Person-centred care (PCC) research in Ghana: a scoping review protocol.

INTRODUCTION: Person-centred care (PCC) is provision of care that is respectful of and responsive to individual patient preferences, needs and values, and ensures that patient values guide all clinical decisions. While there is a large body of evidence on the benefits of PCC in high-income countries, little research exists on PCC in Ghana and Sub-Saharan Africa at large. Most studies on PCC have focused on maternity care as part of the global movement of respectful maternity care. The few studies on patient experiences and health system responsiveness beyond maternal health also highlight gaps in patient experience and satisfaction as well as discrimination in health facilities, which leads to the most vulnerable having the poorest experiences. The protocol for this scoping review aims to systematically map the extent of literature focused on PCC in Ghana by identifying patient expectations and preferences, barriers and facilitators, and interventions. METHODS AND ANALYSIS: The protocol will be guided by the Arksey and O'Malley methodological framework and recommendations by Levac et al. A comprehensive search strategy will be used to search for published articles in PubMed, EMBASE, Web of Science and the African Journals Online from their inception to August 2022. Grey literature and reference lists of included studies will also be searched. Two independent reviewers will perform the literature search, eligibility assessments and study selection. Any disagreements will be resolved through discussion with a third reviewer. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for the scoping reviews will be used to outline the study selection process. Extracted data from the included articles will be synthesised and reported under key concepts derived from the outcomes of the scoping review. ETHICS AND DISSEMINATION: This scoping review does not require ethical approval. The findings will be disseminated through publications and conference presentations. SCOPING REVIEW REGISTRATION: OSF Registration DOI 10.17605/OSF.IO/ZMDH9.

Physical inactivity among corporate bank workers in Accra, Ghana: Implications for health promotion.

INTRODUCTION: Any type of activity that results in caloric expenditure has the potential to reduce the risk of cardiovascular diseases; nonetheless, most people, especially office workers, are physically inactive. This study sought to evaluate the extent of physical inactivity and its determinants among the staff of selected banks in Accra, Ghana. METHODS: This was a cross-sectional study involving 219 banking staff randomly selected from five commercial banking institutions in Accra, Ghana. Demographic data was collected with a structured questionnaire. Physical inactivity was assessed using the Global Physical Activity Questionnaire. Study associations were determined using univariate analysis, and multivariate logistic regression models with adjusted odds ratio (AOR) and 95% confidence intervals (CI) estimated. RESULTS: Two hundred and nineteen (219) participants were recruited, out of which 56.6% were males and 43.4% were females. The mean age (± SD) of the participants was 40.0±7.9 years. Physical inactivity was observed in 179 (81.7%) participants. The following were independently associated with physical inactivity: travel-related activities (AOR, 0.151; 95% CI, 0.059-0.384; p<0.001); working in the bank for 6-10 years (AOR, 4.617; 95% CI, 1.590-13.405; p = 0.005); and working in the bank for 11 years and above (AOR, 2.816; 95% CI, 1.076-7.368; p = 0.035). CONCLUSION: Physical inactivity was very high among bankers. Travel-related activities reduced physical inactivity whiles working at the bank for more than six years increased physical inactivity. Thus, promoting regular physical activity, frequent monitoring, and implementation of other appropriate healthy lifestyle intervention strategies are vital to reduce risk of early onset disease conditions associated with physical inactivity in this population.

Comparative efficacy and safety of the artemisinin derivatives compared to quinine for treating severe malaria in children and adults: A systematic update of literature and network meta-analysis.

BACKGROUND: The artemisinin derivatives are the preferred antimalaria drugs for treating severe Plasmodium falciparum malaria. However, their clinical effectiveness compared to each other is unknown. Our objective, therefore, was to evaluate the efficacy and safety of the artemisinin derivatives and quinine for treating severe P. falciparum malaria in children and adults using a network meta-analysis. METHODS AND FINDINGS: Review protocol was registered with PROSPERO, CRD42020218190. We updated the search strategies of three Cochrane systematic reviews which included published and unpublished randomised control trials (RCTs) that have compared specific artemisinin derivatives to quinine in treating severe malaria. Search included CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science and trial registries up to February 2021. We screened studies, extracted data, assessed risk of bias, and quality of evidence in duplicate. Separate network meta-analyses in the frequentist framework, using a random effects model, with quinine as reference, were conducted for adults and children, and rankings were produced using p-scores to assess mortality, parasite clearance, coma recovery, fever clearance, neurological sequela and adverse events. Searches identified 818 citations, 33 RCTs were eligible. We pooled 7795 children and 3182 adults. The networks involved artesunate, artemether, rectal artemisinin, arteether and quinine. Compared to quinine, artesunate reduced mortality in children (risk ratio (RR), 0.76; 95%CI [0.65 to 0.89], moderate quality), adults (RR, 0.55; 95%CI [0.40 to 0.75], moderate quality) and in cerebral malaria (RR, 0.72; 95%CI [0.55 to 0.94], moderate quality). Compared to rectal artemisinin and intramuscular arteether, the efficacy and safety of parenteral artesunate, and intramuscular artemether in treating severe malaria are not clear. Rankings showed that none of the artemisinin drugs were consistently superior in all the outcomes assessed. Indirect evidence produced were of very low ratings due to suspected publication bias and imprecision. CONCLUSIONS: Artesunate reduces mortality compared to quinine for both adults and children in Asia and Africa including cerebral malaria. The artemisinin derivatives remain the best treatment for severe malaria but their comparative clinical effectiveness is yet to be fully explored.

Incidental finding of COVID-19 infection amongst staff at a primary care facility in Ghana.

The COVID-19 pandemic has affected nearly every country worldwide and all African countries. The issue of healthcare workers (HCWs) contracting the disease is a growing concern in Ghana, because of the risk of spreading infections amongst themselves and to vulnerable patients in their care. This article illustrates how 14 staff at the Korle Bu Polyclinic/Family Medicine Department were incidentally found to be Covid-19 positive with most of them being asymptomatic. This observation led to a modification of the personal protective equipment (PPE) used by clinical staff when attending to patients. Furthermore, this finding suggests that a different criteria or guideline may be needed for testing of HCWs during a pandemic where a significant proportion of infected people are asymptomatic. We conclude that in the primary care setting HCWs must be ready to see all the following cases safely: routine patients, asymptomatic COVID-19 patients and suspected COVID-19 patients.

Incidental finding of COVID-19 infection amongst staff at a primary care facility in Ghana

The COVID-19 pandemic has affected nearly every country worldwide and all African countries. The issue of healthcare workers (HCWs) contracting the disease is a growing concern in Ghana, because of the risk of spreading infections amongst themselves and to vulnerable patients in their care. This article illustrates how 14 staff at the Korle Bu Polyclinic/Family Medicine Department were incidentally found to be Covid-19 positive with most of them being asymptomatic. This observation led to a modification of the personal protective equipment (PPE) used by clinical staff when attending to patients. Furthermore, this finding suggests that a different criteria or guideline may be needed for testing of HCWs during a pandemic where a significant proportion of infected people are asymptomatic. We conclude that in the primary care setting HCWs must be ready to see all the following cases safely: routine patients, asymptomatic COVID-19 patients and suspected COVID-19 patients