Drivers of household antibiotic use in urban informal settlements in Northern Ghana: Implications for antimicrobial resistance control.

Background: Urban informal settlements have been described as the epicenters of frequent antibiotic misuse, which has local and global consequences on the goals of antimicrobial stewardship. The aim of this study was to assess the relationship between knowledge, attitude, and practices of antibiotic use among households in urban informal settlements in the Tamale metropolis of Ghana. Method: This study was a prospective cross-sectional survey of the two major informal settlements in the Tamale metropolis, namely Dungu-Asawaba and Moshie Zongo. In all, 660 households were randomly selected for this study. Households with an adult and at least a child under 5 years old were randomly chosen. An adult with knowledge of household healthcare practices was selected  to respond to a structured questionnaire. Results: In all, 291 (44.1%) of the 660 households reported taking at least one type of antibiotic within the last month before the study and 30.9% (204/660) had used antibiotics without a prescription. Information on which antibiotics to use was obtained mostly from friends/family members 50 (24.5%) and were commonly purchased from a medical store or a pharmacy 84 (41.2%), saved up from a previously used antibiotic 46 (22.5%), a friend/family members 38 (18.6%), and drug hawkers 30 (14.7%). Amoxicillin 95 (26.0%) was the most frequently used antibiotic and the commonest indication for antibiotics use was diarrhea 136 (37.9%). Female respondents (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 2.199-4.301; p < 0.0001), larger households (OR = 2.02; 95% CI = 1.337-3.117; p = 0.0011) and those with higher monthly household income (OR = 3.39; 95% CI = 1.945-5.816; p < 0.0001) were more likely to have good knowledge of appropriate antibiotic use and antibiotic resistance. Furthermore, bad attitudes influenced participants' use of antibiotics without prescription (OR = 2.41; 95% CI = 0.432-4.05; p = 0.0009). Conclusion: This study exposes the drivers of inappropriate use of antibiotics at the household level, particularly in urban informal settlements. Policy interventions aimed at controlling the indiscriminate use of antibiotics in such settlements could improve the responsible use of antibiotics. Keywords: antibiotic resistance, informal settlements, Tamale, Ghana.

Validating local drivers influencing land use cover change in Southwestern Ghana: a mixed-method approach.

Addressing undesirable changes associated with the driving forces of land use cover change are critical to sustainable land management, and the future modeling of land use systems in developing countries. The study accentuates local drivers of land use cover change in Southwestern Ghana using a mixed-method approach. The approach aided in identifying key land-use drivers, using different research strategies for comparisons through confidence level analysis and Analytic Hierarchy Process. We used expert interviews, existing literature and geostatistical tools to ascertain the driving forces triggering such unprecedented changes. Landsat imagery 5 MSS, 4 and 5 TM, 7 ETM + and 8 OLI/TIRS were acquired from the United States Geological Survey's website. Land-use analysis revealed a decline in forests (- 82.41%) and areas covered by waterbodies (- 27.39%). A fundamental drift in built-up (+ 1288.36%) and farmlands/shrubs (+ 369.81%) areas were also observed. The contribution rate of change analysis revealed built-environment and increasing population contributed the most to surface temperature and land-use change. A steady increase in surface temperature can be attributed to the undesirable changes associated with land-use systems over the past 50 years. Socio-economic development in Southwestern Ghana is fuelling interest in studies related to land use cover change. Biophysical, cultural and technological factors are considered key drivers despite the "medium-to-very low confidence" in results generated. They could potentially impact climate-sensitive sectors that significantly modify land-use systems from the pessimists' and optimists' perspectives. Standpoints established through this study will enrich basic datasets for further studies at the continental level. Supplementary Information: The online version contains supplementary material available at 10.1007/s12665-022-10481-y.

Low intensity intimate partner aggression in Ghana: Support for the revised gender symmetry theory in an African country.

Sex differences in the perpetration and victimization of low intensity intimate partner aggression (IPA) were investigated in Ghana. The sample consisted of 1,204 adults (mean age 44.1 yrs., SD 13.5), 602 males and 602 females. IPA was measured with the DIAS-Adult questionnaire, which measures perpetration and victimization of physical, indirect, nonverbal, cyber, and economic aggression in a relationship. Males scored higher than females on being victimized by their partner from physical, indirect, and nonverbal aggression, while females scored higher than males on being perpetrators of physical, indirect, nonverbal, and cyber aggression. A high educational level was positively associated with both perpetration and victimization of IPA. This is the second study to report men being more victimized by low intensity IPA than women in an African nation, thus finding support for Archer's (2018) revised gender symmetry theory of IPA not only in Western, but also in African countries.

Assessing the sensitivity and specificity of First Response HIV-1-2 test kit with whole blood and serum samples: a cross-sectional study.

BACKGROUND: Human immunodeficiency virus (HIV) Rapid diagnostic Test (RDT) kits are the preferred assays for HIV testing in many countries. Prevention of Mother-to-Child Transmission, Know Your Status Campaigns, Blood-Safety, Voluntary Counseling and Testing are major strategies adapted to control transmission of the virus and the pivot of these interventions is either screening or diagnosing individuals through testing. There are reports of inconsistent sensitivity and specificity with whole blood and serum samples collected from the same individual. Little is known about the diagnostic characteristics of First Response HIV-1-2 RDT kit, used as a single test kit in national HIV prevention and control programmes. The debate has always centered on choosing between whole blood and serum in a case where a single test kit that runs on only blood specimen will be used for testing. The variations in specificities and sensitivities with whole blood and serum samples imply that some individuals who might be true positives will be missed and elude care. This study determined the best blood-based specimen type (whole blood or serum) that improves performance of First Response HIV RDT kit in detecting HIV-specific antibodies. METHODS: A hospital-based cross-sectional study was conducted on 280 HIV infected and non-infected patients from May 2015 to June 2015. Blood samples from each participant were separated into whole blood and serum, and tested on First Response HIV-1-2 kits (Premier Medical Corporation Ltd., Kachigam, India) using Electro-chemi-luminescence assay (ECLIA) as reference assay. RESULTS: First Response HIV-1-2 RDT kit showed 100 % sensitivity and 100 % specificity with whole blood specimen and 100 % sensitivity and 82.86 % specificity with serum specimen for the detection of HIV-1. The positive and negative predictive values were 100, 100 and 85.35, 82.86 % for whole blood and serum respectively. CONCLUSION: Whole blood specimen(s) from an individual have higher specificity, positive and negative predictive values than serum. Whole blood is the primary specimen to use on First Response HIV-1-2 RDT kit when screening peripheral blood for HIV-1-specific antibodies.