RESUMO
Background: Malaria remains a global public health concern for centuries. The study assessed the knowledge, prevalence and control strategies of malaria among households in the Sunyani Municipality, Bono Region, Ghana. Method: A simple random sampling method was used to administer semi-structured questionnaires to the respondents (n = 422). STATA version 14.0 was used to analyse the data and the results were presented in charts, graphs, and tables. Result: The study shows that the knowledge level of malaria, its vector of transmission and mosquitoes breeding sites among the respondents was quite high. Among the respondents, 43% reported to have been infected by malaria once in a year and 94% indicated that, their relatives have been infected with malaria parasites previously. Also, majority, 65% of the respondents selected environmental management and sanitation (EMS), followed by settlement (building houses) away from wetlands, 20.0% as alternative vector control methods to be employed to supplement the core vector control methods in the Municipality. Further, majority, 69% of the respondents indicated that enforcement of environmental sanitation bye-laws will compel residents to clean their environment, and this is likely to eliminate most mosquito breeding sites, whiles 46% called on Government to support, and employ more Environmental Health Officers and Sanitary Labourers, and adequately resource them to work effectively. Conclusion: Health authorities in the Sunyani Municipality must intensified education on malaria at all levels with the aim to influence the attitudes of households towards its prevention and control. Central and Local Government must employ more Environmental Health Officers, and empower and adequately resourced them to strictly enforce the environmental sanitation bye-laws. Malaria control authorities in the study area must consider employing environmental management and sanitation (EMS) and application of larvicides for mosquito larval control as alternative/supplementary malaria prevention and control methods to compliments the current core vector control methods.
RESUMO
Background: For centuries malaria infection remains a public health burden globally as well as in the Sunyani Municipality. This exploratory qualitative study aimed to assess the prospects of environmental management and sanitation (EMS) as a malaria vector control strategy among key stakeholders involved in the prevention and control of malaria in Sunyani Municipality, Ghana. Method: We used an exploratory qualitative study and a designed focus group discussion (FGD) guide (with specific research questions) to solicit opinions and/or views among Malaria Control Focal Persons, Environmental Health Officers (Health Inspectors), and Honourable Assembly Members. Data were collected between December 2019 and February 2020. The responses were analyzed according to the specific research questions. Result: Findings from this study shows that high government support and/or political will by investing in environmental sanitation infrastructure, creating the enabling environment for strict enforcement of environmental sanitation bye-laws by Environmental Health Officers/Health Inspectors, effective and efficient collaboration among key stakeholders and organization of communal labor activities is likely to help reduce the majority of the mosquito breeding sites. Conclusion: The prospects of environmental management and sanitation (EMS) as a vector control strategy, look promisingly very high, pertinent, and workable and a likelihood game changer of winning the fight against malaria due to the residual transmission that is happening outdoors. However, EMS can be employed as a supplementary method to the current core vector control methods if the following conditions and bottlenecks are addressed and in place: (a) Effective collaboration among key stakeholders at all levels; (b) Adequate allocation of funds to the Environmental Health and Sanitation Department; (c) Enactment of robust educational campaigns across all educational levels and via different media; (d) Recognition, empowerment, and adequate resourcing of Environmental Health Officers; (e) Adherence to the building regulations to prevent encroachment of natural wetlands; (f) Revision of fees/fines and prosecution of sanitary offenders; (g) Enactment of an Environmental Sanitation Day (ESD), and establishment of the Environmental Health and Sanitation Fund (EHSF).
RESUMO
Background: Ineffective hand hygiene in healthcare settings is a global challenge that is associated with a high rate of nosocomial infections. The study aimed to measure the effectiveness of handwashing at Dilla University referral hospital. Method: This study consisted of 2 parts; the survey work and laboratory analysis. A total of 63 participants were selected to take surveys using an interviewer-administered questionnaire to collect the data regarding the socio-demographic and hand hygiene-related practices. A laboratory tests (swab test) was used to assess handwashing effectiveness from 63 participants by taking 126 swab test (63 before and after hand washing sessions). A swab test was collected from the palms of each participant before and after hand washing using a sterile technique. The cultures were then incubated aerobically overnight at 37°C, and examined for microbial growth. The bacterial load was reported as the number of colony-forming units (CFU). Result: The proportion of effective hand washing in Dilla University Referral Hospital was 82.5%. The mean colony-forming unit before and after handwashing were 55 and 2 CFU/ml, respectively with an average reduction of 94.6% in terms of CFU/ml. The mean amount of water used for effective handwashing was 336.03 (±219.46) ml. There was a significant mean difference in the amount of water used and duration of hand rubbing between effective and non-effective handwashing among the participants (P < 0.01). The bacterial load before and after handwashing indicated that there was a significant (53.3 mean CFU) reduction in bacterial load after handwashing practice which indicated that the handwashing intervention in the Referral hospital was effective (P < 0.01). Conclusion: The proportion of effective Hand washing in Dilla University referral Hospital was 82.5% with a 94.6% reduction in terms of (CFU/ml). The amount of water use and the duration of hand rubbing showed a significant difference in the reduction of the microbial load.
