ABSTRACT
Background: Integrated health systems with strong laboratory networks are critical in improving public health. The current study assessed the laboratory network in Ghana and its functionality using the Assessment Tool for Laboratory Services (ATLAS). Intervention: A national-level laboratory network survey was conducted among stakeholders of the Ghanaian laboratory network in Accra. Face-to-face interviews were conducted from December 2019 to January 2020, with follow-up phone interviews between June and July 2020. Also, we reviewed supporting documents provided by stakeholders for supplementary information and transcribed these to identify themes. Where possible, we completed the Laboratory Network scorecard using data obtained from the ATLAS. Lessons learnt: The Laboratory Network (LABNET) scorecard assessment was a valuable addition to the ATLAS survey as it quantified the functionality of the laboratory network and its overall advancement toward achieving International Health Regulations (2005) and Global Health Security Agenda targets. Two significant challenges indicated by respondents were laboratory financing and delayed implementation of the Ghana National Health Laboratory Policy. Recommendations: Stakeholders recommended a review of the country's funding landscape, such as funding laboratory services from the country's internally generated funds. Also, they recommended laboratory policy implementation to ensure adequate laboratory workforce and standards.
ABSTRACT
PURPOSE: Malaria continues to be a major health issue globally with almost 85% of the global burden and deaths borne by sub-Saharan Africa and India. Although the current artemisinin derived combination therapies in Ghana are still efficacious against the Plasmodium falciparum (Pf) parasite, compounding evidence of artemisinin and amodiaquine resistance establish the need for a full, up-to-date understanding and monitoring of antimalarial resistance to provide evidence for planning control strategies. MATERIALS AND METHODS: The study was cross-sectional and was conducted during the peak malaria transmission seasons of 2015, 2016, and 2017 in two ecological zones of Ghana. Study participants included children aged 6 months to 14 years. Using ex vivo 4,6-diamidino-2-phenylindole (DAPI) drug sensitivity assay, 330 Pf isolates were used to investigate susceptibility to five antimalarial drugs: chloroquine (CQ), amodiaquine (AMD) dihydroartemisinin (DHA), artesunate (ART) and mefloquine (MFQ). RESULTS: The pooled geometric mean IC50S (GMIC50) of the five drugs against the parasites from Cape Coast and Begoro were 15.5, 42.4, 18.9, 4.6 and 27.3nM for CQ, AMD, DHA, ART, and MFQ, respectively. The GMIC50 values for CQ (p<0.001), ART (p<0.011) and DHA (p<0.018) were significantly higher for Cape Coast isolates as compared to Begoro isolates. However, GMIC50 estimates for MFQ (p<0.022) were significantly higher for Begoro isolates. Positive correlations were found between each pair of drugs with the weakest found between MFQ and DHA (r = 0.34;p<0.001), and the strongest between ART and DHA (r =0.66; p<0.001). CONCLUSION: The parasites showed reduced sensitivities to three (AMD, DHA and MFQ) out of the five drugs assessed. The study also demonstrated the continual return of chloroquine-sensitive parasites after 13 years of its withdrawal as the first-line drug for the treatment of uncomplicated malaria in Ghana. The ex vivo DAPI assay is a reliable method for assessing antimalarial drug sensitivities of Pf field isolates under field settings.
ABSTRACT
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.
