Biomedical subjects

A Lartey

Publications and source records attributed to A Lartey.

9 recordsLinked to original sources

PubMed2005

Factors associated with exclusive breastfeeding in Accra, Ghana.

OBJECTIVE: To assess factors associated with exclusive breast-feeding (EBF) in Accra, Ghana. DESIGN, SUBJECTS, SETTING: Data on current and past infant feeding patterns, sociodemographic, biomedical and biocultural factors were collected using a cross-sectional design, from a sample of 376 women with infants 0-6 months, attending maternal and child health (MCH) clinics in Accra. EBF was defined in two ways: (a) based on a 24-h recall, and (b) based on a recall of liquids or foods given since birth. RESULTS: Although 99.7% of mothers were currently breastfeeding (BF), only half (51.6%) of them EBF their infants. About 98% of participants had heard about EBF, and 85.6% of them planned to EBF on delivery. Based on 'since birth' EBF, planned EBF on delivery was associated with higher likelihood of EBF (OR=2.56; 95% CI, 1.06-6.17) and delivery at a hospital/polyclinic was associated with a two times higher likelihood of EBF (OR=1.96; 95% CI, 1.08-3.54). Women living in their own houses were more likely to EBF (OR=3.96; 95% CI, 1.02-15.49) than those living in rented accommodations and family houses. Those with a more positive attitude towards EBF were more likely to EBF (OR=2.0; 95% CI, 1.11-3.57) than their counterparts with more negative attitudes. The '24-h recall' EBF model yielded similar results. CONCLUSION: In this population, EBF was associated with delivery at hospital/polyclinic, having secondary school education, intention to EBF prior to delivery, owning a home and having a positive attitude to EBF.

Adult↗

PubMed2005

Sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans in an Assay using punch biopsy specimens for diagnosis of Buruli ulcer.

Punch biopsy specimens from Mycobacterium ulcerans disease lesions were used to compare the sensitivities and specificities of direct smear, culture, PCR, and histopathology in making a diagnosis of M. ulcerans disease in a field setting. PCR for the insertion element IS2404 was modified to include uracil-N-glycosylase and deoxyuridine triphosphate instead of deoxythymidine triphosphate to reduce the risk of cross contamination. The "gold standard" for confirmation of clinically diagnosed Buruli ulcer was a definite histological diagnosis, a positive culture for M. ulcerans, or a smear positive for acid-fast bacilli (AFB), together with a possible histological diagnosis. For 70 clinically diagnosed cases of M. ulcerans disease, the modified PCR was 98% sensitive and gave a rapid result. The sensitivities of microscopy, culture, and histology were 42%, 49%, and 82%, respectively. The use of a 4-mm punch biopsy specimen was preferred to a 6-mm punch biopsy specimen since the wound was less likely to bleed and to need stitching. Given adequate technical expertise and the use of controls, the PCR was viable in a teaching hospital setting in Ghana; and in routine practice, we would recommend the use of Ziehl-Neelsen staining of biopsy specimens to detect AFB, followed by PCR, in AFB-negative cases only, in order to minimize costs. Histology and culture remain important as quality control tests, particularly in studies of treatment efficacy.

Adolescent↗

PubMed2004

Factors associated with unconstrained growth among affluent Ghanaian children.

AIM: To identify socio-economic factors associated with unconstrained growth among children living in well-off neighbourhoods of Accra, Ghana. METHODS: A cross-sectional study involving the assessment of the anthropometric status of preschool children. Children (n = 309) between the ages of 12 and 23 mo who live in affluent communities in Accra, Ghana were recruited for the study. Weight, length and mid-upper arm circumference were taken. Information was collected on household demographics and socio-economic status, including parental education and household income. Associations between these variables and attained growth were analysed to establish cut-offs for screening children with unconstrained growth. RESULTS: The mean weight-for-age (WA), length-for-age (LA) and weight-for-length (WL) Z-scores of the sub-sample selected on the basis of high socio-economic criteria were -0.18, -0.40 and 0.16, respectively. Among these well-off children, 0% were underweight, 3.0% were stunted and 0% were wasted (Z-scores <-2). Factors associated with better anthropometric status were paternal education and household income. Two screening criteria combining the two variables were selected: polytechnic education and income > 1,000,000 cedis (435 US dollars) or university education and income > 200,000 cedis. CONCLUSIONS: The children experiencing unconstrained growth belonged to a sub-population of affluent households characterized by high paternal education and household income. This subpopulation was targeted for screening for the WHO Multicentre Growth Reference Study in Ghana.

Analysis of Variance↗

PubMed2004

Feasibility of thyroid ultrasonography in field studies in a developing country, Ghana.

This study was carried out to determine the feasibility of using ultrasonography for goitre estimation in the field situation. It is a cross sectional study that was conducted using community based cluster sample. Thyroid sonography was performed on 112 randomly selected school children aged 10 -15 years from two districts in the Greater Accra area of Ghana, using normative values for thyroid volume recommended by WHO/ICCIDD. The mean age of all subjects was 13.5 years+/-0.13 SEM. The male to female ratio was 1:1. The mean height and weight of the children were 1.5 metres+/-0.9 SEM and 38.1 Kg+/-0.7 SEM, respectively. The mean body surface area was 1.27 m2+/-0.2. There were no significant gender differences in their ages (13.6yrs+/-0.2 SEM, 13.4yrs+/-0.1 SEM, respectively) and height (1.50m+/-1.6 SEM, 1.46m+/-1.7 SEM, respectively). The girls (40.0kg+/-1.2 SEM) weighed more than the boys (35.6kg+/-1.1). The mean and median urinary iodine concentration were 82.4+/-8.5 SEM and 67.9 ug/l, respectively. All the children examined had normal thyroid sonogram. The thyroid volumes ranged from 3.6 ml to 15.3ml. The mean thyroid volume was 7.0ml+/-0.2 SEM and the thyroid volume was higher in the girls (7.5ml+/-0.3 SEM) than the boys (6.5ml+/-0.2 SEM). The criteria of thyroid volume per age and sex yielded a goitre prevalence of 1.8 %. In contrast, the criteria of thyroid volume by surface area yielded a goitre prevalence of 8 %. Our study has shown that it is feasible to employ ultrasonography for field studies to determine goitre prevalence in school children in a developing country such as Ghana. However, the best criteria for goitre in children in Ghana, requires to be confirmed in future studies.

Adolescent↗

PubMed2002

Obstetric difficulties in developing countries motivate preference for birth size.

The aim of this study was to assess the influence of labor difficulties on mothers preference for birth size. A total of 502 pregnant Ghanaian women were interviewed to ascertain what size of infant they wished to deliver. Information on reasons, measures taken to achieve preferred birth size and birth weight of infants delivered by them was obtained. Results showed that even though mothers had particular preferences for birth size, actual birth weight of infants delivered did not tally with mothers' preference. More women with previous childbirth experience wanted small infants than those who had no experience. Overall 41% of the mothers preferred small or medium size infants for easy labor. Large infants on delivery were preferred by 11% of the mothers because they claimed large infants are tough. Approximately 48% of mothers had no particular preference for birth size. It seemed mothers wanting small infants had previous labor problems due to large birth size. A substantial number (40%) of the mothers did not take measures to achieve the preferred birth size. About 4% reported to have reduced their dietary intake to less than the non-pregnancy intake to deliver small infants. About 7% of the women who preferred large infants at birth claimed they ate more food to achieve their aim. Mothers who had mechanical difficulties during labor delivered infants of significantly higher birth weight than those who delivered normally without extra assistance (p < 0.002). Women who experienced a difficult childbirth, believed that high infant birth weight can pose labor problems.

Adult↗

PubMed2000

Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants.

OBJECTIVE: To examine factors associated with the physical growth of breast-fed Ghanaian infants during the first 18 months of life. DESIGN: A community-based longitudinal study. SETTING: The study was carried out in Techiman, a district capital and major food trading center in the Brong Ahafo region of Ghana. SUBJECTS: One-month old infants (n=216) with birth weight >/= 2.5 kg were recruited from Maternal and Child Health Centers. METHOD: From 6 to 12 months, infants were provided with one of four types of nutritionally enhanced complementary foods. Anthropometric assessments were completed monthly from 1 to 12 months and every other month from 12 to 18 months. Information was collected on household characteristics, morbidity from common infections and dietary intakes. Blood samples were collected at 6 and 12 months to assess iron, zinc, riboflavin and vitamin A status. Multiple regression analysis was used to examine factors associated with growth during the age intervals of 1-6, 4-6, 6-12 and 12-18 months as well as size attained at 12 and 18 months. RESULTS: Prevalence of diarrhea and fever were negatively associated with growth during the first year of life. No significant relationship was found between respiratory illness (defined as cough or purulent nasal discharge) and growth. With the exception of dietary zinc intake, dietary variables were generally not significantly associated with growth. Maternal education was positively associated with growth during most of the age intervals. CONCLUSION: These findings suggest that interventions to reduce morbidity and improve the education of girls may benefit children's growth in this population. SPONSORSHIP: Nestle Foundation; Rockefeller Foundation African Dissertation Internship Award; Fulbright Scholarship. European Journal of Clinical Nutrition (2000) 54, 41-49

Anthropometry↗

PubMed2000

Predictors of micronutrient status among six- to twelve-month-old breast-fed Ghanaian infants.

This study describes the factors associated with hemoglobin and plasma ferritin, zinc and retinol concentrations and erythrocyte riboflavin status among 208 Ghanaian infants who participated in a complementary feeding intervention trial from 6 to 12 mo of age. Anthropometric, morbidity and dietary data were collected regularly from 1 to 12 mo; blood samples were collected at 6 and 12 mo. The prevalence of low micronutrient status at 6 and 12 mo, respectively, was as follows: hemoglobin <100 g/L, 30 and 34%; plasma ferritin <12 microg/L, 17 and 43%; plasma zinc <10.7 micromol/L, 4 and 6%; plasma retinol <0.7 micromol/L, 26 and 26%; erythrocyte riboflavin <200 umol/L of packed red cells, 14 and 10%. Multiple regression was used to identify factors significantly associated with micronutrient status. From 6 to 12 mo, fever prevalence was associated with a decrease in hemoglobin, but an increase in erythrocyte riboflavin concentrations, and diarrhea prevalence was related to a decrease in plasma retinol. Seasonal differences were evident for most of the indicators of micronutrient status, and elevated C-reactive protein levels (indicative of recent infection) were related to lower hemoglobin, retinol and zinc concentrations but higher ferritin and erythrocyte riboflavin concentrations. Weight at birth or at 1 mo of age was positively related to iron, zinc and vitamin A status, but a more rapid weight gain was associated with depletion of iron stores. Socioeconomic status was related to higher hemoglobin, riboflavin and zinc concentrations. The feeding of a micronutrient-fortified food was positively associated with plasma ferritin and retinol concentrations at 12 mo. These results suggest that prenatal factors, socioeconomic status, dietary intake and morbidity all influence infant micronutrient status, and that fortification of complementary foods is one potential avenue for preventing deficiencies.

Anthropometry↗

PubMed1999

The effects of fermentation and/or vacuum flask storage on the presence of coliforms in complementary foods prepared for Ghanaian children.

Microbial contamination of complementary foods is a major cause of childhood diarrhoea. In a community-based study in Ghana, we evaluated whether fermentation of maize porridge or storage of porridge in vacuum flasks reduces coliform contamination. The complementary food examined, Weanimix, consisted of, on a dry weight basis, toasted maize (75%), peanuts (10%), and soybeans (15%) milled into flour. The fermented food was Weanimix made with drum-dried, previously fermented maize. Fifty women with infants 6-18 months of age participated. A repeated measures cross-over design was used. Each mother participated in all four treatments (1 week per treatment, in random order): (a) non-fermented Weanimix (W), (b) fermented Weanimix (F), (c) non-fermented Weanimix stored in a vacuum flask (WV), and (d) fermented Weanimix stored in a vacuum flask (FV). Each week, mothers were supplied with the appropriate food, and asked to prepare a porridge each morning by boiling the dry mix in water. Samples were collected in the evenings and immediately plated onto 3 M Petrifilm. Contamination was defined as > or = 100 colony-forming units of coliforms per ml. Contamination rates (95% confidence intervals) were W = 48% (38-58%), F = 25% (17-34%), WV = 42% (32-52%), and FV = 13% (6-20%). All pairwise comparisons were significant (P < 0.05) except for W vs WV. Within the WV treatment, contamination rates were 85% when the sample temperature fell below 50 degrees C (N = 41) vs 12% when it remained > 50 degrees C (N = 59) (P < 0.001). These results indicate that contamination is reduced by fermentation, and further reduced by vacuum flask storage of fermented foods. For non-fermented foods, vacuum flask-storage was protective only when the temperature was maintained at > 50 degrees C; at < or = 50 degrees C vacuum flask storage increased the risk of contamination.

Cross-Over Studies↗

PubMed1999

A randomized, community-based trial of the effects of improved, centrally processed complementary foods on growth and micronutrient status of Ghanaian infants from 6 to 12 mo of age.

BACKGROUND: Koko, a fermented maize porridge used as the primary complementary food in Ghana, has been implicated in the high prevalence of child malnutrition. Weanimix, a cereal-legume blend developed by the United Nations Children's Fund and the Ghanaian government, has been promoted as an alternative. OBJECTIVE: We evaluated the effect of feeding Weanimix and 3 other locally formulated, centrally processed complementary foods on the nutritional status of 208 breast-fed infants. DESIGN: Infants were randomly assigned to receive 1 of 4 foods from 6 to 12 mo of age: Weanimix (W), Weanimix plus vitamins and minerals (WM), Weanimix plus fish powder (WF), and koko plus fish powder (KF). Dietary and anthropometric data were collected regularly. Blood was collected at 6 and 12 mo of age to assess iron, zinc, vitamin A, and riboflavin status. Before and after the intervention, cross-sectional data on the anthropometric status of infants not included in the intervention (NI; n = 464) were collected. RESULTS: There were no significant differences between intervention groups in weight or length gain or in hemoglobin, hematocrit, transferrin saturation, plasma zinc, or erythrocyte riboflavin values between 6 and 12 mo of age. From 9 to 12 mo of age, z scores were lower in NI infants than in the combined intervention groups [at 12 mo: -1.71 +/- 0.90 compared with -1.19 +/- 0.93 for weight and -1.27 +/- 1.02 compared with -0.63 +/- 0.84 for length (P < 0.001 for both), respectively]. The percentage of infants with low ferritin values increased significantly between 6 and 12 mo of age in groups W, WF, and KF but not in group WM. Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 groups combined (0.14 +/- 0.3 compared with -0.04 +/- 0.3 micromol/L, P = 0. 003). CONCLUSIONS: All 4 foods improved growth relative to the NI group. Infants fed WM had better iron stores and vitamin A status than those fed nonfortified foods.

Adult↗