Evaluation of AFP surveillance indicators in polio-free Ghana, 2009–2013

BACKGROUND: Ghana recorded the last case of indigenous wild poliovirus in 1999 but suffered two more outbreaks in 2003 and 2008. Following the World Health Organization (WHO) guidelines, transmission was interrupted through high routine immunisation coverage with live-attenuated oral polio vaccine (OPV), effective acute flaccid paralysis (AFP) surveillance and supplementary immunisation activities (SIA). This article describes the results of a five-year surveillance of AFP in polio-free Ghana, evaluate the surveillance indicators and identify areas that need improvement. METHODS: We investigated 1345 cases of AFP from children aged less than 15 years reported to the Disease Surveillance Department from January 2009 to December 2013. Data on demographic characteristics, vaccination history, clinical presentation and virological investigation on stool specimens collected during investigation were analysed. RESULTS: Of the specimens analysed, 56% were from males and 76.3% were from children less than 5 years of age. Twenty-four percent of the children received up to 3 doses of OPV, 57% received at least 4 doses while the status of 19% was unknown. Core AFP surveillance indicators were partly met for non-polio AFP rate while the WHO target for stool adequacy and timeliness was exceeded over the period of study. All the cases were classified virologically, however no wild polio was found. Sixty-day follow-up was conducted for 56.3% of cases and 8.6% cases classified as compactible with polio. CONCLUSION: Both laboratory and epidemiological surveillance for AFP were efficient and many WHO targets were met. However, due to the risk of poliovirus importation prior to global eradication, longterm surveillance is required to provide a high degree of confidence in prevention of poliovirus infection in Ghana. Thus, efforts should be made to strengthen regional performance and to follow–up on all AFP cases in order to establish proper diagnoses for the causes of the AFP leading to proper care

Polio eradication in Ghana: past, present, and future

IntroductionGhana joined the Global Polio Eradication Initiative in 1996 to interrupt wild poliovirus transmission in the country. This was a collaborative effort by the Ghana Health Service (Disease Surveillance Department and the Expanded Program on Immunization) and the Polio Laboratory in the Noguchi Memorial Institute for Medical Research, University of Ghana.MethodsThe polio surveillance started from the southern regions and was extended to the northern regions over time. Surveillance officers were sensitized to improve case detection. The most important surveillance indicators—annualized non-polio AFP rate and stool adequacy—continued to improve, and the WHO targets for laboratory indicators of timeliness were met. The introduction of the oral polio vaccine in 1978 by the Expanded Program on Immunization led to a significant reduction in polio cases. The routine immunization coverage increased from 72% in 1999 to 94% in 2007, with an improvement in supplementary immunization activities.ResultsMolecular characterization of wild poliovirus from Ghana between 1995 and 2008 and vaccine-derived poliovirus from 2019 to 2022 revealed that the transmission of wild poliovirus and vaccine-derived poliovirus can be interrupted with active acute flaccid paralysis surveillance and adequate and efficient implementation of immunization activities. The country attained a polio- free status in 2015 after successfully submitting documentation to the Regional Certification Committee. Analysis of vaccine-derived polioviruses contributed to a better understanding of the poliovirus transmission, showing that the VDPV is indistinguishable from wild poliovirus and therefore poses a risk as a source of paralytic polio in a polio-free world.DiscussionGhana will sustain efforts to maintain polio- free status; intensify routine immunization to improve equity and OPV3 coverage; improve vaccine management and logistics; and enhance surveillance and outbreak preparedness, community engagement, and mobilization to eliminate the circulating vaccine-derived poliovirus. Furthermore, the country will strengthen partnerships with the WHO, UNICEF, CDC, Rotary International, and other stakeholders and secure dedicated funding to ensure consistent support for immunization and surveillance activities

Influenza surveillance in 15 countries in Africa, 2006-2010

BACKGROUND: In response to the potential threat of an influenza pandemic, several international institutions and governments, in partnership with African countries, invested in the development of epidemiologic and laboratory influenza surveillance capacity in Africa. METHODS: We used a standardized form to collect information on influenza surveillance system characteristics, the number and percent of influenza-positive patients with influenza-like illness (ILI) or severe acute respiratory infections (SARI) and virologic data. RESULTS: Between 2006 and 2010, the number of ILI and SARI sites in 15 African countries increased from 21 to 127 and from 2 to 98, respectively. Influenza was detected in 22% of ILI cases and 10% of SARI cases. Children 0-4 years accounted for 48% all ILI and SARI cases of which 20% and 10 respectively were positive for influenza. Influenza peaks were generally discernible in North and South Africa. Substantial co-circulation of influenza A and B occurred most years. CONCLUSIONS: Influenza is a major cause of respiratory illness in Africa, especially in children. Further strengthening influenza surveillance, along with conducting special studies on influenza burden, cost of illness, and role of other respiratory pathogens will help detect novel influenza viruses and inform and develop targeted influenza prevention policy decisions in the region.The work presented in this manuscript was funded completely or in part by host governments, Institute Pasteur, and cooperative agreements with the U.S. Centers for Disease Control and Prevention and/or the U.S. Department of Defense.http://www.journals.uchicago.edu/toc/jid/currenthb2013ay201

Factors that Influence Modern Contraceptive use Among Women Aged 35 - 49 Years and their Male Partners in Gomoa West District, Ghana: A Qualitative Study

Abstract Background: The use of contraception among women aged 35 to 49 years is imperative due to the risk of unplanned pregnancy and poor obstetric outcomes. However, the use of contraceptives in this age group has been reported to be low. In Ghana, studies are limited that determine factors influencing contraception among women in this age group, in particular the influence of husbands. This study aims to ascertain factors that influence contraception among women aged 35 to 49 years and their male partners. Objectives: The objective of the study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in the Gomoa West District of Ghana. Methods: A total of 44 informants participated in the study. In-depth interviews were conducted remotely for 22 women, 15 male partners of women interviewed, and seven family planning service providers. Twenty-one informants participated in four focus group discussions organized. A simple thematic analysis was undertaken. Results: Factors that influenced the use of modern contraceptives were achieved desired family size, counselling by health professionals, health reasons, and influence of male partner. Barriers to using modern contraceptives included religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, and the belief that contraceptive use is a matter for women. Conclusions: This study described factors that influence contraception among women 35 to 49 years and their male partners. All informants used some form of contraception, although traditional contraceptive method users (TCMUs) did not consider traditional contraceptive methods (TCMs) as a form of contraception. Education on effective TCMs as an alternative for non-users of modern contraceptive methods (MCMs) is needed. Strengthening male involvement in family planning and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.</jats:p

Factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District, Ghana: a qualitative study

Abstract Background Fertility declines with age, but it remains important to protect women from unplanned pregnancies throughout their reproductive lives. The objective of this study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana. Methods In-depth interviews were conducted remotely for 22 women, 15 male partners of the women interviewed and seven family planning (FP) providers. In all, a total of 44 participants took part in the study. Seven refusals were recorded, four females and three males. Four focus group discussions were organized for 21 participants who took part in the in-depth interviews. Data collected were transcribed and coded after exporting to Nvivo12 qualitative analysis software. Thematic analysis was undertaken using an abductive approach. Results Factors that influenced the use of modern contraceptives included: achieved desired family size, providing for the family, counselling by health professionals, influence of the male partner, and health reasons. Barriers cited included: religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, declining fertility, and the belief that contraceptive use is a matter for women. Within the study group, roughly half of women used modern contraceptives, while the majority of male partners were non-users. Conclusion Contraception among women aged 35 to 49 years and their male partners is influenced by several factors such as achieved desired family size, influence of the male partner, rumors or misconceptions, and declining fertility. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives

Factors That Influence Contraceptive Use Among Women Aged 35 - 49 Years and Their Male Partners in Gomoa West District, Ghana: A Qualitative Study

Abstract BackgroundThe use of contraception among women aged 35 to 49 years is imperative due to the risk of unplanned pregnancy and poor obstetric outcomes. However, the use of contraceptives in this age group has been reported to be low. In Ghana, studies are limited that determine factors influencing contraception among women in this age group, in particular the influence of husbands. This study aims to ascertain factors that influence contraception among women aged 35 to 49 years and their male partners. ObjectivesThe objective of the study was to describe factors that influence contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana.MethodsA total of 44 informants participated in the study. In-depth interviews were conducted remotely for 22 women, 15 male partners of women interviewed, and seven family planning service providers. 21 informants participated in four focus group discussions organized. A simple thematic analysis was undertaken. ResultsFactors that influenced the use of contraceptives were achieved desired family size, counselling by health professionals, experience and/or fear of side effects, health reasons and influence of male partner. Barriers to using modern contraceptives included religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, and the belief that contraceptive use is a matter for women. ConclusionsThis study described factors that influence contraception among women 35 to 49 years and their male partners. All informants used some form of contraception. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.</jats:p

Evaluation of remote teaching and learning in Universities in Ghana during the COVID-19 pandemic

Due to Covid-19, several schools worldwide were forced to close immediately to prevent the virus from spreading. Many nations, including Ghana, have implemented an online learning system to promote learning activities in order to maintain continuity of learning among students. Many universities and colleges throughout the globe have been compelled to replace face-to-face study with remote learning. The study looked into how Ghanaian students reacted to online learning in higher education. The researchers used an online questionnaire to collect data using a descriptive survey methodology. A total of 675 students from various Ghanaian higher education institutions were used as a sample in the study. Percentage and frequency were used to analyze the data. Students responded positively to online learning, according to the study's findings. The majority of them knew about e-learning and platforms like Google Classroom and Alison. For online learning, laptops and cell phones were utilized. They were, however, unprepared for online learning due to a lack of sufficient training, limited internet connection, and a lack of funds to purchase computers and cell phones. The study recommended that university administration should guarantee that students have access to materials that will allow them to assess their readiness for an online course and provide preparatory advice. Academic staff should also provide instructional support through instructional activities that can assist students in gaining the necessary skills for online learning, assessing their readiness, and considering using flexible teaching methods and deadlines to accommodate students with reliable Wi-Fi or broadband access challenges, as well as emotional support to ensure a smooth transition to emergency remote learning

Molecular Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with a Large Cholera Outbreak in Ghana in 2014

BACKGROUND: Ghana is affected by regular cholera epidemics and an annual average of 3,066 cases since 2000. In 2014, Ghana experienced one of its largest cholera outbreaks within a decade with more than 20,000 notified infections. In order to attribute this rise in cases to a newly emerging strain or to multiple simultaneous outbreaks involving multi-clonal strains, outbreak isolates were characterized, subtyped and compared to previous epidemics in 2011 and 2012. METHODOLOGY/PRINCIPAL FINDINGS: Serotypes, biotypes, antibiotic susceptibilities were determined for 92 Vibrio cholerae isolates collected in 2011, 2012 and 2014 from Southern Ghana. For a subgroup of 45 isolates pulsed-field gel electrophoresis, multilocus sequence typing and multilocus-variable tandem repeat analysis (MLVA) were performed. Eighty-nine isolates (97%) were identified as ctxB (classical type) positive V. cholerae O1 biotype El Tor and three (3%) isolates were cholera toxin negative non-O1/non-O139 V. cholerae. Among the selected isolates only sulfamethoxazole/trimethoprim resistance was detectable in 2011, while 95% of all 2014 isolates showed resistance towards sulfamethoxazole/trimethoprim, ampicillin and reduced susceptibility to ciprofloxacin. MLVA achieved the highest subtype discrimination, revealing 22 genotypes with one major outbreak cluster in each of the three outbreak years. Apart from those clusters genetically distant genotypes circulate during each annual epidemic. CONCLUSIONS/SIGNIFICANCE: This analysis suggests different endemic reservoirs of V. cholerae in Ghana with distinct annual outbreak clusters accompanied by the occurrence of genetically distant genotypes. Preventive measures for cholera transmission should focus on aquatic reservoirs. Rapidly emerging multidrug resistance must be monitored closely.This work was supported by the German Center for Infection Research (Deutsches Zentrum für Infektionsforschung, DZIF). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscriptS