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Biomedical subjects

S Adjei

Publications and source records attributed to S Adjei.

At least 19 recordsLinked to original sources
PubMed2001

Community perception of school-based delivery of anthelmintics in Ghana and Tanzania.

This paper presents the results of an evaluation of community perception of two large-scale, government-run, school-based health programmes delivering anthelmintic drugs to primary school children, in Ghana (80 442 children in 577 schools) and Tanzania (110 000 children in 352 schools). Most teachers (96% in Ghana and 98% in Tanzania) were positive about their role in the programme, including administration of anthelmintic drugs, and parents and children fully accepted their taking on this role. The benefits of the programme were apparent to teachers, parents and children in terms of improved health and well-being of the children. Over 90% of parents in both Ghana and Tanzania indicated a willingness to pay for the continuation of drug treatment. The evaluation also highlighted areas that are critical to programme effectiveness, such as communication between schools and parents, the issue of collaboration between the health and education sectors, parents' perception of the importance of helminth infection as a serious and chronic health problem (compared with more acute and life threatening illnesses such as malaria), and who should pay for treatment of side-effects.

Adult↗
PubMed2001

Anaemia in schoolchildren in eight countries in Africa and Asia.

OBJECTIVE: To report on the haemoglobin concentrations and prevalence of anaemia in schoolchildren in eight countries in Africa and Asia. DESIGN: Blood samples were collected during surveys of the health of schoolchildren as a part of programmes to develop school-based health services. SETTING: Rural schools in Ghana, Indonesia, Kenya, Malawi, Mali, Mozambique, Tanzania and Vietnam. SUBJECTS: Nearly 14 000 children enrolled in basic education in three age ranges (7-11 years, 12-14 years and > or =15 years) which reflect the new UNICEF/WHO thresholds to define anaemia. RESULTS: Anaemia was found to be a severe public health problem (defined as >40% anaemic) in five African countries for children aged 7-11 years and in four of the same countries for children aged 12-14 years. Anaemia was not a public health problem in the children studied in the two Asian countries. More boys than girls were anaemic, and children who enrolled late in school were more likely to be anaemic than children who enrolled closer to the correct age. The implications of the four new thresholds defining anaemia for school-age children are examined. CONCLUSIONS: Anaemia is a significant problem in schoolchildren in sub-Saharan Africa. School-based health services which provide treatments for simple conditions that cause blood loss, such as worms, followed by multiple micronutrient supplements including iron, have the potential to provide relief from a large burden of anaemia.

Adolescent↗
PubMed2001

Pharmacists' role in managing sexually transmitted infections: policy issues and options for Ghana.

The debate about extending the role of pharmacists in health care is growing in recognition of the ongoing difficulties experienced by many public sector services. The perceived accessibility and confidentiality of pharmacists makes them particularly attractive to patients for the management of health problems such as sexually transmitted infections (STI) that may lead to stigmatization. Despite growing interest in the subject, there are few documented analyses of the role of pharmacists in low-income countries. In Ghana, pharmacists are acknowledged by the government to be the preferred option for people seeking treatment for STI. A study was conducted to investigate the current role played by pharmacists in Greater Accra Region in the management of STI. On the basis of these findings, training schemes were developed, implemented and evaluated. This paper presents the findings of this operation-research and considers their implications for deciding to what extent and in what way pharmacists should be involved in managing STI in Ghana and other similar country settings. These findings suggest that pharmacists have a crucial role in effective management of STI, particularly in the management of urethral discharge. They may need to limit their management of genital ulcer to referring customers to laboratories and medical practitioners. They also represent a currently under-utilized opportunity for preventive activities. Regulation and quality assurance issues need to be addressed by both pharmacy and medical professions.

Anti-Infective Agents↗
PubMed2001

Continuous quality improvement in public health in Ghana: CQI as a model for primary health care management and delivery.

This article describes the context and examines factors influencing the quality of primary health care delivery and management in Ghana, West Africa. It describes the potential of continuous quality improvement as a management philosophy and tool to improve the quality of primary health care delivery and management in Ghana. It compares the Ghanaian context in which the use of continuous quality improvement in health care is new and untried with the developed country context (mainly the U.S.), where continuous quality improvement has a relatively long history of use in health care and is a requirement for the accreditation of health institutions. Finally, the article discusses the steps that have to be taken to translate continuous quality improvement from a theoretical management concept to improve quality of care to an actual managerial intervention in Ghana. In conclusion, continuous quality improvement is shown to be a potential viable approach to improving quality of care in the Ghanaian context and merits further investigation.

Delivery of Health Care↗
PubMed2001

Impact of prepackaging antimalarial drugs on cost to patients and compliance with treatment.

OBJECTIVE: To examine the extent to which district health teams could reduce the burden of malaria, a continuing major cause of mortality and morbidity, in a situation where severe resource constraints existed and integrated care was provided. METHODS: Antimalarial drugs were prepackaged into unit doses in an attempt to improve compliance with full courses of chemotherapy. FINDINGS: Compliance improved by approximately 20% in both adults and children. There were 50% reductions in cost to patients, waiting time at dispensaries and drug wastage at facilities. The intervention, which tended to improve both case and drug management at facilities, was well accepted by health staff and did not involve them in additional working time. CONCLUSION: The prepackaging of antimalarials at the district level offers the prospect of improved compliance and a reduction in the spread of resistance.

Acetaminophen↗
PubMed2001

Validity of women's self-reported obstetric complications in rural Ghana.

This retrospective study assessed the utility of women's self-reports to identify obstetric complications in rural Ghana. All consenting obstetric and postpartum inpatients, presenting from the seventh month of gestation to 42 days postpartum, were interviewed at the Holy Family Hospital, Techiman and were asked about their signs and symptoms. A combination of clinical examination and laboratory testing of urine and blood samples was used for determining case status. Self-reported obstetric complications of 340 women were compared with the corresponding diagnostic status for their sensitivity, specificity, predictive value, and test-efficiency. Using algorithms that could not be practically applied at the community level, self-reported symptoms correctly identified the majority (75%) of complicated and uncomplicated pregnancies, but missed one-quarter of cases requiring emergency obstetric care. The positive predictive value of 50% indicates that women's self-reported symptoms should not be used in estimating the incidence of these conditions or in identifying women requiring referral in this population.

Algorithms↗
PubMed1999

The effect of recall on estimation of incidence rates for injury in Ghana.

BACKGROUND: Injury is a major public health problem in many developing countries. Due to limitations of vital registry and health service data, surveys are an important tool to obtain information about injury in these countries. The value of such surveys can be limited by incomplete recall. The most appropriate recall period to use in surveys on injury in developing countries has not been well addressed. METHODS: A household survey of injury in Ghana was conducted. Estimated annual non-fatal injury incidence rates were calculated for 12 recall periods (1-12 months prior to the interview, with each successively longer period including the preceding shorter periods). RESULTS: There was a notable decline in the estimated rate from 27.6 per 100 per year for a one-month recall period to 7.6 per 100 per year for a 12-month recall period (72% decline). The extent of this decline was not influenced by age, gender, rural versus urban location, nor by type of respondent (in-person versus proxy). Rate of decline was influenced by severity of injury. Injuries resulting in <7 days of disability showed an 86% decline in estimated rates from a one-month to a 12-month recall period, whereas injuries resulting in > or =30 days of disability showed minimal decline. CONCLUSIONS: In this setting, longer recall periods significantly underestimate the injury rate compared to shorter recall periods. Shorter recall periods (1-3 months) should be used when calculating the overall non-fatal injury incidence rate. However, longer recall periods (12 months) may be safely used to obtain information on the more severe, but less frequent, injuries.

Adolescent↗
PubMed1998

Computerised tomographic scan of the head in evaluation of stroke in Ghanaians.

One thousand and three patients clinically diagnosed as stroke cases were investigated using computerised tomographic (CT) scan. No diagnosis was made in 56 (5.58%) of the patients. While 56 cases had the CT scans reported as normal, in 40 (4.99%) of the patients disorders other than stroke were diagnosed. They included remediable causes like subdural haematoma (ten cases), cerebral abscess (eight cases), meningioma (four cases), other brain tumours (eighteen cases). Nine hundred and seven of the patients were proven to have suffered a stroke; 547 (60.3%) were haemorrhagic and 360 (39.7%) were infarctive. These results are at variance with previous studies from West Africa which made infarcts the commoner stroke type, but reflect those found in Blacks elsewhere in South Africa and America. Our results were achieved through the use of the CT scan as opposed to the earlier clinically-diagnosed West African studies. The larger number of haemorrhagic strokes had therapeutic implications. Trepidation in the use of anticoagulants, thrombolytics and fibrinolytics before proof of the pathological type is advised. Although clinical evaluation may be more cost-effective in the management of stroke, brain imaging techniques are recommended for accuracy in diagnosis and appropriate management.

Adolescent↗
PubMed1996

Rapid community diagnosis of lymphatic filariasis.

We conducted a pilot study to test rapid assessment procedures for the community diagnosis of lymphatic filariasis in some rural communities in Ghana. The assessment criteria included direct key informant interviews, focus group discussions, routine reporting from health facilities, self-administered questionnaires, and a random examination of adult males for hydroceles. All the data collection methods were easy, convenient, non-invasive to use and acceptable to the community. The study provided reliable estimates of the burden of lymphatic filariasis in the community when compared with data from standard epidemiological surveys. The direct key informant interviews and focus group discussions gave a broad perspective of the burden of diseases in the community in general, and lymphatic filariasis in particular. The use of self-administered questionnaires provided data comparable with data on elephantiasis in the community from a case search. Examination of a random 30-40 adult males for hydroceles provided a good correlation with the community microfilaria prevalence, with a correlation coefficient of linear regression r = 0.79. These individual rapid assessment procedures of the burden of lymphatic filariasis, if further developed and tested could, be widely used in combination for the mapping of the distribution of lymphatic filariasis in Ghana and possibly, the African sub-region.

Adult↗
PubMed1996

Filariasis in northern Ghana: some cultural beliefs and practices and their implications for disease control.

This article reports on how some endemic rural communities in northern Ghana perceive and manage lymphatic filariasis. The disease was mainly attributed to supernatural and spiritual factors. Except for a few instances of neglect, the community was generally caring towards people with the disease. Issues related to marriage, stigma, concealment and leadership are discussed. On the whole, the importance of social and cultural perceptions of a disease and its relevance to control cannot be over emphasized.

Culture↗
PubMed1996

The economic burden of lymphatic filariasis in northern Ghana.

The socio-economic impact of lymphatic filariasis was investigated in a rural community in northern Ghana, as part of a multi-country study. The entire community was followed up for a period of one full calendar year, to document episodes of acute adenolymphangitis (ADL), treatment seeking and the cost of treatment. Cases of chronic filarial disease identified at the start of the study were also visited every 3 months to monitor treatment seeking and the costs of treatment. The subjects, who were mainly subsistence farmers, were found to be materially very poor. The incidence of ADL, which lasted an average of 5 days, was found to be very high. Most of those affected were unable to perform their normal activities for much of the ADL episode. In general, most subjects with long-standing chronic disease, such as elephantiasis of the leg and hydroceles, tended not to seek treatment except when there was superimposed ADL. Some aspects of treatment seeking, the cost of treatment, the burden of the disease on the community, and the public-health implications are discussed.

Cost of Illness↗
PubMed1996

The epidemiology of acute adenolymphangitis due to lymphatic filariasis in northern Ghana.

A study to investigate the socioeconomic impact of lymphatic filariasis was conducted in a rural community in northern Ghana. The incidence, severity, and duration of acute adenolymphangitis (ADL), as identified by local terminologies and confirmed using World Health Organization diagnostic criteria, were investigated. Local terminologies were found to be highly specific and sensitive for diagnosing ADL (sensitivity = 0.978, specificity = 0.980). The incidence of ADL was 95.9 per 1,000 per annum among adults more than 10 years of age, being much higher in females than in males. Among those with elephantiasis and other chronic filarial symptoms, there was no clear relationship between the stage of chronic lymphedema and the incidence of ADL. The incidence of ADL was found to be closely related to the rainfall pattern. The design of the study, its findings, and the public health implications of the findings are discussed in this paper.

Acute Disease↗
PubMed1993

Bancroftian filariasis in the Kassena Nankana District of the upper east region of Ghana: a preliminary study.

A filariasis prevalence survey was conducted in April 1992 in the Southern sector of the Kassena Nankana District which was the site of the Ghana Vitamin A Supplementation morbidity trial. In all, 106 compounds from five different communities were randomly selected from the vitamin A trial database. All resident compound members of 10 years and above were clinically examined and blood was taken for thick films between 2100 and 0200 hours. Haemoglobin levels were also measured. All the blood slides were examined by the investigators in Navrongo. Two reference laboratories examined 10% each of the slides for quality control. In all, 531 people were examined, 247 males and 284 females. The results showed an overall microfilaraemia rate of 41.1% (95% CI 36.9-45.3%). The only species identified was Wuchereria bancrofti. The most important clinical manifestation was hydrocele, 30.8% of males (95% CI 25-36.6%); followed by elephantiasis of the leg, 3.6% of the study population (95% CI 2.0-5.2%). The mean haemoglobin level of the population was 12.4 g dl-1. There were no significant differences between the communities in clinical or parasitological findings.

Adolescent↗