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Search Results: 1 - 10 of 1573 matches for " Seth Owusu-Agyei "
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Acceptability of Rapid Diagnostic Test-Based Management of Malaria among Caregivers of Under-Five Children in Rural Ghana
Frank Baiden, Seth Owusu-Agyei, Eunice Okyere, Mathilda Tivura, George Adjei, Daniel Chandramohan, Jayne Webster
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0045556
Abstract: Introduction WHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-based combination treatment (ACT) should be restricted to rapid diagnostic test (RDT)-positive cases. This is a departure from what caregivers in rural communities have been used to for many years. Methods We conducted a survey among caregivers living close to 32 health centres in six districts in rural Ghana and used logistic regression to explore factors likely to influence caregiver acceptability of RDT based case management and concern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitative findings and to elicit further factors. Results A total of 3047 caregivers were interviewed. Nearly all (98%) reported a preference for TBMM over presumptive treatment. Caregivers who preferred TBMM were less likely to be concerned about the denial of ACT to their test-negative children (O.R. 0.57, 95%C.I. 0.33–0.98). Compared with caregivers who had never secured national health insurance cover, caregivers who had valid (adjusted O.R. 1.30, 95% CI 1.07–1.61) or expired (adjusted O.R. 1.38, 95% CI 1.12–1.73) insurance cover were more likely to be concerned about the denial of ACT to their RDT-negative children. Major factors that promote TBMM acceptability include the perception that a blood test at health centre level represents improvement in the quality of care, leads to improvement in treatment outcomes, and offers opportunity for better communication between health workers and caregivers. Acceptability is also enhanced by engaging caregivers in the procedures of the test. Apprehensions about negative health worker attitude could however undermine acceptance. Conclusion Test (RDT)-based management of malaria in under-five children is likely to be acceptable to caregivers in rural Ghana. The quality of caregiver-health worker interaction needs to be improved if acceptability is to be sustained.
Haemoglobin and haematocrit: is the threefold conversion valid for assessing anaemia in malaria-endemic settings?
Ilona A Carneiro, Chris J Drakeley, Seth Owusu-Agyei, Bruno Mmbando, Daniel Chandramohan
Malaria Journal , 2007, DOI: 10.1186/1475-2875-6-67
Abstract: Concurrent measures of haemoglobin and centrifuged haematocrit in children aged 6–59 months were compared by modelling the difference between the two measures against their average. A random effects linear regression of the difference of the measures on their average was used to describe the line of best agreement and 95% limits of agreement for these two measures over a range of values after adjusting for statistically significant covariates.There was a consistent bias between the two measures, with haemoglobin less than haematocrit/3 in 87% (899/1,030) of observations. This difference was non-uniform, decreasing with the average measure, i.e. less difference at higher haemoglobin and haematocrit values. In these studies, use of haematocrit would have underestimated the prevalence of anaemia by misclassifying 10% (89/920) of individuals with haemoglobin < 11 g/dl, 66% (252/380) of individuals with haemoglobin < 8 g/dl and 100% (23/23) of individuals with haemoglobin < 5 g/dl. The mean difference between the measures was greater in males than females, increased with age between 6–59 months, and was greater in the wet than dry season suggesting that the relationship between haemoglobin and haematocrit may be modified by exposure to malaria.The regression model indicated that the standard threefold conversion from haematocrit to haemoglobin underestimates the prevalence of haemoglobin < 11 g/dl in children under five years of age in malaria endemic settings. This bias was more acute for more severe anaemia defined by haemoglobin < 8 g/dl and haemoglobin < 5 g/dl. This has important implications for the comparability of studies using these different measures. Direct determination of haemoglobin should be the measurement of choice for assessing anaemia outcomes in malaria intervention trials and surveys.Anaemia is increasingly being used as an indicator of the impact of malaria control in intervention trials [1-8] and for monitoring and evaluation by the Roll Back Malar
Detectability of Plasmodium falciparum clones
Michael T Bretscher, Francesca Valsangiacomo, Seth Owusu-Agyei, Melissa A Penny, Ingrid Felger, Tom Smith
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-234
Abstract: A longitudinal molecular study was conducted in the Kassena-Nankana district in northern Ghana. From each of the 80 participants, four finger prick samples were collected over a period of 8 days, and tested for presence of different Merozoite Surface Protein (msp) 2 genotypes. Implications for estimating q were derived from these data by comparing the fit of statistical models of serial dependence and over-dispersion.The distribution of the frequencies of detection for msp2 genotypes was close to binomial if the time span between consecutive blood samples was at least 7 days. For shorter intervals the probabilities of detection were positively correlated, i.e. the shorter the interval between two blood collections, the more likely the diagnostic results matched for a particular genotype. Estimates of q were rather insensitive to the statistical model fitted.A simple algorithm based on analysing blood samples collected 7 days apart is justified for generating robust estimates of detectability. The finding of positive correlation of detection probabilities for short time intervals argues against imperfect detection being directly linked to the 48-hour periodicity of P. falciparum. The results suggest that the detectability of a given parasite clone changes over time, at an unknown rate, but fast enough to regard blood samples taken one week apart as statistically independent.In areas of high endemicity of Plasmodium falciparum, human hosts are often superinfected with multiple clones of the parasite [1]. Identification of these concurrent infections is important for understanding patterns of drug resistance [2] and of the transmission of the parasite. PCR-based methods for detecting parasites not only have lower detection limits than blood smear microscopy, but also make it possible to distinguish genetically distinct clones, and hence to compute multiplicity of infection. But at least two diagnostic problems remain: i) the same host might be infected with more than o
Demographic patterns and trends in Central Ghana: baseline indicators from the Kintampo Health and Demographic Surveillance System
Seth Owusu-Agyei,Obed Ernest A. Nettey,Charles Zandoh,Abubakari Sulemana
Global Health Action , 2012, DOI: 10.3402/gha.v5i0.19033
Abstract: Background: The dearth of health and demographic data in sub-Saharan Africa from vital registration systems and its impact on effective planning for health and socio-economic development is widely documented. Health and Demographic Surveillance Systems have the capacity to address the dearth of quality data for policy making in resource-poor settings. Objective: This article demonstrates the utility of the Kintampo Health and Demographic Surveillance System (KHDSS) by showing the patterns and trends of population change from 2005 to 2009 in the Kintampo North Municipality and Kintampo South districts of Ghana through data obtained from the KHDSS biannual update rounds. Design: Basic demographic rates for fertility, mortality, and migration were computed by year. School enrolment was computed as a percentage in school by age and sex for 6–18 year-olds. Socio-economic status was derived by use of Principal Components Analysis on household assets. Results: Over the period, an earlier fertility decline was reversed in 2009; mortality declined slightly for all age-groups, and a significant share of working-age population was lost through out-migration. Large minorities of children of school-going age are not in school. Socio-economic factors are shown to be important determinants of fertility and mortality. Conclusion : Strengthening the capacity of HDSSs could offer added value to evidence-driven policymaking at local level.
Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana  [PDF]
Yeetey Enuameh, Charlotte Tawiah, Samuel Afari-Asiedu, Obed Ernest A. Nettey, Abubakari Sulemana, Emmanuel Mahama, George Adjei, Ellen Boamah, Alex Manu, Stephanie Gyaase, Charles Zandoh, Nelson Amanfo, Kwaku Poku Asante, Timothy Letsa, Seth Owusu-Agyei
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.411096
Abstract: In lower middle-income countries like Ghana, it is common to find low contraceptive use among adolescents with corresponding high pregnancy outcomes. Evidence points to the fact that the use of contraceptives prevents maternal, neonatal and infant deaths, but in most lower middle-income countries, socio-cultural practices inhibit adolescents’ use. Ensuring the uptake of family planning among adolescents is deemed a necessary means of reducing maternal, neonatal and infant mor-tality. This manuscript seeks to provide contextually relevant approaches to satisfying family planning needs of adolescents in a population lacking it. We employed a qualitative study design from an interpretive paradigm with phenomenology as the methodology to understand societal attitudes towards family planning delivery to adolescents, so as to arrive at contextually appro-priate ways of providing family planning to this needy group. Focused group discussions and in-depth interviews techniques were used in data collection among adolescents, relevant commu-nity opinion leaders and family planning & health services providers. Themes that emerged from data analysis with respect to “perspectives on family planning care delivery to adolescents” and “best ways in addressing adolescents’ family planning needs” are presented, followed by discussion of the issues emerging. A significant and encouraging finding of the study was that opinion leaders and healthcare providers viewed family planning as a means of protecting adolescents against pregnancies and their complications. A key recommendation is for policy makers and political leaders to enact legislations that enable adolescents to have friendly family planning service delivery in all places and at all times.
Family Planning Needs of Adolescents in Predominantly Rural Communities in the Central Part of Ghana  [PDF]
Yeetey Enuameh, Obed Ernest Nettey, Emmanuel Mahama, Charlotte Tawiah, Ellen Boamah, Abubakari Sulemana, George Adjei, Stephanie Gyaase, Samuel Afari Asiedu, Alexander Manu, Charles Zandoh, Kwaku Poku Asante, Seth Owusu-Agyei
Open Journal of Preventive Medicine (OJPM) , 2015, DOI: 10.4236/ojpm.2015.56030
Abstract: The manuscript presents findings of a descriptive analysis of data from a cross-sectional study of adolescents aimed at identifying their family planning needs and the best approaches to addressing them in the Kintampo Districts of Ghana. Data for the paper were from the family planning module of a sexual and reproductive health survey carried out by the Kintampo Health and Demographic Surveillance System in 2011. Adolescents in this study recorded high marital (1.6% females and 0.4% males) and pregnancy rates (11.5% females and 1.5% males). Their knowledge of contraceptive methods was high (87.7% females and 82% males), but utilization was low (17.9% females and 6% males). Most study participants viewed family planning as important to their health and wellbeing (59.6% females and 58.6% males). A minority of adolescents were of the perception that contraceptive use was solely the responsibility of women (41.1% females and 32.4% males); and that the use of contraceptives could lead to promiscuity among women (43.8% females and 42.5% males). Those adolescents who previously had unwanted pregnancies would have accepted some help in preventing it (33.1% females and 9.1% males). Recommendations made by respondents included creating a friendly atmosphere by care providers for family planning services delivery to adolescents. Other suggestions were ensuring that family planning services are available and accessible to adolescents, and educating adolescents on the diverse methods available.
Adolescents’ Willingness and Intentions to Use Contraceptives in Rural Ghana  [PDF]
Sulemana Abubakari, Yeetey A. Enuameh, Emmanuel Mahama, Obed Ernest A. Nettey, George Adjei, Gifty Fosuaa Nuamah, Edward Apraku Anane, Robert Adda, Francis Dzabeng, Seeba Amenga-Etego, Charles Zandoh, Kwaku Poku Asante, Seth Owusu-Agyei
Open Journal of Social Sciences (JSS) , 2015, DOI: 10.4236/jss.2015.311029
Abstract: Efforts made to improve the availability and access to family planning services to adolescents in Ghana have not yielded the desired results. Adolescents in the Kintampo Health and Demographic Surveillance System area are no exception. This study explored contraceptive use intentions, preferences and their determinants among adolescents in rural Ghana. This was to contribute evidence towards achieving universal access to reproductive health. A cross-sectional study design was used to collect Sexual and Reproductive Health data in the Kintampo districts in 2011. A total of 1805 female adolescents were randomly sampled from a resident female adolescent population of 16,795. This study used intention and/or willingness of adolescents to use contraceptives as the outcome variable and the explanatory variables were demographic and socioeconomic factors. Descriptive and inferential statistical analyses were done. The findings indicated 54.3% of adolescents’ were willing to use contraceptives. Injectable was the most preferred contraceptive method among adolescents (48.6%); this was followed by the pill (29.6%) with the least being foam or jelly (0.2%). The most commonly cited reason for not intending to use contraception was adolescents’ opposition to family planning (31.5%) followed by a fear of side effects (25.8%). Age and education influenced adolescents’ willingness to use contraceptives in the future. Formal education of the young generation coupled with knowledge of contraceptive methods could yield positive outcomes for contraceptive use and ultimately reproductive health of the adolescent population in the near future.
Adherence to Artesunate-Amodiaquine Therapy for Uncomplicated Malaria in Rural Ghana: A Randomised Trial of Supervised versus Unsupervised Drug Administration
Kwaku Poku Asante,Ruth Owusu,David Dosoo,Elizabeth Awini,George Adjei,Seeba Amenga Etego,Daniel Chandramohan,Seth Owusu-Agyei
Journal of Tropical Medicine , 2009, DOI: 10.1155/2009/529583
Abstract: Introduction. To enhance effective treatment, african nations including Ghana changed its malaria treatment policy from monotherapy to combination treatment with artesunate-amodiaquine (AS
Duration of Protection against Malaria and Anaemia Provided by Intermittent Preventive Treatment in Infants in Navrongo, Ghana
Matthew Cairns, Ilona Carneiro, Paul Milligan, Seth Owusu-Agyei, Timothy Awine, Roly Gosling, Brian Greenwood, Daniel Chandramohan
PLOS ONE , 2008, DOI: 10.1371/journal.pone.0002227
Abstract: Background Intermittent preventive treatment for malaria in Infants (IPTi) has been shown to give effective and safe protection against malaria. It has been suggested that IPTi might have long-lasting beneficial effects but, in most settings, the protection provided by IPTi appears to be short-lived. Knowledge of the duration of protection given by IPTi would help interpret the results of existing trials and suggest optimal delivery schedules for IPTi. This study investigated how the protective efficacy of IPTi against malaria and anaemia changes over time. Methods and Findings A secondary analysis of data from a cluster-randomised, placebo-controlled trial of IPTi using sulfadoxine-pyrimethamine (SP) in Ghana was conducted. In this trial IPTi was given to 2485 infants at 3, 4, 9 and 12 months of age; children remained in follow-up until two years of age. Poisson regression with a random effect to adjust for the cluster-randomised design was used to determine protective efficacy of IPTi against clinical malaria and anaemia in defined time strata following administration of IPTi. Analysis of first-or-only clinical malaria episode following the individual IPTi doses showed that some protection against malaria lasted between 4 to 6 weeks. A similar pattern was seen when the incidence of all malaria episodes up to 2 years of age was analysed in relation to the most recent IPT, by pooling the incidence of malaria after the individual IPTi doses. Protective efficacy within four weeks of IPTi was 75.2% (95% CI: 66–82) against malaria, 78.9% (95% CI: 69–86) against high parasite density malaria, and 93.8% (95% CI: 73–99) against anaemia. Protection against these outcomes was short-lived, with evidence of any effect lasting for only 6, 6 and 4 weeks respectively. Protection in children who were parasitaemic when receiving IPTi appeared to be of shorter duration than in uninfected children. There was no evidence of any benefit of IPTi after the immediate period following the IPTi doses. Conclusions Intermittent preventive treatment provides considerable protection against malaria and anaemia for short periods, even in an area of intense seasonal transmission. Due to the relatively short duration of protection provided by each dose of IPTi, this treatment will be of most benefit when delivered at the time of peak malaria incidence.
Insecticide resistance profiles for malaria vectors in the Kassena-Nankana district of Ghana
Francis Anto, Victor Asoala, Thomas Anyorigiya, Abraham Oduro, Martin Adjuik, Seth Owusu-Agyei, Dominic Dery, Langbong Bimi, Abraham Hodgson
Malaria Journal , 2009, DOI: 10.1186/1475-2875-8-81
Abstract: Indoor resting Anopheles mosquitoes were collected. Blood-fed and gravid females were allowed to oviposit, eggs hatched and larvae reared to 1–3 days old adults and tested against permethrin 0.75%, deltamethrin 0.05%, cyfluthrin 0.15%, lambdacyhalothrin 0.1% and DDT 4%, based on WHO methodology. PCR analyses were carried out on a sub-sample of 192 of the An. gambiae for sibling species complex determination. Resistance to pyrethroids and DDT was determined by genotyping the knock-down resistance kdr gene mutations in the study area.A total of 9,749 1–3 days-old F1 female Anopheles mosquitoes were exposed to the insecticides. Among the pyrethroids, permethrin, 0.75% had the least knockdown effect, whilst cyfluthrin 0.15%, had the highest knock-down effect. Overall, no difference in susceptibility between An. gambiae 93.3% (95% CI: 92.5–94.1) and An. funestus 94.5% (95% CI: 93.7–95.3) was observed when exposed to the pyrethroids. Similarly, there was no difference in susceptibility between the two vector species (An. gambiae = 79.1% (95% CI: 76.6–81.8) and An. funestus = 83.5% (95% CI: 80.2–86.4) when exposed to DDT. Overall susceptibility to the insecticides was between 80% and 98%, suggesting that there is some level of resistance, except for cyfluthrin 0.15%. The kdr PCR assay however, did not reveal any kdr mutations. The analysis also revealed only the molecular M (Mopti) form.The findings in this study show that An. gambiae and An. funestus, the main malaria vector mosquitoes in the Kassena-Nankana district are susceptible to the insecticides being used in the treatment of bed nets in the malaria control programme. There is however, the need for continuous monitoring of the pyrethroids as the efficacy is not very high.Malaria is a major public health problem in Ghana. The strategy of the National Malaria Control Programme is based on effective case management and the use of insecticide treated bed nets among vulnerable groups, such as children under five years o
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