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
Aim: We investigated a foodborne outbreak to determine its magnitude, source of infection and causative agent using laboratory confirmation. Study Design: Descriptive cross-sectional study Place and Duration of Study: Koforidua Township of the New Juaben Municipality, Eastern Region, 5th - 8th November 2009 Methodology: A case was defined as any person presenting with abdominal cramps, diarrhea and or nausea to the Eastern Regional Hospital between 5th and 8th November, 2009 and had eaten salad from the salad eatery. All the cases that reported to the hospital were interviewed and medical records reviewed. Four stool samples, portions of the different vegetables (cabbage, carrots, green pepper and onion) used in preparing the salad and a mixed salad portion were collected for laboratory diagnosis. Environmental assessment at the salad eatery was conducted. We assessed the site were the vegetables were prepared and the transportation process of vegetables to the salad eatery. Results: A total of 40 cases were identified with an attack rate of 0.26/1000 population with no fatalities. This was a point source outbreak with an incubation period of 7-20hours. The most affected were cases aged 21-30years (35%) and females (55%). Laboratory diagnosis confirmed Clostridium perfringens (C. perfringens) as the probable causative agent in two stool samples. C. perfringens was also confirmed in the mixed salad portion and the cabbage. The spore count for the mixed salad was 107 CFU/gram of salad and the cabbage was 109 CFU/gram of cabbage. The vegetables were washed with ordinary water only and transported to the salad eatery with poor temperature control of warm cabbage. Conclusion: We confirmed an outbreak probably caused by C. perfringens food poisoning. The inadequate washing of vegetables and poor temperature control of warm cabbage was the probable source of the outbreak. Education of food vendors on strict food hygiene was conducted in the Koforidua Township and the inspection of food eateries re-enforced.
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.