.

 

Conclusion: The YF attack rates for Bole and STK were 1.4/ 10,000 and 0.8/ 10,000, respectively. Proximity to a water body and wildlife were associated with the YF outbreak. The outbreak affected more children. We found low awareness and knowledge of YF among residents.

 

Keywords: Yellow fever, Bole, Sawla- Tuna- Kalba

 

 

Moses Kportoe^1,2,3,&, Abdul Gafaru Mohammed^1,3, Nana Yaw Prempeh⁴, Magdalene Odikro¹, Charles Noora Lwanga^1,2,3, Donne Kofi Ameme^1,2, Moses Kportoe^1,2,3, Ernest Kenu^1,2

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana, ²Department of Epidemiology and Disease Control, University of Ghana, Accra, Ghana, ³Ghana Health Service, Accra, Ghana, ⁴National Malaria Elimination Programme, Accra, Ghana

^&Corresponding author: Moses Kportoe, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana

 

Email: bronstedl@yahoo.com

Background: Tuberculosis (TB) is one of the top 10 causes of death worldwide and the leading cause of death of patients affected with a single infectious agent ranking above HIV/AIDS. Although Ghana has made progress in TB control, the incidence in 2019 was 48 per 100,000, and the disease persists. There is no available data on the epidemiological profile of the disease in the Ketu South Municipality. We analysed the surveillance data to assess the epidemiological profile of TB in the Municipality.

 

Methods: We conducted a descriptive analysis of TB surveillance data reported in the Ketu South Municipality from 2015 to 2020. We extracted data from the TB Case Registration forms (TB07) and TB Treatment Outcome forms (TB08). Variables extracted included; age, sex, HIV status, treatment outcome and mortality. Microsoft Excel 2016 was used to analyse data into frequencies and percentages, with results presented in graphs.

 

Results: The overall case detection rate of TB over the period was 98.9%. Males accounted for about 60%, and the age group of 30-49 years accounted for about 40.6% of all Tuberculosis cases. Some Wego had the highest average TB case notification rate of 22%; the least was Aflao East at 10%. The highest treatment success rate of 26% was achieved in 2017, and the lowest of 12% in 2020. The average mortality rate was 15.7%, with 2015 and 2017 recording the highest TB mortality rate (26%).

 

Conclusion: There was a declining TB case detection rate over the period. Most cases reported were among males and persons aged 30-49 years. Some Wego sub-district accounted for the majority of cases. The Ketu South Municipal Health Directorate should ensure the appropriate use of the new TB screening tool at the various health facilities to help increase case detection.

 

Keywords: Tuberculosis, HIV/AIDS, Ketu South, Ghana, Surveillance

 

 

Richard Asomadu Obeng^1,3,&, Stephen Ofori Nyarko^1,3, Yaw Larbi¹, Gifty Mawuli¹, Gifty Boateng², Charles Lwanga Noora³, Donne Ameme³, William Ampofo¹, Ivy Asantewaa Asante¹, Ernest Kenu³

¹University of Ghana, Virology Department, Noguchi Memorial Institute for Medical Research, Legon, Accra, ²National Public Health and Reference Laboratory, Ghana Health Service, Accra, ³Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra

^&Corresponding author: Richard Asomadu Obeng University of Ghana, Virology Department, Noguchi Memorial Institute for Medical Research, Legon, Accra

 

Email: obengasomadu@gmail.com

 

Background: Avian influenza viruses (AIVs) are a major health threat that causes significant economic loss to poultry farmers globally. In addition, the constant circulation and mutation of AIVs pose a potential health threat to humans. Periodic outbreaks in West Africa motivate Ghana's AIV surveillance which has been conducted biannually since 2017. This study analysed AIVs surveillance data to determine Avian Influenza (AI) prevalence and distribution amongst farm animals in Ghana. Methods: Secondary data analysis was conducted using AI surveillance data from 2017 to 2021, where animal type, animal health status, sampling region, specimen type, and year of sampling variables were collated and analysed. Univariate analysis was conducted to determine the trends and summarised demographic characteristics. Logistics regression was used to determine factors associated with AI detection.

 

Results: Overall, AI prevalence was 1.9% (103/5319), of which subtype AH5 strains dominated at 83.5% (86/103), AH7 was 1.9% (2/103), and AH9 was 14.6% (15/103). Most, 58.9% (79/3130) of the AI cases occurred in the coastal belt, followed by 19.6% (9/1024) from the northern belt. AI detections increased gradually from 2017 (1.1%, 3/265) to 2019 (3.3%, 8/930) and declined in 2020 (0.1%, 1/1238). However, after an AI outbreak in July 2021, there was a sharp increase in AIV detection (3.4%, 87/2581). Tracheal specimen type (aOR 0.52, 95% CI 0.31-0.89), dead/sick bird health status (aOR 0.03, 95% CI 0.01-0.06), coastal and northern belt location (OR 0.34, CI 0.17-0.67), and animal type being a chicken (fowl) (OR 0.26, CI 0.14-0.47) were significantly associated with AI.

 

Conclusion: The wide AI distribution across Ghana due to migratory birds on Ramsar sites and the importation of poultry from foreign countries should be monitored. This information on key factors associated with avian influenza occurrences in poultry guides appropriates One Health interventions and targeted surveillance.

 

Keywords: Avian Influenza, Poultry, Birds, Ghana

 

 

Robert Ossom^1,&, Ernest Kenu¹, Samuel Oko Sackey¹, Charles Lwanga Noora¹, Donne Kofi Ameme¹, Chrysanthus Kubio²

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra, Ghana, ²Regional Health Directorate, Savannah Region, Ghana Health Service, Damongo, Ghana

^&Corresponding author: Robert Ossom, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra, Ghana

 

Email: ratogmerc@yahoo.com

Background: Measles is an infectious viral disease earmarked for elimination by all WHO-affiliated countries. Ghana's Integrated Disease Surveillance and Response (IDSR) Strategy drives this elimination goal. Periodic surveillance systems evaluation is necessary to promote optimal performance. We evaluated the measles surveillance system and its attributes in the Asunafo South District to know if they were meeting their objectives.

 

Methods: We adopted CDC's updated framework for surveillance system evaluation (2001) and the 3rd Edition IDSR (2020) to evaluate the surveillance system operations and attributes. Key stakeholders were interviewed using a semi-structured questionnaire to assess knowledge of measles. We reviewed and observed data management practices, retrieved data from 2017 - 2021 from DHIMS2, SORMAS and Epi-info-v3.5.1 and analysed. We conducted records review of consulting room registers; and validated data on case investigation forms and weekly/monthly IDSR reports. Data were analysed descriptively and presented in tables.

 

Results: Thirteen (13) sites were visited at different levels. The structure and operation of the surveillance system functioned well. Information flows from the community to the national level. Measles case definition was found at key units. Staff had knowledge of the basic clinical presentations of measles. Records reviews were performed, and cases were monitored and plotted weekly. Data quality indicators like completeness and timeliness were above 95% for IDSR weekly/monthly reports. Data was inconsistent across measles data sources and administrative levels. Four measles cases were confirmed IgM-positive in three consecutive years (2019–2021). Data is representative; 95.2% (20/21) of surveillance sites are actively reporting.

 

Conclusion: The measles surveillance system in Asunafo South District is meeting the objectives of both measles surveillance and system attributes. Surveillance is effective and can detect and report suspected cases in time. Data quality is generally good but inconsistent. Surveillance Officers should conduct weekly/monthly data validation meetings to improve data quality.

 

Keywords: Measles, CDC, WHO, SORMAS, DHIMS2, IgM positive

 

 

Sarja Jarjusey^1,2,&, Baba Ceesay², Georgia Ghartey¹, Charles Lwanga Noora¹, Donne Ameme¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana, ²Ministry of Health, Banjul, The Gambia

^&Corresponding author: Sarja Jarjusey, Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana

 

Email: jarjuseysarja@gmail.com

Background: The global resurgence of measles cases in 2017 and 2019 prevented the WHO Africa region from meeting the 2020 target of eliminating measles. More than 22 million infants missed their first dose of measles in 2020, the highest number in two decades, creating the potential for outbreaks. In Ghana, measles is one of the diseases targeted for eradication under the Integrated Disease Surveillance and Response (IDSR) strategy. We evaluated the system to assess its attributes, usefulness, and system's performance in meeting its objectives

 

Methods: We evaluated the system by adopting the CDC Updated Guidelines for evaluating public health surveillance systems. We reviewed five-year data (2017-2021) from the case-based forms, DHIMS, and laboratory database. Twenty stakeholder interviews were conducted among surveillance staff at all levels, and observations were made. We performed a descriptive analysis (proportions) and compared our findings with the system's objectives.

 

Results: The Municipality suspected 115 cases of measles from 2017 to 2021. The majority, 60% (69/115), were males, and 78% (90/115) were five years and below. Most (89%, 102/111) samples transported to the laboratory were examined, of which only 1.9% (2/102) and 0.98 % (1/102) tested positive for measles and rubella, respectively. The system promptly detects fever and rash cases. Most (96%) of the reports were submitted within 24 hours. However, private hospitals were not contributing to the measles surveillance, and only 45% (45/102) tested received feedback.

 

Conclusion: The measles surveillance system is meeting its objectives. It was timely and prompt in detecting fever and rash but lacked trend analysis and feedback from the laboratory. We, therefore, recommend improvement in representativeness and feedback.

 

Keywords: Measles, Surveillance, Representativeness, Usefulness, Attributes

 

 

Valentine Boafo Opoku-Menkah^1,&, Philip Allan Kommey¹, Fransisca Happy Ametirwodufia¹, Dennis Kushitor¹, Gbelee Burgess Jr¹, Sherry Johnson¹, Charles Lwanga Noora¹, Donne Ameme¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana, ²Ghana Health Service, Accra, Ghana

^&Corresponding Author: Valentine B. Opoku-Menkah, Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana

 

Email: vbopoku-menkah@st.ug.edu.gh

Background: In 2020, motorcyclists were about 28 times more likely to die in a car crash than people in passenger cars and were four times more likely to be hurt. According to the National Road Safety Authority (NRSA) of Ghana, motorcycle accidents constitute 40% of the total accidents recorded in 2021. This study was conducted to determine the proportion of motorcycle riders using helmets in Madina and the perception behind helmet usage.

 

Method: A cross-sectional study was conducted at Madina in the La Nkwantanang Municipality, Greater Accra, Ghana, in 2022. Two sets of observations were carried out: one from 7 a.m. to 11 a.m. during rush hour and another from 1:00 p.m. - to 2:00 p.m. when participants were returning from their places of employment. Semi-structured questionnaires were used to interview participants, and a tally sheet was used to observe helmet usage among motorcycle riders and passengers.

 

Results: A total of 105 participants were interviewed at five main stations of the market, and 1,833 motorcycle riders were observed from the overhead of the junction. All of the participants interviewed were males. The proportion of helmet use among motorcycle riders was 88.6% (1628/1836), whilst this was lower among passengers at 36.9% (170/460). A non-response rate of 7.6% was noted. Most motorcycle riders were in the 20-29 age group, which reflected 64% (63/97) of the total number interviewed.

 

Conclusion: Heat generation in helmets and discomfort deter helmet use among passengers. The study shows a high proportion of helmet usage among motorcycle riders which shows that the regulation is being implemented. However, helmets are rarely used by passengers. More sensitisation is needed to ensure that motorcycle rider and their passengers wear helmets according to standards.

 

Keywords: Helmet, Motorcycle, Riders, Passengers, Road traffic accident (RTA)

 

 

Thelma Teley Aphour^1,&, Jessica Asante², Comfort Dede Tetteh³, Yaa Danquah Akuamoah-Boateng³, Senanu Kwasi Djokoto⁴, Christian Gohoho⁴, Prosper Amegadzie⁵, Charles Lwanga Noora¹, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Program, School of Public Health University of Ghana, Accra, Ghana²IQVIA, World Health Organization, Accra, Ghana, ³Ghana Health Service, Accra, Ghana, ⁴Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana, ⁵Municipal Health Directorate, Ghana Health Service, Ho, Ghana

^&Corresponding author: Thelma Teley Aphour, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health University of Ghana, Accra, Ghana

 

Email: thelmaaphour@gmail.com

Background: Neglected Tropical Diseases (NTDs) impact the lives of about two billion people globally, with a DALY of 56% years lost to disability and 44% years lost to life. Global efforts at eliminating and eradicating NTDs prescribe a robust and responsive surveillance system. We evaluated the NTDs surveillance system in Ho to assess its attributes, usefulness, and if it was meeting its set objectives.

 

Methods: We assessed the system's communication and reporting channels, data analysis, case management, attributes, usefulness and availability of reports and registers. Staff perception of the attributes of the system was also assessed. Observation, records review key-informant interviews and semi-structured questionnaires were used. Secondary data from DHIMS 2 for 2017-2021 was extracted. A descriptive analysis was conducted, and the results were presented as proportions, tables, and graphs.

 

Results: Eleven health workers were interviewed of these, 45.5% had served for more than 5years. The system was not well decentralised at facility levels; Case identification was low, while validated data showed cumulative cases of 15(Leprosy), 7(schistosomiasis), and 1(lymphatic filariasis). 11 (24.4%) of 45 facilities reported on NTDs data for 2017-2021, and 14% of NTDs assessed had a constant logistics supply. Data validation showed 88% errors in data entered in DHIMS 2 compared to registers and reports. The introduction of a new reporting form in 2020 had no effect on the system. Two Mass Drug Administration (MDA) were organised. 91% of health workers agreed that the system was acceptable, 73% agreed with stability and flexibility and 84% with data quality.

 

Conclusion: The system is partly meeting its objectives. Not simple, not acceptable, partly flexible, and partly stable. Data quality needs improvement. The system is useful. We recommend an improvement in data validation, financial and logistical support, and well robust system for the NTDs surveillance system.

 

Keywords: Evaluation, surveillance system, NTDs, Ho

 

 

William Nsemani^1,&, Holy Alomatu¹, Fortress Yayra Aku², Charles Noora¹, Donne Ameme¹, Baffour Appiah¹, Winfred Ofosu³, Paul Twene³, Ernest Kenu¹

¹Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Ghana, ²Department of Epidemiology and Biostatistics, Fred Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana, ³Eastern Region Health Directorate, Ghana Health Service, Koforidua, Ghana

^&Corresponding author: William Nsemani, Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Ghana

 

Email: nsemaniwilliam@gmail.com

Background: On May 13, 2022, the Ghana Field Epidemiology and Laboratory Training Programme (GFELTP) was notified of a suspected H3N2 outbreak in Senior High Schools in the Akwapim district of the Eastern Region. On June 6, 2022, residents from GFELTP started investigating the outbreak to assess its magnitude and risk factors and describe it by person, place, and time.

 

Methods: A retrospective descriptive investigation of H3N2 was conducted from 6^th to 11^th June 2022 in high schools in the New Juaben South district. Data were collected through a records review, environmental assessment, and H3N2 adherence checklist. Data were analysed descriptively and presented as frequencies and proportions.

 

Results: Out of 84 students suspected to have H3N2 in four schools, 26 tested positive, with a median age of 16.6 (IQR:15–17 years), and 65.0% (13/20) were females. The majority, 69.0% (18/26) of the cases were from New Juaben Senior High, 23.0% (6/26) from Koforidua School of the Deaf, Koforidua Sectech, and Oti Boateng Senior High had 4.0% (1/26) each. The attack rate was 0.47%. The peak of cases was on May 21, 2022, and the last occurred on May 25, 2022. The source of the infection was thought to be an inter-school gathering held at Koforidua Sectech early in the month of May 2022. Congestion in dormitories and dining halls and non-compliance to H3N2 protocols by students were attributable risk factors of transmission within schools.

 

Conclusion: The investigation confirmed the outbreak of H3N2 with 26 students infected in four schools between 15^th and 25^th May 2022. Congestion in dormitories and dining halls and non-adherence to H3N2 prevention measures were attributed to causing the outbreak.

 

Keywords: New Juaben South district, H3N2, Outbreak, Retrospective, Investigation

 

 

Hudatu Ahmed^1,&, Veronica Charles-Unadike¹, Mawuli Gohoho^2,3, Samuel Adolf Bosoka^2,4, Isaac Annobil³

¹Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana, ²Ghana Field Epidemiology and Laboratory Training Programme, Accra, Ghana, ³Jasikan Municipal Health Directorate, Ghana Health Service, Jasikan, ⁴Volta Regional Health Directorate, Ghana Health Service, Hoe, Ghana

^&Corresponding author: Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana

 

Email: hudalove6312@gmail.com

Background: In the Jasikan Municipality, more than half of the confirmed cases of COVID-19 were among students as at 31st December 2021. Persons fully vaccinated against COVID-19 in the municipality were 39.3% as at 24th November 2022. Evidence suggests COVID-19 infection may progress to severe clinical outcomes which may affect students' academic output. This study therefore examined the predictors of intention to receive COVID-19 vaccine among students in Jasikan Municipality using the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB) Model.

 

Methods: We conducted a cross-sectional study and selected students using a multistage sampling technique from Senior High Schools in the Jasikan Municipality. We assessed the students on socio-demographics, knowledge on COVID-19, adherence to COVID-19 protocols, health-related questions, HBM and TPB related questions, and intention to vaccinate against COVID-19. Hierarchical logistic regression was performed to assess the predictors of intention to receive COVID-19 vaccine. Statistical significance was set at P <0.05.

 

Results: Of 420 students interviewed, 206 (51.0%) were females, 141 (33.6%) aged 15-17 years and 168 (40.0%) had good knowledge on COVID-19. Also, 257 (61.0%) reported having the intention to vaccinate against COVID-19. Previous COVID-19 infection (OR = 3.36, 95%CI [1.16–9.77]) and adherence to social distancing (OR = 1.79, 95%CI [1.13–2.82]) were significantly associated with intention to vaccinate against COVID-19. Likewise, attitude (OR=1.10, 95%CI [1.03-1.18]), subjective norms (OR = 1.09, 95% CI [1.04–1.15]) and self- efficacy (OR = 1.21, 95%CI [1.12–1.31]) were significantly associated with intention to vaccinate against COVID-19.

 

Conclusion: History of COVID-19 infection, social distancing adherence, attitude, subjective norms and self-efficacy were predictors of intention to vaccinate against COVID-19. Education to address COVID-19 vaccine misconception and teachers serving as COVID-19 vaccine champions can help improve the intention to vaccinate against COVID-19.

 

Keywords: Intention, COVID-19, Behavioral Models, Hierarchical Logistic Regression, Jasikan Municipality

 

 

Yakubu Sidik^1,2,&, George Akowuah², Magdalene Akos Odikro², Ernest Kenu²

¹Environmental Health and Sanitation Department, Upper West Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana, Accra, Ghana

^&Corresponding author: Yakubu Sidik, Environmental Health and Sanitation Department, Upper West Region, Ghana

 

Email: sidik2012@yahoo.com

Introduction: Community Led Total Sanitation (CLTS) is an innovative methodology for moving communities to take collective action to become totally 'open defecation free' (ODF) by building and using their own latrines. Only 14% of Ghanaian households have an improved, not shared sanitation facility. In the Upper West Region, it is estimated that seven out of ten dwelling units practice open defecation. From 2012, CLTS was implemented in the Upper West Region and data are being collected periodically without being analyzed. We described the trend of ODF certification and the geographical distribution of CLTS in Upper West Region.

 

Methods: A descriptive secondary data analysis was conducted in Upper West Region. CLTS data from 2017 to 2020 were extracted from the Basic Sanitation Information System (BaSIS) CLTS excel database, regional and district annual reports. Data was reviewed, cleaned and analyzed using Microsoft Excel 2013 to generate frequencies and proportions. QGIS was used for geographical analysis. Results were presented in text, tables, and figures.

 

Results: Over the five-year period, 360 communities practicing ODF were triggered. Of these, 70.5% (254/360) achieved ODF certification in the region. The trend of ODF certifications saw a general decline from a peak of 24 in 2017 to 2 in 2021. The highest number of certifications, 25 and 26, were recorded in April 2017 and 2018 respectively. Jirapa Municipal recorded the highest certification rate, 19.6% (50/254) followed by Wa West, 17.7% (45/254).

 

Conclusion: More than two-thirds of triggered communities in Upper West attained ODF certification over the period. CLTS certifications declined over the years. Jirapa Municipal amd Wa West recorded the highest certification rate among all districts over the period. Data should analysed regularly and feedback shared with the districts to promote ODF certification competition among districts in the region.

 

Key words: Community Led Total Sanitation (CLTS), secondary data analysis, open defecation, Ghana

 

 

Felix Oduro^1,2,&, Henry Nii Ayi¹, Robert Bayuo¹, Rita Asante Kusi^2,3, Joseph Asamoah Frimpong²

¹Veterinary Services Directorate, Upper East Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana, Accra, Ghana, ³Food and Drugs Authority, Upper East Region, Ghana

¹Corresponding Author: Felix Oduro, Veterinary Services Directorate, Upper East Region, Ghana

 

Email: foduro.of@gmail.com

Background: Contagious pustular dermatitis (Orf) is an acute, neglected zoonotic infection that affects domestic and wild animals. Mainly ruminants including sheep and goats are most susceptible. Orf infection leads to impairment of livestock and about 10% mortality. This study determined the prevalence, distribution and trends of Orf cases in Upper East Region (UER) of Ghana.

 

Method: Secondary data analysis was employed for the Orf data in Bolgatanga for the period, January 2017 to December 2021. The data was extracted from the regional veterinary offices' electronic database. Variables extracted included species type affected, dates of infection, and districts. The data was entered into Microsoft excel version 19 and analyzed into frequencies, proportion and rates. Quantum GIS was used to map the distribution of cases within districts in UER. Data was presented in tables and graphs.

 

Results: A total of 278 Orf cases were recorded with majority, 220 (79.1%) being goats. The highest, 37 (13.3%) of cases occurred in June and September with the lowest cases 11 (4.0%) in May. The year 2021 recorded the highest, 102 (36.7%) Orf cases and 2019 recorded the lowest 32 (11.5%). Among the fifteen (15) Municipals and Districts Assembly in Upper East Region, 11 (73.3%) reported Orf cases with Bolgatanga Municipality having the highest number of reported Orf cases 96 (34.5%) within the 5-year period.

 

Conclusion: Orf occurred throughout the year across the entire Upper East Region affecting mostly goats. The number of cases recorded showed an increasing trend. The Regional Veterinary head should ensure that all veterinary officers in UER are trained to include Orf sensitization and public education in their routine activities.

 

Keywords: Contagious pustular dermatitis, ruminants, prevalence, distribution, Upper East Region, Veterinary Services Directorate

 

 

Fatawu Yussif Akomnaba^1,2,&, Rita Asante Kusi² , Magdalene Akos Odikro², Joseph Asamoah Frimpong², Samuel Oko Sackey²

¹Environmental Health and Sanitation Unit, Builsa South District, Fumbisi, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program, University of Ghana, Accra, Ghana

^&Corresponding author: Fatawu Yussif Akomnaba, Environmental Health and Sanitation Department, Builsa South District, Fumbisi, Ghana

 

Email: fatawu24@gmail.com

Background: In Ghana, one of every 40 persons gets infected with a food-borne disease annually resulting in over 65,000 deaths. The Environmental Health Department of district assemblies ensures that food vendors are medically screened, certified and trained on food hygiene and sanitation practices. We performed a descriptive analysis of food vendors medical screening in Upper East Region districts to determine the trends, and distribution and proportions of contagious communicable disease infections.

 

Methods: Secondary data analysis of food vendors medical screening data from Bongo, Builsa South, Pusiga and Talensi for 2019-2021 was conducted. Data was obtained from Microsoft word and Excel databases kept electronically and manually in offices of the various Environmental Health and Sanitation Units. Data was also obtained from designated private medical laboratories who screen vendors medically in the district assemblies. Data were collated and analyzed to generate frequencies and proportions. Results were presented as graphs, text and tables.

 

Results: Of the 2,968 food vendors screened in the four districts, females formed majority, 2,766 (93.2%). Talensi district recorded the highest, 1,129 (38%) vendors screened. Of 882 vendors with age captured from Bongo and Builsa districts, 297 (33.7%) were between 31-40 years. The year 2021 recorded the most screenings 1,188 (40%) and 2019 the least 833 (28.1%). Out of 1,839 food vendors tested, about 583 (32%) were positive for Hepatitis B and/or Typhoid with Typhoid fever being highest 384 (65.9%).

 

Conclusion: An increasing trend of food vendors medical screening was observed for the period. Majority of food vendors screened were females with most screening recorded in Talensi district. Typhoid fever is the most common communicable disease among food vendors screened. The Regional Environmental Health Officer together with the Metropolitan, Municipal and District Assemblies should increase public sensitization on food safety practices to promote public health.

 

Keywords: Food Vendors, Medical Screening, Bongo, Builsa South, Pusiga, Talensi

 

 

Fuseini Mahama Dramani^1,2,&, Samuel Oko Sackey², Samuel Dapaa², Joseph Asamoah Frimpong²

¹Environmental Health and Sanitation Department, Yunyoo- Nasuan District, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University pf Ghana, Accra, Ghana

^&Corresponding author: Fuseini M. Dramani, Department of Environmental Health and Sanitation, Yunyoo-Nasuan District, Ghana

 

Email: Fuzzydfm1@gmail.com

Background: Open defecation is known to contribute to spread of feco-oral diseases such as cholera, dysentery, worm infestations and typhoid fever. Ghana adopted the Community Led Total Sanitation (CLTS) concept aiming to bring a lasting solution to this menace. The CLTS surveillance system monitors trend of open defecation, detects and reports feco-oral related diseases for investigation and implementing preventive and control measures. We evaluated the surveillance system to determine its usefulness, objectives and the attributes.

 

Methods: A descriptive cross-sectional design was used to evaluate the CLTS surveillance system in Yunyoo-Nasuan District from 2019 to 2021. Center for Disease Control and Prevention's updated guidelines for evaluating public health surveillance systems was adapted. Key stakeholders were interviewed with a semi-structured questionnaire. Records review and observation were also used to collect data. Quantitative data were summarized into frequencies and proportions and qualitative data described based on themes. Results were presented in text and tables.

 

Results: For the evaluation period, 66 communities were triggered of which 81.8% (54) were declared ODF. Stakeholders participation was 100% (6/6) at all the levels. Each area council had communities represented. Nasuan Area Council 56.1% (37), Yunyoo Area Council 33.3% (22) and 10.6% (7) Gbangurugu Area Council. The system is mainly donor funded with no sustainability plan. We observed 75% (3/4) reported data in the district were inconsistent with data at regional level. All, 100% (4/4) reports were untimely submitted.

 

Conclusion: The CLTS surveillance system was useful and meeting its objectives. The system was sensitive, acceptable, and representative. It was complex, untimely, unstable and not flexible with poor data quality. The various districts should develop a sustainability plan for the system.

 

Key word: Sanitation, Feco-oral, Open defecation, Evaluation, Ghana

 

 

Saibu Adama Sawadigo^1,2,&, Samuel Dapaa², Samuel Oko Sackey², Ernest Kenu²

¹Ghana Health Service, Regional Health Directorate, Western North Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana

^&Corresponding author: Saibu Adama Sawadigo, Ghana Health Service, Regional Health Directorate, Western North Region, Ghana

 

Email: adamasaibu@gmail.com

Background: In 2020, 10 million new TB cases and 1.5 million deaths were recorded worldwide. TB prevalence in Ghana is estimated at 165 per 100,000 population. The evaluation of the surveillance system was done to assess its attributes, usefulness and system's performance in meeting its objectives.

 

Methods: A descriptive evaluation was carried out using data for 2019-2021. There was review of data, interview of key stakeholders and observations. The system attributes and usefulness were assessed using CDC's Updated Guidelines for Evaluating Public Health Surveillance Systems. Summary descriptive statistics was performed on quantitative data and directed content analysis on information gathered from interviews.

 

Results: Seventy-three cases including 2 MDR-TB cases were detected from 2019 – 2021, 68.5% (50/73) were screened for HIV and 80% (4/5) were put on AVRs. The TB cure rate was 51% (30/46) and treatment success rates of 87% (40/46) for 2019 and 2020. Information flow for the system was clear and structured. All stakeholders were participating in the system with 7.3% (73/996) positive predictive value recorded for the three years assessed. The TB case definition was sensitive and captured TB cases. In 2021, Timeliness of reporting in DHIMS II was 86.5% (83/96). Data completeness was 73.9% (459/621), 3.6% difference was observed between data in register (27) and DHIMS II (28).

 

Conclusion: The surveillance system is useful at all levels but partially meeting its objective with regard to the cure rate. It was flexible, stable, acceptable, sensitive and representative. Simplicity, data quality and timeliness were fair with low predictive value positive. DHD should ensure periodic monitoring and supervision to improve timeliness of reporting, data completeness and to improve the system's attributes.

 

Key words: Multi drug resistant TB, Surveillance System, Evaluation, Juaboso, Ghana

 

 

Samuel Twum Andoh^1,2,&, Samuel Dapaa², Magdalene Akos Odikro², Joseph Asamoah Frimpong²

¹Western North Regional Health Directorate, Ghana Health Service, Sefwi Bodi, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana, Accra, Ghana

^&Corresponding author: Samuel Twum Andoh, Western North Regional Health Directorate, Ghana Health Service, Sefwi Bodi, Ghana

 

Email: sammitwum@gmail.com

Background: Yellow Fever (YF) is an infectious disease endemic in tropical and sub-tropical areas of Africa and South America that causes up to 200,000 cases and 60,000 deaths annually. YF disease has no known cure, and vaccination is the most effective means of prevention. As part of routine surveillance, data must be analyzed regularly. This analysis was to establish the burden and distribution of YF cases, data quality and trend of vaccination coverage in Aowin Municipality from 2017-2021.

 

Methods: A descriptive analysis of secondary data from the Yellow Fever surveillance system for the period January 2017 to December 2021 was conducted. Data from line list, case-based forms and District Health Information Management System II (DHIMS2) were obtained. Microsoft Excel 2019 was used to analyze the data into frequencies, proportions and rates and presented in text, tables, and charts.

 

Results: A total of 24 suspected YF cases were reported of which 14 (58.3%) were females. The median age was 14 years (range: 1-63), 18 (75%) of the cases ware below the age of 20 years and one died (CFR: 4.2%). Cases were reported from 7 out of 9 sub-districts. Four to five 5 cases were reported annually. Completeness of reporting was 58.3%. Average coverage of childhood vaccination was 78.8% (SD: 7.95).

 

Conclusion: Suspected Yellow Fever cases were mostly females and below the age of 20 years. Case burden is between 4 to 5 cases annually, and average vaccination coverage is below 80%. The YF surveillance data has quality issues that require attention. There is the need for monthly data validation and the review of line list to include important variables such as ‘signs and symptoms’, ‘education level’ and ‘occupation’.

 

Key words: Yellow Fever, Surveillance, Data Analysis, Case fatality, Western North Region

 

 

Gloria Odame-Asiedu^1,2,3,&, Samuel Dapaa², Magdalene Odikro² , Joseph Asamoah Frimpong²

¹Food and Drugs Authority, Accra, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana

^&Corresponding author: Gloria Odame-Asiedu, Food and Drugs Authority, Accra, Ghana

 

Email: glorianyankumah@gmail.com

Background: Food safety has focused on manufacturing sites and food handlers. However, food in storage has a high tendency to raise food safety alarms. The Food and Drugs Authority inspects storage sites to ensure compliance to good hygiene and cold storage practices. We evaluated the Animal product cold storage facility inspections system in the central region to determine the usefulness of the system, whether the system met its objectives and assessed the systems attributes.

 

Methods: A descriptive cross-sectional design was used following updated Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems. Stakeholders were interviewed using semi-structured questionnaire. Records from 2019 to 2021 were reviewed and observations made. Qualitative data was analysed by direct content approach while quantitative data was summarized into frequencies and percentages. A score of one was given to each indicator that supports the attribute assessed and percentages calculated. Scores were categorized as <50% (poor), 50-70% (moderate) and >70% (good). Results were presented in tables and charts.

 

Results: Out of 37 applications, 67.5% (25/37) were inspected of which 37.8% (14/37) were licensed. Cold Storage Facilities were found in 40.9% (9/22) of districts in the Region. Case definition was well understood by staff and checklist was easy to use. SmartWork Place system application improved reporting between Regional and National Offices. Government funds are used to operate the system and it took averagely 3-4weeks after application for an inspection to be conducted. About 50% (5/10) of application forms were completely filled and 80% (4/5) of owners were satisfied with feedback received.

 

Conclusion: The system partly met its objectives. The system was simple, flexible and very useful. However, stability, representativeness, acceptability, sensitivity, timeliness and data quality were moderate. System can be enhanced through intensified scouting of unlicensed cold storage facilities across all districts in the region.

 

Keywords: Animal product, Cold storage, Inspections, Evaluation, Ghana

 

 

Simon Effah Adjei^1,2,&, Fatawu Akomnaba^2,3, Juah Jiah Jaito^2,4, Louis Jean Piu^1,2, Felix Oduro^2,5, Zachariah Adam^1,2,&, Aba Sam Essel², Rita Agyekumwah Asante², Charles Lwanga Noora², Magdalene Akos Odikro², Samuel Oko Sackey²

¹ Ghana Health Service Upper East Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program, Accra, Ghana, ³Environmental Service Department, Upper East Region, Ghana, ⁴Food and Drugs Authority, Upper East Region, Ghana, ⁵Veterinary Service Directorate, Upper East, Region, Ghana

^&Corresponding author: Simon Effah Adjei, Ghana Health Service Upper East Region, Bolgatanga, Ghana

 

Email: adjeisimon2@gmail.com

Background: On 22nd April, 2022, a woman reported to the Zuarungu Health Centre with her child presenting with yellow eyes and skin, weakness, itchy eyes and fever. Blood samples were taken on the 24th April 2022 and sent to National Public Health and Reference Laboratory, Accra. Positive result for yellow fever was received on 7th June 2022. We investigated this outbreak to determine its' magnitude, cause and institute control measures.

 

Methods: A descriptive cross-sectional study was used. We conducted register review, active case search, cold chain and environment assessment. Community members and health workers were interviewed on knowledge about YF disease. Serum samples were taken for virologic testing. Data was analyzed using Microsoft Excel 2019 and Quantum Geographic Information System (QGIS). Frequencies and Proportions were calculated and results presented in tables and graphs.

 

Results: A total of 12 cases were suspected with one (8.3%) confirmed case. The median age was 19 (0.5-33) years with 8 (66.7%) of 12 cases vaccinated. None of the 980 records reviewed in six health facilities met the case definition. Females formed majority, 8 (70%) out of 11 contacts. Environmental assessment revealed poor sanitary conditions in case household and neighbouring houses with knowledge level on YF being good for 32 (86.5%) out of 37 community members and health staff interviewed. One (14.3%) out of 7 vaccine storage facilities had controlled access. Routine YF Vaccination coverage for Zonno CHPS where case resided was 103.2% in 2019 and 145.5% in 2021.

 

Conclusion: The extent of the YF outbreak was minimal with no additional confirmed case. Community members and health workers had good knowledge on YF disease. Index case un-vaccination status and poor environment conditions were the possible cause of the outbreak. We educated community members on the importance YF vaccination and environmental sanitation.

 

Key Words: Yellow Fever, outbreak, investigation, Bolgatanga East

 

 

Asumadu Gyetuah^1,2,&, Samuel Dapaa², Joseph Asamoah Frimpong², Magdalene Akos Odikro², Samuel Oko Sackey²

¹Ghana Health Service, West Mamprusi North East Region, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana, Accra, Ghana

^&Corresponding author:Asumadu Gyetuah, Ghana Health Service, West Mamprusi North East Region, Ghana

 

Email: arisdomichael@gmail.com

Background: Acute Flaccid Paralysis (AFP) is a sudden onset of weakness of the limb(s), usually in children below 15 years or any person a clinician suspects. Ghana recorded 30 cases of Circulating Vaccine Derived Poliovirus Type 2 (cVDPV2) between 2019 and 2020, with one case from Chereponi District in the North East Region. We evaluated the AFP surveillance system in West Mamprusi Municipality to determine whether the system was meeting its objectives and assessed its usefulness and attributes.

 

Methods: Using the updated Centers for Disease Control guidelines, a descriptive cross-sectional design was used to evaluate the AFP surveillance system in West Mamprusi Municipality from 2017 to 2021. Data were collected from key stakeholders through interviews, records review and observations. Quantitative data were summarized into frequencies and proportions while qualitative data were summarized by direct content analysis. Results were presented in text and figures.

 

Results: The system detected nine AFP cases where two specimens taken for each, tested negative for poliovirus. Case reporting (9/9, 100%), specimen taking (9/9, 100%) and 60 days follow-ups (9/9, 100%) were done within the stipulated time. Laboratory feedback was received after 17 days (range 14-28 days). Key stakeholders knew the case definition however, the system required sophisticated processes to confirm a case. Although the government had no sustainability plan, partners were willing to continuously support the system. Mass vaccination campaigns were conducted during the evaluation period. AFP surveillance was part of the Integrated Disease Surveillance and Response and has adopted the Surveillance Outbreak Response and Management Analysis Software in capturing data.

 

Conclusion: The AFP surveillance system was meeting its objectives. It was useful, flexible, stable, acceptable, representative, sensitive and of good data quality. The system was not simple, not timely and had low Predictive Value Positive. Surveillance officers should intensify training to increase suspicion index.

 

Keywords: Acute Flaccid Paralysis, Disease Outbreaks, Ghana

 

 

Selassie Kennedy Kofitse^1,2,&, Rita Agyekumwah Asante Kusi², Samuel Oko Sackey²

¹Regional Health Directorate, Ghana Health Service, Cape Coast, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program, Accra, Ghana

^&Corresponding author: Selassie Kennedy Kofitse, Regional Health Directorate, Ghana Health Service, Cape Coast, Ghana

 

Email: selaseken@gmail.com

Background: In malaria-prone nations like Ghana, malaria is the largest public health threat to children under the age of five. Malaria prevalence in children in Central region, is estimated to be 30%. The objective of the study is to describe the trend and pattern of malaria cases in the Central Region from 2016 to 2021.

 

Method: Malaria data was analyzed using secondary data extracted from District Health Information Management System (DHIMS2). The data for the Outpatient Department (OPD) malaria cases was obtained from the monthly OPD morbidity reporting form, while the data for the hospitalized cases came from the inpatient statement. The results were presented as rates, percentages, trends, and C2 was used to establish threshold.

 

Results: The proportion of under-five (<5) malaria cases was 953,635 (29.5%) of 3,241,454 <5 OPD cases reported for the period. The year 2016 recorded lowest 145,063 (24.1%) of 601,033 <5OPD cases while most 178,805 (32.7%) of 547,369 and 143,356 (32.7%) of 438,532 as highest were recorded in 2019 and 2020 respectively. About 395,410 (41.4%) of malaria cases were males respectively. Throughout a five-year period Malaria CFR decreased from 36 (0.36%) in 2016 to 4 (0.05%) in 2021. Malaria risk among children under 5 years was highest, 503 per 1,000 in 2017 and least 275 per 1,000 population in 2020. The threshold determined indicated, the region experienced outbreaks from January to April 2017, July 2019, and November 2020. Ajumako Enyan Essiam incidences averaged 445 per 1,000 relatives to 341 per 1,000 for the region.

 

Conclusion: Males and females were almost equally affected. The risk of Malaria declined within the period. Malaria deaths among hospitalized patients declined. Malaria threshold determined revealed some outbreaks. The malaria threshold should be adopted by region for monitoring, detection, and prevention of outbreaks.

 

Keywords: Malaria, DHIMS2, OPD, Inpatient, Case Fatality Rate, Threshold

 

 

Adam Anas^1,2,&, Samuel Dapaa², Asumadu Gyetuah^2,3, Godwin Kwablavi Faigo^2,4, Dramani Fuseni Mahama^2,5, Yussif Abubakari^2,6, Richard Obeng Asumadu², Kenneth Yeboah², Joseph Asamoah Frimpong², Samuel Oko Sackey²

¹Ghana Health Service, North East Regional Health Directorate, Ghana, ²Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Accra, Ghana, ³Ghana Health Service, West Mamprusi Municipal Health Directorate, Ghana, ⁴Veterinary Services Directorate, Mamprugu-Moagduri District, North East Region, Ghana, ⁵Environmental Health Department, Yunyoo-Nasuan District, North East Region, Ghana, ⁶Food and Drugs Authority, North East Region, Ghana

^&Corresponding author: Adam Anas, Ghana Health Service, North East Regional Health Directorate, Ghana

 

Email: adamanas@yahoo.com

Background: Measles is a highly contagious disease that affects all ages especially children under five years. Over 140,000 people died from measles in 2018 despite the availability of safe and effective vaccine. The Chereponi district recorded measles cases in health facilities. This outbreak was investigated to describe the magnitude, identify the source, and risk factors of the outbreak.

 

Methods: Stakeholders were engaged at regional, district and community levels. Measles line list was compiled from client folders, consulting room registers, and interviews with cases. A case-control design was used to identify exposure factors. Cases were those who tested positive for measles whiles controls were family members of cases or neighbours of the same age group who were not ill. The cold chain system was assessed using data from vaccine fridge tags, vaccine vial monitors, and vaccine fridge monitoring forms. Vaccination coverages were assessed through records review and secondary analysis of DHIMS2 data. Chi-square test was conducted. Frequencies, proportions and summary statistics were calculated and results presented in text and figures.

 

Results: A total of 72 cases were suspected and results were received for 34.7% (25/72). Of these, 80% (20/25) tested positive with case fatality rate of 5% (1/20). Females represented 55% (11/20). The median age was 3 years (0 – 12). Chereponi sub-districted recorded 45% (9/20) of confirmed cases. The odds of not traveling to Togo/Nigeria was 0.74 (CI = 0.13 – 4.35) times among cases compared to controls. The odds of vaccination was 0.14 (CI = 0.03 – 0.75) among cases compared controls.

 

Conclusion: Children under five years and males were mostly affected. The possible source of the outbreak was migrants from Togo. Not being vaccinated or fully vaccinated was a significant risk factor. The measles surveillance was simple, stable, acceptable, sensitive and representative of the population. DDHS should strengthen routine vaccination.

 

Keywords: Measles, Outbreak, vaccination, cold chain, fatality

 

 

Yaa Fosua Kwarteng^1,&, Samuel Dapaa¹, Saibu Adama Sawadigo², Samuel Twum Andoh², Ahmed Bannan³, Ephraim Foanor Kwadzodeh⁴, Gloria Odame-Asiedu⁵, Patrick Avevor⁶

¹Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Acrra, Ghana, ²Ghana Health Service, Regional Health Directorate, Western North Region, Ghana, ³Veterinary services, Bibiani Anhwiaso Bekwai Municipal, Western North Region, Ghana, ⁴Environmental Health Service, Aowin Municipal, Western North Region, Ghana, ⁵Food and Drugs Authority, Western North Region, Ghana, ⁶World Health Organization Ghana Country Office, Acrra, Ghana

^&Corresponding author: Yaa Fosua Kwarteng, Ghana Field Epidemiology & Laboratory Training Programme, University of Ghana, Accra Ghana

 

Email: yafokwart@gmail.com

Background: Mumps is a highly contagious viral disease transmitted via direct contact with respiratory droplets of infected persons. Though the most effective prevention of mumps is vaccination, Ghana's current childhood immunisation program does not include mumps. In July 2022, a sudden increase in cases of parotitis and acute salivary gland swelling, suspected to be mumps, was reported in the Western Region. We investigated to confirm the outbreak, determine its magnitude and identify risk factors.

 

Methods: We reviewed the initial line lists and clinical records of cases and interviewed health workers. We developed a suspected case definition as “Any person living in Western North Region presenting with parotitis (acute salivary gland swelling) with or without encephalitis, hearing loss, orchitis, oophoritis, mastitis, pancreatitis from 1st April 2022 to date” and a confirmed case definition as “Any suspected case with a positive laboratory confirmation for mumps virus using RT-PCR or viral culture”. We conducted an active case search using a structured questionnaire and updated the line list. A one-to-one unmatched case-control study was conducted to assess risk factors associated with the outbreak. Descriptive and inferential statistics were done, with odds ratios generated at 95% CI.

 

Results: A total of 267 suspected cases of mumps were reported from March 23 to August 1 2022. About 55.1% (147/267) of cases were males, 90.3% (241/267) were aged 1-15 years, and 88.4% (236/267) were primary school pupils. Attack rates ranged from 5 (Anhwiaso and Sefwi Bekwai) and 250 cases (Juaboso) per 100,000 population. Contact with infected family (OR = 0.93, 95% CI = 0.48 – 1.82) and attending social gatherings (OR=1.84, 95% CI = 0.93 – 3.63) were risk factors found to be crudely associated with the outbreak.

 

Conclusion: The outbreak of mumps occurred in the Western North Region predominantly affected children of school-going age. Contact with infected family and attending social gatherings might have propagated the spread. Regular health education, increased pupil supervision and including mumps prophylaxis in childhood immunisation programs are recommended to prevent future outbreaks.

 

Keywords: Mumps, Mumps Outbreak, Mumps virus

 

 

Carlota Martinho Sá^1,2,&, Paul Henry Dsane-Aidoo³, Abigail Brago Ofosuhene³, Charles Lwanga Noora³, Donne Ameme³, Ernest Kenu³, Samuel Oko Sackey³, Edwin Afari³

¹Guinea-Bissau Field Epidemiology Training Programme, Conakry, Guinea, ²Ghana Field Epidemiology & Laboratory Training Programme, University of Ghana, Accra, Ghana, ³Ministry of Public Health- Guinea-Bissau

^&Corresponding Author: Carlota Martinho Sá, Guinea-Bissau Field Epidemiology Training Programme, Conakry, Guinea v

 

Email: cileyde@yahoo.com

Background: Dog bites have been estimated to cause 10 million injuries annually in the world, occurring as the second most common source of human injury and among the top 12 causes of non-fatal injuries. Dog bites remain a public health concern in Ghana with three out of every 1000 incidence resulting in human rabies. There is a need to regularly analyze dog bites surveillance data to understand the burden and trends at all reporting levels. This analysis aimed at determining the distribution of dog bites that occurred in the Ga West Municipality from 2016 to 2020.

 

Methods: A descriptive secondary data analysis was conducted covering a five-year period (January 2016 - December 2020) on dog bite cases in Ga West Municipality in Greater Accra. Dog bite data was extracted from the District Health Information Systems 2, cleaned, coded and analysed using Microsoft Excel 2016. Descriptive analysis was performed and results were expressed as frequencies and rates and represented in tables, graphs, and maps.

 

Results: A total of 1203 dog bites and 9 resulting deaths were reported in the municipality in the 5-year period, with a case fatality rate of 0.74%. The majority of the victims were males (68.7%; 842/1203) and children aged 5-9 years (25.8%, 311/1203). More than half of the dog bite cases were reported to the Ga West Municipal Hospital only (70.2%; 844/1203). Dog bite cases were highest in the municipality in 2017 and were relatively lower in 2020.

 

Conclusions: The burden of dog bites was high in the Ga West municipality and children were the most affected. We recommended that the Ga West Municipal Health Directorate in liaison with the Veterinary Medicine Department should regularly educate community members, especially children, on the prevention of dog bites and on seeking healthcare and required vaccination for dogs.

 

Keywords: Surveillance Data Analysis, Dog bite, Ga West, Greater Accra

 

 

Mallam Boubacar Barka^1,2,&, Issifou Djibo³, Barry Djibril³, Herman Yoda⁴, Pauline Yanogo^1,4, Meda Nicola^1,4, Mahamadou Yacouba Moustapha⁵

¹Burkina Field Epidemiology and Laboratory Training Program (BFELTP), Ouagadougou, Burkina Faso, ²Ministère de l'Environnement et de la Lutte Contre la Désertification, Niamey, Niger, ³African Field Epidemiology Network (AFENET), Niamey, Niger, ⁴University Joseph Ki-Zerbo, Ouagadougou, Burkina-Faso, ⁵Ministère de la Santé Publique (MSP), Niamey, Niger

^&Corresponding author: Mallam Boubacar Barka, Burkina Field Epidemiology and Laboratory Training Program (BFELTP), Ouagadougou, Burkina Faso

 

Email: boubacarbarakabb@gmail.com

Background: Rift Valley Fever (RVF) is an arboviral disease caused by a phlebovirus that affects animals as well as humans. In Niger, several outbreaks of RVF have been recorded since 2016, the most recent occurring in 2021. The health districts of Tchintabaraden and Tassara reported suspected RVF cases on February 13, 2022. We investigated to confirm the outbreak and determine its magnitude and distribution.

 

Methods: We investigated the outbreak among humans and animals in Tchintabaraden and Tassara from February 15 to 21, 2022. We reviewed previously prepared line lists and interviewed health workers and veterinary doctors in the affected health districts. We collected data using interview guides (for patients and animal owners), questionnaires, and observation grids and updated the line lists. We analyzed the data using Epi-info 7.2.2.6 and Microsoft Excel 2016. Results were expressed as proportions and means and presented in tables and graphs. We conducted environmental assessments for potential risk factors.

 

Results: Only 8% (11/137) of humans interviewed met the suspected case definition, with none of these cases being laboratory confirmed. There were 198 suspected animal cases (sheep, goat, cattle) in Afissa, Egwane, Tassara, Amassara, Ajimillé, Aougoussis, Tijinguilit, Chinjangar, Bloukoum and Maya, with 28 confirmed by ELISA. There was an overall lethality of 51.51% estimated from the 102 death counts. There was a high case fatality of 55.76% among the sheep group. Potential RVF vectors, culex mosquitoes, accounted for 16.12% of sandflies and mosquitoes that were captured in some of the communities under investigation.

 

Conclusion: The investigation confirmed RVF cases in Tchintabaraden and Tassara with a general case fatality of 51.51%. We recommended an increase in disease surveillance efforts among animals, especially sheep, goats and cattle in the localities of Amassara, Tijinguilit and Maya.

 

Keywords: RVF, RVF Outbreak, Tchintabaraden, Tassara, Niger

 

 

Siddo Bouraima Abdoulay^1,&, Gandou- Issiakou², Elhadji Ibrahim Tassiou³, Barry Djibril¹, Pauline Yanogo¹, Meda Nicola¹

¹Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI ZERBO, Ouagadougou, Burkina Faso, ²University Joseph KI ZERBO, Ouagadougou, Burkina Faso, ³African Field Epidemiology Network (AFENET), Niamey, Niger

^&Corresponding author: Siddo Bouraima Abdoulaye, Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI ZERBO, Ouagadougou, Burkina Faso, Ouagadougou, Burkina Faso.

 

Email: siddoabdoulaye@gmail.com

Background: The Kandadji National Nature Reserve is home to a rich and varied fauna and is a category VI protected area according to the classification of the International Union for Conservation of Nature. To achieve its objectives, the ministry in charge of wildlife management set up a reserve management unit with an ecological monitoring system. After several years of implementation of activities of the system, it is appropriate to evaluate it to assess the system's attributes, usefulness and if it is meeting its objectives.

 

Methods: We collected socio-environmental and epidemiological data from managers of protected areas and the local populations and reviewed records using semi-structured interviews and checklists respectively, following the CDC and WHO guidelines. We analyzed the data with Epi-info 7.2.2.6 and Microsoft Excel and calculated the frequencies, proportions and rates.

 

Results: About 57.14% of the actors interviewed reported that the data collection tool (forms) used in monitoring system were easy to fill out, 60% accepted the system, 57.14% said the system was representative and responsive, and 71.42% considered that the stability of the system is low due to poor mobilization of financial resources. Sensitivity was estimated to be 48.57% characterizing the system's ability to detect major attacks on the integrity of the fauna. This system was found to be useful for the recording of the forms of pressure on the reserve, including human-hippo conflicts, wildlife zoonoses and the destruction of wildlife habitat. The objectives of the system have been moderately achieved.

 

Conclusions: The system was found to be simple, acceptable, representative, somewhat responsive and sensitive but not stable. The system was considered to be generally useful and partially achieving its objectives. Sustainable funding needs to be implemented to maintain the stability of the system and aid in achieving all objectives of the system.

 

Keywords: Surveillance System Evaluation, Ecological Monitoring System, Niger, Kandadji

 

 

Moussa Fati^1,&, Fatoumata Mounkaila Isaa¹, Barry Djibril², Pauline Yanogo², Herman Yoda², Fatima Diallo² , Meda Nicola²

¹Ministry of Health, Niamey, Niger, ²Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI ZERBO, Ouagadougou, Burkina Faso

^&Corresponding author: Moussa Fati, Ministry of Health, Niamey, Niger

 

Email: oussafati75@yahoo.com

Background: Rotavirus, the leading cause of diarrhoea in babies and young children is a highly contagious digestive virus often implicated in gastroenteritis. There is little analysis of rotavirus epidemiological surveillance data in Niger. The objective of this study was to describe the epidemiological profile of rotavirus diarrhoea in children aged 0 to 59 months in the rotavirus diarrhoea surveillance sentinel site of the Niamey National Hospital.

 

Methods: This analytical study was a descriptive analysis of secondary data collected on rotavirus among children aged 0 to 59 months from the Niamey National Hospital in the period of January 1, 2011, to December 31, 2021. Data was extracted from the hospital records, cleaned and analyzed using Microsoft Excel and Epi info 7.2.2.6. Frequencies and rates were calculated and represented in charts and graphs.

 

Results: Out of a total of 969 suspected cases of rotavirus, 257(27%) were confirmed, of which 52% had unknown vaccination status. An overall lethality of 1.16% was recorded. The sex ratio of the confirmed cases was 1.6 (M/F) with more than half of the confirmed cases aged 0 to 11 months (51.75%). Most of the positive cases (226; 87.93%) were located in the Niamey region. Dehydration (156, 60.70%) and vomiting in (161, 62.64%) were among symptoms reported by patients. All samples were taken within 48 hours of patient admission and tested for rotavirus by ELISA test.

 

Conclusion: Rotavirus diarrhoea is very common in Niger with a high rate of unknown vaccination status despite the introduction of the vaccine. Strengthened communication and intensified education for massive membership of the Expanded Immunization Program was recommended.

 

Keywords: Analysis, Rotavirus diarrhoea, epidemiological profile, Niger, 2011-2021

 

 

Aboubacar Hadjara^1,2,&, Mohamed Mahmoud Ely Mahmoud^1,2, Djobo Issoufou^2,4, Barry Djibril^1,3, Pauline Yanogo^1,3, Meda Nicola^1,3

¹Burkina Field Epidemiology and Laboratory Training Program (BFELTP), University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso, ²Ministry of Health, Niamey, Niger, ³Faculty of Medicine, University Ouaga 1 Joseph KI ZERBO, Ouagadougou, Burkina Faso, ⁴African Field Epidemiology Network, Niamey, Niger

^&Corresponding author: Aboubacar Hadjara, Burkina Field Epidemiology and Laboratory Training Program, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso

 

Email: aboubacarhadjara@yahoo.fr

Background: Yellow fever (YF) is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The virus is endemic in tropical areas of Africa and Latin America. In Niger, 915 suspected cases of yellow fever have been reported, including 3 confirmed cases from 2004 to 2021. Very little analysis has been done on the data of this disease. To contribute to the improvement of the epidemiological surveillance system and guide strategic decision making, we analyzed national data on this disease from 2012 to 2021.

 

Methods: We conducted a descriptive time-lapse and person-based study of yellow fever cases reported in Niger from 2012 to 2021. We extracted data from the national records and cleaned using Microsoft Excel 2016. We used Microsoft Excel 2016, Epi-info 7.2.2.6 and QGIS for analyses and calculated proportions and frequencies presented in tables, graphs and maps.

 

Results: A total of 620 YF cases were recorded in the period of analysis, with outcomes of 97% being alive, 1% deceased and 2% whose outcomes were unknown. Only 3 of the recorded cases were laboratory confirmed as IgM positive, represented by a positivity rate of 1.16%. The median age of the cases was 15(0-80 years). The male sex represented 340(54.84%) of all cases in a sex ratio of M/F=1.2. More than half of the cases (511; 82.82%) lived in rural areas. More than half (57%) of the cases had unknown vaccination status.

 

Conclusion: We retain that yellow fever is a notifiable disease in Niger. Given the confirmation of 3 cases between 2020 and 2021, we recommend intensification of surveillance, identification of areas at risk, education and required vaccination of the population.

 

Keywords: Analysis, Data, Surveillance, Yellow fever, Niger, 2022

 

 

Moussa Ahamadou^1,&, Ibrahim Salifou Alkassoum³, EIh Tassiou², Djibril Barry¹, Yoda Herman³, Yanogo Pauline^1,3, Nicola Meda^1,3

¹Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI ZERBO, Ouagadougou, Burkina Faso, ²Ministry of Health, Niamey, Niger, ³Faculty of Medicine, University Niamey, Niger

^&Corresponding Author: Moussa Ahamadou, Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI ZERBO, Ouagadougou, Burkina Faso

 

Email: dmoussame@gmail.com

Background: In 2020 alone, the International Agency for Cancer Research estimated that the incidence of cancer was 19.2 million. In Niger, an analysis of the national cancer registry published in 2013 found that the number of cancers increased from 186 in 1992 to 646 in 2009, resulting in strengthening of surveillance and case management systems. It is therefore appropriate to regularly analyze more recent data to update the epidemiology of cancer in Niger. This study analyzed cancer data collected from 2010 to 2018 in Niger to determine the burden and distribution of the disease.

 

Methods: We conducted a descriptive analysis of cancer cases reported in Niger from 2010 to 2018. Data was extracted from the national database of the National Center for the Fight Against cancers and cleaned using Microsoft Excel. The analysis was done using Epi info 7.2.5.0 and Excel 2016, frequencies and rates were estimated and presented in tables and graphs.

 

Results: A total of 5,889 cases of cancer were reported in Niger from 2010 to 2018. Cases reported annually tripled from 543 (in 2010) to 1565 (in 2018). The median age was 48 (35.60) years. Women were the most affected (61.32%) with 1259 (34.87%) and 677 (18.77%) of reported cases being breast and uterine cancers. The most common cancers in men were liver (661, 29.02%) and bile duct (327, 14.75%) cancers. Specific cancer-related mortality was 6.77%, and 93.98% of deaths occurred in the first year of diagnosis. Survival at 5 years was 84.84%, and was lower in men (78.75%) than in women (89%).

 

Conclusion: There was an increase in cancer incidence over the years, probably aggravated by the inadequacy of advanced treatment options in Niger. It was recommended that Niger takes steps to offer all modern cancer treatment technologies on the spot to improve patient survival.

 

Keywords: Epidemiology, Analysis, Cancer, Niger

 

 

Boushab Mohamed Boushab^1,2,3,&, Barry Djibril³, Pauline Yanogo^3,4 Mohamedou Hmeind Maham^3,5, Abdallahhi Mohammed Kheirou Traore, Elhadj Malick Kane², Leonard Basco^6,7, Nicolas Meda^3,4

¹Médecine interne et Maladies Infectieuses, Centre Hospitalier de Kiffa, Assaba, Mauritanie, ²Programme National de Lutte contre la Tuberculose et la Lèpre, Mauritanie, ³Epidémiologie de Terrain et de Laboratoire du Burkina-Faso, Université Joseph KI ZERBO, Ouagadougou, Burkina Faso, ⁴Faculté de M�édecine, Université Joseph KI ZERBO, Ouagadougou, Burkina Faso, ⁵Direction Générale des Services de Santé des Forces Armées et de Sécurité Mauritanie, Mauritanie, ⁶Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France, ⁷IHU-Méditerranée Infection, Marseille, France

^&Corresponding author: Boushab Mohamed Boushab, Médecine interne et Maladies Infectieuses, Centre Hospitalier de Kiffa, Assaba, Mauritanie

 

Email: bboushab@gmail.com

Background: Leprosy is a chronic infectious disease that mainly affects the skin, mucous membranes and the peripheral nervous system. The diagnosis of leprosy is made on the basis of WHO diagnostic criteria. The disease's elimination as a public health problem seemed to increase ignorance and risk of late diagnosis of the disease. An analysis of leprosy surveillance data in Mauritania was conducted to determine epidemiological trends and clinical forms of cases reported from 2009 to 2019.

 

Methods: We conducted a descriptive analysis on leprosy data reported in Mauritania from 2009 to 2019. We extracted and cleaned the data using Microsoft Excel and analyzed in time, place and people with Epi Info 7.2.5.0. We calculated frequencies, proportions and rates.

 

Results: A total of 164 cases were notified in the analysis period. Among the notified cases, 58.5% (96/164) were males, represented in a sex ratio of M/F = 1.4. The mean age was 44.0 ± 17.1 years, with children under the age of 16 accounting for 5.5% (9/164) of the cases. The average annual detection rate of leprosy from 2009 to 2019 varied between 0.2 and 0.8 cases per 100,000 inhabitants, with an average incidence of 0.3 cases/100,000. Most of the cases were residents of the Wilaya de Nouakchott region. Over the past 11 years, the predominance of multibacillary form (66.5%) and the discovery of new cases of leprosy in pediatric patients demonstrated the persistence of leprosy transmission in Mauritania. All reported cases were treated with multidrug therapy.

 

Conclusion: There was a persistence of leprosy in Mauritania from 2009 to 2019. It is necessary to relaunch and intensify diagnosis and treatments services at all levels in order to reduce the morbidity associated with this disease, and eventually eliminate it from the country.

 

Key words: Leprosy, Epidemiology, Data Analysis, Mauritania

 

 

Ramdhane Bany Mohamed^1,2,&, Assane Hamadi¹, Mariata Lam^1,3, Mohamed Mahmoud Ely Mahmoud³, Alkassoum Moussa³, Pauline Yanogo^1,4

¹Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso, ²Office National de Recherche, de développement de l'élevage et de pastoralisme, Mauritanie, ³Direction General de la sant� publique, Mauritanie, ⁴Université Joseph KI-ZERBO, Ougadougou, Burkina Faso

^&Corresponding author: Ramdhane Bany Mohame, Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso

 

Email: mouhamed.ramdhane@gmail.com

Background: In Mauritania, 249 people contracted mealses in 2021 alone. The Regional Health Directorate of Hodh El Charghi in Mauritania was notified of a suspected measles outbreak in the refugee camp of Mberra in January 2022. An investigation was conducted to confirm and determine the magnitude of the outbreak in affected areas.

 

Methods: A descriptive study was conducted from January 10 to February 27, 2022 in the Hodh Charghi region. A previously prepared line list was obtained, and a working case definition developed based on data observations. An active search was conducted in health facilities in districts that notified cases and samples were collected for laboratory testing at the National Institute of Public Health Research. The line list was updated with data collected from identified cases. Data collected were analyzed with Excel 2016, Epi info7 and presented in tables and graphs.

 

Results: A total of 1145 cases of measles were identified, with one death. Cases were residents of the Moughataas of Nema, Bassiknou, Timbeedra, Oualat and Mbeket Lahouach. The index case of this epidemic came from a region of Mali bordering Mauritania. The attack rate of confirmed cases was 2 cases per 100 inhabitants in the refugee camp. The attack rates were lower in other Moughataa, ranging from 0.056 in Oualata to 0.003 in Nema. The 12-59 months age group was the most affected, with an attack rate of 5.45%. About 82% of the measles cases were not vaccinated. Symptoms presented by cases were fever, rash and cough.

 

Conclusion: An outbreak of measles was confirmed to have occurred in the Mberra refugee camp, affecting 1145 persons. The investigation's response allowed for the proper management of cases and a vaccination campaign that resulted in the vaccination of 87,486 people aged 6 months to 14 years.

 

Key words: Measles, Outbreak, Refugee camp, Mauritania

 

 

Soumaila Garba^1,2,&, Sani Karimou^1,2, Barry Djibril¹, Jean Kabore^1,3, Herman Yoda^1,3, Fadima Diallo¹, Pauline Yanogo^1,3

¹Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI-ZERBO, Ouagadougou, Burkina Faso, ²Ministry of Health, Niamey, Niger, ³Faculty of Medicine, University Ouaga Joseph KI-ZERBO, Ouagadougou, Burkina Faso

^&Corresponding author: Soumaila Garba, Burkina Field Epidemiology and Laboratory Training Program (BFELTP), University Joseph KI-ZERBO, Ouagadougou, Burkina Faso

 

Email: garbasoumaila@yahoo.com

Background: On February 14, 2022, the Integrated Health Center of Goula reported a suspected case of neonatal tetanus. On March 28, the Epidemic Surveillance and Response Directorate in collaboration with the Maradi Regional Directorate of Public Health investigated the case. The objective of the investigation was to confirm the case of neonatal tetanus and conduct a response.

 

Method: We conducted the investigation from March 28 to April 4, 2022. The case investigation form and notification reports were reviewed, followed by a child protection investigation before birth. Against tetanus consisted in administering A WHO questionnaire was adapted and used to interview 15 other mothers of children under 2 years old in the Hardo Alto group. The data was entered in Excel version 2016 analyzed with Epi-info 7.2.2.6. Proportions and frequencies were calculated.

 

Results: The identified patient was a 15 days old male. The investigation showed that the baby was born in conditions of an unintended pregnancy, no maternal immunization against Tetanus, and delivery at home by an unskilled person. The survey revealed 100% (15/15) of all mothers delivered at home and only 27% of children had received 3 doses of Penta. It was reported that women who aided with delivery used non-sterile blade (93%) to cut the umbilical cord of children and applied cow's milk (27%), plant liquid (20%), hot water (20%) and soap from Marseille (20%) on the stump of the umbilical cord.

 

Conclusion: The investigation made it possible to confirm the case of neonatal tetanus and to lead the response through against neonatal tetanus in the Hardo Alto group.

 

Key words: Investigation, neonatal tetanus, Goula, Dakoro, Niger, 2022

 

 

Soumaila Garba^1,2,&, Sani Karimou^1,2, Barry Djibril¹, Herman Yoda^1,3, Fadima Diallo¹, Yanogo Pauline^1,3

¹Burkina Field Epidemiology and Laboratory Training Program, University Joseph KI ZERBO, Ouagadougou, Burkina Faso, ²Ministry of Health, Niamey, Niger, ³Faculty of Medicine, University Ouaga 1 Joseph KI ZERBO, Ouagadougou, Burkina Faso

^&Corresponding Author: Soumaila Garba, Burkina Field Epidemiology and Laboratory Training Program (BFELTP), University Joseph KI ZERBO, Ouagadougou, Burkina Faso

 

Email: garbasoumaila@yahoo.com

Background: Cholera continues to be a public health problem worldwide causing 323,320 infections and 857 deaths in 2020 alone. In 2021, Niger recorded 5,553 cholera cases, including 163 deaths, represented by a case-fatality rate of 3%. It is important to frequently evaluate the cholera surveillance system in Niger to determine the strengths and weaknesses of the system, and hence, improve upon the system We evaluated the cholera surveillance system in the |Dosso region, on its performance from 2018 to 2021, to assess its attributes, usefulness and if it was meeting its objectives.

 

Methods: The system was evaluated using CDC guidelines. An interview guide was used to conduct semi-structured interviews with stakeholders in the region. Surveillance records from case-based forms, reporting forms, disseminated charts and database systems were reviewed. Microsoft Excel 2016 and Epi-info 7.2.2.6 were used to descriptively analyze the data, proportions and scores were estimated and presented in tables and graphs.

 

Results: The cholera surveillance system in the Dosso region promptly detected 215 cases including 13 deaths from 2018 to 2021, represented by case fatality rate of 6.04%. The median age was 28 (3 - 70) years. Data quality (86.01%), simplicity (91.53%), acceptability (88.11%) and positive predictive value (81.25%) were good in 2021. The latter was 16.66% in 2018. Reactivity was average (61.5%), and sensitivity was low in 2021 (23%) and 2018 (17%).

 

Conclusion: The cholera surveillance system in Dasso was found to be useful and partially achieving its objectives from 2018 to 2021. It is simple, acceptable and with good quality data. However, case confirmation and timely feedback need to be improved to boost responsiveness and sensitivity.

 

Keywords: Evaluation, surveillance, Cholera, Niger, 2018-2021

 

 

Joseph Obeng-Asante^1,&, Constance Amoakowaah², Mustapha Adams³, Roseline Agyei⁴, Nana Akwasi Katakyie-Premoh³

¹Bono Regional Health Directorate, Ghana Health Service, Sunyani, Ghana, ²Ashanti Regional Health Directorate, Ministry of Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana, ³Biomedical Science Department, School of Allied Sciences, University for Development Studies, Tamale, Ghana, ⁴Department of Public Health, Bono Regional Health Directorate, Ghana Health Service, Sunyani, Ghana

^&Corresponding Author: Joseph Obeng-Asante, Bono Regional Health Directorate, Ghana Health Service, Sunyani, Ghana

 

Email: neggmed@gmail.com

Background: Occult Hepatitis B virus Infection (OBI) unlike the Hepatitis B surface Antigen (HBsAg), is characterized by the absence of detectable HBsAg in human blood. Due to this, OBI poses the risk of chronic Hepatitis B Virus (HBV) infection and potential increase of mother to child transmission rates. The purpose of this study was to determine the prevalence of OBI among HBsAg negative pregnant women and to characterize associated genotypes.

 

Method: A cross-sectional study was conducted among a sample of pregnant women of all trimesters in the Sunyani West Municipality from September 2021 to February 2022. Serum samples were collected and assayed for HBsAg and HBV core antibody (anti-HBC) seromarkers using enzyme-linked immunoassay (ELISA). In anti-HBc positive samples, HBV DNA was detected using real-time polymerase chain reaction (RT-PCR). Data were entered into Epi-Data 3.1, cleaned, and analyzed using IBM SPSS Statistics V21.0. Statistical significance was decided at p<0.05.

 

Results: A total of 89 pregnant women were included in the study; 13 (14.6%) tested positive for HBsAg. Of the 76 negatives further assayed for anti-HBc, 21(27.6%) were found positive for anti- HBc implying previous exposure to HBV. Of the 21 anti-HBc positives, 8(38.1%) had HBV DNA signifying OBI. In effect, the isolated OBI cases from the entire study population was 8 out of 89 participants (8.9%). The HBV DNA concentration below 200 Iµ/mL was 82.9%.

 

Conclusion: The prevalence of OBI among the pregnant women was 8.9%, suggesting possibility of residual cryptic transmission from mother to child during delivery. This indicates the burden of HBV in the district is worth reconsidering, since previous estimates and screening were exclusively dependent on HBsAg. We recommend that nucleic acid-based testing (NAT) should be an essential part of screening pregnant women to prevent missing OBI transmission.

 

Keywords: HBsAg, anti-HBC, HBV, HBV DNA, OBI, Sunyani West Municipal