Poliovirus neutralizing antibody levels among individuals in three regions of Ghana

Introduction: Ghana was declared polio-free in 2015 after the last polio case in 2008. We determined the poliovirus neutralizing antibody levels among individuals to identify possible immunity gaps. Methods: A cross-sectional, hospital-based study was undertaken in Northern, Ashanti and Greater Accra regions of Ghana. Individuals referred for haematology at the teaching hospitals' laboratories were invited to participate in our study. Neutralizing-antibody titers to poliovirus serotypes 1,2 & 3 were assayed by WHO-standards. Antibody titers of ≥8 were considered protective. Bivariate and multivariate analyses were conducted on subject characteristics to assess potential factors for failure to seroconvert. P-values < 0.05 were considered statistically significant. Results: Poliovirus (PV) neutralizing-antibody serotypes 1, 2 and 3 were detected in 86.0% (264/307), 84% (258/307) and 75% (230/307) of samples respectively. 60.1% (185/307) were seropositive for the three poliovirus serotypes. Neutralizing poliovirus antibodies for PV1 and PV2 were higher than for PV3. Seroprevalence of poliovirus-neutralizing antibodies among males (PV1=51.9%, PV2= 51.6% and PV3= 52.6%) were higher than in females. Seroprevalence rates of poliovirus-neutralizing antibodies (PV1, PV2, and PV3) were highest in the Northern region (90%, 81%, and 77%). Poliovirus neutralizing-antibodies (PV1and PV2) decreased with age [p< 0.001]. Low seroprevalence of poliovirus-neutralizing antibodies was significantly associated with low school attendance of mothers (p<0.001). Conclusion: Our study population has some protection from polio. However, immunity appears to be lower with a higher age or low Mother's education. This may suggest the need for young-adult booster-dose to minimize the risk of wild poliovirus infection

Prescribing Practices for Uncomplicated Malaria in a Rural District in Ghana, 2012.

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.