Adverse drug reaction reporting by community pharmacists in the Greater Accra Region of Ghana, 2016.

Objectives: To assess adverse drug reactions (ADRs) reporting and identify factors to improve ADR reporting among community pharmacists in the Greater Accra Region of Ghana. Design: A quantitative cross-sectional study. Setting: Community pharmacies in the Greater Accra Region of Ghana. Participants: We randomly selected 210 pharmacists from a list community of pharmacies in Accra, Ghana. All participants had been practicing in the past one year, with this study being conducted from June to July 2016. Main outcome measure: Prevalence of ADR reporting by community pharmacists in Accra, Ghana. Results: Of the 210 community pharmacists interviewed 54.0% were males. Mean age was 32±10 years. Majority (96.0%) had heard of ADR reporting in Ghana, yet 18% had never seen the ADR reporting form. Reasons given for failure to report suspected ADRs included unavailability of reporting forms (83.1%), uncertainty about a causal relationship between the drug and the suspected ADR and classification of the reaction as "normal" with the medication being taken (23.6%). Only 34.0% of pharmacists had the ADR reporting forms available in their facilities. Marital status was the only factor significantly associated with ADR reporting (OR 3.18, 95%CI 1.02 - 9.12). Conclusion: ADR reporting by community pharmacists in Ghana remains low. To improve the proportion of reporting, ADR forms should be made available in all pharmacies, pharmacists and the general public should be made aware of online reporting systems, with continuous professional development in Pharmacovigilance with the advice that all suspected ADRs should be reported irrespective of uncertainty about causality. Funding: None declared.

Evaluation of the rural response system intervention to prevent violence against women: findings from a community-randomised controlled trial in the Central Region of Ghana.

Background: Intimate partner violence (IPV) affects one in three women globally and undermines women's human rights, social and economic development, and health, hence the need for integrated interventions involving communities in its prevention.Objective: This community-randomised controlled trial evaluated the Rural Response System (RRS) intervention, which uses Community Based Action Teams to prevent IPV by raising awareness and supporting survivors, compared to no intervention.Methods: Two districts of the Central Region of Ghana were randomly allocated to each arm. Data were collected by repeated, randomly sampled, household surveys, conducted at baseline (2000 women, 2126 men) and 24 months later (2198 women, 2328 men). The analysis used a difference in difference (DID) approach, adjusted for age and exposure to violence in childhood.Results: In intervention communities, women's past year experience of sexual IPV reduced from 17.1% to 7.7% versus 9.3% to 8.0% in the control communities (DID = -9.3(95%CI; -17.5,-1.0), p = 0.030). The prevalence of past-year physical IPV among women in the intervention communities reduced from 16.5% to 8.3% versus 14.6% to 10.9% in the controls (DID = -4.2(-12,3.6), p = 0.289). The prevalence of severe IPV experienced by women reduced from 21.2% to 11.6% in intervention versus 17.3% to 11.4% in controls (DID = -3.7(-12.5,5.1), p = 0.408). The direction of impact of the intervention on violence perpetrated by men was more towards a reduction but changes were not statistically significant. Emotional IPV perpetration was significantly lower (DID = -15.0(-28.5, -1.7), p = 0.031). Women's depression scores and reports of male partner controlling behaviour significantly also reduced in the intervention arm compared to those in the control arm (DID = -4.8(-8.0,-1.5), p = 0.005; DID = -2.7(-3.3,-1.0), p = 0.002, respectively).Conclusion: Our findings indicate that the RRS intervention reduced women's experiences of IPV, depression, and partner controlling behaviour and some evidence of men's reported reductions in the perpetration of IPV. The RRS intervention warrants careful scale-up in Ghana and further research.

Factors contributing to road crashes among commercial vehicle drivers in the Kintampo North Municipality, Ghana in 2017.

OBJECTIVE: The study assessed driver, vehicular and road-related factors associated with road crashes (RC) in the Kintampo North Municipality. DESIGN: Cross-sectional study. SETTING: Kintampo North Municipality. DATA SOURCE: Demographics, vehicular and road usage information on registered drivers at Ghana Private Road and Transport Union (GPRTU) and Progressive Transport Owners Association (PROTOA) in Kintampo North Municipality. MAIN OUTCOME: involvement in road crashes and related factors. RESULT: A total of 227 drivers were approached for this study. None of them declined participation. They were all males. Most were between 28-37 years (30%). The proportion of drivers that reported RC ever involvement in at least one RC was 55.5% (95% CI: 8.0%, 62.1%). In the bivariate analysis, drink and drive changed lane without signalling, ever bribed police officer, drove beyond the maximum speed limit, paid a bribe at DVLA for driving license, violation of traffic signals were found to be associated with RC involvement (p<0.05). Drivers who violated traffic signals had 2.84 odds of being involved in road crashes compared to those who did not [aOR; 2.84 (95%CI:1.06,7.63)]. CONCLUSION: The proportion of drivers ever involved in road crashes was high. The major factor that is associated with RC involvement was a violation of the traffic light signals. Continuous driver education and enforcement of road traffic regulations by the appropriate authorities could curb the road crash menace in the Municipality. FUNDING: The authors funded this work.

Evaluation of surveillance system for pneumonia in children below five years, Tema Metropolis, Ghana, 2012 - 2016.

BACKGROUND: We evaluated the pneumonia surveillance system in Tema Metropolis to determine whether it is meeting its objectives and to assess its attributes. DESIGN: Descriptive primary and secondary data analysis. DATA SOURCE: We interviewed health staff on the system's operation and resources. We also extracted 2012-2016 surveillance dataset for under-five pneumonia cases and deaths from the District Health Information Management System for review. PARTICIPANTS: Health staff. INTERVENTION: The Centers for Disease Control (CDC) updated guidelines for evaluating surveillance systems was used to assess system attributes. MAIN OUTCOME MEASURE: state of the pneumonia surveillance system in Tema. RESULTS: A suspected case was defined as fast breathing in any child < 5 years old. The case definition was easy to apply, even at the community level. From 2012 to 2016, a total of 3,337 cases and 54 deaths (case fatality rate 1.6%) was recorded from 13 (23.6%) of 55 health facilities. Two epidemics were missed by the district because data were not being analysed. There were no laboratory data on antimicrobial resistance. Although reporting timeliness increased from 28.1% in 2012 to 83% in 2016, data inconsistencies existed between reporting levels. CONCLUSION: The surveillance system for under-five pneumonia in Tema Metropolis is simple, stable, flexible, timely, but of low sensitivity and acceptability, and only partly meeting its objectives. Major shortcomings are lack of laboratory data, non-use of data and low representativeness. FUNDING: The study was supported by a grant to author DB by the President's Malaria Initiative (PMI) -CDC CoAg 6NU2GGH001876.

Rural response system to prevent violence against women: methodology for a community randomised controlled trial in the central region of Ghana.

Violence against women (VAW) is common in Ghana, with nation-wide surveys reporting high prevalence of intimate partner violence (IPV) (physical, sexual and/or emotional violence). Our trial assesses the community level impact of the Rural Response System which uses Community-Based Action Teams 'COMBAT' for preventing VAW in Ghana. This study is a mixed method unmatched cluster randomised controlled trial and includes rural (n = 23), peri-urban (n = 7) and urban (n = 10) communities in four districts of the Central Region, Ghana. The trial will last three years with one baseline survey, one impact assessment and a qualitative baseline, midpoint and endline evaluation. A total of 40 localities were selected to serve as clusters (20 per trial arm) with about 82 households per cluster recruited at baseline. The same number will be recruited post-intervention. Adult women (18 to 49 years) and men (≥ 18 years) were drawn from different localities. Sampling of households within a community was random and done using a computerised system. In each selected household, one female or male resident was invited to participate. Individuals are eligible for inclusion in the study if they usually live (sleep and eat) in the household, have lived in the community for at least a year, and are between the ages of 18-to-49 years old. Our impact assessment component will compare past 12 months incidence of IPV (i.e. IPV experiences for women and perpetration of physical and/or sexual IPV for men) between arms in the trial. The implementation of this community trial comes at an opportune time when evidence on the effectiveness of a targeted VAW intervention in the Ghanaian society is needed to inform the development of national policies for preventing VAW. Our progressive research approach using a mixed method design will further extend knowledge globally on a multifaceted intervention to reduce the incidence of intimate partner violence in a developing country.