Prevalence of, and barriers to the disclosure of HIV status to infected children and adolescents in a district of Ghana.

BACKGROUND: Globally there are about 3.3million children under the age of 15 years living with HIV. Of this number, 88% live in sub-Saharan Africa. In Ghana, an estimated 33,000 children were said to be living with the HIV infection in 2012. Lack of disclosure adversely affects the well-being of the child, including access to paediatric HIV treatment and care and adherence to treatment. However, the greatest psychosocial challenges that parents and caregivers of HIV-infected children face is disclosure of HIV status to their infected children. This study sought to determine the prevalence of and the barriers to the disclosure of HIV status to infected children and adolescents in Lower Manya-Krobo District in Ghana. METHODS: A cross sectional study with a sample of 118 caregivers of HIV infected children and adolescents aged 4-19 years attending three HIV clinics in the Lower Manya Krobo District, and 10 key informants comprising of healthcare workers and HIV volunteer workers involved in the provision of care to infected children and their families. RESULTS: The prevalence of disclosure was higher. Main barriers to disclosure identified in this study included age of child, perceived cause of HIV, stigma attached to HIV, child's inability to keep diagnosis to self and fear of psychological harm to child. CONCLUSION: There is the need for the Ghana Health Service in conjunction with the Ghana Aids Commission and the National Aids Control Programme to develop comprehensive context-based disclosure guidelines.

Total coliforms, arsenic and cadmium exposure through drinking water in the Western Region of Ghana: application of multivariate statistical technique to groundwater quality.

In recent times, surface water resource in the Western Region of Ghana has been found to be inadequate in supply and polluted by various anthropogenic activities. As a result of these problems, the demand for groundwater by the human populations in the peri-urban communities for domestic, municipal and irrigation purposes has increased without prior knowledge of its water quality. Water samples were collected from 14 public hand-dug wells during the rainy season in 2013 and investigated for total coliforms, Escherichia coli, mercury (Hg), arsenic (As), cadmium (Cd) and physicochemical parameters. Multivariate statistical analysis of the dataset and a linear stoichiometric plot of major ions were applied to group the water samples and to identify the main factors and sources of contamination. Hierarchal cluster analysis revealed four clusters from the hydrochemical variables (R-mode) and three clusters in the case of water samples (Q-mode) after z score standardization. Principal component analysis after a varimax rotation of the dataset indicated that the four factors extracted explained 93.3 % of the total variance, which highlighted salinity, toxic elements and hardness pollution as the dominant factors affecting groundwater quality. Cation exchange, mineral dissolution and silicate weathering influenced groundwater quality. The ranking order of major ions was Na(+) > Ca(2+) > K(+) > Mg(2+) and Cl(-) > SO4 (2-) > HCO3 (-). Based on piper plot and the hydrogeology of the study area, sodium chloride (86 %), sodium hydrogen carbonate and sodium carbonate (14 %) water types were identified. Although E. coli were absent in the water samples, 36 % of the wells contained total coliforms (Enterobacter species) which exceeded the WHO guidelines limit of zero colony-forming unit (CFU)/100 mL of drinking water. With the exception of Hg, the concentration of As and Cd in 79 and 43 % of the water samples exceeded the WHO guideline limits of 10 and 3 µg/L for drinking water, respectively. Reported values in some areas in Nigeria, Malaysia and USA indicated that the maximum concentration of Cd was low and As was high in this study. Health risk assessment of Cd, As and Hg based on average daily dose, hazard quotient and cancer risk was determined. In conclusion, multiple natural processes and anthropogenic activities from non-point sources contributed significantly to groundwater salinization, hardness, toxic element and microbiological contamination of the study area. The outcome of this study can be used as a baseline data to prioritize areas for future sustainable development of public wells.