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Biomedical subjects

S Ofosu-Amaah

Publications and source records attributed to S Ofosu-Amaah.

At least 19 recordsLinked to original sources

Evaluation of risk factors for advanced glaucoma in Ghanaian patients.

PURPOSE: This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. METHODS: A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases) was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. RESULTS: Univariate analysis showed that initial IOP>31 mmHg, age of > 60 years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP>31 mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95% confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95% CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR 5.16, 95% CI 1.97, 13.51; P-value 0.0008) were more likely to present with advanced glaucoma than younger ones CONCLUSIONS: Subjects with initial IOP>31 mmHg were nearly three times more likely to present with advanced glaucoma than those with IOP<32 mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects.

Adult↗

Prevalence of glaucoma in an African population.

PURPOSE: To determine the prevalence of primary open-angle glaucoma (POAG) in a Ghanaian population aged 30 years and above and to describe any ethnic variations in glaucoma prevalence in this population. METHOD: A cross-sectional prevalence survey for POAG was carried out on residents of 30 years and above in the Akwapim-South district of Ghana. The principal investigator examined all glaucoma suspects and those diagnosed as glaucoma in the initial screening to determine all definite cases of POAG. All cases had intraocular pressure measurements. Glaucoma cases and suspects and some normal subjects had fundus biomicroscopy with 78 D Volk lens, and Humphrey FDT N-30 visual fields plotted. RESULTS: A total of 1843 people aged 30 years were screened from the population. The standardized age-specific prevalence was 7.7% (30 years and above) and 8.5% (40 years and above). The best-fit trend line for prevalence/age relationship was exponential. No gender or ethnic difference in prevalence was found. CONCLUSIONS: The prevalence of POAG in this population is high and comparable to those in black populations in Barbados and St. Lucia

Adult↗

An assessment of the safety of street foods in the Ga district, of Ghana; implications for the spread of zoonoses.

Street food refers to food and beverages prepared and sold by vendors in streets and other public places for immediate consumption. In Ghana street foods are sold at small eating places popularly known as 'chop bars'. Food safety studies were conducted on the premises of 160 'chop bars' in the Ga District of Ghana in July 1998. Only three (1.8%) of the proprietors met all the requirements (based on a five-point checklist) for basic hygiene. Twenty-four (15%) out of the 160 proprietors had access to potable water while the other 136 (85%) proprietors purchased water from vendors and six used pond water. These two latter sources of water were of poor microbiological quality (as shown by faecal coliform values which ranged from 1.0x10(2)-1.9x10(5) cfu/ml). One hundred and five proprietors (65.6%) did not obtain their meat supply from an approved source. Factors influencing the purchase of meat from an approved source included the proximity of a chop bar to a slaughter facility, the conduct of meat inspection personnel and affordable user fees.

Colony Count, Microbial↗

Implementation of the Bamako Initiative: strategies in Benin and Guinea.

Two West African countries, Benin and Guinea, have been reorganizing their peripheral health systems since 1986, with the goal of improving access to primary health care (PHC). A comprehensive approach evolve, based on improving effectiveness, optimizing efficiency, ensuring financial variability and promoting equity. These strategies were launched as the Bamako Initiative by the World Health Organization's Regional Assembly in 1987. This is the first in a series of five articles on the Bamako Initiative in Benin and Guinea. The strategies implemented in these two countries are discussed. Subsequent articles discuss the improved health indicators, impact on service costs efficiency, and community empowerment through local cost recovery and equity implications. The health center is the basis for a revitalized primary care system. From here, an integrated minimum health care package is readily accessible to meet basic community health needs. Through the Bamako Initiative program, drugs and other essential resources are always available, regular contract between the community health service providers and communities has increased, and the quality of care has improved while also becoming more efficient. Community health resources are managed locally through joint microplanning and monitoring, involving health personnel and village committees. Community ownership, fostered by local budgeting and decision making, is an essential pillar for the success of the system.

Benin↗

Serum polio antibodies in unimmunized preschool children in a rural village in Ghana: before active immunization programme.

The finding of the neutralizing antibodies against poliovirus in unimmunized preschool children confirms the endemicity of the disease in the rural community. The predominant polio antibody types were types 1 and 2. In children under 4 months of age, 82% were seropositive to type 1, 91% to polio type 2 and 55% to polio type 3; evidence of maternal transplacental antibodies. There were fewer seropositives in the age group 4-9 months, 28%, 44% and 12% to the types 1, 2 and 3, respectively. However, the percentages of seropositives to all three types increased for the rest of the age groups, indicating possible contact with the wild poliovirus in early infancy. Community spread of the virus is also supported by the intrafamilial clustering of the seropositives.

Age Factors↗

Clinical and serological reactions after immunization of children in Ghana, West Africa, with the Japanese acellular pertussis vaccine.

A sero-epidemiological survey of pertussis and a field trial with acellular pertussis vaccine was carried out in children in a rural village in Ghana, West Africa. ELISA antibody assays in 109 children aged three months to three years disclosed the rapid disappearance of transplacental maternal antibody in early infancy and the accumulation of seronegative children under three years of age. One hundred and ten children aged three months to three years were immunized with the newly developed acellular pertussis vaccine; 32 were immunized twice and 77 were immunized three times. Serological responses after immunization were measured in both groups. There were no severe adverse reactions attributable to vaccine injections among the children studied.

Antibodies, Bacterial↗

Comparison of methods for estimating the frequency of paralytic poliomyelitis in developing countries.

Standard reporting systems have proved to be unreliable in estimating the frequency of paralytic poliomyelitis in many developing countries. The effectiveness of three survey methods for estimating the prevalence of lameness attributable to poliomyelitis were compared in the Danfa Health Project district of rural Ghana. Lameness was studied because it is easily identified by inexpensive survey techniques. A postal survey of school headteachers was the least costly and most accurate method, giving a prevalence of lameness attributable to poliomyelitis of 7.2 per 1000 schoolchildren. This method is recommended for countries with an extensive network of primary schools. Medical examinations in a village health survey yielded a prevalence of 4.6 per 1000 children aged 6-15 years. This method was relatively expensive but could be justified if the survey was multipurpose. A question added to the annual district census showed a prevalence of 2.2 per 1000 children, a rate still many times higher than estimates from national statistics. The inclusion of such a question in a census or other national survey entails little additional cost and with more careful questioning results should improve. Repeated surveys can be used to assess the success of poliomyelitis vaccination programmes.

Adolescent↗

An evaluation of male contraceptive acceptance in rural Ghana.

To evaluate the effect of male contraceptive acceptance on fertility, the Danfa Family Planning Project in rural Ghana studied a sample of its male family planning acceptors. The findings show that half of the survey respondents accepted foam for use by their partners and half accepted the condom. The continuation rate (69 percent at 12 months) and use-effectiveness rate (80 percent at 12 months) reported by men were higher than those reported by women program acceptors. It is felt that men can play a significant role in affecting fertility through their influence on a couple's choosing to use contraception and as a result of their motivation to obtain contraception and see that it is used. It is urged that increasing emphasis be placed on providing family planning services for men in African programs.

Adolescent↗

Outside Europe. Is poliomyelitis a serious problem in developing countries?--the Danfa experience.

Children were examined for lameness in the Danfa Project district of rural Ghana to assess the impact of endemic poliomyelitis and to test a widely held hypothesis that paralytic poliomyelitis is relatively rare in such districts (less than 1 per 1000 children affected). The observed prevalence of lameness attributable to poliomyelitis was 7 per 1000 school-aged children, and the annual incidence is estimated to be at least 28 per 100 000 population. Although no evidence for an epidemic was found, these rates are comparable with those in the USA and Europe during the years of severe epidemics and indicate that a high price is being paid in the Danfa district for the natural acquisition of immunity. As a result, immunisation against poliomyelitis has been given high priority. A teacher questionnaire was also tested for use in postal surveys as a rapid means of estimating the prevalence of lamenes attributable to poliomyelitis in countries with a reasonable network of primary schools.

Adolescent↗

Is poliomyelitis a serious problem in developing countries?--lameness in Ghanaian schools.

A postal survey of lameness in schools throughout Ghana showed an estimated prevalence of lameness attributable to poliomyetitis of 5-8 per 1000 school-aged children and an estimated mean annual incidence of paralytic poliomyelitis of 23 per 100 000 population. Official reported incidence rates range from 0-1 to 2-1 per 100 000 population, indicating that at least 90% of cases are not reported. No evidence of epidemics was found to account for these high rates. These suggest that mean annual incidence rates in tropical endemic countries have always been as great, if not greater, than those experienced by temperate countries during epidemic periods in the twentieth century and that the total number of cases of paralytic poliomyelitis occurring in the world each year has been reduced by only 25% since the advent of polio vaccine. Immunisation against poliomyelitis must have a high priority in Ghana and other tropical countries where the disease is endemic.

Adolescent↗

Haematological values in a rural Ghanaian population.

Early in 1973 residents of 20 randomly selected rural villages in southern Ghana were studied to determine the prevalence of anaemia. Laboratory tests were conducted to learn what haemoglobin phenotypes were present and the distribution of white blood cell counts. Moderate anaemia (below 10 g%) was fairly common, particularly in children and 15--29 year old women, but severe anaemia (below 7 g%) was rare. Malaria infection and diets with low iron content were major factors affecting haemoglobin level, while hookworm infestation and high parity had little effect. Neutropenia (about two-thirds of Caucasian values) and the distribution of haemoglobin types (AS 16.3%; AC 11.1%) were similar to findings in earlier studies. To improve haemoglobin levels in children and young women, low-cost intervention programmes based on volunteer village workers are recommended.

Adolescent↗

The training of traditional birth attendants in Ghana: experience of the Danfa Rural Health Project.

Three quarters of deliveries in Ghana are still attended by untrained personnel, including traditional birth attendants (TBA's), and maternal mortality remains high. The Ministry of Health is exploring ways of improving this situation. Recently, training traditional birth attendants to improve maternal and child health practices and promote family planning has been considered. Most TBA's in rural Ghana are elderly illiterate farmers. The Danfa Project has identified and trained 57 of these TBA's with the objective of developing a programme that might be replicated elsewhere in the country. This paper describes the design of the programme and problems encountered and makes recommendations to others who may be considering similar programmes in other countries.

Female↗