Dihydroartemisinin-piperaquine for the routine treatment of uncomplicated malaria in Northern Ghana

Background:Dihydroartemisinin-piperaquine is a first line treatment for uncomplicated malaria in Ghana. A facility-based study was undertaken to examine the effectiveness of thetreatment in the routine health care system.Methods:The study was undertaken at the Navrongodemographic surveillance area. Patients presenting with acute febrile illness were enrolled after informed consented and confirmation by microscopy. Patients were randomized into supervised group who received treatment under direct observation and unsupervised group which had only the first treatment given under supervision. Treatment was according to bodyweight and 42 days follow-up was undertaken.Results:A total of 194 patients were enrolled; 54.1% were females and 51% had supervised treatment. The median age and weight were 6.7 years and 20.0kg respectively. Mean baseline temperature, haemoglobin concentration and parasite density were, 37.6oC, 11.1 g/dl and 11,098 parasites per microliter of blood respectively. Study completion rate was 93.3%, day 42 polymerase chain reaction-unadjusted adequate clinical and parasitological responses rate (ACPR) was 93.4% by evaluable and 87.1 % by intention-to-treat (ITT). The day 42 ACPR by evaluable was 92.3% in the supervised arm compared to 94.4% in the unsupervised arm. The day 42 ACPR by ITT was 85.7% in the supervised and 88.5% in the unsupervised arms. The fever resolution and haemoglobin concentration changes for the two arms were similar.Conclusions: The results show that dihydroartemisinin-piperaquine iseffective and good first-line antimalarial in the routine health delivery system

Descriptive epidemiology of anaemia among pregnant women initiating antenatal care in rural Northern Ghana

Background: Anaemia in pregnancy is associated with adverse obstetric outcomes. When detected early in pregnancy, it can be treated; however, information on its prevalence and associated factors is limited in rural Ghana.Aim: The aim of this study was to determine the prevalence and maternal factors associated with anaemia in pregnancy at first antenatal care (ANC) visits.Setting: The study was conducted in the Navrongo War Memorial Hospital, a secondary referral facility in the Kassena-Nankana district in rural northern Ghana.Methods: A retrospective analysis of antenatal clinic records of pregnant women collected from January to December 2014. All pregnant women initiating antenatal clinic, who had initial haemoglobin (Hb) levels measured, were included in the study. Logistic regression analyses were carried out to determine factors associated with anaemia at the initiation of ANC.Results: We analysed data from 506 women with median Hb of 11.1 g/dL (IQR 7.31­13.8). The median gestational age at booking was 14 weeks (5­36 weeks). The prevalence of anaemia was 42.7%, with 95% confidence interval (CI) [38.4­47.1], and was high among teenage mothers (52% [34.9­67.8]), mothers who booked in the third trimester (55% [33.6­74.7]) and grand multiparous women (58% [30.7­81.6]). Factors associated with anaemia included grand multiparity (odds ratio [OR] = 1.94 with 95% CI [1.58­2.46]), booking during the third trimester (OR = 2.06 [1.78­2.21]) and mother who were underweight compared to those with normal weight (OR = 3.17 [1.19­8.32]).Conclusion: Burden of anaemia in pregnancy is still high in rural northern Ghana. We advocate further strengthening of the primary health care system to improve early access to ANC deliver

Descriptive epidemiology of anaemia among pregnant women initiating antenatal care in rural Northern Ghana

Background: Anaemia in pregnancy is associated with adverse obstetric outcomes. When detected early in pregnancy, it can be treated; however, information on its prevalence and associated factors is limited in rural Ghana. Aim: The aim of this study was to determine the prevalence and maternal factors associated with anaemia in pregnancy at first antenatal care (ANC) visits. Setting: The study was conducted in the Navrongo War Memorial Hospital, a secondary referral facility in the Kassena-Nankana district in rural northern Ghana. Methods: A retrospective analysis of antenatal clinic records of pregnant women collected from January to December 2014. All pregnant women initiating antenatal clinic, who had initial haemoglobin (Hb) levels measured, were included in the study. Logistic regression analyses were carried out to determine factors associated with anaemia at the initiation of ANC. Results: We analysed data from 506 women with median Hb of 11.1 g/dL (IQR 7.31­13.8). The median gestational age at booking was 14 weeks (5­36 weeks). The prevalence of anaemia was 42.7%, with 95% confidence interval (CI) [38.4­47.1], and was high among teenage mothers (52% [34.9­67.8]), mothers who booked in the third trimester (55% [33.6­74.7]) and grand multiparous women (58% [30.7­81.6]). Factors associated with anaemia included grand multiparity (odds ratio [OR] = 1.94 with 95% CI [1.58­2.46]), booking during the third trimester (OR = 2.06 [1.78­2.21]) and mother who were underweight compared to those with normal weight (OR = 3.17 [1.19­8.32]). Conclusion: Burden of anaemia in pregnancy is still high in rural northern Ghana. We advocate further strengthening of the primary health care system to improve early access to ANC delivery