Social and Behaviour Change Communication Intervention Improves Coverage and Acceptance of Ivermectin Mass Drug Administration in Onchocerciasis Endemic Communities in Ghana: A Quasi Experimental Design (preprint)

Background: Poor community awareness and social mobilization serve as a major barrier by increasing absenteeism and downplaying the relevance of the ivermectin mass distribution by community members. Inadequate awareness also creates confusion among community members especially when one intervention is mistaken for the other. MethodsWe designed a targeted Social and Behaviour Change Communication (SBCC) intervention with clearly defined and tailored messages of ivermectin MDA program targeting onchocerciasis in endemic communities in Ghana. Quasi experiment was conducted with a total sample size of 2008 at baseline and 2113 at endline. ResultsAt baseline, 63.9% respondents did not receive Ivermectin during the previous year (2019) MDA programme and more than half of them (53.3%) were not aware of the drug distribution. The communities that received the intervention at endline revealed a significantly higher increase in coverage (SATT=0.123, 95% CI=0. 0.073, 0.173, p<0.001). At baseline, uptake rate of 91.0% was recorded. Post the intervention, there was an increase in the proportion of respondents who ingested the MDA drugs (ivermectin) from 91.0% to 95.45%. Previous uptake of MDA drugs (AOR=10.67; 95%CI: 5.59-20.38, p<0.001), Perceived benefit of MDA drug (AOR=4.13; 95%CI: 1.69-10.15, p<0.001) and being aware of the MDA programme (AOR=2.28; 95%CI: 1.00-5.02, p=0.049) was associated with improved receipt of Ivermectin. ConclusionThe findings of this study reveal that SBCC intervention improves ivermectin coverage and uptake rate in mass drug administration. Further research with technological innovations which can enhance SBCC is recommended taking hind sight of the limitations of the study due to the COVID-19 pandemic.

Transmission of SARS-CoV-2 in Northern Ghana; Insights from Whole Genome Sequencing (preprint)

In regions lacking genomic data, analysis of sequences from the early stages of an outbreak can provide important insights into the diversity of pathogens present. Following the detection of the first imported case of COVID-19 in the Northern sector of Ghana on 13th March 2020, we have now molecularly characterized and phylogenetically analysed sequences including three (3) complete genomes of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) isolated from nine (9) patients observed in Ghana. Eight (8) of these patients reported with a recent history of foreign travel and one (1) with no history of foreign travel. We performed high throughput sequencing for 9 samples following the determination of high concentration of viral RNA. In addition, we estimated the potential impact that long distance transportation of samples to testing centres may have on sequencing outcomes. Here, two samples that were closest in terms of viral RNA concentration but transported from sites which are over 400km apart were assessed. All sequences were compared to previous sequences from Ghana and representative sequences from regions where our patients had previously travelled. Complete genomes were obtained for three (3) sequences and with another near complete genome with a coverage of 95.6%. Sequences with coverage in excess of 80% were found to belong to three lineages namely A, B.1 and B.2. Our sequences clustered in two different clades with the majority falling within a clade composed of sequences from sub-Saharan Africa. Less RNA fragmentation was seen in sample KATH23 which was collected 9km compared with sample TTH6 which was collected and transported over a distance of 400km to the testing site. The clustering of several sequences from sub-Saharan Africa suggests regional circulation of the viruses in the subregion. Importantly, there may be the need to decentralize testing sites and build more capacity across Africa to boost the sequencing output of the subregion.