Epidemiology of COVID-19 outbreak in Ghana, 2020

Objective: Describe the epidemiology of COVID-19 cases detected in the first four months of the pandemic in Ghana by person, place and time to provide an understanding of the local epidemiology of the disease. Methods: We conducted an exploratory descriptive study of all confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020. Data was merged from the country's electronic databases, cleaned and summarized using medians, proportions and geospatial analysis. Design: A cross-sectional study design Setting: Ghana Participants: All confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020 Interventions: None Main Outcome measures: Epidemiological characterization of all confirmed COVID-19 cases recorded from March 12 ­ June 30, 2020 in Ghana by person, place and time. Results: A total of 17,763 cases were recorded with median age (IQR) of 33years (One month to 85 years). Among the confirmed cases, 10,272 (57.8%) were males and 3,521 (19.8%) were symptomatic with cough recorded in 1,420 (40.3%) cases. The remaining 14,242 (80.2%) were asymptomatic. Greater Accra region recorded the highest number of confirmed cases 11,348 (63.9%). All 16 administrative regions had recorded cases of COVID-19 by June 30, 2020 due to internal migration between the hotspots and other regions. The epidemiological curve showed a propagated outbreak with 117 deaths (CFR= 0.67%) recorded. Conclusion: A propagated outbreak of COVID ­ 19 was confirmed in Ghana on March 12, 2020. Internal migration from hotspots to other regions led to the spread of the virus across the nation. Majority of cases were asymptomatic

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.