ABSTRACT
Objectives: Given the paucity of community based surveys on hypertension and other non-communicable diseases in the Akwapim North District (AKND) of Ghana’s Eastern-Region (ER), we conducted a population survey to determine the prevalence of hypertension and its associated determinants. Methods: We recruited 519 adults age ≥ 25years in a multi-stage sample of enumeration centres over a one-month period. We measured body weight, waist and hip circumference, height, blood pressure (BP) and obtained demographic and risk factor information. Univariate and bivariate-analysis determined the prevalence of hypertension, significant difference and predictors of known risk factors (p <0.05). Results: Among the 519 participants, 62.8% were women. The mean age and body mass index (BMI) were 48.6±16.8 years and 23.2±5.2 kg/m2 respectively. Prevalence of hypertension was 32.2% with a male-to-female distribution of 27.5% and 35.0% respectively. The prevalence of alcohol use was high at 65.6% (340/519). Age and waist circumference were predictors of diastolic BP. Conclusions: There is a high prevalence of hypertension in the AKND of Ghana. Stakeholders should structure interventions on hypertension to promote healthier-lifestyles.
ABSTRACT
Background: The use of Artemisinin–based Combination Therapies (ACTs) for laboratory confirmed malaria, in conformity to recommended guidelines, remains critical to halting the emergence of drug resistance. We reviewed prescribing practices for malaria in Kwahu South District (KSD) and determined factors influencing conformity to guidelines. Methods: We conducted a cross-sectional survey in seven health facilities from three randomly selected sub-districts in KSD. We reviewed patients’ records with a diagnosis of malaria from January to December 2012. Patients’ records were selected by systematic random sampling. Variables reviewed were demographics, clinical presentation and prescription patterns. Prescriptions were considered to conform to recommended guidelines if ACT was prescribed for confirmed uncomplicated malaria and not prescribed for test negative or presumptive malaria. Frequencies, relative frequencies, mean and median were calculated. Unadjusted odds ratios were used to determine associations at 5% significance level. Predictors of conformity were determined by logistic regression model, adjusting for potential confounders. Results: Four hundred and four records were reviewed of which 247(61.1%) were females. Median age was 23 years (interquartile range 12-38). Overall, 202(50%) of prescriptions conformed to guidelines: 132 (65.3%) being Artesunate-Amodiaquine (AA). Temperature of ≥37.5°C [adjusted odds ratio (AOR)=1.8, (CI:1.11-2.92)] and being managed at the district hospital [AOR=8.7, (CI:5.41-14.12)] were independent predictors of conformity. Conclusion: Conformity of prescribing practices to recommended guidelines was suboptimal. Determinants of conformity were fever and being managed at the hospital. We recommended targeted interventions to improve conformity of case management practices to guidelines.
ABSTRACT
Background: On the 28th of October, 12 students from a Senior-High-School (SHS) in the Akwapim North-District-Ghana, reported to the district hospital with abdominal cramps, diarrhea and vomiting. We investigated to identify the cause, the source of infection and to recommend control measures. Methods: We conducted a descriptive investigation; with active case-search and a retrospective cohort-study. A case-patient was a student presenting with abdominal cramps, diarrhea and or vomiting from the 28th of October to the 2nd of November in the SHS. We interviewed students and reviewed medical records. Stool from case-patients and water samples were taken from known sources of drinking water and associated boreholes for laboratory diagnosis. We performed univariate analysis by person, place and time and assessed risk factors through relative risk 95% confidence level. Results: Aeromonas-spp and Eschericia-coli were isolated from stool and water samples respectively. The overall attack rate was 8.0 (101/1254) /1000 with no fatalities. The index case, a 15 yr-old female student reported on october 28th and case-patients peaked (16/101) 24hours later. The mean age of case-patients was 17 years (±1.2) with females 77% (78/101) mostly affected. Eating waakye [RR=3.13(CI 2.35-4.17)], banku [(RR= 2.21(CI 1.33-3.69)], kenkey [RR=1.39 (CI 1.03- 1.87)] and drinking borehole water [( RR=7.60 (CI 6.26-9.25)] were associated with the gastroenteritis. Conclusions: Drinking Eschericia coli-contaminated-bore hole water was the most likely cause of this point-source outbreak. Chlorination of the boreholes water coupled with education on food safety and personal hygiene were initiated based on our recommendations and these measures were temporally associated with containment of the outbreak.