ABSTRACT
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
ABSTRACT
Background:Three different artemisinin-based combination therapies (ACTs) namely; artesunate-amodiaquine, artemether-lumefantrine and dihydroartemisinin-piperaquine (being the latest to be introduced) are concurrently being used forthe treatment of falciparummalaria in Ghana. This study assessed patients’ experience, perceptions and willingness to use dihydroartemisinin-piperaquine, brand name duo-cotecxin as an alternative first line ACT for the treatment of falciparummalaria in Northern Ghana.Methods:This was a qualitative study using phenomenology approach where sixty in-depth interviews were conducted with two groups; thirty patients who were given duo-cotecxin, one group and thirty interviews with patients who were given other ACTs (artesunate-amodiaquine, artemether-lumefantrine) as another group. The interviews were conducted between August and November, 2015 Purposive sampling technique was used to select study participants. The interviews were transcribed andcoded into themes using QSR NVivo 11 software for thematic content analysis.Results:All patients who used duo-cotecxin reported that the drug was very good in treating uncomplicated malaria compared to other ACTs they had used in the past. Some of the patients who used other ACTs could not complete their doses because of the side effects. However, none of the patients who used duo-cotecxin reported side effects. The findings revealed high acceptance and preference to use duo-cotecxin to treat uncomplicated malaria compared with other ACTs. All the participants were also willing to recommend duo-cotexcin to their relatives and friends to use. Conclusions: Duo-cotecxin as an alternative first line ACT for treatment of uncomplicated malaria is highly accepted, preferred and there was willingness to use it compared with other first line recommended ACTs.
ABSTRACT
Introduction: Meningitis is an acute inflammation of the protective membranes covering the brain and the spinal cord. It can cause severe brain damage and is fatal in 50% of cases if untreated. The Upper East Region (UER) of Ghana recorded 70 case-patients in 2014 with a case fatality of 10%. Furthermore, there have been series of out outbreaks of bacterial meningitis in the region. The study reviewed meningitis surveillance data to assess the progress towards interruption of meningitis transmission and identified opportunities for surveillance improvement in the UER. Methods: This involved records review and secondary data analysis of all reported meningitis cases in the Region from 2010 to 2014. Data quality was assessed: described by person, place, time, causative agents involved and identified opportunities for system improvement. Results: Of 1142 suspected cases of meningitis recorded at the health facilities and communities in the UER, 352(30.8%) were confirmed cases of various forms of Bacterial meningitis. Majority of the cases (50.7%) were males. The age group 0-9 years was mostly 491(43.0%) affected. There were 146 deaths, giving a case fatality rate of 13.0%. The identified etiological agents were Neisseria meningitides (Nm W135) 50.3%, Streptococcus pneumonia (41.7%), Neisseria meningitides (Nm A) 1.7%, Neisseria meningitides (Nm Y 5%), Haemophilus Influenzae Type B1.5%. Majority of the case-patients were observed in 2010 (34.7%) and 2012 (44.2%) between February and April (%). The Kassena Nankana Municipal recorded the highest number of cases 234(20.5%) and the Bulsa South District recorded no case of bacterial meningitis cases. 69 (6%) of case-patients had no lumber puncture done. Time spent before presentation of case-patients to the health facilities had no significant association with the outcome of the infection (p= 0.319). Conclusions: There has been a consistent outbreak of Bacterial meningitis in the Upper East Region that involved many cases-patients with some mortality. More bacterial meningitis cases were recorded in children compared to adults. Lumber puncture was not performed in all casepatients. Many case-patients were recorded in the first quarter of the year with the majority in the Kassena Nankana District. There is an urgent need to review the management of meningitis, coupled with enhanced strategies in prevention of occurrences of the disease in the Upper East Region of Ghana.