Predictors of Subjective Well-Being among Older Ghanaians

Background: Later years of life are accompanied by many physical; emotional and environmental changes which may impact on the well-being of the individual. Many factors are known to influence the subjective well-being of older adults; but most; if not all of this information was the result of studies in the Western world. This study aimed at obtaining and documenting the predictors of subjective well-being (SWB) among older Ghanaians. Methods: Data for the study was obtained from the WHO SAGE study. The single item measure of life satisfaction was used to determine subjective wellbeing. Descriptive statistics as well as logistic regression analysis were carried out to determine the predictors of SWB. Results: A total of 4724 individuals aged 50 years and above responded to the questionnaires. Of these 50.4 were males. Following multivariate logistic regression analysis; age; sex; educational level; income and ethnic background were found to significantly affect the SWB of older Ghanaians. Being male was associated with higher level of SWB (OR=1.68; CI: 1.39 - 2.03). For those 50 years and above; being younger (50-59 years) was also associated with a high level of SWB (OR=17.72; CI: 10.13-30.98). Earning a low income and having low educational level were both associated with low levels of SWB (OR=0.304; CI: 0.22-0.42; and OR=0.47; CI: 0.37-0.60 respectively). Ewes (p=0.027); Grumas (p=0.002) and Mole-Dagbons (p=0.04) had significantly higher SWB compared to the other ethnic groups. Conclusion: Among older Ghanaians; factors that positively influence SWB are younger age; male sex; high educational level and high income

Utility and Effectiveness of Computerised Motion Sensitivity Screening Tests in Rural Onchocercal Community Survey

BACKGROUND: Non-invasive tool of community diagnosis for onchocercal endemicity needs to be identified and ascertained for their utility and effectivity in order to facilitate the control of onchocerciacis in sub-Saharan Africa OBJECTIVE: To determine the utility and effectiveness of the Wu-Jones Motion Sensitivity Screening Test (MSST) in detecting optic nerve diseases in onchocercal-endemic rural Africa. METHODS: MSST was applied to sampled subjects in the selected communities of Raja in Sudan; Bushenyi in Uganda; Morogoro in Tanzania; and of Ikom; Olamaboro and Gashaka in Nigeria. Basically; six points within the central field of vision were repeatedly tested at 1/3 meter from the screen of a laptop computer in a room darkened. Motion sensitivity was expressed as a percentage of motion detected in the individual eye and this was averaged for the community. RESULTS: A total of 3;858 eyes of 2;072 patients were examined. Seventy-six percent of the subjects completed the test; at an average test time of 120.4 (66.7) seconds. The overall mean motion sensitivity of all eyes tested was 88.49 (17.49). At a cut-off point of 50; 6.4of all subjects tested were subnormal; while at 70cutoff; 13.3were subnormal. The highest proportion of 50cutoff sub-normality was recorded at Morogoro at 12.7. CONCLUSION: Motion Sensitivity Screening Test was widely accepted and easily administered to the rural and largely illiterate subjects studied. Our data suggest that the proportion of severe field defects by MSST in a community; with cutoff at 33; best correlates with optic nerve disease prevalence; while proportion of defect from a higher cut-off level at about 50; best correlates with overall ocular morbidity

Apoc impact assessment study: baseline prevalence and distribution of ocular Onchocerciasis in three ecological zones in Nigeria

During the APOC/WHO Impact Assessment studies in Nigeria held in 1998 and 1999, one thousand and sixty four randomly selected subjects underwent detailed eye examination in three selected sites namely, Cross River State (rain forest ecological zone), Taraba State (savanna ecological zone) and Kogi State (forest- savanna ecological zone). The general objective of the impact assessment studies was to evaluate the ophthalmological impact of onchocerciasis control (CDTI) in Nigeria, this paper highlights the public health significance of ocular onchocerciasis in three different ecological zones in Nigeria. The presence of ocular onchocerciasis was established in all the study sites, with a predominance of posterior segment manifestations, in the rain forest zone. A blindness prevalenc e of 2.4o/o was recorded in the study, with onchocerciasis being responsible for 13 out of the 43 (30.2%) bilaterally blind subjects identified. Onchocerciasis-induced blindness prevalence was relatively high in the rain forest and forest savanna zones of Cross River and Kogi States with Cross River State having the highest site-specific- prevalence (5/10) 50.0% of onchocercal blindness followed by Kogr with (5/12) 41.7%. Taraba site recorded only 27.3% (3121). Other conditions identified included glaucoma, optic nerve disease and cataract rates of which were also found to be high among the population (6.90/o,6.5 % and8.9oh respectively). Anterior segment onchocercal lesions, punctate and sclerosing keratitis were the predominant features of the infection in Taraba site (14.1o/o and 6.3% respectively), a savanna zone while posterior segment lesions were much more common in the forest zone of Cross-River site. Visual field measurements reflected the predominant posterior segment disease. The need to sustain the present efforts aimed at controlling onchocerciasis through mass ivermectin distribution is fuither highlighted. Integration of other Eye Care Programme for the conffol of glaucoma and cataract, into the community directed treatment initiative of APOC for onchocerciasis control should also be strongly considered, in order to drastically reduce the prevalence and incidence of ocular morbidity and blindness, in Nigeria, especially in the onchocerciasis endemic areas.

Apoc impact assessment study Onchocerciasis: baseline ophthalmological Survey in southwestern Sudan

A cross-sectional survey of eye disease supported by the African Programme for Onchocerciasis Conffol (APOC) was carried out in October 1998, in Raja, Sudan, a Savanna ecological zone to determine the prevalence and distribution of onchocercal eye disease. Detailed eye examination including measurement of visual field using the Wu-Jones computerized Motion Sensitivity Screening Test (MSST) were carried out. A total of 481 individuals were examined, of which 379 underwent detailed eye examination. A high prevalence of blindness (8.1%) from all causes was recorded. Onchocerciasis-induced eye disease was responsible for blindness in 56.40/o of all blind persons. Of the 38 persons who had visual impairment, 13 (2.7%) were severely affected. As many as 91 (24.0%) persons had microfilariae (mfs) in the anterior chamber (AC) and /or cornea with the highest prevalence of 29.3Yo and 28.8% respectively, recorded among the young and active individuals. This age group (15-24yeus) also had the highest prevalence (15.3%) of flufff corneal opacities. Sclerosing keratitis was present in 46 (12.1%) subjects while iridocyclitis was diagnosed in 9.0% with the highest prevalenc e of 25 .0o/o noted in the 45 - 54 age group. Prevalence of blinding cataract was 54.1% while that of glaucoma was12.2%. Presumed optic nerye disease, a known pathway to onchocercal blindness was observed in 19.6% with one third of this percentage already at the advanced stage. Another common pathway to blindness, chorioretinitis, affected 15.2% of the subjects of which 7.2% had reached advanced stages.Prevalence of abnormal visual fields was 6.6Yo. Posterior segment oncho disease was found to be the main ocular pathology in 15.6% subjects followed closely by 13.5% whose main cause was anterior segment oncho lesion. Both sexes were almost equally affected. Ocular findings in this area particularly among the young conform to high intensity levels of onchocerciasis infection and therefore require urgent effective intervention to forestall further devastating oncho-induced blindness and alleviate the socio-economic burden imposed on this population.

Monitoring progress towards health for all by the year 2000: indicators from Iganga District, Uganda

A Sample of 5018 inhibitants in 3 countries of Iganga District ; Uganda was selected by means of a multi-cluster sampling procedure and interviewed in 1984. A sub sample was re-interviewed; the following year to study population dynamics. 50.2of the population were under 15 years of age and 4.2were aged one year or less. About 80of both sexes aged 6-15 years were in school or had primary education. Male adult literacy rate was 62and female adult literacy rate was 38. The average number of people per sleeping room was 2.4. 82.9of households used well or unprotected spring as main source of water and 30of hosueholds did not not have pit latrine. Infant mortality rate was estimated to be 126 per 1000 livebirths and measles was the major cause of mortality (38) in the under fives. The crude birth rate estimate was 51 per 1000. The estimate of lameness due to polio was 6.6 per 1000 children aged 15 years or below. The mean weight and the mean height of the children were both below 50th percentile of the NCHS standards. In the re-survey; the crude birth rate and infant mortality rate estimates corresponded well to the initial values for the total sample obtained in the previous survey. 5of the population had moved out of the village and 1.8have moved to settle in the village. The growth rate in both weight and height of the under five children was satsifactory comapred to the rate of the standard. From the result of the study; only six years after adoption of PHC in Ugandaa; the relatively high educational level of the younger population should be taken as a positive indicator of better health indices in the future

Korle-Bu Teaching Hospital: Bed Occupancy and Manpower Statistics (1991 and 1992)

In 1991; the daily bed occupancy rate for the hospital was 75.2 per cent with bed turnover rate of 2 per month and bed turnover interval of 4 days. There was a daily average of 57 floor-patients in the hospital. Nurses and other medical staff on admission formed about 2 per cent of the daily population. The seriously ill patients formed 6.4 per cent of the patient population. The average daily patient population was 1166 with average daily admissions of 92 patients (SD 21.2); discharges of 87 (SD 9.7) and the daily deaths of 11 (SD 3.7). The corresponding figures for 1992 were very close. In 1992; daily patient population was 1151; daily admissions was 103; discharges 90 and daily deaths was 11. Thus. about 10 per cent of the hospitals daily patient population is admitted daily and about 1 per cent die daily. With respect to the individual wards or departments; the highest daily admission rate was at Chenard Ward A; for gynaecological emergencies with about 10 patients a day. Children's wards followed with a rate of about 5 per day; then Medical wards with about 3 per day; Maternity wards and Surgical wards with 2 per day and Orthopaedic wards (Allied Surgical wards C; D; H; I and N) with about 1 per day. The highest number of deaths occurred in emergency wards; (Children's emergency; Neonatal Intensive Care Unit (NICU); Surgical/Medical emergency; Korle-Bu Polyclinic and Accident centre). The ranking order of departments with deaths in the wards were Children's; Medical; Chest; Surgical and Obstetrics (Maternity). On average there were 16 nurses and 7 orderlies to a ward running three shifts a day. Excluding housemen; Surgical wards had an average of 3 doctors to a ward; Medical wards had 8 doctors per ward; Obstetrics and Gynaecology had 6 doctors to a ward; Children's block had 8 doctors to a team and Allied Surgical wards had an average of 6 doctors to a ward.The policy implications of these statistics are discussed