Browsing by Author "Baffour-Awuah Sandra"

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    Evaluation of onchocerciasis control in the Upper Denkyira East municipal in the forest area of Ghana: Responses of participants and distributors to the CDTI programme
    (ELSEVIER, 2018) Agyemang Osei Naana Abigail; Badu Kingsley; Baffour-Awuah Sandra; Owusu-Dabo Ellis; Biritwum Nana-Kwadwo; Garms Rolf; Kruppa Florian Thomas
    The African Programme for Onchocerciasis Control (APOC), which focused on annual mass treatment with ivermectin, was launched in 1995 and was replaced by the Expanded Special Project for Neglected Tropical Diseases (ESPEN) by the end of 2015. In Ghana, the Community Directed Treatment with Ivermectin (CDTI) was introduced in 1999. After a decade, biannual reinforcement was introduced during which the Ghana Health Service (GHS) recorded coverage rates through routine data collection. Transmission studies conducted in the Upper Denkyira East Municipal (UDEM) of the forest zone of Ghana in 2002 and 2006 had shown that annual treatments with ivermectin had hardly any effect on the transmission of Onchocerca volvulus by the vector Simulium sanctipauli. In order to establish whether or not this was due to an insufficient compliance to the CDTI programme, an additional questionnaire survey was carried out in 2013 following those conducted in 2002 and 2006. The repeat transmission survey conducted in 2013 in the same area revealed that the vector S. sanctipauli had apparently disappeared from the rivers Ofin and Pra due to gold mining activities. In 2006 and 2013, we conducted surveys using structured questionnaires to address issues related to compliance and to compare re sults on the effectiveness of CDTI. A total of 692 individuals from 7 villages and 447 individuals from 9 villages were interviewed in 2006 and 2013 respectively. Questions asked included whether or not they had taken the ivermectin and reasons for not doing so when that was the case. Results were compared with the previous investigations conducted in 2002. Whereas official reported coverage rates ranged from 59 to 85% in 2006 and from 88 to 97% in 2013, compliance rates decreased from 36% in 2006 to 21% in 2013. Factors affecting compliance included fear of unpleasant side effects (pruritus and oedema), which decreased from 36% to 21% for the same period. Lack of awareness of CDTI sharply increased from 12% to 46% for the same period. Participants believed that treatments were no longer necessary due to the absence of vectors observed in 2013. There seems to be a considerable difference between coverage and compliance rates in the study communities. The difference can be attributed to the performance of the Community-Directed Distributors (CDDs) and the absence of the vector population observed in 2013. Discussions with CDDs suggested that factors that led to non compliance were mostly side effects, unawareness of the disease by immigrants and lack of financial motivation for the CDDs. Also included was the fact that they needed to complete distribution of the drugs in the entire village, covering all households within just one week irrespective of the size of the catchment area. This, they thought was too much work for a short period of time. We propose to intensify the training of CDDs by the national Neglected Tropical Diseases Programme (NTDP) and to include the Community-based Health and Planning Services (CHPS) concept into onchocerciasis control efforts for awareness creation while the vector population and the transmission should be further monitored. The population should be made aware that the side effects they experienced from previous treatments or had heard about had reduced significantly. They also should be in the known that vector flies may return and so the risk of transmission remains
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    Insecticide resistance in malaria vectors in Kumasi, Ghana
    (BioMed Central, 2016) Baffour-Awuah Sandra; Annan A. Augustina; Owusu-Dabo Ellis; Maiga-Ascofare Oumou; Dieudonné Diloma Soma...et al
    Background: There have been recent reports of surge in resistance to insecticides in pocketed areas in Ghana necessitating the need for information about local vector populations and their resistance to the insecticides approved by the World Health Organization (WHO). We therefore studied a population of malaria vectors from Kumasi in the Ashanti Region of Ghana and their resistance to currently used insecticides. We conducted susceptibility tests to the four major classes of insecticides by collecting larvae of anopheline mosquitoes from several communities in the region. Surviving adults from these larvae were then subjected to the WHO-approved susceptibility tests and characterization of knockdown resistance and acetylcholinesterase mutant genes. Results: Out of 619 Anopheles specimens sampled, 537 (87%) were identified as Anopheles gambiae (sensu stricto), which was also the species with the lowest knockdown resistance mutant gene, 61% (P = 0.017). Knockdown resistance mutant gene was as high as 91% in An. coluzzii. Mosquitoes collected showed susceptibility ranging from 98–100% to organophosphates, 38–56% to carbamates and 15–47% and 38–46% to pyrethroids and organochlorides, respectively. The knockdown resistance mutation frequency of Anopheles gambiae (sensu lato) mosquitoes that were exposed to both pyrethroids and organochlorides was 404 (65%). Acetylcholinesterase mutant gene was not found in this population of vectors. Conclusion: Our study shows that pyrethroids have the highest level of resistance in the population of mosquito vectors studied probably due to their frequent use, especially in impregnation of insecticide-treated nets and in insecticides used to control pests on irrigated vegetable farms. We recommend studies to monitor trends in the use of all insecticides and of pyrethroids in particular.